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Friday, May 25, 2012

ATOD News Recap - Week ending May 25, 2012

Throwing Unused Prescription Drugs in Trash May Be Best for Environment: Study

A new study concludes that throwing away unused prescription drugs in the trash may be the most environmentally friendly option. The study appears shortly after the Drug Enforcement Administration’s fourth National Prescription Drug Take-Back Day, which collected 276 tons of unwanted or expired prescription medications. The researchers compared the environmental impact of flushing medication, throwing it in the trash, and burning it. Drugs collected through take-back programs are incinerated. The study took into account how much of the drugs would enter the environment, as well as emission impacts from water treatment, transportation and burning of waste materials, NPR reports.
They found flushing allows the highest levels of drugs to enter the environment, and creates more air pollution than throwing unused drugs in the trash. Drug collecting and the burning that follows produce far greater emissions of greenhouse gases and other pollutants than the other two options, the researchers found. That is largely due to the travel required for people to come to drop-off points, and for the drugs to be shipped somewhere to be incinerated.

“It’s surprising to find out that even though there’s this push towards take-back, trash seems to be the best option for several different reasons,” lead author Sherri Cook of the University of Michigan, told NPR. Cook noted that when people throw their drugs out at home, they are using an infrastructure that already exists for collecting household trash. The findings appear in the journal Environmental Science and Technology.

The Food and Drug Administration’s website explains the best ways to dispose of unused medications, including directions for throwing them away in household trash.
Alcohol Treatments Not One-Size-Fits-All

Not all treatments for alcoholism work for everyone who needs them, experts tell The New York Times. There are a few drugs that have shown promise in treating alcoholism when used with therapy. The challenge is to determine which treatments will benefit which patients.

“Just as breast cancer isn’t just one type of breast cancer, alcoholism is heterogeneous as a disorder, so there’s clearly not one drug that is going to work for everybody,” Dr. Nora D. Volkow, Director of the National Institute on Drug Abuse, told the newspaper.
Some addiction experts say as soon as a decade from now, the approach for treating alcoholism may be similar to that of treating depression. There will be a range of medication to choose from, coupled with therapy and other treatments.

Three drugs have been approved by the Food and Drug Administration for treating alcoholism. Naltrexone and acamprosate reduce cravings to drink, while disulfiram makes patients sick if they drink.
Studies have shown both naltrexone and acamprosate work well for about one in seven people, and have almost no effect on the others. The antispasm drug Baclofen is sometimes prescribed for alcoholism, but results of studies on the drug are mixed, the article notes. Other drugs that have been tested include the antinausea drug ondansetron and the epilepsy drug gabapentin.

Alcoholics Anonymous and the Betty Ford Center emphasize abstinence instead of medication for alcoholism, the article states. “When you medicalize the disease and pay a lot of attention to the biology, it’s easy to get a patient to say, ‘Well, my cravings are gone, there’s nothing else I have to do,’” said Dr. Harry L. Haroutunian, Physician Director at the Betty Ford Center in Rancho Mirage, California. “We try to use the principles of the 12-step program as a source of strength during times of craving, to deal with the inevitable stressors. We want patients firmly involved with that.”

Trust for America’s Health and the Robert Wood Johnson Foundation have released a new report -- The Facts Hurt:  A State-By-State Injury Prevention Policy Report.  The report concludes that millions of injuries could be prevented each year if more states adopted additional research-based injury prevention policies, and if programs were fully implemented and enforced.  The report recommends that states adopt, implement and enforce the evidence-based policies and programs featured in the report, ranging from primary seat belt laws to mandatory ignition locks for all convicted drunk drivers to strong laws for youth sports concussions.  This means making injury prevention a high priority and providing the resources and dedicated staff needed to successfully carry out these programs.  The full report and supporting materials is available on the TFAH website at  For some additional expert perspectives, you can go to NewPublicHealth at
Breaking the Intergenerational Cycle of Substance Abuse

Children raised in a household with one or more parents struggling with a substance use disorder often use compliance as a coping mechanism—a skill that often no longer serves them well in adulthood, according to an expert who spoke recently at the National Council Mental Health and Addictions Conference. Teaching new skills to substitute for learned patterns can help break the intergenerational cycle of substance abuse, says Robert Neri, MA, LMHC, CAP, Senior Vice President/Chief Clinical Officer of the WestCare Foundation in St. Petersburg, Florida.

“We see a number of clients who have learned to be compliant because of how unpredictable the adults were in their life—they realized the best strategy was to blend into the woodwork, and not to make waves or test anyone,” he says. “Most kids test the adults around them, to stretch and make their world bigger, but in children living in families with substance abuse, compliance is a survival tool.”
Neri teaches his counseling staff that if a client does everything in treatment correctly, that can be a sign they are not internalizing, but rather simply adapting. “We see that with people who have been in treatment settings a lot—they learn not to make mistakes. But as the saying goes, ‘If you make an A in treatment, you make an F in recovery.’ We have to realize that mistakes are a wonderful opportunity to learn.” He encourages his staff to tell clients that making mistakes allows them to learn how to tolerate frustration. Compliance is one key reason so many people with substance use disorders do well while in the criminal justice system, but relapse, often only days after they are released. “They do well in a structured environment, but when that structure goes away, the person hasn’t built any internal structure to rely on.”
Learning how to play is another coping skill Neri teaches clients. “Children who grow up in a family with substance abuse become pseudo-adults, learning how to take care of their parents,” Neri says. “They’ve missed their childhood. When we get them into treatment, they often avoid leisure-time activities. They are uncomfortable with these activities, because they never experienced them as children,” Neri observes. Knowing who to trust is also a vital coping skill, according to Neri. “First, we have to acknowledge that not trusting people has, in many cases, probably kept them alive, but now they need to expand their interpersonal tools to learn how to trust,” he says. Clients learn how to evaluate who is trustworthy through exercises such as making a list of qualities they would want in a potential business partner, and interviewing members of their treatment group to see who matches the qualifications.

Clients who have spent years viewing themselves as victims can break the cycle of substance abuse by learning they are free to make choices, Neri states. “This gives them a model of empowerment, so they can take control and change the script.”
Teens Who Listen to High-Volume Music at Greater Risk of Substance Abuse

Teens and young adults who listen to high-volume digital music with ear buds, or who visit music venues such as clubs or concerts, are at greater risk of substance abuse than their peers who don’t engage in so-called risky music-listening behaviors, according to a new study. Young people who listen to loud music with ear buds are almost twice as likely to smoke marijuana as those who do not listen to music on MP3 players, the Los Angeles Times reports. Teens and young adults who attend loud concerts and dance clubs are almost six times as likely as those who don’t frequent these venues to have had five or more alcoholic drinks in a row at some point in the previous month, the study found. They are also twice as likely to have sex without using a condom every time.Researchers in the Netherlands surveyed 944 low-income students at two vocational schools, who ranged in age from 15 to 25. “This study highlights the need to regard high-volume music listening as a risk factor for risk-taking behavior,” they wrote in the journal Pediatrics. They suggested the findings could lead to practical interventions, such as handing out condoms and earplugs at concerts, or printing messages about alcohol abuse on concert ticket stubs.
Colleges Confront Issue of Medical Marijuana

Medical marijuana laws are posing a challenge to colleges, NPR reports. Since marijuana is illegal under federal law, colleges that allow students to use medical marijuana on campus are at risk of losing federal funding, by violating the Drug Free Schools and Communities Act and the Drug Free Workplace Act.
“It’s not a question of right or wrong, ethical or not ethical, any of that,” Stephen Nelson, who oversees student misconduct at the University of Southern Maine, told NPR. “Right now, we just can’t run the risk of losing federal dollars.” He noted his university receives research funding, as well as more than $60 million worth of Title 4 financial aid. In total, hundreds of millions of dollars could be withheld, he says.
Jill Creighton of the University of Colorado, Denver, who has been discussing medical marijuana with college administrators around the country, agrees that Title 4 funding is at risk. “Some student codes of conduct are much more lax about marijuana use in general, but the assumption is if we were to allow medical marijuana on our campuses, we would then be jeopardizing our Title 4 funding,” she says.

A spokesperson for the U.S. Department of Justice said in a written statement, “The Department of Justice is focusing its limited resources on significant drug traffickers, not seriously ill individuals who are in compliance with applicable state medical marijuana statues.”

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