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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.

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