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Friday, December 21, 2012

ATOD Weekly Recap - Week-ending December 21st

Nearly One Third of College Student Substance Abuse Treatment Admissions with Co-occurring Mental Disorders Abuse Prescription Drugs

A recent study of college students identified links between nonmedical prescription drug use, depressive symptoms, and suicidality, and raised the possibility “that students may be inappropriately self-medicating psychological distress with prescription medications.” The Treatment Episode Data Set (TEDS) is a compilation of data on admissions to substance use treatment that can be used to look at college students with mental disorders who have been admitted to treatment for drug abuse. Specifically, TEDS data for 2010 show that across college student substance abuse treatment admissions,2 those with a co-occurring mental disorder were more than twice as likely as those without a co-occurring mental disorder to report abuse of prescription drugs3 (31.6 vs. 15.0 percent), cocaine (14.4 vs. 5.5 percent), and heroin (14.3 vs. 5.8 percent) (Figure). They were also less likely to report abuse of alcohol (62.0 vs. 72.3 percent).  Because college student admissions that have a co-occurring mental disorder are more likely to abuse prescription drugs, cocaine, and heroin, they may need to access special services, such as mental health care and pharmacotherapies that can treat and ease withdrawal symptoms from heroin and certain types of prescription drugs, including narcotic pain relievers, benzodiazepines, barbiturates, and sedatives. Please click on the URL for the PDF file to see the full SAMHSA TEDS Report and the bar chart:
A Sober Assessment of High-Risk Drinking on College Campuses

A few years ago, in the middle of a snowy night, an officer of the Cornell University Police Department found a shirtless young man sitting on a rock in the creek in one of our gorges, dangling his feet in the water. Asked what he thought he was doing, the student explained that he was calling a friend to pick him up. The majority of college students will never drink enough to wind up in a situation like this—or worse—but a significant minority will come close. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “about half of college student drinkers engage in heavy episodic consumption,” commonly defined as downing five or more drinks in a row for men and four or more drinks for women at least once in a two-week period. Since about 21.6 million Americans were enrolled in college in fall 2012, the number of students who engage in high-risk drinking on U.S. campuses easily exceeds the population of New York City. As part of its Changing the Culture initiative, the NIAAA has compiled data on the consequences of heavy drinking for college students. For example: Each year, nearly 700,000 students are assaulted by fellow students who have been drinking. Almost 600,000 students are injured—and about 1,825 students die—as a result of alcohol poisoning and alcohol-related accidents, including motor vehicle crashes. Each year, nearly 100,000 students are survivors of sexual assault, including rape, while under the influence of alcohol; 400,000 students have unprotected sex while drunk; more than 100,000 students were so intoxicated while having sex that they weren’t sure if they consented or not. The rest of the story is available here
UMass officials trying to understand why more college females than males treated for alcohol problems than in past
University of Massachusetts officials are looking at the data to better understand why more female than male students have needed medical treatment for alcohol consumption in recent months -- but the numbers actually could indicate a new campus program is working.  This fall, 43 women and 32 males have been transported to Cooley Dickinson Hospital for alcohol related issues, said Amherst Fire Chief Walter O. "Tim" Nelson. And he has seen more females since he became chief two plus years ago. But he said it seems to be a national trend.  Rest of the story is available here
Canada getting out of medical marijuana business

Canada's Conservative government will soon stop producing and distributing medical marijuana, leaving it up to the private sector in a policy change that angered critics. Canada's Health Minister Leona Aglukkaq made the announcement on Sunday, claiming current regulations "have left the system open to abuse." "We have heard real concerns from law enforcement, fire officials, and municipalities about how people are hiding behind these rules to conduct illegal activity, and putting health and safety of Canadians at risk," the minister said. "These changes will make it far more difficult for people to game the system." Aglukkaq said Ottawa would no longer produce and distribute marijuana for medical purposes. Instead, companies will be licenced to grow and sell the product at market rates. Patients with a prescription from a doctor starting in March 2013 will be allowed to purchase a variety of strains of marijuana from licensed producers, who will set prices. Also individuals will no longer be permitted to grow marijuana in their homes for their own personal use, said Aglukkaq. Police and fire officials claimed that home grow operations are at "risk of abuse and exploitation by criminal elements" and one in 22 catch fire, and so they applauded the move. Read more at:
Oregon finds efforts to treat drug addicts paying off

Health officials and social service workers in the state find early efforts to combat drug dependency save money and lives. The guiding principle behind addiction treatment in Oregon is simple: Pay for it now, make it easy to get and you'll save money and lives down the road. Research from across the nation shows that treatment reduces crime and medical expenses while boosting employment, meaning every dollar spent on treatment actually saves an average of $7. Read the rest of the story here.

Synthetic drugs: The challenge and the opportunity

"Blueberry Spice" sounds harmless enough - like hot herbal tea for a winter's day. But a chemical compound in the synthetic drug, a THC analog that mimics the effects of marijuana, caused a wave of kidney failure among a dozen people earlier this year in Casper, Wyoming. The rise in the toxic and sometimes lethal synthetics - Spice, K2 and Bath Salts - was the topic at a two-hour-long, Hazelden-sponsored panel discussion in St. Louis Park that drew more than 400 school officials, family practitioners, emergency room staff, psychologists, law enforcement officials, social workers and family members. Click here to read the full story.
Younger teens smoking less; older teens drinking more; Marijuana use up.

Almost one-quarter of the nation’s high school seniors say they have smoked marijuana in the past month, and just over 36 percent admit to using the drug in the past year, according to the 2012 Monitoring the Future Survey. Researchers at the University of Michigan who conducted the annual survey found 6.5 percent of high school seniors smoked marijuana daily.

  • The 2012 national survey results from the Monitoring the Future study show a continuation of the declines in teen smoking in all three grades under study—grades 8, 10, and 12. Based on annual surveys of 45,000 to 50,000 students, the researchers found that the percentage saying that they smoked at all in the prior 30 days fell for the three grades combined, from 11.7% to 10.6%—a statistically significant drop. There was some evidence from the study that in 2010 the long-term decline in teen smoking might have come to a halt, but the decline resumed in 2011 and has continued into 2012 with statistically significant declines both years. An increase in the federal tax on tobacco products, instituted in 2009, may have contributed to this recent decline in smoking in this age group, according to the investigators. The Monitoring the Future study, which has been tracking teen smoking in the United States for the past 38 years, found that between 2011 and 2012 the percentage of students reporting any cigarette smoking in the prior 30 days (called 30-day prevalence) has decreased among 8th graders from 6.1% to 4.9% (a statistically significant decrease), among 10th graders from 11.8% to 10.8%, and among 12th graders from 18.7% to 17.1%.  One reason that the current smoking rates have declined so sharply is that the proportion of students who ever tried smoking has fallen quite dramatically. In 1996, 49% of 8th graders had tried cigarettes, but by 2012 only 16% had done so, a two thirds drop in smoking initiation over the past 16 years. Further, the initiation of smoking is still falling significantly among 8th and 10th graders. These estimates come from the study’s national surveys of 45,000 to 50,000 students in about 400 secondary schools each year. The study was designed by and is directed by a team of research professors at the University of Michigan’s Institute for Social Research, and since its inception has been funded through research grants from the National Institute on Drug Abuse— one of the National Institutes of Health.
  • About 24 percent of the high school seniors surveyed reported binge drinking within the past two weeks in 2012 - an increase of two percent from 2011. For the purpose of the study, binge drinking was defined as having more than five drinks in a row. The percentage of U.S. teens that smoke has continued to decline in 2012, according to an annual report released Wednesday.
  •  High school seniors are also misusing Adderall more than students in eighth and tenth grades, where misuse rates decreased this year, according to the study.
  • Continued high use of marijuana by the nation's eighth, 10th and 12th graders combined with a drop in perceptions of its potential harms in this year's Monitoring the Future survey, an annual survey of eighth, 10th, and 12th-graders conducted by researchers at the University of Michigan. The 2012 survey shows that 6.5 percent of high school seniors smoke marijuana daily, up from 5.1 percent five years ago. Nearly 23 percent say they smoked it in the month prior to the survey, and just over 36 percent say they smoked within the previous year. For 10th graders, 3.5 percent said they use marijuana daily, with 17 percent reporting past month use and 28 percent reporting use in the past year. The use escalates after eighth grade, when only 1.1 percent reported daily use, and 6.5 percent reported past month use. More than 11 percent of eighth graders said they used marijuana in the past year. The Monitoring the Future survey also showed that teens' perception of marijuana’s harmfulness is down, which can signal future increases in use. Only 41.7 percent of eighth graders see occasional use of marijuana as harmful; 66.9 percent see regular use as harmful. Both rates are at the lowest since the survey began tracking risk perception for this age group in 1991. As teens get older, their perception of risk diminishes. Only 20.6 percent of 12th graders see occasional use as harmful (the lowest since 1983), and 44.1 percent see regular use as harmful, the lowest since 1979.
New “Credentials for Youth” tool
The Employment and Training Administration’s (ETA) Division of Youth Services, within the U.S. Department of Labor, recently launched a new tool “Credentials for Youth”, to help workforce professionals identify promising occupations for youth served by the workforce system, and the credentials that help youth attain them. Click here to read the rest of the article.
Major foundation award will fuel addiction education for MDs

The Betty Ford Center on Dec. 12 announced that the Florida-based Scaife Family Foundation, a longtime supporter of the treatment center’s Summer Institute for Medical Students (SIMS), has awarded the center $1.2 million to implement the Medical Education Initiative. Click here to read the rest of the story.

Building on a rich history
The operators of recovery residences are drawing from their past as they more sharply define their place in the continuum of care.

A critical document that is newly released provides an unprecedented overview and analysis of the rapidly emerging field of recovery residences; it is aptly titled A Primer on Recovery Residences: FAQs from the National Association of Recovery Residences. Noted addictions and recovery researchers William White, Amy Mericle, PhD, Leonard Jason, PhD, and Doug Polcin, EdD, in conjunction with members of the National Association of Recovery Residences (NARR), have authored a comprehensive narrative and assessment of all types of recovery residences, heretofore known under a variety of terms (i.e., sober living, halfway houses, transition homes, extended care). Rest of the story is available here.

A Sober Assessment of High-Risk Drinking on College Campuses

A few years ago, in the middle of a snowy night, an officer of the Cornell University Police Department found a shirtless young man sitting on a rock in the creek in one of our gorges, dangling his feet in the water. Asked what he thought he was doing, the student explained that he was calling a friend to pick him up. The majority of college students will never drink enough to wind up in a situation like this—or worse—but a significant minority will come close. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “about half of college student drinkers engage in heavy episodic consumption,” commonly defined as downing five or more drinks in a row for men and four or more drinks for women at least once in a two-week period. Since about 21.6 million Americans were enrolled in college in fall 2012, the number of students who engage in high-risk drinking on U.S. campuses easily exceeds the population of New York City. As part of its Changing the Culture initiative, the NIAAA has compiled data on the consequences of heavy drinking for college students. For example: Each year, nearly 700,000 students are assaulted by fellow students who have been drinking. Almost 600,000 students are injured—and about 1,825 students die—as a result of alcohol poisoning and alcohol-related accidents, including motor vehicle crashes. Each year, nearly 100,000 students are survivors of sexual assault, including rape, while under the influence of alcohol; 400,000 students have unprotected sex while drunk; more than 100,000 students were so intoxicated while having sex that they weren’t sure if they consented or not. Click here for more.
Marines’ new alcohol policy strictest in U.S. military

The Marine Corps' new on-duty standard for drinking alcohol is so strict that less than one drink at lunch would trigger a "positive" and get a warrior in hot water. The Washington Times reported earlier this week that the Corps sent a Dec. 12 message to commanders officially beginning mandatory breath tests for all 197,000 Marines twice each year. A reading of just .01 percent subjects a Marine to counseling. A Marine who registers a .04 must be examined by medical staff for fitness for duty. The Corps is the first among the Army, Air Force and Navy to begin random mandatory testing of all personnel. The Army leaves test decisions up to a commander and prohibits a blood alcohol content (BAC) of .05 percent or higher. The Air Force also instructs commanders to order alcohol tests when appropriate but has no compulsory program. The Navy said in March it plans to conduct mandatory breath tests. A spokeswoman says the program will not start until next year. Overall, this makes the new Corps' anti-alcohol testing the military's strictest. The Marine memo calls a "positive test result" a reading of .01 or greater, which results in automatic "screening and treatment as appropriate." The Marine Corps did not respond to a question from The Times on why it choose .01 as a "positive" reading requiring corrective action. Army regulations say an on-duty soldier with .05 BAC or more is subject to discipline under the Uniform Code of Military Justice and can receive a less-than-honorable discharge. Commanders may set limits below .05 and bar alcohol consumption altogether on deployment. A blood-alcohol content of .08 — which means eight one-hundredths of 1 percent of the blood by volume is alcohol — is the U.S. standard for drunkenness while driving. Concentration, reasoning, depth perception and other skills can be impaired by a blood-alcohol content lower than .08. The armed forces for years have required mandatory drug testing. The services have wrestled with the idea of doing the same for alcohol, given the belief that domestic violence and sexual assaults often are rooted in excessive drinking. In September, in a study requested by the Pentagon, the Institute of Medicine, part of the National Academy of Sciences, concluded that drug and alcohol abuse by military personnel constitutes a "public health crisis" and "both are detrimental to force readiness and psychological fitness."

Friday, December 14, 2012

ATOD Weekly Recap - Week-ending December 14th

Suboxone Sales Estimated to Reach $1.4 Billion in 2012—More Than Viagra or Adderall
Sales data from the first three quarters of 2012 indicate that Suboxone retail sales in the U.S. will likely reach $1.4 billion* this year—nearly a ten-fold increase over the $137.1 million in sales in 2006 (see figure below). Suboxone currently has the 28th highest retail sales of all prescription drugs in the U.S., up from 198th in 2006. Suboxone sales  will likely continue to increase in light of new SAMHSA regulations allowing Opioid Treatment Programs (OTPs) to dispense a multiple days’ supply of take-home buprenorphine, the main ingredient in Suboxone, to eligible patients without having to adhere to previous length of time in treatment requirements. The steady and rapid increase in Suboxone sales suggests that the drug is being widely adopted in the treatment of opioid dependence, likely because of its effectiveness and because it can be prescribed in both private physicians’ offices and OTPs.  While increased availability means that more opioid dependent persons are being treated, it is also likely that  diversion and nonmedical use will increase. Prior issues 

of the CESAR FAX  have indicated that buprenorphine  is being diverted for use by those who do not have a prescription and that there has been an increase in the health-related consequences of nonmedical use of buprenorphine.3 Furthermore, a recent State of Florida medical examiner report4 found that the number of buprenorphine-related deaths had increased from 6 in 2009 to 27 in 2011 (compared to 62 heroin-related deaths in 2011). These figures likely underestimate buprenorphine-related
deaths because, unlike heroin, buprenorphine is not systematically tested for by State of Florida medical examiners.

Editor’s Note: The true magnitude and scope of buprenorphine diversion, misuse, and adverse consequences is unknown because current epidemiologic measures do not systematically monitor buprenorphine. Routine drug testing protocols used by workplaces and the criminal justice system may not include buprenorphine. Similarly, buprenorphine-related deaths are not accurately tracked because medical examiners and coroners do not routinely test for the drug. We believe that in order to maximize the effectiveness and legitimacy of buprenorphine as a treatment for opioid dependence, it is essential that adequate systems for monitoring potential diversion, misuse, and adverse consequences be put in place throughout the country. According to the manufacturer, Suboxone “can cause serious life-threatening respiratory depression and death, particularly when taken by the intravenous (IV) route in combination with benzodiazepines or other central nervous system (CNS) depressants.”5 Failure to adequately assess the potential risks of diversion and misuse could result in serious public health consequences and more limitations on the drug’s use.
SOURCE:, Suboxone Sales Data, November 2012. Online at

Woman Accused Of Driving Drunk After Drinking Half A Bottle Of Hand Sanitizer

A Middletown (CT) woman is accused of driving drunk after drinking a half a bottle of hand sanitizer. According to The Middletown Press, police say 36-year-old Jennifer Wilcox lost control of her car on Oct. 5, almost crashing into another vehicle. Officers arrested her after she failed a field sobriety test, blowing a blood alcohol level of .17. Wilcox “admitted to drinking one half of a bottle of hand sanitizer,” police told the Press. Wilcox told WTNH-TV that she drank the bottle of hand sanitizer on her own merit. “I just saw it there so I drank it,” Wilcox told the station. WTNH reports that Wilcox drank the equivalent of 32 shots of vodka. “It’s the same alcohol in beer, in wine and Jack Daniels, however, it is more concentrated,” Dr. Danyal Ibrahim said of St. Francis Hospital told the station. Wilcox was charged with driving under the influence and was released on $500 bond.

FDA Panel Votes Against Recommending Zohydro for Approval

A panel of experts assembled by the U.S. Food and Drug Administration (FDA) voted against recommending approval of the painkiller Zohydro ER on Friday. The panel cited concerns over the potential for addiction, Reuters reports. FDA officials said they could still approve the painkiller by imposing safety restrictions. In the 11-2 vote against approval, the panel said that while the drug’s maker, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone. Zohydro contains the opioid hydrocodone. Unlike some hydrocodone products such as Vicodin, Zohydro does not contain acetaminophen. The FDA will decide by March 1 whether to approve Zohydro for sale in the United States for people who need an around-the-clock painkiller for an extended period. Emergency room visits related to hydrocodone have soared since 2000. Click here to read the rest of the story.

Teens Who Experience Dating Violence at Increased Risk of Substance Abuse

Teenage girls who experience dating violence are more likely to binge drink compared with their peers who aren’t in abusive relationships, a new study finds. Teen boys who report dating violence are more likely to use marijuana as young adults compared with boys with healthy dating relationships. The study included more than 5,600 teens who had been in at least one relationship with someone of the opposite sex in 1996. About one-third said they had experienced dating violence, including emotional and physical abuse, WebMD reports. Five years later, those who experienced dating violence in their teen years were more likely to engage in unhealthy behaviors. For girls, those behaviors included smoking, suicidal thoughts and symptoms of depression, in addition to binge drinking. For boys, the unhealthy behaviors included suicidal thoughts and being antisocial, in addition to marijuana use. Teens who were in physically abusive relationships were two to three times more likely to be in a violent relationship between the ages of 18 and 25, the article notes. The study appears in the journal Pediatrics.

Synthetic Version of “Magic Mushrooms” Tested As Treatment for Alcoholism, Smoking

Scientists are testing the synthetic version of the active compound in “magic mushrooms,” psilocybin, for a variety of purposes, including treatment of alcoholism, according to The compound is also being studied as a smoking cessation aid. At the recent annual meeting of the American College of Neuropsychopharmacology, scientists described their research using the hallucinogen. According to the article, psilocybin is the active ingredient in more than 100 species of mushroom, and has been used for hundreds of years in ceremonies and rituals in South America. Studies on psilocybin’s effect on smoking cessation and alcoholism have just started, but early results are promising, researchers say. A study published in the Archives of General Psychiatry by UCLA researchers found psilocybin improved the mood of patients with anxiety related to a diagnosis of advanced-stage cancer for at least three months. Once ingested, magic mushrooms generally cause feelings of nausea before the desired mental effects appear. The high from using magic mushrooms is mild and may cause altered feelings and distorted perceptions of touch, sight, sound and taste. Other effects can include nervousness and paranoia. On some trips, users experience sensations that are enjoyable. Others can include terrifying thoughts, and anxiety, fears of insanity, death, or losing control. Some magic mushroom users experience “flashbacks,” which are reoccurrences of hallucinations long after ingesting the drug. The causes of these effects, which in some users occur after a single experience with the drug, are not known.

Heroin deaths rise as crackdown on prescription drug abuse succeeds

As efforts to crack down on the abuse of prescription drugs have worked, a new problem has emerged, with addicts who can no longer get their fix by popping pills turning to the old-fashioned street drug heroin, health and law enforcement officials say. The trend shows up in local arrests, drug seizures and overdose deaths. Drug dealers are finding new markets in the suburbs, where teenagers once got their stash from local drugstores or their parents' medicine cabinets, some experts say. The rest of the story is available here.

Does the NFL have a drinking problem?

Since January 2000, NFL players have been arrested at least 624 times on various charges, including 42 times this year, according to data compiled by USA TODAY Sports. Of those 624 arrests, 177 (28%) were arrested because they were suspected of driving under the influence of alcohol or drugs. Despite the league's various attempts to stop the problem, it remains the single-biggest criminal issue in the NFL. Nothing else comes close. Nothing else has been more deadly. Read the rest of the story here.

Prescription Painkillers Mixed With Alcohol: A Deadly Mix

On Dec. 19, 2011 a 28-year-old graduate student at the George Washington University went to sleep and never woke up. Earlier that night, Benjamin Gupta mixed a prescription painkiller with alcohol. It was a mistake that cost him his life. By all accounts, Ben Gupta was smart, motivated and much-liked -- someone with a passion for public service. The Omaha, Neb. native had worked under Secretary of State Hillary Clinton as a coordinator for the State Department's Global Partnership Initiative. He also served in 2007 as a staff assistant for then-Congressman Rahm Emanuel. Ben was dedicated to completing his graduate studies, but he never got the chance when he took oxycodone, a prescription painkiller, and then an alcoholic drink. Ben Gupta's blood alcohol level was just .04 the night of his death, far below the legal limit. Yet the mixture killed him. According to the Centers for Disease Control and Prevention (CDC), nearly three out of four prescription drug overdoses are caused by the same kind of opioid painkillers that Ben Gupta took on that fateful night. Drug overdose rates in the United States have more than tripled since 1990, paralleling an astounding 300 percent increase in sales of these prescription painkillers. Rest of the story is available here

Admins launch new alcohol-related initiatives

Administrators have launched two new alcohol-related initiatives that aim to evaluate alcohol culture at Yale and seek ways to form a safer undergraduate experience.  In an email sent yesterday afternoon to the student body, Yale College Dean Mary Miller and Secretary and Vice President for Student Life Kimberly Goff-Crews announced the "Task Force on Alcohol and Other Drugs" and "University Council Committee on Alcohol in Yale College," which will each tackle alcohol use at Yale. The 15-person task force, which will be chaired by Dean of Student Affairs Marichal Gentry, will focus on three areas of alcohol culture: safety and education, programming and communications.  Gentry told the News on Monday that Miller approached him earlier this semester and asked him to form the task force and develop tactics "to help Yale College make the undergraduate experience safer, and to protect that experience from the risks that alcohol and other drugs present." The committee's membership includes Yale Police Department Chief Ronnell Higgins, Associate Dean for Student Organizations and Physical Resources John Meeske and Yale College Council President John Gonzalez '14.  According to Gonzalez, the task force has met five times since its first meeting on Nov. 7. Gentry said Miller may turn the task force into an "implementation committee" once the group recommends strategies and tactics regarding alcohol use to Miller.  The University council committee, which University President Richard Levin will convene in January 2013, will comprise of alumni and parents and aims to provide a "broad overview and more strategic guidance to the University's senior leadership," according to the email..

To Reduce Prescription Drug Abuse, Focus Less on Patient Satisfaction

Pain management education must help prescribers focus less on patient satisfaction, and more on their functional improvement, according to Sherry Green, the CEO of the National Alliance for Model State Drug Laws (NAMSDL).

Current pain management education is largely based on the concern that people in chronic pain are not receiving adequate relief, Green says. “More and more emphasis has been placed on patient satisfaction. With doctor ratings available online, some physicians are concerned that if they don’t give patients what they want, they will drive them away and receive unsatisfactory ratings. That may make them less willing not to give someone the drug they’re asking for.” The pressure to satisfy patients may also come from hospitals, whose own ratings are influenced in part by patients’ satisfaction with doctors, she adds. Improving prescriber education was one of the topics at the recent meeting convened by NAMSDL for state and local professionals from around the country to identify legislative and policy options for addressing “pill mills” and safeguarding the legitimate practice of pain management. Participants included doctors, law enforcement officials, medical board representatives and addiction treatment specialists. They crafted a preliminary set of proposals which NAMSDL will distribute in early 2013 to a wide variety of stakeholders for further review and comment. The goal of the multi-step, multi-disciplinary approach is to provide policymakers with practical solutions to preventing prescription drug abuse, addiction and diversion while safeguarding legitimate access to prescription drugs. 

Participants at the meeting agreed patient satisfaction may be receiving too much emphasis. “There’s a concern we’ve gone too far down that road,” notes Green. They also discussed how pill mills have fueled the prescription drug abuse epidemic. “Pill mills do not necessarily refer to a specific location, but rather to a set of practices that is not legitimate medicine,” Green says. “Pill mills’ entire focus is on prescribing drugs, without taking medical histories, performing physical exams or providing followup. There is no individualized care, and the same kinds of pills are given across multiple types of patients.” Legitimate pain management involves practices diametrically opposed to pill mills, according to Green. “Pain management is more holistic – it looks at other ways of treating pain in addition to pills,” she notes. Prescription drug monitoring databases as a tool for combating prescription drug abuse will be a big focus on the state level in 2013, she adds. There are many details that states must consider, including whether to require doctors and other prescribers to use the databases. “Our goal is to see what are the best kinds of policy and regulatory changes that are needed to reduce prescription drug abuse. Once we agree, our stakeholder groups can move forward and make these changes,” she says.

Children and Teens Who Overeat More Likely to Start Using Marijuana

A new study finds children and teens who overeat are more likely to start using marijuana and other drugs, compared with their peers who don’t eat too much. The study is based on surveys of almost 17,000 youth, Reuters reports.

“Physicians and parents should be aware that both overeating and binge eating are quite common in adolescents, and these problems put them at risk for other problems, such as drug use,” lead researcher Kendrin Sonneville of Boston Children’s Hospital told Reuters. “The earlier we can screen for who is at risk, the more able we are to prevent the onset of drug use.”

Dr. Sonneville said pediatricians should talk to their patients about eating patterns. Parents who notice their child is eating much more than usual in one sitting should consult the child’s doctor, she advised. The children in the study, who were between the ages of 9 and 15 when it began, filled out health questionnaires every year or two between 1996 and 2005. During that period, 41 percent started using marijuana, and 32 percent used other illicit drugs.Those who reported overeating were 2.7 times more likely to start using marijuana or other drugs. Binge eaters—those who lost control during overeating—were 1.9 times more likely to start using drugs. The findings appear in the Archives of Pediatrics & Adolescent Medicine.

Military cracks down on alcohol abuse amid age-old binging habit
Officials within the U.S. military are actively targeting over-boozing troops at home and abroad, but addiction specialists and service members say binge drinking remains as rampant as ever inside the armed services.
Among the new initiatives to stem the problem: The Marines, starting next year, will give random breathalyzer tests to Corps members; the Air Force and Army curbed some overnight liquor sales for U.S. military personnel in Germany; and American service members in Japan were barred from leaving their residences after consuming more than one adult beverage. The restrictions seem to have been independently created by brass within each branch - for example, the new rules for service members in Japan follow the October sexual assault of an Okinawa woman allegedly carried out by two U.S. sailors. Still, the fresh regulations arise three months after a study commissioned by the Department of Defense found that binge drinking by active-duty troops now constitutes "a public health crisis," noting as well that drunken soldiers were cited as a problem as far back as the Revolutionary War. Rest of the story is available here.

New Report: Underage Drinking Is Declining, But Still a Major Problem
“Data show meaningful reductions in underage drinking, particularly among younger age groups. From 2004 to 2012, young people ages 12 to 20 showed statistically significant declines in both past-month alcohol use and binge alcohol use,” according to the 2012 Report to Congress on the Prevention and Reduction of Underage Drinking, from the Secretary of Health and Human Services, released on November 30, 2012.  However the new summary of the latest scientific research confirms that “alcohol continues to be the most widely used substance of abuse among America’s youth, a greater proportion of whom use alcohol than use tobacco or other drugs.”  The annual report was prepared by the Substance Abuse and Mental Health Services Administration (SAMHSA) on behalf of the federal Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). SAMHSA administrator Pamela S. Hyde, J.D. serves as the ICCPUD Chair. In her Foreword to this fourth report in the series, Hyde notes that it includes a new section on prevention of binge drinking on college and university campuses, and an expanded section about underage drinking prevention and enforcement activities in the 50 states and the District of Columbia.

Surgery Destroys Parts of Brain’s “Pleasure Centers” in Attempt to Cure Addiction

A controversial surgical procedure being studied in China attempts to cure addiction by destroying parts of the brain’s “pleasure centers,” reports. The research is being conducted on alcoholics and people addicted to heroin. The procedure risks permanently damaging a person’s ability to have longings and feel joy, the article notes.

The Chinese Ministry of Health banned the procedure in 2004. Some doctors were allowed to continue to perform the operation for research purposes. In a recent study published in the journal Stereotactic and Functional Neurosurgery, researchers called the surgery “a feasible method for alleviating psychological dependence on opiate drugs.” They note more than half of the 60 patients in the study had lasting side effects. These included memory problems and loss of motivation. After five years, 47 percent of participants were still drug free. That compares with a 30-40 percent rate of significant recovery with conventional addiction treatment, the news outlet states. Experts feel the small increase in success rates with the surgery is not worth the large risk.

Patients are awake during the procedure, to minimize the risk of destroying parts of the brain involved in movement, consciousness or sensation. A surgeon uses heat to destroy cells in small sections of the part of the brain containing large amounts of brain chemicals called dopamine and endogenous opioids, which are involved in desire and pleasure. Experts say they are opposed to using the procedure to treat addiction. “To lesion this region that is thought to be involved in all types of motivation and pleasure risks crippling a human being,” Dr. Charles O’Brien, head of the Center for Studies of Addiction at the University of Pennsylvania, told

Sharp rise in admissions for certain drug combinations over 10 years

Substance abuse treatment admissions for addiction involving combined use of benzodiazepine and narcotic pain relievers rose a total of 569.7 percent, to 33,701, from 2000 to 2010, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). Overall substance abuse treatment admissions of people ages 12 and older in the same period rose 4 percent, to 1.82 million, the agency said. Read the rest of the press release here.

An insidious threat to AA, NA
It is projected that nearly three-quarters of a million members of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) will die from tobacco-related causes, according to a 2012 study from the Wisconsin Nicotine Dependence Integration Project (WINTIP), with nearly half a million of those individuals residing in the United States and Canada. Attempts at encouraging AA and NA, highly successful addiction recovery societies, to address tobacco as a central issue have been unsuccessful so far. Both societies have traditions that discourage them from dealing with what they have described as “outside issues.” Click here to read the rest of the story.

Treatment Rate Jumps for Addiction to Benzodiazepines and Narcotic Pain Relievers

Treatment admissions for people addicted to both benzodiazepines and narcotic pain relievers jumped 569.7 percent between 2000 and 2010, according to a new government report. Overall, substance abuse treatment admissions increased 4 percent over the same period. The report, by the Substance Abuse and Mental Health Services Administration (SAMHSA), found 33,701 people received treatment for addiction to both medications in 2010, Science Daily reports.

“Clearly, the rise in this form of substance abuse is a public health problem that all parts of the treatment community need to be aware of,” SAMHSA Administrator Pamela S. Hyde said in a news release. “When patients are battling severe withdrawal effects from two addictive drugs, new treatment strategies may be needed to meet this challenge. These findings will help us better understand the nature and scope of this problem and to develop better approaches to address it.”

According to the report, 38.7 percent of those with this combined addiction began using both drugs in the same year, while 34.1 percent first became addicted to narcotic pain relievers, and 27.1 percent started with benzodiazepines. Almost half of patients treated for the combined addiction also had a psychiatric disorder. Non-Hispanic whites accounted for 91.4 percent of combination treatment admissions. Women accounted for 49.2 percent of such admissions, and people ages 18 to 34 represented 66.9 percent of those treated.

Children in Kentucky Pay Price for Parents’ Prescription Drug Abuse

More than 86,000 children in Kentucky are being raised by someone other than a biological parent, and prescription drug abuse is largely to blame, community leaders say. CNN reports that while it is difficult to assess how many children are orphaned after a parent overdoses from prescription drugs, state data shows Kentucky is the fourth most medicated state in the country, and has the sixth highest rate of overdose deaths.
“Someone has to take care of these kids, and we simply do not have the facilities to do that,” said U.S. Representative Hal Rogers, whose district in Kentucky is hard hit by prescription drug abuse. “So it’s neighbors, it’s churches, other civic groups that are trying to be parents to these kids who are orphaned by drug-abusing parents. That’s a huge undertaking, because there’s literally tens of thousands of these young children.” He started the Operation UNITE drug task force in 2003 to fight the prescription drug abuse epidemic in Kentucky. The task force has set up programs at schools across the state to help children who have lost their parents to these drugs.

The state has taken steps to combat prescription drug abuse. Earlier this year, Kentucky Governor Steve Beshear signed into law a bill requiring that all pain clinics be licensed, specifies requirements for ownership and employment, and obliges Kentucky’s licensure board to develop regulations for pain clinics. It gives law enforcement easier access to the state’s prescription drug monitoring database. Doctors must examine patients, take full medical histories, and check electronic prescription records before writing prescriptions for opioids. Last month, Dan Smoot, Law Enforcement Director of Operation UNITE, noted that as Kentucky begins to see results from its crackdown on prescription drug abuse, officials are reporting a rise in heroin use.

Don’t Eat Daddy’s Cookies: How to Talk to Your Kids About Pot

Washington state’s legalization of marijuana last week was a professional triumph for Alison Holcomb, a Seattle attorney who wrote the law. But the legal victory created a personal dilemma: how to discuss the no-longer illicit drug with her 4-year-old son. “He’s a sponge right now, and I don’t know if he’s yet at the age when I can have a meaningful conversation with him about it,” says Holcomb, the drug policy director for the American Civil Liberties Union (ACLU) of Washington. “He has never seen me smoke anything. I probably won’t do it in front of him.”  Read more here.

Friday, December 7, 2012

ATOD Weekly Recap - Week-ending December 7th

Parents More Important Than School in Preventing Use of Alcohol, Marijuana Use

A new study concludes that parental involvement is more important than the school environment in preventing or limiting children’s use of alcohol or marijuana. Researchers evaluated data from more than 10,000 students, parents, teachers and school administrators. They looked at “family social capital”—bonds between parents and children—as well as “school social capital”—a school’s ability to provide a positive environment for learning, Science Daily reports. Measures of family social capital include trust, open communication and active engagement in a child’s life, while school social capital includes student involvement in extracurricular activities, teacher morale and the teachers’ ability to address student needs. “Parents play an important role in shaping the decisions their children make when it comes to alcohol and marijuana,” study co-author Dr. Toby Parcel of North Carolina State University said in a news release. “To be clear, school programs that address alcohol and marijuana use are definitely valuable, but the bonds parents form with their children are more important. Ideally, we can have both.” The researchers found students with high levels of family social capital and low school social capital levels were less likely to have used either marijuana or alcohol, or to have used them less frequently, compared with students with high levels of school social capital and low family social capital. The study appears in Journal of Drug Issues.

A new prescription to treat prescription drug abuse
Prescription drugs have arguably become more dangerous to addicts than street drugs. The pharmaceutical industry may now have uncovered an effective treatment that reduces dependence by restoring the functions that opioids disrupt, and it presents the manufacturer with a major market opportunity for its therapy. A recent Centers for Disease Control and Prevention (CDC) study found that over 30,000 people were killed from prescription drug abuse in 2008, which now exceeds the death toll from illegal drugs. Car accidents took just slightly more lives. The cost of painkiller abuse can exceed US$70 billion annually, the report noted. That does not include the social problems they perpetuate and addicts’ lost or stalled potentials. Clinical trials are now underway in New York to determine the efficacy of MediciNova’s Ibudilast for treating dependency involving prescription drugs such as OxyContin, Percocet, and Vicodin. The drug is a powerful anti-inflammatory that is usually indicated for patients suffering from asthma and strokes. It is helpful in the treatment of addiction, because it crosses the blood brain barrier and restores normal “glial cell” activity. That has the benefit of diminishing the intense opioid cravings that can cause prescription drug abusers to relapse.

“The drug of abuse can cause physical neuronal damage that may take a significant period of time to correct,” said MediciNova chief scientific officer, Dr. Kirk Johnson. “So it is expected that MN-166 (the test code for Ibudilast) would be a therapy subjects would take for a considerable period of time to successfully manage initial withdrawal and the high-risk period for relapse.” That is, after the FDA approves it for sale.

MediciNova estimates that it could take five years for Ibudilast to come to market in the United States. The drug been approved in Japan for the aforementioned uses for over 15 years, and has a safety database of millions of patients, Johnson said. It would be taken at home, and a course of treatment could last between 6-18 months, or until the patient’s brain has recovered and necessary lifestyle changes have been made. The prescription trial was announced last month, and is being funded by the National Institutes for Drug Abuse (NIDA), part of the National Institutes of Health. Another trial is already underway to determine whether Ibudilast would be helpful in treating methamphetamine addiction. Alleviation of withdrawal symptoms and a reduction in relapses has been observed in animal models, Johnson noted. If approved, MediciNova believes that it will be able to meet demands based on NIDA’s assumption that 20 percent of the 350,000+ meth addicts would seek a pharmaceutical treatment every year. The number of prescription abusers is even higher, but MediciNova says that it will be able to manufacture required amounts. MediciNova cannot comment on a price point yet, but cited Dr. Phil Skolnick, director of pharmacotherapies & medical consequences of drug abuse at NIDA stating that a $1,000/month price point for a six-month course of treatment was reasonable. The market opportunity is well above $400M per annum for meth alone.

Reckitt Benckiser currently sells over $1.2B of Suboxone, a drug used for treating opioid dependence, annually, a MediciNova spokesperson said. When asked if it was ironic that a prescription drug will be used to wean people off of other prescription drugs, Johnson demurred, noting that some drugs are safer than others. “It is not really ironic at all; not all prescription drugs are created equal, and opioids especially are hazardous to long-term health (and potentially, if abused, short-term health as well),” he said.

Psychiatric Association Creates Category of “Substance Use and Addictive Disorders”
The American Psychiatric Association has approved a new edition of its Diagnostic and Statistical Manual for Mental Disorders (DSM-5) that combines substance abuse and dependence into a single category of “substance use and addictive disorders.” The DSM is the official guide to classifying psychiatric illness, according to The Wall Street Journal. Currently, substance abuse is defined as short-term binging, while substance dependence is considered to be addiction, the article notes. The new spectrum of substance use and addictive disorders includes 11 specific symptoms. These include the inability to cut down or meet obligations at home or at work.

The spectrum’s severity will be judged based on how many criteria a patient meets. A person with two or three will be diagnosed with a mild disorder, while someone who meets six or more will be diagnosed with a more severe disorder. While supporters of the change say it will make it easier to spot problems earlier, some opponents say it could pathologize occasional binging.

The changes to the manual come after more than a decade of discussion and debate. They can affect who qualifies for subsidized services, insurance reimbursements and treatment programs. Another major change in the DSM-5 is the combination of subcategories of autism, such as Asperger’s syndrome, into one category of autism spectrum disorder. The manual also creates a new diagnosis of disruptive mood dysregulation disorder, for children with frequent behavioral outbursts. The new edition of the manual will be published next spring.

Physician, Heal Thyself

Physicians aren't much different than anyone else when it comes to susceptibility to addiction and prescription drug abuse.  In fact, as a group, they may be more vulnerable.  In the bible, Luke 4:23, Jesus reiterated what he knew the crowd of disbelievers was saying and thinking:  "Physician, heal yourself!  Do here in your hometown what we have heard that you did in Capernaum."  In short, Jesus' reply was that it doesn't work that way.  Please review the Star Ledger article attached below, "Surgeon facing Rx drug charges" in the November 30, 2012 paper. In fact in today's world, it doesn't work that way either.  Many physicians with the family gene of addiction plus easy access to prescription drugs are likely candidates for prescription drug abuse and addiction. In spite of their degree, their background, their experience and their knowledge, they are vulnerable.  Because of their status in our society it becomes much more difficult for them to admit "I am and addict or I am an alcoholic."  In fact, such an admission will most likely jeopardize their livelihood, their family and even their future, but without the recognition of their own disease, it is unlikely that they will receive the help and the treatment and the recovery support that they desperately need.  This is a major problem with many physicians and other medical staff as you might well imagine. So here's my advice to all medical staff with the disease of addiction:   You can recover from this disease and you will resume normal relations and recognition by your, family, your patients and the public, once you accept the disease and once you treat the disease and once you understand the lifetime recovery protocol essential to maintaining a clean and sober lifestyle. Talking to physicians and medical personnel: "How do you do this?"
  1. First you should understand that it is not essential to blab to any and all people you meet about your disease.  "I'm Bob and I'm an alcoholic" is not the only way to start for all people with this disease.
  2. Second however, it is essential that you admit to yourself and your loved ones that you have this disease.
  3. Third, it is essential that you reach out for advice and for help.  Treatment and recovery support can come in all different shapes and sizes.  One approach does not necessarily fit all.  We have over 200 public and private treatment programs in New Jersey alone, and all states have treatment that is available and affordable.
  4. Fourth, it is essential that you understand the nature of this disease and the nature of its' "cure." The disease is relentless and not to be taken lightly and there is no "cure."  In other words, the disease will always be part of you even though you're not drinking or drugging. 
  5. Fifth, the disease can be arrested and it is a fact that millions of people have learned to live their lives clean and sober and always in recovery, one day at a time.
  6. Sixth, it is similar to other medical diseases such as diabetes and hypertension in that it can be arrested and controlled with the right protocol.

Is medical marijuana safe for children?
Like some cancer patients in states where it's allowed, Mykayla Comstock uses cannabis as part of her treatment.

Comstock is 7-years old. Her mother, a long time advocate for medical use of the illegal drug, has been giving her a gram of oral cannabis oil every day. Despite the fact that medical marijuana is legal in Oregon, where Comstock lives, the idea of giving it to a child still gives pause to many adults who associate the drug with recreational use that breaks the law. As reported by ABC News, Mykayla was diagnosed with acute lymphoblastic leukemia in July. Against her doctor's wishes, her mother, Erin Purchase, began giving her lime-flavored capsules filled with cannabis oil after she had a poor response to her initial chemotherapy treatment. Her doctors suggested a bone marrow transplant, but while she was taking the medical marijuana, she went into remission in August. She continues to rely on cannabis to ease pain and nausea and her mother plans to continue giving her the drug during the additional two to three years of chemotherapy she still faces. Purchase believes that certain components in marijuana, which show anti-cancer activity in many early studies, helped spark the remission. Mykayla's current doctor knows she takes the capsules, but doesn't discuss the marijuana as part of her medical therapy.

Experts like Igor Grant of the University of California's Center for Medical Cannabis Research warn that the effects of the drug on child development are unknown. But the same is true for other medications used to fight pain and nausea that are currently given to children with cancer, as well as for powerful antipsychotic drugs that are used in long term treatment of childhood mental illnesses. Opioid drugs like morphine and Oxycontin, which are sometimes used to treat the severe pain that accompanies life-threatening cancer and other diseases, for example, can cause overdoses. Although marijuana can be addictive, addiction rates are often lower than those to opioid drugs, and discontinuing opioids is associated with severe physical withdrawal symptoms not seen with marijuana. While opioids can cause nausea and vomiting, marijuana reduces the risk of these symptoms that frequently plague cancer patients as side effects of radiation or chemotherapy. Advocates like Purchase argue that if opioids are acceptable to treat youngsters' cancer pain, then marijuana should be as well.
The American Academy of Pediatrics, however, disagrees, and opposes the use of marijuana to treat young children, citing its addictive potential and the many unknowns about how it may affect developing bodies. The Institute of Medicine (IOM), a scientific group of experts consulted by Congress, analyzed the available data and since 1999 has acknowledged that certain legitimate medical uses of marijuana are worth additional study. While the panel noted that many effective treatments already exist to relieve nausea and cancer pain, it recognized that for some patients who may not respond to these therapies, the components in marijuana may be helpful. The group's main objection to the drug was its use in smoked preparations, which is not an issue in this case. The IOM's report highlights the need for much more research into understanding medicinal uses of marijuana -- including for which symptoms or conditions it might be most effective, and for which patients. Those concerns are magnified when it comes to treating children like Comstock, who often are not included in clinical trials because of their young age, and who may have many more years to contend with any possible side effects of the drug.

Some experts point out that not all of marijuana's components, and their effects on the body, have been studied, not to mention well understood. Without more research, both doctors and parents will continue to face the difficult decision of giving youngsters a compound and hoping it will do more good than harm.

Drug Combination May Help Treat Cocaine Addiction, Study Suggests

A new study suggests combining the anti-seizure drug topiramate with amphetamines may help treat cocaine addiction. The Los Angeles Times reports topiramate has shown promise in treating nicotine and alcohol dependence, while amphetamines are used to treat attention deficit hyperactivity disorder. Both classes of drugs have been tested independently as a treatment for cocaine addiction. Topiramate is slow to take effect, while amphetamines have not shown promise by themselves as a treatment for cocaine dependence. No single drug has been proven effective in treating cocaine addiction, the article notes. In the new study, 39 people with cocaine dependence were given the drug combination for 120 days, while 42 received a placebo. Those who received the drug combination were about twice as likely to be abstinent from cocaine use for three consecutive weeks (33 percent vs. 16.7 percent). Participants in both groups received psychotherapy designed to keep them on their medication, while avoiding street drugs. The combination treatment appeared to work within a few weeks. Previous studies of topiramate alone indicated the drug took eight weeks to show an effect. The new treatment seemed most effective in those who used cocaine most frequently. The combination appears to correct several chemical imbalances in the brain caused by frequent use of cocaine, the researchers note in the journal Biological Psychiatry. “The combination of mixed amphetamine salts and topiramate appears promising as a treatment for cocaine dependence,” the researchers from Columbia University and New York State Psychiatric Institute noted in a news release. “The positive results observed in this study need to be replicated in a larger, multicenter clinical trial. The findings also provide encouragement for the strategy of testing medication combinations, rather than single agents, for cocaine dependence.”

Research reveals why some teenagers more prone to binge drinking

New research helps explain why some teenagers are more prone to drinking alcohol than others. The study, led by King's College London's Institute of Psychiatry (IoP) and published in Proceedings of National Academy of Sciences (PNAS) provides the most detailed understanding yet of the brain processes involved in teenage alcohol abuse. Alcohol and other addictive drugs activate the dopamine system in the brain which is responsible for feelings of pleasure and reward. Recent studies from King's IoP found that the RASGRF2 gene is a risk gene for alcohol abuse, however, the exact mechanism involved in this process has, until now, remained unknown. Click here for the rest of the story.

Study of Genetics, Environment and Alcoholism Leads to Pilot Prevention Program

Genes explain about 60 percent of the risk for alcoholism, while the environment accounts for the rest, according to an expert who has developed a pilot program to prevent high-risk drinking in college freshman. Marc A. Schuckit, MD, Distinguished Professor of Psychiatry at the University of California, San Diego, based the first evaluation of a prevention program on his 30 years of research in the field, with more than 400 families. Dr. Schuckit recently discussed how genes and the environment relate to the risk for alcoholism at the Association for Medical Education and Research in Substance Abuse annual meeting. He explained the risk factors that impact alcoholism. “Genes operate through these risk factors,” he notes.

One risk factor is having a low sensitivity to alcohol. “Some people are a good deal less sensitive to alcohol from the very first time they drink,” Dr. Schuckit says. “They require higher doses of alcohol to get the effect they want.” Low sensitivity to alcohol is seen in groups of people at high risk for alcoholism, including children of alcoholics and Native Americans, he adds. Low sensitivity to alcohol predicts alcoholism and alcohol-related problems, he says.

This low sensitivity interacts with factors in the environment that magnify the risk, such as associating with heavy-drinking peers, higher levels of life stress and using alcohol to cope with that stress. During the course of his research, Dr. Schuckit has identified four genes related to the low response to alcohol. His pilot program for 64 students, which he has tested with incoming freshman at the University of California, San Diego, used a questionnaire to identify those with low-and high-alcohol responses. All the selected students, including equal numbers of those with low-and high-alcohol responses, participated in one of two prevention programs, one with an emphasis on how the low response leads to heavy drinking, and one with general information on how to decrease drinking but no mention of the low response. Those students who had a low response to alcohol decreased their drinking more when in the first program compared to the more general education sessions. “The program looks very promising,” he said. “It helps students realize their specific risk and to modify their drinking.” The study results, published earlier this year in Alcoholism: Clinical & Experimental Research, suggest that tailoring prevention efforts to address specific predisposing factors, such as a low response to alcohol, may help reduce these students’ drinking. He is planning on beginning a much larger, potentially more definitive study in 2013.

Synthetic Marijuana Sent 11,000 People to Emergency Rooms in 2010

More than 11,000 people ended up in emergency rooms after using synthetic marijuana in 2010, according to a new government report. Most were teenagers and young adults, USA Today reports. Synthetic marijuana, commonly known as K2 or Spice, is a mixture of herbs, spices or shredded plant material that is typically sprayed with a synthetic compound chemically similar to THC, the psychoactive ingredient in marijuana. K2 is typically sold in small, silvery plastic bags of dried leaves and marketed as incense that can be smoked. It is said to resemble potpourri. Short term effects include loss of control, lack of pain response, increased agitation, pale skin, seizures, vomiting, profuse sweating, uncontrolled spastic body movements, elevated blood pressure, heart rate and palpitations. In addition to physical signs of use, users may experience severe paranoia, delusions, hallucinations and increased agitation.

The new report, from the federal government’s Drug Abuse Warning Network, is the first to analyze the impact of synthetic marijuana, the newspaper notes. The report found 12-to-17-year-olds accounted for one-third of the emergency room visits, while young adults ages 18 to 24 accounted for an additional 35 percent. Among patients ages 12 to 29, the report found 59 percent of those who paid visits to the emergency room for synthetic marijuana use had no evidence of other substances. In 2010, marijuana sent 461,028 people to the emergency room. In July, President Obama signed legislation that bans synthetic drugs. The law bans harmful chemicals in synthetic drugs such as those used to make synthetic marijuana and bath salts.

Study Finds Possible Link Between Gene Variation and Teen Binge Drinking

Scientists in London have found a genetic variation that may play a role in binge drinking in teenagers, Reuters reports. The two-phase study included mice and teenage boys. “People seek out situations which fulfill their sense of reward and make them happy, so if your brain is wired to find alcohol rewarding, you will seek it out,” lead researcher Professor Gunter Schumann of King’s College Institute of Psychiatry in London said in a news release.

The researchers found that a gene called RASGRF-2 is important in controlling how alcohol stimulates the brain to release the brain chemical dopamine, which triggers feelings of reward. Previous studies have suggested that this gene increases the risk for alcohol abuse, but the mechanism was unclear, the article notes. The researchers began by studying mice whose RASGRF-2 gene was removed, to see how they would react to alcohol. The lack of the gene was found to significantly reduce alcohol-seeking activity in the mice. When the rodents did consume alcohol, the lack of the gene reduced the activity of dopamine-releasing activity in the brain, and limited any sense of reward. The scientists then analyzed brain scans of 663 teenage boys. They found when the boys were expecting a reward in a mental test, those with genetic variations in the RASGRF-2 gene had more activity in the brain involved in dopamine release. This suggests people with the genetic variation release more dopamine when they anticipate a reward, and get more pleasure out of it, the researchers said. Two years later, the researchers retested the boys, many of whom had begun drinking frequently. Those with the gene variation drank more often than those without it. Their findings appear in the Proceedings of the National Academy of Sciences.

Substance Abuse Much More Likely in Adults with Mental Illness: Report

Substance dependence or abuse is much more likely to occur in adults with a mental illness, compared with those without mental health problems, according to a new government report. An estimated 17.5 percent of those with a mental illness, and more than 22 percent of those with a serious mental illness, met the criteria for substance dependence or abuse. In contrast, 5.8 percent of those without a mental illness met the criteria, HealthDay reports.

Two million 12-to-17-year-olds had a major depressive episode in the previous year. These young people were more than twice as likely to use illicit drugs during that year, compared with their peers who did not have a major depressive episode (26 percent vs. 17 percent). The 2011 National Survey on Drug Use and Health found one in five adults in the United States—45.6 million people—had a mental illness in the past year. Nearly 30 percent of young adults ages 18 to 25 had a mental illness, compared with about 14 percent for those 50 and older. The survey found 23 percent of women had a mental illness in the previous year, compared with 16 percent of men. “Although mental illness remains a serious public health issue, increasingly we know that people who experience it can be successfully treated and can live full, productive lives,” Pamela S. Hyde, head of the Substance Abuse and Mental Health Services Administration, said in a news release. “Like other medical conditions, such as cardiovascular disease or diabetes, the key to recovery is identifying the problem and taking active measures to treat it as soon as possible.”

Law Enforcement Alerted to Possible Influx of Painkillers From Canada

The White House Office of National Drug Control Policy (ONDCP) has alerted U.S. law enforcement to prepare for a potential influx of painkillers from Canada, which has given approval to six generic drug companies to manufacture oxycodone products. The Wall Street Journal reports R. Gil Kerlikowske, Director of National Drug Control Policy, called Canada’s health minister last week to talk about the issue. He offered assistance in fighting prescription drug abuse, a major concern in both the United States and Canada. ONDCP sent an alert to law enforcement agencies, warning them to look for inexpensive oxycodone products. The drugs could hit the market as early as next month, the alert notes. “The potential exists for diversion into the United States because the old formulations, which are easier to abuse, are unavailable in the United States,” the alert stated. The United States will face a similar decision about whether to approve generic versions of powerful painkillers. A U.S. patent on the original formulation of OxyContin will expire next April, the article notes. Generic versions of the painkiller Opana will become more widely available on January 1, unless the Food and Drug Administration (FDA) takes action.

“We’ve got a big problem coming up here,” April Rovero, President of the National Coalition Against Prescription Drug Abuse, told the newspaper. “It’s horrifying to think of what’s going to befall us when these drugs hit the market.”

U.S. Representative Harold Rogers of Kentucky met with FDA officials last week to urge them not to allow generic versions of OxyContin and Opana. “I am frustrated beyond belief,” he said. “If we don’t address these issues before January 1, we are going to face a fresh wave of deaths, which is totally avoidable.”

New Poll Finds 51 Percent of Americans Support Legalization of Marijuana

A poll released Wednesday finds 51 percent of Americans support legalizing marijuana, while 44 percent oppose it. Men and younger voters are more likely to support legalization, Reuters reports. The Quinnipiac University poll was released a month after voters in Colorado and Washington state approved the recreational use of marijuana. The drug remains illegal under federal law. “With the use of marijuana for medicinal purposes legal in about 20 states, and Washington and Colorado voting this November to legalize the drug for recreational use, American voters seem to have a more favorable opinion about this once-dreaded drug,” Peter Brown of the Quinnipiac University Polling Institute said in a news release. Two-thirds of voters under age 29 support legalizing marijuana; a majority of voters over age 65 oppose the idea. “It seems likely, however, that given the better than two-to-one majority among younger voters, legalization is just a matter of time,” Brown said. The poll found 59 percent of men, and 44 percent of women, want marijuana to be legalized.

What does rising prescription drug abuse mean for the war on drugs?
The drugs of choice for an increasing number of Americans are prescription painkillers. Nowhere is the problem more apparent than Houston, where the renowned medical center area has become “a national hotspot for prescription drug abuse,” according to a recent story in the Houston Chronicle. The paper reported in November that a Drug Enforcement Administration operation dubbed “King of the Pill” shut down “pill mills” in raids that were the culmination of an eight-month investigation involving 14 state and local agencies.  As policymakers grapple with how to address this growing problem — including a quiet reassessment of U.S. policies that focus on keeping illegal drugs out of the country — drug policy experts at the Baker Institute ask: What does rising prescription drug abuse mean for the “war on drugs”? Nonresident drug policy fellow Gary Hale, former chief of intelligence in the Houston Field Division of the Drug Enforcement Administration, leads off this three-day installment of Baker Institute Viewpoints by laying out the scope of the problem.

Prescription drug abuse is the nation’s fastest-growing drug problem. Some studies suggest that it has reached epidemic proportions, with prescription drugs being the second-most abused category of drugs after marijuana. Some people experiment with prescription drugs because they think they will help them have more fun, lose weight, fit in, or study better. The National Survey on Drug Use and Health shows that in 2009, nearly one-third of teens using drugs for the first time chose to experiment with a prescription drug. The same study shows that more than 70 percent of people who abused prescription pain relievers got them from family members or acquaintances, while approximately 5 percent got them from a street dealer or via the Internet. There is also a misguided belief that “medications” are safer than illegal drugs because they are prescribed by a medical doctor. Doctors are reportedly prescribing more drugs for more health problems than in the past, and Internet pharmacies often provide prescription drugs without any form of verification. The rest of the story is available here.

New Iowa 'CALCohol' site tallies alcohol content in drinks

With a proliferation of extra-large flavored malt beverages on the market, the Iowa Alcoholic Beverages Division has created a new mobile site that calculates alcoholic content based on listed proof and size of a drink. The site, called CALCohol, can also give the recommended serving suggestion for any type of alcoholic beverage, as long as a user knows the alcohol content. “The industry is changing, and we’re seeing products that fall into the traditional beer category that are significantly higher proof than what beer traditionally would be,” explained Tonya Dusold, communications director of the state-run alcohol industry regulator. “Someone sits down to have a beer, and that one beer is multiple servings of alcohol.” A traditional beer generally contains 5 percent alcohol by volume. One serving, according to USDA guidelines, is 12 ounces. But some specialty drinks, including wine coolers, ciders and flavored malt liquor, can contain 8, 12 or even 20 percent alcohol by volume. A 24-ounce can of a Four Loko-type drink could equal more than four regular beers. Unlike nonalcoholic beverages, the packaging is not required to break down the can’s contents per serving — only the alcohol by volume or proof.

“As the marketplace trends to flavored and sweeter products, it becomes more difficult for the consumer to be aware of how much alcohol they are consuming,” said Iowa Alcoholic Beverages Commission Chairman Jim Clayton in a news release. “CALCohol is a tool that will quickly identify the number of standard servings and may show, on some occasions, one drink is more than enough.”

Iowa Interactive built the CALCohol site at no cost to the state’s Alcoholic Beverages Division. According to Dusold, this is the first site of its kind, and the division is hoping it will catch on in other states. Jeff Bruning, an owner of El Bait Shop, said the website could be useful for customers sampling the bar’s 250-plus beer menu. “I think anything that helps people figure out how much they’ve been drinking is a good thing,” Bruning said.

“We have a beer that’s 15 percent alcohol by volume,” Bruning explained. “A Coors Light is a 4.2 ABV. If that’s what drinking beer is to them, when they come and have something like that, that might throw them off.”

The beer Bruning referred to, Founders Brewing’s Bolt Cutter, is a barley wine that he serves in 10-ounce portions (that’s 2.5 drinks, according to CALCohol). But Bruning has seen other bars pour Bolt Cutter into a pint glass. “That’s irresponsible,” he said. “If you drink two of those pints, it’s like drinking two bottles of wine.” The calculator, he said, could prove handy for educating customers as well as servers. “We’re definitely down for it,” he said.

Rule Provides Flexibility in Dispensing Buprenorphine for Opioid Addiction Treatment
SAMHSA issued a Federal rule to allow patients being treated through an Opioid Treatment Program (OTP) to receive take-home supplies of buprenorphine from an OTP in a more flexible manner. Buprenorphine is a medication used in opioid addiction treatment. The regulation takes effect on January 7, 2013. Under the rule change, OTPs will be permitted to dispense buprenorphine to eligible patients without having to adhere to previous length of time in treatment requirements. Currently, OTPs require a person to be in treatment a certain amount of time before being given a multiple days' supply of medicine to take home. The change in the rule will not affect requirements for dispensing methadone—the other opioid agonist treatment medication used by OTPs. SAMHSA based the change in the restrictions for dispensing buprenorphine on several factors. These include differences in the abuse potential between methadone and buprenorphine, as well as the actual abuse and mortality rates (buprenorphine is lower in each instance). For more information on the rule, go to: [PDF - 297 KB].

E-Cigarette Companies to Begin Advertising on Television

Marketers of e-cigarettes are introducing ad campaigns that borrow ideas from older cigarette commercials, The New York Times reports. The commercials have been accepted by several cable channels, but no broadcast networks have yet agreed to carry them. Local broadcast stations in major markets including New York, Los Angeles, Chicago, Dallas, San Francisco and Seattle have also agreed to run the ads, the article notes. E-cigarettes are not covered by restrictions on using commercials to sell tobacco cigarettes, because they are not tobacco products. Ads for one e-cigarette product, Njoy King, include the theme “Cigarettes, you’ve met your match,” while the theme for Blu eCigs is “Rise from the ashes.” Some celebrities have begun to endorse the products. The ad budget for Njoy King is estimated at $12 to $14 million for the next six months, according to the newspaper. The campaign includes television commercials, ads in print, in stores and online, and events in restaurants and clubs. Earlier this year, one industry expert predicted that e-cigarettes, currently a small but growing part of the tobacco market, eventually could surpass traditional cigarettes to become a leading tobacco product. E-cigarettes are designed to deliver nicotine in the form of a vapor, which is inhaled by the user. They usually have a rechargeable, battery-operated heating element, a replaceable cartridge with nicotine or other chemicals and a device called an atomizer that converts the contents of the cartridge into a vapor when heated. E-cigarettes often are made to look like regular cigarettes.

CAUTION - This New 'Faces Of Meth' Ad Is Utterly Harrowing

Eight years ago, the Multnomah County Sheriff's Office launched a campaign called "the Faces of Meth" to address Oregon's methamphetamine problem. The images showed the jarring effects of meth on addicts' faces through before-and-after pictures from their arrest records. recently followed suit with this infographic. Warning: these images are disturbing. Read more:

Opioid Overdose Treatment and Prevention: Often Overlooked at Community Level
While many programs aimed at prescription drug abuse focus on how to stop diversion of medications, an often overlooked but critical issue is preventing and treating opioid overdoses, according to a Brown University researcher. Traci Green MSc, PhD, Assistant Professor of Emergency Medicine and Epidemiology, studied prescription opioid overdoses in three communities in Connecticut and Rhode Island that were experiencing a rash of deaths from opioid overdoses in 2009. Please click here to read the rest of this story.

Men and Women Are Helped Differently by Alcoholics Anonymous
Men and women benefit in different ways from Alcoholics Anonymous (AA), a new study suggests. Men benefit more from avoiding companions who encourage drinking and social situations in which drinking is common, according to Health24. Women benefit from the program by having increased confidence in their ability to avoid alcohol when they feel sad, anxious or depressed. “Men and women benefit equally from participation in AA, but some of the ways in which they benefit differ in nature and in magnitude,” lead researcher John F. Kelly, PhD, of the Massachusetts General Hospital Center for Addiction Medicine said in a news release. “These differences may reflect differing recovery challenges related to gender-based social roles and the contexts in which drinking is likely to occur.” One-third of AA’s members are women, the article notes. The researchers studied more than 1,700 participants in AA, 24 percent of whom were women. They were enrolled in a study called Project MATCH that compared three alcohol addiction treatment approaches. The study tracked participants’ success in maintaining sobriety and whether they attended AA meetings. It also evaluated specific measures, such as participants’ confidence in their ability to stay sober in certain situations.
In both men and women, AA participation increased confidence in the ability to deal with high-risk drinking situations, and increased the number of social contacts who supported their recovery efforts. For men, the effect of both of those changes on the ability to stay sober was twice as strong, compared with women in the study. Women were much more likely than men to benefit from improved confidence in their ability to stay away from alcohol when they were sad or depressed.
The study appears in Drug and Alcohol Dependence.

Federal Government Considers Legal Options Against State Marijuana Laws

Federal officials are weighing their options for legal action against Washington and Colorado’s new marijuana laws. Such action could undermine the laws, which legalize the recreational use of the drug. Officials in the White House and Justice Department have been holding meetings to discuss the government’s response to the laws, according to The New York Times. Marijuana use is illegal under the federal Controlled Substances Act. The federal government could sue the states, on the grounds that efforts to regulate the drug are pre-empted by federal law, the article notes. If the Justice Department won that case, both initiatives could be struck down. The question of how to respond to the laws is a thorny one for President Obama, because legalization of marijuana is popular among liberal Democrats who voted for him, according to the newspaper. Several federal officials said the issue raises complex legal and policy considerations. These include the impact of international anti-drug treaties, enforcement priorities and strategies for litigation. Federal prosecutors could bring cases against low-level marijuana users in Washington or Colorado. They would wait for a defendant to make a motion to dismiss the case because marijuana is now legal in their state, and then obtain a court ruling that federal law trumps the state measure. Another option is for the Justice Department to file lawsuits against both states, to prevent them from setting up systems that would regulate and tax the drug. The government also could cut off federal grants to Colorado and Washington unless their legislatures restored laws forbidding marijuana use.

War on drugs a trillion-dollar failure
By Richard Branson, Special to CNN
In 1925, H. L. Mencken wrote an impassioned plea: "Prohibition has not only failed in its promises but actually created additional serious and disturbing social problems throughout society. There is not less drunkenness in the Republic but more. There is not less crime, but more. ... The cost of government is not smaller, but vastly greater. Respect for law has not increased, but diminished." This week marks the 79th anniversary of the repeal of Prohibition in December 1933, but Mencken's plea could easily apply to today's global policy on drugs. We could learn a thing or two by looking at what Prohibition brought to the United States: an increase in consumption of hard liquor, organized crime taking over legal production and distribution and widespread anger with the federal government. Click here to read the rest of the story.

Vet Never Opened Medals Drawer After Army Addictions
For a while when she was living on the streets, Nira Williams sold beer for $1 a can to the drunks who hung out at the shelters in Phoenix. She didn’t imbibe herself. Alcohol, she said, is one thing she didn’t get hooked on when she was in the U.S. Army.  The former private first class said she became an addict -- to prescription painkillers, to heroin, to most any drug she could score -- while stationed in Iraq, Germany and Texas. She wasn’t tested in the combat zone, she said, “but I was dirty for sure.” She was kicked out because of her heroin abuse in October 2010. Then she was homeless.  The rest of the story is available here.