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Tuesday, October 9, 2012

ATOD Recap for week-ending October 5



College Binge Drinking: How Bad Is the Problem Really?

There’s no shortage of media coverage of drunken excess on college campuses. Just this week, the New York Times filled us in on how social media facilitates students’ expedient drinking and hooking up — so much so that traditional collegetown bars are becoming obsolete and closing shop in towns like Ithaca, N.Y., home of Cornell University.

Such extreme stories would have us believe that college kids are out of control, even drunker and higher than their parents before them. Actually, though, that’s not the case. Properly collected study data — which has gone unmentioned in recent media trend stories — suggest that today’s college students aren’t misusing alcohol or drugs at any higher rates than their parents did. For example, according to the newly released 2011 results from the National Survey on Drug Use and Health, among people aged 18 to 25, just under 40% binged on alcohol in the past month, down slightly from nearly 42% in 2003. Most surveys of people this age conducted since the early 1980s show similar rates.

Among Americans aged 18 to 20, 31% binge drank (five or more drinks on one occasion) in the last month — but 53% of people that age drank no alcohol at all. In terms of illegal drug use, today’s young people are also indulging less. For example, while 15% of 24-year-olds report having ever tried cocaine, nearly 29% of 50- to 54-year-olds have done so. (Since most people who will ever use drugs have tried them by their late teens or early 20s, the difference here is not likely due to the fact that older people have simply been around longer.)

Even on prescription drug misuse, the news is good. Past-month nonmedical use of prescription drugs among people of college age fell 14% from 2010 to 2011. And the overall percentage of people over 12 who used painrelievers nonmedically in the past month has been stable at roughly 2% since 2002, with the current figure at 1.7%. The same is true for the percent of the population who have diagnosable problems with prescription pain drugs: it’s just under 1% and has been since 2002.

As for the recent Times story, “Last Call for College Bars,” the newspaper apparently got played by a group of drunken students, who lied about their names — and possibly about their other experiences as well. So, here’s a hint to the rest of the media covering youthful misbehavior: if you want actual trend data,  the National Household Survey on Drugs and the Monitoring the Future survey are both reliable, annually updated sources — and they won’t lie about their names, either.

Commentary: Defining The Epidemic of Prescription Painkiller Abuse

The Centers for Disease Control and Prevention has described the country’s sharp rise in overdoses over the last decade from prescription painkillers, or opioids, as an epidemic. But it can be easy to lose sight of what “epidemic” truly means. In this case, it means that, in the past decade, more than 100,000 people from across the United States died from overdoses involving prescription painkillers. That’s enough people to fill Yankee Stadium to capacity —twice.

It means that for every 1 person who died from a prescription painkiller overdose in 1999, nearly 4 died in 2009. It means that if the painkiller overdose death rate had remained level since 1999, rather than rising so sharply, more than 60,000 people would still be alive today.

The epidemic can trace its roots to a dramatic increase in the 1990s in the prescribing of prescription painkillers in an attempt to better treat pain. Unfortunately, this increase in prescribing has paralleled an increase in drug overdoses and overdose deaths. In fact, enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month. We have an unprecedented public health problem on our hands, and it does not need to be this way. Our public health response must be consistent with the scale of the problem.

As a doctor, I know the vast majority of health care providers want only to help their patients. We must educate and equip providers with the appropriate skills and tools to accomplish this. We need to have safeguards in place to alert providers to signs of prescription drug abuse and to help patients who are abusing them. We must also have mechanisms that will spur communities to take action when health care providers are irresponsible or engage in illegal activities like running pill mills. State prescription drug monitoring programs are electronic databases that can help providers see their patients’ prescription history and identify problematic behaviors. These critical public health tools have great potential to reverse this epidemic, and must be accurate and timely, and convenient to use by busy providers.

The costs of prescription drug abuse should be made clear to insurance carriers so they are motivated to monitor the prescribing and use of addictive prescription drugs and to impose appropriate limits. For example, private insurers and Medicaid programs find that coordinating care by limiting at-risk clients to one doctor and one pharmacy for controlled prescription drugs can reduce inappropriate use and decrease costs. We also need to help patients who are abusing prescription drugs to get into treatment. Some emergency departments and primary care providers have found success by identifying patients who are abusing prescription drugs and connecting them to community resources and treatment centers to help manage their addiction.

These are just a few of the promising interventions that can make a big difference. Other interventions such as clinical guidelines, public and provider education, safe medication storage and disposal, and improving access to substance abuse treatment are also important to addressing this critical public health issue. This epidemic of drug overdose is not a necessary consequence of adequate pain management. Sensible interventions to prevent prescription painkiller abuse and diversion will not condemn more people to untreated pain. Instead, they will allow us to reduce the number of people who misuse, abuse or overdose from these powerful drugs while ensuring patients have access to safe, effective pain treatment.

Thomas R. Frieden, MD, MPH, Director, Centers for Disease Control and Prevention, Administrator, Agency for Toxic Substances and Disease Registry

National Campaign Aims to Prevent Medicine Abuse Among Teens

A national campaign launched this week aims to prevent half a million teenagers from abusing medicine within five years. CBS New York reports The Medicine Abuse Project is a multi-year effort to help educate parents, teens and the public about the dangers of medicine abuse.

New research released this week by The Partnership at Drugfree.org shows that while only 6 percent of parents of teens believe their child has abused medicine, in fact one in 10 teens (10 percent) admit they misused/abused medicines in the past six months.

According to the new survey, although roughly one in five teens and parents (19 percent and 22 percent respectively) say they know someone who has died due to medicine abuse, the issue is simply not on parents’ radar screens. Parents rank medicine abuse only 13th among the list of greatest concerns for teens, below both alcohol and illegal drug use.

A majority of teens (79 percent) say they know where their parents keep their prescription medicines, and 37 percent of teens say it’s relatively easy to get medicines from home. Of those parents who said they keep medicines in their home, nearly two-thirds (63 percent) keep them in case they, or someone else, need them in the future.

“Our new research reveals that Americans drastically underestimate the negative impact that the abuse of prescription drugs and over-the-counter cough medicine is having on teens today,” said Steve Pasierb, President and CEO of The Partnership at Drugfree.org. “Unfortunately, right now, all the elements are aligned for a ‘perfect storm’ to continue threatening the health and well-being of our kids. From the easy accessibility that teens have to medicines in their own homes, coupled with a low perception of risk in abusing them – to parents giving their own kids medicines that are not prescribed to them – we must all take action to turn the tide on this epidemic. Our children’s lives depend on it.”

Treating Alcoholism Reduces Financial Burden on Families, Study Finds

Treating alcoholism saves families money, largely by cutting down on expenses related to alcohol and cigarettes, a new study finds.

The study of 48 German families with an alcoholic member found that after one year of treatment, family costs directly related to alcoholism dropped from an average of $832 per month to $178 per month, according to HealthDay.

Costs for alcohol fell from an average of $310 per month to $87 per month, while cigarette costs dropped from $114 per month to $79 per month after a year of treatment. The average amount of time spent caring for an alcoholic family member decreased from 32 hours each month to eight hours a month.

“When they look at effects on families, addiction studies mainly focus on problems such as domestic violence and depression, not on the financial burden of caring for an alcoholic,” lead researcher Dr. Hans Joachim Salize said in a news release. “But when health services and policymakers study the costs and benefits of treating alcoholism, they need to know that treatment has an immense financial effect not just on the alcoholic but also on his or her spouse, partner, children and parents. The benefits of treatment reach well beyond the individual patient.”

The results appear in the journal Addiction.

Number of Smoking Scenes in Youth-Rated Movies Rose by More Than One-Third in 2011

The number of smoking scenes in movies rated G, PG and PG-13 increased by more than one-third from 2010 to 2011, according to a new report by the Centers for Disease Control and Prevention. The increase signals a reversal after a five-year decline in such smoking scenes, HealthDay reports. The report, published in the journal Preventing Chronic Disease, found four of the six major Hollywood films showed more smoking in their youth-rated movies compared with the previous year. The biggest jump in smoking scenes occurred in movies from the three major film studios that have published policies on onscreen smoking: Disney, Warner Brothers and Universal. Youth-rated movies accounted for 68 percent of all tobacco scenes in 2011, compared with 39 percent in 2010. The study suggested that the movie rating system should be modified to give films with any tobacco use an R rating.

The report was funded by Legacy for Health, a national public health group that seeks to reduce tobacco use in the United States. “These data show us that individual policies that movie studios created in good faith to address this important public health problem do not stand up,” Cheryl Healton, Legacy President and CEO, said in a news release. “The only way to ensure a substantial and permanent reduction in young people’s exposure to onscreen smoking is for the movie industry to adopt a uniform set of policies that apply to all producers and distributors, and provide structural incentives for lasting change.”

A study published this summer suggests that children ages 10 to 14 who view many movies with characters who smoke are more likely to try cigarettes themselves.

Spotting the Signs of Drug Abuse

By Gregory Struve
As clinical director at a relatively well-known Arizona drug rehab program and alcohol rehab I get asked for advice about drug addiction and alcoholism from both clients and friends with regularity.  Some call me when they’re suspicious, others wait until there is a full-on crisis and their loved-one needs to go to treatment.  In either case there are always questions about signs and symptoms.  This article is designed to provide you, the reader, with an idea of some of the more common signs of drug abuse and provide you with some ideas about what to do if a loved-one might be needing rehab.

Three tell-tale signs of drug abuse / addiction
1. Lies
This is the most consistent and persistent component of addiction.  For an addiction to survive it must remain hidden.  This is why most people don’t get treatment for their addiction until it becomes so severe that they cannot hide it anymore.

We recently admitted a beautiful young woman who is addicted to heroin.  She talks openly of the drug being the only love she has in her life.  This is despite having a child and a family that love her very much.  Addicts will lie to protect their addiction from danger (aka discovery) just as you or I might lie to protect a child or loved one from an aggressive assailant.
Common areas where lies start stacking up might include loved-ones disappearing for long periods of time, suddenly needing quite a bit more sleep, or the disappearance of money and possessions — particularly consumer electronics or jewelry.
2.  Friendships
Addiction, like misery, loves company.  Whenever a person starts using heavily his or her peer-group will change, often quite quickly.  This is because people who do not share the addict’s vice will generally become concerned and/or alienated.  It’s one thing to smoke a joint at a party; it’s another thing when marijuana use starts happening multiple times a day every day.  The first scenario is teens experimenting; the second is a life-style choice that will generally bring with it a specific and narrow peer selection.

This is actually one of the easiest ways for me to tell who is doing well in the treatment center I run.  The degree to which those who are bent on becoming sober and healthy attract like-minded clients is almost uncanny.  Sadly, the opposite is also true.  There have been many times over my years in the field where I have thought a client was moving in one direction, but observation of their peer-group lead me to another conclusion.
It should be noted that this shift is often a bit more difficult to discern with alcoholism. Consumption of alcohol is a societal norm so it does not carry the stigma associated with other drugs of abuse.  There is also a cultural expectation that binge drinking is simply part of late-adolescence.  I remember an old friend who used to tell me “it can’t be considered alcoholism until after we graduate college.”
3. Appearance, media and lifestyle
When someone becomes addicted to a substance or behavior they begin to build a life around their addiction.  It’s the most important thing in their lives, their one true love. This will have an inevitable and usually significant impact on their choice in clothing, their choices in media and their lifestyle in general.

An environmentalist is someone whose lifestyle is built around being good to the Earth. There are those who might be considered recreational environmentalists, for whom environmental preservation is one of a number of interests, and there are those who are more passionate.  When an environmentalist goes to buy a new car are they more likely to look at a Prius or a Land Rover? The choice will be the one that corresponds most directly with their personal interests and passions.
In the same way, a recreational user will generally have things that are more important than drugs or alcohol in their lives and their lifestyle correspond.  A full-blown addict will make every decision, every day, with their addiction first in their mind.

“My loved one may be an addict.  What do I do now?”
If you’ve gotten to this point in the article it’s possible that you’ve experienced the progressive sinking sensation in your stomach that often accompanies noticing a number of signs of addiction in your own life or the life of a loved one.  So now what?  Here are three next steps to take.

1. Involve an addiction professional
Talking to a therapist or a treatment center about the behaviors you’ve observed will often shed a lot of light on what the next step might be.  For some clients in-patient treatment will be needed, for others out-patient might be the next step.

2. Start attending Al-Anon meetings 
Al-Anon is the sister fellowship to Alcoholics Anonymous.  There you will find answers about the nature of addiction and also some great tips for addressing some of the ways that the family system is supporting the addiction.

So far I’ve yet to find an addict whose family didn’t support the addiction in some way. Whether by making threats to not follow through, helping them avoid the crises and natural consequences of their behavior, or giving them money to “pay rent” and the like.  These things are often done unwittingly, but they keep the addict stuck in addiction.  Al-Anon can help you identify these things.
3. Organize an intervention
I advocate the use of an intervention only with the help of a professional who is trained and experienced with interventions, and only when the situation is life-threatening.  Generally an intervention has serious and significant consequences.   Sometimes these are good consequences, but frequently they are not.  And generally speaking you won’t get a second chance to launch an effective intervention.

I’ve read estimates that 50% of the world population is impacted directly by addiction.  I think that’s probably low.  If addiction is part of your journey right now, it’s my sincere hope that these tools will be useful to you in finding the next step along your path.

Gregory Struve is the clinical director at http://www.asoberwayhome.org, an Arizona Alcohol & Drug treatment center that has been featured on A&E’s Intervention and The Oprah Winfrey Show.  Mr. Struve is an adjunct professor of Addiction Studies at Rio Salado Community College and a recovering addict.

Addiction and Reality TV

"You'd be amazed how quickly you forget about the cameras. Now they're reacting a little bit, this is something that I did not, I've not had experience with, so they're having quite a bit of anxiety about seeing themselves on TV and how people are going to perceive them and think about them." -- Dr. Drew Pinsky

The portrayal of addiction on television is always a thorny morass. Whether it's the truly harrowing portraits of addicts on A&E's Intervention and Vh1's Celebrity Rehab with Dr. Drew, or the constant care and feeding of the Lindsay Lohan/Amanda Bynes broken-starlet industry, there's something ignoble about watching real people in the firm grasp of their disease's tendrils as they wind their way (or unwind their way) through the druggy labyrinth of addiction on camera. Someone's court date or intimate rehab disclosures are just so disconcertingly none of my business, it can be hard to take. Not that reality TV profiles don't do real good; I think they surely do. But recovery as entertainment is not something any of us should be totally comfortable viewing.

I watched the first episode of Dr. Drew's new season of Rehab -- "Intake Day" -- and once again found myself torn between the utterly compelling plight of the addict and the intense desire to shield these young people (and they are all young) from the cameras.

Does an addict who uses 40 bags of heroin (!) per day really have the mental wherewithal to give informed consent to be filmed? How much desperation (I need help but I can't afford it, can you help, Dr. Drew?) goes into such consent? But then there is Dr. Drew on camera, calmly handling the toughest cases, explaining addiction to millions of viewers (millions!) with the cool ease of a pro but in the ordinary language of the layman. He is also obviously and painstakingly devoted to his patients' recoveries. And then I feel the moral equivalence of a new set of questions tugging at my brain. How many people will see this show right now and seek help? How many relatives will recognize their family's addict in these scared faces and make a life-saving phone call? How many un-addicted Americans will learn to be a bit more compassionate, a bit more knowledgeable, and a bit more well-informed thanks to this show?

I did find it interesting that Dr. Drew eschewed going back to the well of addicted celebrities this season and instead is focusing on non-famous addicts. At first, in a purely cynical moment, I thought this was a terrible decision. (Won't the ratings be better with celebrities, Vh1?) But then something happened: I became viscerally taken with these twentysomethings' troubles precisely because they are not well-known. Fame, I realized, had been a buffer between the viewers and the recovering addicts these last five seasons. Don't get me wrong, I found the celebrities' stories deeply moving, too: You could feel gears click into place for Brigitte Nielsen and also sense the danger Mike Starr's rage and profound sadness put him in long before his disease finally came calling for keeps. But the celebrities were from a different world than my own -- a world of "Hollywood parties" and fawning fans and a kind of moral lawlessness that seemed to emanate exclusively from Los Angeles itself, an addiction hellmouth.

And though intellectually I knew none of that mattered, or was even true or real, I still felt a slight distance between me and the addicts on Celebrity Rehab. A fame fence came between us; they were other. Not so with this fresh crop, some of whom are coming straight from their bewildered, sad, angry, enabling, spooked parents' homes. These normal people with their extraordinary addictions expose the convenient lie that celebrities are somehow manufactured beings from the town of manufactured dreams. A lie some defensive part of myself created so the mirror they held up to me wouldn't be quite so recognizable.

Sacha Z. Scoblic, Writer
Source: http://www.huffingtonpost.com/sacha-z-scoblic/rehab-with-dr-drew_b_1909349.html?utm_source=Join+Together+Daily&utm_campaign=ce4650d768-JT_Daily_News_Defining_The_Epidemic&utm_medium=email


FDA Warns Consumers About Fraudulent Internet Pharmacies

The Food and Drug Administration (FDA) is launching a new campaign to warn consumers to avoid buying medicine from fraudulent online pharmacies. The National Association of Boards of Pharmacy estimates that less than 3 percent of online pharmacies meet state and federal laws. The campaign, called “BeSafeRx: Know Your Online Pharmacy,” explains that drugs purchased from rogue online pharmacies can pose a serious risk, because they may contain too much or too little active ingredient, CNN reports. These drugs may contain the wrong ingredients, or have no active ingredients. The FDA recommends that patients only buy prescription drugs online through pharmacies that are located in the United States, require a valid prescription from a doctor or healthcare professional, provide a licensed pharmacist for consultation, and are licensed by the patient’s state board of pharmacy.
“Buying medicines from rogue online pharmacies can be risky because they may sell fake, expired, contaminated, not approved by FDA, or otherwise unsafe products that are dangerous to patients,” FDA Commissioner Dr. Margaret Hamburg said in a news release. “Fraudulent and illegal online pharmacies often offer deeply discounted products. If the low prices seem too good to be true, they probably are. FDA’s BeSafeRx campaign is designed to help patients learn how to avoid these risks.”


A survey by the FDA found about one-fourth of consumers purchased prescription drugs online, but almost 30 percent said they were not confident about buying drugs safely on the Internet.

  'Smiles': New street drug tied to 'Sons of Anarchy' death

Johnny Lewis, an actor in the popular “Sons of Anarchy” motorcycle-gang cable drama, died early Wednesday in Los Angeles, suspected of killing his 81-year-old former landlord, Catherine Davis, and possibly himself.    Police think the 28-year-old rising star, who played Kip 'Half-sack' Epps on the FX show, may have been under the influence of a drug few have heard of, a substance known informally as “Smiles.”


It’s part of a new wave of synthetic drugs finding their way onto America’s streets and into its clubs. With the chemical name 2,5-dimethoxy-4-iodophenethylamine, it is known by drug agents and chemists as 2C-I, part of a closely-related family of “2C” drugs. While Smiles may seem obscure, it’s already done damage, and not just in drug-hip Hollywood.

When 18-year-old Adam Budge of East Grand Forks, Minn., gave a derivative of the Smiles drug to his buddy, 17-year-old Elijah Stai, of nearby Park Rapids this year, Stai wound up dead. The drug was supposed to be a cheap, harmless high. But within an hour of mixing the powder into some chocolate and eating it, Stai was convulsing, hallucinating, and eventually stopped breathing. Now Budge faces charges that could put him in prison for many years.


But what is Smiles?


Like all the 2C drugs, it’s a psychoactive, hallucinogenic chemical that alter the brain’s balance of dopamine and serotonin. Smiles is particularly powerful, binding to serotonin receptors in the brain at 20 times the rate of another drug used in schizophrenia research, according to an experiment performed by Purdue University chemists. The effects of 2C-I, like those of LSD, can last up to eight hours. But because the effects can take time to appear, users may think they haven’t taken enough to get the desired high, and so take more, risking overdose. The drug can be taken as small tablets, on pieces of blotter paper like LSD, or in powder form, often mixed with something else, like chocolate.


In June, as part of a Substances Control Act overhaul, Congress made 2C-I a schedule I drug -- highly restricted, like methamphetamine. But, explained Drug Enforcement Administration spokesperson Rusty Payne, trying to get government arms around these new drugs is “like playing whack-a-mole. There are just so many emerging chemicals.”


Labs, often located in Europe or Asia, can use legal, common chemicals to produce huge batches of the drugs. Once one formulation is discovered, and banned, all the chemists have to do is slightly alter the structure of the molecules to create another, potentially legal, substitute until that one is banned. There is no known geographic hot spot for the 2C drugs, unlike, say, methamphetamine, which became known as a rural, small-town problem. The U.S. Drug Enforcement Administration believes that most, if not all, the 2C drugs are being imported to the country, not made domestically.  


Often, Payne said, teens rationalize the use of the drugs because they think, or are told, that it’s legal and if it’s legal, it’s safe. Another problem is that users often think they’re taking something else. 


“We are getting so many calls because people are dying abusing chemicals that nobody ever heard of,” Payne said. “They’re told it’s harmless. If you can just go buy it somewhere, or on the internet, then it must be safe, but nothing could be further from the truth.”


Users aren’t the only ones who are often in the dark. According to Payne, even the DEA’s own agents are behind the curve when it comes to designer synthetics.


“It’s tough for our agents to stay up to date,” he explained. “Chemicals that used to take years to synthesize now take months. And many chemicals are diverted” from legal uses to illicit ones.


Chemical and pharmacologic research appears in journals, is posted online, and becomes easily available to all. That is often a good thing, but it also allows rogue chemists to use the science to create new analogs of drugs like 2C-I. The drug “Spice,” for example, which made headlines over the past two years as a marijuana substitute, began as a research project by a Clemson chemist named John W. Huffman. He was doing the research under the auspices of the National Institute for Drug Abuse.


“This synthetic stuff is the new frontier of drugs,” Payne said.


Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young Ph.D., of "The Chemistry Between Us: Love, Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com), now on sale.

  
 Alcohol enemas latest fad at college parties, officials say 

Before an unruly Tennessee party ended with a student hospitalized for a dangerously high blood alcohol level, most people had probably never heard of alcohol enemas. Thanks to the drunken exploits of a fraternity at the University of Tennessee, the bizarre way of getting drunk is giving parents, administrators and health care workers a new fear. When Alexander “Xander” Broughton, 20, was delivered to the hospital after midnight on Sept. 22, his blood alcohol level was measured at 0.448 percent — nearly six times the intoxication that defines drunken driving in the state. Injuries to his rectum led hospital officials to fear he had been sodomized. Police documents show that when an officer interviewed a fellow fraternity member about what happened, the student said the injuries had been caused by an alcohol enema.

“It is believed that members of the fraternity were utilizing rubber tubing inserted into their rectums as a conduit for alcohol,” according to a police report.

While Broughton told police he remembered participating in a drinking game with fellow members of the Pi Kappa Alpha chapter, he denied having an alcohol enema. Police concluded otherwise from evidence they found at the frat house, including boxes of Franzia Sunset Blush wine.

“He also had no recollection of losing control of his bowels and defecating on himself,” according to a university police report that includes photos of the mess left behind in the fraternity house after the party.

Broughton did not respond to a cellphone message seeking comment on Friday. The university responded with swift investigation and a decision Friday to shutter the fraternity until at least 2015. The national Pi Kappa Alpha fraternity organization also accepted the withdrawal of the campus charter.
Alcohol enemas have been the punch lines of YouTube videos, a stunt in a “Jackass” movie and a song by the punk band NOFX called “Party Enema.” But Corey Slovis, chairman of department of emergency medicine and Vanderbilt University Medical Center, said actually going through with the deed can have severe consequences.

“It’s something that offers no advantages, while at the same time risking someone’s life,” he said.

The procedure bypasses the stomach, accelerating the absorption rate, Slovis said. Pouring the alcohol through a funnel can increase the amount of alcohol consumed because it’s hard to gauge how much is going in.

“When you’re dumping it into your rectum, often via a funnel, one or two ounces seems like such a minuscule amount,” he said. Ingesting more can create unconsciousness quite quickly, he explained.

The effects have been fatal in at least one case. An autopsy performed after the death of a 58-year-old Texas man in 2004 showed he had been given an enema with enough sherry to have a blood alcohol level of 0.47 percent. Negligent homicide charges were later dropped against his wife, who said she gave him the enema. Students walking across campus this week generally responded with sighs and eye rolls when asked about the allegations.

“It’s like a big joke,” said Erica Davis, a freshman from Hendersonville. “Because who does that?”

Gordon Ray, a senior from Morristown, said the details of the case caught him off guard, but not the fact that fraternity members would be overdoing it with alcohol.

“It is definitely over the top,” said Ray. “But it doesn’t surprise me, I don’t guess.”

The harm the news has done to the university’s national reputation was on the mind of several students.

“If someone wants to be stupid, then they should do it where it won’t affect anyone else,” said Marlon Alessandra, freshman from Independence, Va.

James E. Lange, who coordinates alcohol and drug abuse prevention strategies at San Diego State University, said alcohol enemas aren’t a common occurrence on campuses, though normal consumption still contributes to hundreds of student deaths annually. And many of those can be attributed to reckless attitudes about the consequences of heavy drinking, he said.

“It’s not unusual to hear that students are drinking to get drunk,” he said.

Lange said he hopes students don’t draw the wrong lessons from the University of Tennessee incident.

“Students and people in general are pretty good at denying that they are at risk for whatever happened to someone else,” he said. “So they can look at something like this and say ‘I’m OK because I would never do that.’

“However, they may be drinking heavily, or doing things like mixing alcohol with prescription meds that is putting them at serious risk,” he said.

To Tennessee freshman Cody Privett of Sevierville, there’s nothing appealing about the incident on his campus.

“It’s stupid, it’s an unfortunate situation,” said Privett, of Sevierville. “I mean there’s partying, and then there’s other things.”

Facts on the Emerging Science on the Effects of Marijuana Marijuana is one of the most hotly debated drugs of our time, according to Kevin Sabet, PhD, Policy Consultant and Assistant Professor, University of Florida. He says that while sifting through the rhetoric about the drug can be difficult, it is important to know what the research has established. There is now a plethora of scientific studies about the use of the drug and its public health implications.

According to Dr. Sabet, we can say with some certainty that marijuana use is significantly linked with addiction, heart and lung complications, mental illness, car crashes, IQ loss and poor school outcomes, poor quality of life outcomes and poor job performance.

In the first of a two-part series of white papers to outline the facts about the drug, Dr. Sabet discusses:
•    Marijuana and the brain
•    What makes marijuana harmful? Three simple letters: T-H-C
•    Marijuana and addiction
•    Marijuana and driving
•    Marijuana use and performance at school and on the job


Read the white paper here Marijuana and Your Health- Just The Facts Part I.


Drug and Alcohol Use Common Years After Juveniles Released From Detention
Researchers at Northwestern University in Chicago interviewed 1,200 males and more than 650 females, ages 10 to 18, who were being held at a juvenile detention center. They were interviewed again several times, up to five years later. More than 45 percent of males and almost 30 percent of females had psychiatric disorders. Alcohol and drug use were the most common and persistent psychiatric disorders, the study found.

While it has been known that psychiatric disorders are common among teenagers in detention, this is the first study to examine whether these disorders persisted in subsequent years, the researchers said.


“These findings demonstrate the need for special programs — especially for substance use disorders — not only while these kids are in corrections but also when they return to the community,” lead author Linda Teplin said in a news release. “People think these kids are locked up forever, but the average stay is only two weeks. Obviously, it’s better to provide community services than to build correctional facilities. Otherwise, the lack of services perpetuates the revolving door between the community and corrections.”


The findings appear in the Archives of General Psychiatry.


Moderate Alcohol Consumption Could Raise Heart Disorder Risk
Moderate drinking may increase the risk of the heart rhythm disorder called atrial fibrillation in older people with heart disease or diabetes, a new study suggests. Atrial fibrillation is a risk factor for stroke, according to HealthDay. The findings come from an international study of more than 30,000 people ages 55 and older who had a history of heart disease or advanced diabetes that caused organ damage. The researchers found that moderate to high alcohol consumption was associated with an increased risk of developing atrial fibrillation. The study defined moderate drinking for women as up to two drinks a day, or one to 14 drinks per week. For men, moderate drinking was defined as three drinks daily, or one to 21 drinks each week.

“Because drinking moderate quantities of alcohol was common in our study (36.6 percent of the participants), our findings suggest that the effect of increased alcohol consumption, even in moderate amounts, on the risk of atrial fibrillation among patients with existing cardiovascular disease may be considerable,” lead researcher Dr. Koon Teo of McMaster University said in a news release.


“Recommendations made about the protective effects of moderate alcohol intake in patients at high risk of cardiovascular disease may need to be tempered with these findings,” the researchers noted.


The study is published in CMAJ, the journal of the Canadian Medical Association.


Drug Abuse Office Offers Videos for Docs

The White House has launched another salvo in its war on prescription drug abuse and diversion: training videos for physicians. The Office of National Drug Control Policy (ONDCP) on Monday released two online modules it developed to provide clinicians with training material and video vignettes modeling doctor-patient conversations on the safe use of opioid analgesics for pain.

Lack of training in prescribing such medication is a barrier to reducing medication abuse, ONDCP Director Gil Kerlikowske said at a press conference Monday morning. Opioid analgesics were implicated in more than 15,000 overdose deaths in 2009, according to the CDC -- four times the number they were involved in a decade prior. The modules contain lessons for providers on various topics, including:

  • Educating patients on the drugs' risks
  • Screening patients for risk factors to identify those a greater risk for abuse
  • Discarding unused medicine safely
  • Spotting patients who may be forming an addiction
"The videos show the way that the physicians interact with these patients, asking them questions that are sensitive and many physicians feel uncomfortable asking," said Nora Volkow, MD, director of the National Institute on Drug Abuse. "Those that are viewing the videos, by seeing the examples, will feel more comfortable so that when they are faced with that situation they can use what they've learned."
One video is a woman visiting a primary care doctor after receiving opioids from an emergency department for an ankle injury. The physician monitors the pain and discontinues medication when it is no longer needed. The other video is of a middle-age man taking opioids for chronic back pain, whom the physician suspects may be abusing the drugs.

Providers can receive 1.25 CME credits per module and each takes about an hour to complete, Volkow said.

More than 5,000 physicians already have taken the online training. "It is quite impressive, but I think it also highlights the sense that there's a need for training materials that clinicians can use that can help guide them to screen their patients who are being treated with opioid medication for the management of pain," Volkow said.
Providers provide an important line of defense in stopping prescription drug abuse, Kerlikowske said.
"Too often I hear from the medical community that there are very few hours in medical school devoted to safe and effective pain management," Kerlikowske said. "Unfortunately, this lack of training can lead to improper prescribing of powerful painkillers and a lack of understanding about the disease of addiction and how it can be prevented and treated."

Kerlikowske called on professional medical societies to let their membership know of the online modules.

"We still believe that training in proper opioid prescribing should be a prerequisite for anyone who prescribes certain types of prescription drugs," Kerlikowske said.

Last week, the White House released a report showing prescription drug abuse was down among 18- to 25-year-olds 14 percent from 2011 to 2010. However, that same report showed heroin use was up.

When asked Monday if prescription drug abusers were simply shifting from one substance to another, Volkow said physicians and policymakers need to focus on the abuse of opioid prescriptions.

"If you can mount a very aggressive prevention strategy to avoid the abuse of prescription medication, then you will not have that transition into injection use of heroin," Volkow said. Patients become addicted to opioids and then shift to less-expensive heroin to feed their addition, she said.


The White House's plan to cut prescription drug diversion and abuse, released last year, calls on supporting provider education, expanding state-based monitoring programs, and reducing the prevalence of "pill mills" and doctor-shopping through enforcement actions.


Number of Teens Who Drink and Drive Fell 54 Percent Since 1991

The number of U.S. teens who drink and drive has decreased 54 percent since 1991, according to a new government report. Last year, 90 percent of high school students 16 and older said they don’t drink and drive.

The report, by the Centers for Disease Control and Prevention (CDC), found motor vehicle crashes remain the leading cause of death among American teenagers. “We are moving in the right direction. Rates of teen drinking and driving have been cut in half in 20 years,” CDC Director Thomas R. Frieden, M.D., M.P.H, said in a news release. “But we must keep up the momentum — one in 10 high school teens, aged 16 and older, drinks and drives each month, endangering themselves and others.”

The CDC estimates that almost a million high school teens 16 and older drove after drinking alcohol in 2011. The report states that 85 percent of teens who admitted to drinking and driving also participated in binge drinking in the past month. According to Frieden, younger drivers are 17 times more likely to die in an accident when alcohol is involved.

According to CNN, 10.3 percent of teenagers admitted to drinking and driving last year, compared with 22.3 percent in 1991.

The study found male students were more likely than female students to drink and drive (11.7 percent vs. 8.8 percent). The study found 11.5 percent of Hispanic students, 10.6 percent of white students, and 6.6 percent of African American students said they drink and drive.

The reduction in drinking and driving is due to several factors, including raising the minimum drinking age to 21 across the country, the report notes. Other factors include zero tolerance laws, which do not allow teens to have any alcohol in their system when they drive, and an increase in programs that ease new drivers into full driving privileges, known as graduated driver’s licensing.

Almost 1 in 12 Injured Workers Prescribed Opioids Still Taking Them Months Later

Almost one in 12 injured workers prescribed opioids are still taking the drugs three to six months later, a new study finds. Drug testing and psychological evaluation aimed at reducing drug abuse are not conducted in these workers most of the time.

The study of 300,000 workers compensation claims in 21 states was conducted by the Workers Compensation Research Institute (WCRI). About 24 percent of workers taking long-term opioids received at least one drug test, the Journal Sentinel reports. Only 4 to 7 percent of injured workers taking long-term opioids also received a psychological evaluation, which can screen out those who are not good candidates for opioid treatment because of past substance abuse or psychological problems.


“This study addressed a very serious issue: how often doctors followed recommended treatment guidelines for monitoring injured workers under their care, who are longer-term users of narcotics,” Dr. Richard Victor, WCRI’s Executive Director said in a news release. “This study will help public officials, employers, and other stakeholders understand as well as balance providing appropriate care to injured workers while reducing unnecessary risks to patients and costs to employers.”


In July, WCRI released a study that found a growing number of workers who get hurt on the job are getting their medication directly from their physicians, instead of pharmacies, which is driving up costs. For example, the cost of Vicodin is four times higher when it is dispensed by doctors instead of pharmacies, according to the study.


Now on tap at your local pub: 'Navy strength' bourbon

Distillers are rolling out a growing number of whiskies, rums, gins - even cognacs - with higher-than-normal concentrations of alcohol.  The offerings come by a variety of monikers, with some makers dubbing them "overproof" - a reference to the fact that they go beyond the standard proof of 80 (or 40% alcohol by volume). Others prefer "cask strength" or "barrel strength," which means a spirit hasn't been heavily diluted before bottling.

Still others use the term "navy strength," the potency historically demanded by the British Royal Navy. (If gunpowder doused with a spirit ignited, it was "proof" the navy got what it ordered.)

Tim Cooper, resident bartender with the downtown New York cocktail spot GoldBar, says he focuses less on names and more on how this burgeoning category of spirits helps him concoct drinks.

"The higher the proof, the more flavor that's extracted," says Cooper, who last month won the grand prize in a "Show Me the Proof!" cocktail-making competition sponsored by cognac maker Louis Royer SAS.

The event, held in New York, featured drink mixers from around the country competing to create a winning cocktail using Royer's overproof "Force 53" VSOP cognac. (The 53 refers to the alcohol percentage, which means the cognac registers at a potent 106 proof.)  Other recent additions to the high-alcohol market - in strengths topping out at nearly 150 proof -- include bourbons (Knob Creek Single Barrel Reserve), rums (Plantation Rum Original Dark Overproof), ryes (Wild Turkey 101) and gins (Perry's Tot Navy Strength Gin). Sales are strong for these and other overproof brands, according to officials at various brands.

Beam Inc., the Deerfield, Ill., spirits company known for its namesake Jim Beam bourbon, notes its Scottish-made Laphroaig Cask Strength whisky ($59.99 for a 750-milliliter bottle) as an example:

Sales have surged by 70% for the brand in the latest quarter from a year earlier, the company says. That is a faster growth rate than that of its still-popular, standard-strength Laphroaig 10 Year Old ($49.99).  Beam anticipates selling out of its entire 2,500-case U.S. allotment of the Cask Strength expression by year's end. "High-proof whiskies are in hot demand at the moment," says Beam spokesman Dan Cohen.

America has embraced a range of artisanal alcohol offerings in recent years, from single-malt Scotches to craft beers and ciders.

Frank Coleman, a spokesman for the Distilled Spirits Council of the United States, sees the overproof movement as somewhat akin to the "slow food" movement, which puts a premium on ingredients in their natural state.

"People want authenticity," says Coleman.

For the cocktail crowd, the strength of the alcohol isn't as big a factor as the taste: The flavor of overproof spirits tends to be more robust because the spirits haven't been watered down.  Plus, as Cohen says, the spirits give drinkers greater control: If they want less flavor (and less alcohol), they can simply add water, ice or a splash of soda. "It allows you to customize your experience," he says. Bartenders say the higher-octane offerings give them more options, especially when it comes to delicate spirits, such as cognac, that can easily be lost in a drink in their more mildly flavored, standard-strength versions.

"Cognac has a tendency to stay in the background of a cocktail. But when it's 106 proof, it's going to stand out," says Cooper, the winner of last month's Louis Royer-sponsored cocktail-making competition.  He took home the top prize - a trip to France's Cognac region for his "Bouquet" cocktail, which joined Louis Royer 53 with maple syrup and sherry, among other ingredients.

Turn the clock back a century or two and more potent spirits were the rule, not the exception. The change in potency came about largely because of concerns about alcohol consumption - not just in the U.S., but also in Europe.  From a historical perspective, "everyone has been trying to lower the proof," says Steve Olson, a New York-based consultant to the wine and spirits industry.  But Olson adds that distillers benefited from this temperance-minded push, since a spirit made with more water is naturally cheaper to produce and more profitable.

Still, as premium-priced, higher proof spirits become trendier - and as sales continue to grow - they become a profitable category in their own right.

Jerome Royer, the fifth-generation proprietor behind the Royer cognac brand, points to the fact that the "Show Me the Proof!" competition attracted more than 100 entries from skilled drinks mixers.

"We really tapped into grass-roots interest," he says.


Government Launches Online Program to Help Doctors Fight Prescription Drug Abuse
The Office of National Drug Control Policy (ONDCP) has launched a new online training program to help doctors prescribe opioids more safely and effectively. The program’s goal is to reduce prescription drug abuse, The Boston Globe reports.

The program includes video segments of doctors talking with patients about opioids, the article notes.

“It’s no coincidence that our strategy to address our nation’s prescription drug abuse epidemic begins with education,” Gil Kerlikowske, Director of National Drug Control Policy, said in a news release. “All of us – parents, patients, and prescribers – have a shared responsibility to learn more about this challenge and act to save lives. Prescribers in particular play a critical role in this national effort and I strongly encourage them to take advantage of this training to ensure the safe and appropriate use of painkillers.”

The training materials include two online continuing medical education courses for doctors. According to National Institute on Drug Abuse Director Nora D. Volkow, these courses “provide practical guidance for clinicians in screening their pain patients for risk factors before prescribing. They also help medical professionals identify when patients are abusing their medications, using videos that model effective communication about sensitive issues, without losing sight of addressing pain.”


Nurses Can Help Reduce Substance Abuse in Homeless Youth, Study Finds

Nurses can significantly reduce substance abuse in homeless youth, a new study finds. The study of 154 drug-using homeless young people, many of whom had experienced a number of life crises, tested the effectiveness of three highly interactive group sessions that were led by nurses.

These sessions focused on education about disease transmission and vaccinations, and provided participants with training in self-management and developing healthy social networks.  Participants talked about their experiences, and how they could integrate health promotion strategies into their lives, News-Medical.net reports. The study by researchers at the University of California, Los Angeles School of Nursing found the program led to significant reductions in the use of alcohol and binge drinking, as well as decreases in use of marijuana, cocaine, methamphetamine and hallucinogens.


The researchers found that an “art messaging” program, in which participants created messages about health and drug use to influence other drug-using youths, was also effective in reducing substance abuse. Teachers from the California Institute for the Arts worked with participants in creating messages through art, photography and video, while discussing good health, risky behaviors and ways to stay safe.


After six months, alcohol use dropped 24 percent in the nurse intervention program, and 25 percent in the art messaging program. Marijuana use decreased 17 percent in the nurse group and 20 percent in the art group. In the nurse group, participants reduced use of hallucinogens (20 percent), methamphetamine (18 percent) and cocaine (15 percent).


“Homeless youth often justify their use of drugs because of the need to stay awake at night to avoid getting mugged, because they are ‘self-medicating’ to quell the voices in their head, or because of the need to cope with the stress of life,” lead researcher Adey Nyamathi said in a news release. “But the sad truth is that once substance abuse use is entrenched, drugs begin to dominate all aspects of homeless youths’ lives.”


The study appears in the American Journal on Addictions.


Two Million Tons of Prescription Drugs Collected on DEA’s Drug Take-Back Days

The Drug Enforcement Administration (DEA) has collected a total of two million pounds of unused prescription medications during its five National Prescription Drug Take-Back Days, the agency announced Thursday. During the latest Take-Back Day on September 29, almost half a million pounds of drugs was collected, the Associated Press reports.

The drug collection initiative, which took place over the past two years, was a collaboration between the DEA and state and local law enforcement. People were urged to empty their medicine cabinets, kitchen drawers and bedside tables of prescription drugs that were expired or no longer needed, and bring them to one of thousands of designated disposal sites around the nation.


According to the National Survey on Drug Use and Health, in 2011 more than six million Americans used prescription drugs nonmedically in the past month.


Is Marijuana Medicine?

One of the biggest points of contention about marijuana is whether or not it can be considered medicine, according to Kevin Sabet, PhD, Policy Consultant and Assistant Professor, University of Florida. He says that while smoked crude marijuana is not medicine, marijuana does have medicinal properties – found in its individual components. These components can be isolated and delivered in a safe and effective way. Many of these components are being researched; some have been approved as medicines in the U.S. and elsewhere.
In the second of a two-part series of white papers to outline the facts about the drug, Dr. Sabet discusses:
•    What does the science say?
•    Non-smoked marijuana as medicine
•    Rescheduling marijuana
•    Obtaining marijuana for research
•    Non-FDA approved “medical” marijuana
•    Marijuana as medicine and youth


Read the white paper here Marijuana and Your Health- Just The Facts Part II.

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