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Friday, April 27, 2012

ATOD weekly news recap - Week ending April 27th

High School Seniors Who Misuse Prescription Narcotics. Most Likely to Obtain Drugs from a Friend/Relative or a Personal Prescription

Nearly one in ten U.S. 12th graders reported using prescription narcotics without a doctor’s order in the past year, according to data from the 2011 Monitoring the Future survey. Users of prescription narcotics were most likely to report getting the drugs for free from friends or relatives (70%), followed by buying them from a friend or relative (40%,) and getting them from their own prescription (35%). These findings are similar to those of the National Survey on Drug Use and Health (NSDUH), which asks about the use of prescription pain relievers that were not prescribed for the user or were used only for the experience or feeling the drug causes. Reducing the available supply of prescription drugs in households (e.g., through prescription drug take-back programs) and limiting over prescribing and doctor shopping (e.g., through prescription drug monitoring programs) may help reduce the diversion of prescription pain relievers for nonmedical use.
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Teens End Up In Emergency Room After Drinking Hand Sanitizer

After six teenagers suffered alcohol poisoning from drinking hand sanitizer in California, public health officials are warning parents to look out for signs of abuse.

The teens showed up in two emergency rooms in the last few months, the Los Angeles Times reports. Some of them used salt to separate the alcohol from the hand sanitizer. This makes it a drink that is similar in potency to a shot of hard liquor, the article notes.

“All it takes is just a few swallows and you have a drunk teenager,” Cyrus Rangan, Director of the Toxics Epidemiology Program at the Los Angeles County Department of Public Health, told the newspaper. “There is no question that it is dangerous.” He said while there have been few cases so far, drinking hand sanitizer could become a trend. He pointed out teens can easily and inexpensively purchase it, and they can find instructions online about how to distill it.

Liquid hand sanitizer is 62 percent ethyl alcohol, and can make a 120-proof liquid. After a few drinks, a person can become so drunk that they need to be monitored in the emergency room.
This is the latest over-the-counter product teens have begun using to get a quick high. “Over the years, they have ingested all sorts of things,” said Helen Arbogast, Injury Prevention Coordinator in the Trauma Program at Children’s Hospital Los Angeles. “Cough syrup had reached a very sexy point where young people were using it….We want to be sure this doesn’t take on the same trend.”
Experts advise parents to buy foam hand sanitizer instead of the gel type, because it is more difficult to extract alcohol from it. Don’t leave it around the house, and monitor it as you would any other liquor or medicine, Arbogast recommends. She also tells parents to watch for signs of intoxication.
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Survey: Prescription Painkiller Abuse Often Starts With Free Pills From Friends, Family

A new national survey finds people who abuse prescription painkillers for the first time often get their pills for free from family or friends. Those who chronically abuse prescription painkillers are more likely to obtain the pills from doctors or dealers, USA Today reports. An analysis of data from the National Survey on Drug Use and Health, scheduled to be released on Wednesday, found more than two-thirds of those who said they had gotten high on painkillers for the first time in the past year received the pills from family or friends.
The survey estimates 2.4 million Americans start abusing prescription drugs annually. About one-third of new users are adolescents, according to the newspaper. Almost 6 percent of young adults ages 18 to 25, and 3 percent of teenagers, say they regularly get high on prescription drugs. Two-thirds of people who used painkillers to get high less than once a week got pills for free, or stole them from a relative or friend, the survey found. Among regular users, 28 percent said they bought the pills from a relative, friend, drug dealer or online. Twenty-six percent had prescriptions from at least one doctor.
Saturday, April 28 is National Prescription Drug Take-Back Day, the article notes. The event, sponsored by the Drug Enforcement Administration, provides an opportunity for people who have accumulated unwanted, unused prescription drugs to safely dispose of them.
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Animal Study Suggests Link Between Binge Eating and Other Addictive Behaviors

A study of rats suggests a link between binge eating and the development of other addictive behaviors.
The researchers, from Penn State College of Medicine, note substance abuse is common in people who engage in binge eating, PsychCentral reports. “Substance abuse and binge eating are both characterized by a loss of control over consumption,” said lead researcher Patricia Sue Grigson, PhD.  “Given the common characteristics of these two types of disorders, it is not surprising that the co-occurrence of eating disorders and substance abuse disorders is high. It is unknown, however, whether loss of control in one disorder predisposes an individual to loss of control in another.”

Dr. Grigson divided the rats into four diet groups: normal chow, continuous access to optional dietary fat, one hour of access to optional dietary fat daily, and one hour of access to dietary fat three days a week. The researchers then assessed the rats’ cocaine seeking and using behavior. Rats that only had access to fat three days a week developed binge-eating behavior. This group tended to use more cocaine, tried to get the drug when it was not available and worked harder to get the drug, compared with the other rats. The rats that had continuous access to fat ate more fat than any other group, but were three times less likely to show addictive behaviors than the rats that only could eat fat three days a week.

“While the underlying mechanisms are not known, one point is clear from behavioral data: A history of bingeing on fat changed the brain, physiology, or both in a manner that made these rats more likely to seek and take a drug when tested more than a month later,” Dr. Grigson said in a news release. Her study, published in Behavioral Neuroscience, suggests that conditions that promote excessive behavior toward one substance can increase the odds of excessive behavior toward another, the article notes.
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Almost Two-Thirds of Americans Don’t Follow Doctor’s Orders on Prescription Drugs

New research indicates almost two-thirds of Americans do not follow their physician’s orders correctly when they take prescription drugs. They don’t take their medication, or use pills that were not intended for them, The Wall Street Journal reports.

The findings come from Quest Diagnostics, which analyzed about 76,000 urine samples submitted last year from physicians’ offices and the company’s patient service centers. The results were compared with doctors’ records of the medications prescribed for each patient. The study found many of the drugs patients took that were not prescribed for them were painkillers, sedatives or amphetamines. Overall, 63 percent of patients taking prescription drugs did not use them as prescribed by their doctor. Forty percent of patients misusing medication had been prescribed drugs, but were not taking any, the newspaper reports.
Quest says these results suggest some people cannot afford medication, are skipping treatments or are diverting them to the black market. The remaining 60 percent of patients who misused drugs were taking medications that were not prescribed by their physicians.

Many patients combined drugs without a doctor’s oversight, the study found. Jon R. Cohen, Quest’s Chief Medical Officer, noted this can be dangerous, because some medications can interact with each other.
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Urban youth who have been bullied or bully others may be at increased risk of suicide according to new research

According to new research published in the Journal of Adolescent Health in March 2012, concludes that urban youth who have been bullied as well as those who have bullied others are at increased risk of suicidal ideation and suicide attempts.  The purpose of the study was to determine whether involvement in bullying as a perpetrator, victim, or both victim and perpetrator (victim-perpetrator) was associated with a higher risk of suicidal ideation or suicide attempts among a multiethnic urban high school population in the United States.
In 2008, a total of 1,838 youth in 9th–12th grades attending public high school in Boston, MA, completed an in-school, self-reported survey of health-related behaviors. Logistic regression was used to evaluate the relationship between bullying behaviors and self-reported suicidal ideation and suicide attempts within the 12 months preceding the survey.

Students who reported having been involved in bullying as a perpetrator, victim, or victim-perpetrator were more likely than those who had not been involved in bullying to report having seriously considered or attempted suicide within the past year. When age, race/ethnicity, and gender were controlled, students who were victim-perpetrators of bullying were at highest risk for both suicidal ideation and suicide attempt.
For more information regarding the study, click here.
Source: The Promising Practices Network, RAND Corporation
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Opioid-Overdose Antidote Being More Widely Distributed to Those Who Use Drugs

The opioid-overdose antidote naloxone is being more widely distributed to people who use drugs, according to the Associated Press. While many public health officials say it saves lives, critics argue that making the antidote easily available could make people less likely to seek treatment.

Naloxone, sold under the brand name Narcan, safely reverses the potentially fatal side effects of an overdose of oxycodone, heroin and other opioids. It has been routinely used by emergency rooms and ambulance crews for decades, the AP notes. In the past few years, Naloxone has been distributed free to opioid users and their loved ones, in a growing number of sites around the country. A recent report by the Centers for Disease Control and Prevention (CDC) found that widely distributing Naloxone, and training people in how to use it, could save many lives. It has successfully reversed more than 10,000 drug overdoses since 1996, according to the CDC report. Naloxone is not effective in treating drug overdoses that do not involve opioids. Fifteen states and the District of Columbia have programs to distribute naloxone in the community. The programs train people to identify signs of an overdose and provide naloxone to people who use drugs and their loved ones.
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Friday, April 20, 2012

Weekly ATOD News Recap - Week-ending April 20, 2012

A Drug Policy for the 21st Century

By: Kathleen Sebelius, Secretary of Health and Human Services, Eric Holder, U.S. Attorney General and Gil Kerlikowske, Director of the White House Office of National Drug Control Policy

Illegal drugs not only harm a user’s mind and body, they devastate families, communities, and neighborhoods. They jeopardize public safety, prevent too many Americans from reaching their full potential, and place obstacles in the way of raising a healthy generation of young people.

To address these challenges, today we are releasing the 2012 National Drug Control Strategy – the Obama Administration’s primary policy blueprint for reducing drug use and its consequences in America. The President’s inaugural National Drug Control Strategy, published in 2010, charted a new direction in our approach to drug policy. Today’s Strategy builds upon that approach, which is based on science, evidence, and research. Most important, it is based on the premise that drug addiction is a chronic disease of the brain that can be prevented and treated. Simply put, we are not powerless against the challenge of substance abuse – people can recover, and millions are in recovery. These individuals are our neighbors, friends and family members. They contribute to our communities, our workforce, our economy, and help make America stronger.

Our emphasis on addressing the drug problem through a public health approach is grounded in decades of research and scientific study. There is overwhelming evidence that drug prevention and treatment programs achieve meaningful results with significant long-term cost savings. In fact, recent research has shown that each dollar invested in an evidence-based prevention program can reduce costs related to substance use disorders by an average of $18.

But reducing the burden of our Nation’s drug problem stretches beyond prevention and treatment. We need an all of the above approach. To address this problem in a comprehensive way, the President’s new Strategy also applies the principles of public health to reforming the criminal justice system, which continues to play a vital role in drug policy. It outlines ways to break the cycle of drug use, crime, incarceration, and arrest by diverting non-violent drug offenders into treatment, bolstering support for reentry programs that help offenders rejoin their communities, and advancing support for innovative enforcement programs proven to improve public health while protecting public safety.

Together, we have achieved significant reform in the way we address substance abuse. And the Affordable Care Act will – for the first time - require insurers to cover treatment for drug addiction the same way they would other chronic diseases. This is a revolutionary shift in how we address drug policy in America.

Over the past three decades, we have reduced illegal drug use in America. Over the long term, rates of drug use among young people today are far lower than they were 30 years ago. More recently cocaine use has dropped nearly 40 percent and meth use has dropped by half. And we can do more. As President Obama has noted, we have successfully changed attitudes regarding rates of smoking and drunk driving, and with your help we can do the same with our illegal drug problem.
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Substance Abusers, Even Recovering Ones, May Face Stigma

Scenarios of obese people, smokers drew less negative reaction in study


People are more likely to disapprove of and avoid substance abusers than those who smoke or are obese, according to a new study. Participants were presented with six fictitious scenarios about a person who either abused substances such as alcohol or drugs, smoked, or was obese. "Specifically, participants rated their willingness for the individual in the fictitious scenario to marry into their family, be friends, socialize, work on a job, be a neighbor, and have one's child date," study author Lindsay Phillips, an assistant professor of psychology at Albright College in Reading, Pa., said in a college news release.

As expected, "people who were actively using substances were the most highly stigmatized group, receiving a high level of reported intention to be socially distant from the individual," Phillips said.

The results support previous research that found substance abusers were more stigmatized than people with depression or schizophrenia. However, this new study also found that even former substance abusers still face high levels of social scorn. "Although being in remission results in substantially less stigma for smoking and obesity, stigma is only slightly decreased for individuals in remission from substance use," Phillips said. The findings are troubling because past studies have suggested that stigma can discourage substance abusers from seeking help and make them believe that they can't change their ways, Phillips said.

The study is published online in the Journal of Substance Use.
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Teens Say Drinking and Driving Riskier Than Texting and Driving, Survey Finds

A new survey finds U.S. teens think drinking and driving is riskier than texting and driving, despite research that indicates they can be equally dangerous. The State Farm survey included 652 teens ages 14 to 17. Of the teens who intend to have or already have a driver’s license, 57 percent strongly agree that regularly drinking while driving eventually would be deadly, while 35 percent strongly agreed that if they regularly text and drive they will be killed someday. Among teens with a driver’s license, 57 percent admitted to texting while driving, UPI reports. The adolescents who said they did not text while driving were much more likely to report having frequent conversations with their parents about safe driving, the article notes.
Chris Mullen, Director of Technology Research at State Farm, said research indicates the consequences of texting while driving can be as dangerous as drunk driving.
Teens who refrained from texting while driving were much more likely to report having frequent talks with their parents about safe driving. Once teenagers receive their license, there is a sharp dropoff in conversations between parents and teens about driving, the survey shows. “The conversation should not end when teens get their license,” Mullen said in a news release. “Through this survey and other teen driver research, we know that ongoing parental involvement in the learning process is key to keeping teen drivers safe behind the wheel.” The results of the survey are virtually unchanged from a similar survey conducted in 2010.
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Substance Use More Highly Stigmatized Than Smoking or Obesity, Study Suggests

People who abuse substances are more likely to be stigmatized than those who smoke or are obese, a new study suggests. The study of 161 adults presented participants with six fictitious scenarios about people who either abused substances, smoked or were obese, according to HealthDay. “Specifically, participants rated their willingness for the individual in the fictitious scenario to marry into their family, be friends, socialize, work on a job, be a neighbor, and have one’s child date,” study author Lindsay Phillips of Albright College in Reading, Pennsylvania, said in a college news release. She found people who were actively using substances were the most highly stigmatized group. The study found even people who formerly abused substances still face high levels of stigma. Phillips said this was troubling, because previous research has suggested stigma can discourage people from seeking help for substance abuse, and make them believe they cannot change their ways. The findings are published in the Journal of Substance Use.
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Sharp Increase in Prescription Drug Poisonings Among Teens Reported

Poisoning deaths among teenagers rose 91 percent between 2000 and 2009, primarily due to prescription drug abuse, according to a new report by the Centers for Disease Control and Prevention (CDC). Prescription drug abuse appears to be replacing marijuana as a “gateway drug” that leads to the abuse of harder drugs, said Dr. Julie Gilchrist of the CDC’s Division of Unintentional Injury Prevention. Overall, death rates from unintentional injuries of children and teenagers decreased by almost 30 percent between 2000 and 2009, in large part because of a 41 percent drop in motor vehicle deaths, according to the Los Angeles Times. Drug poisoning deaths among teens could be reduced by appropriate prescribing, proper storage and disposal, discouraging sharing of medication, and state-based prescription drug monitoring programs, the CDC stated in a press release. According to the agency, the percentage of poisoning deaths among teens ages 15 to 19 with prescription drugs as a contributing cause rose from 30 percent in 2000, to 57 percent in 2009.
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Depression, Anxiety Top Reasons Older Adults Abuse Drugs or Alcohol, Survey Finds

Depression and anxiety are the top reasons older adults abuse drugs or alcohol, according to a study by a Florida drug and alcohol treatment and recovery center. The study, conducted by the Hanley Center, found 63 percent of older adults blamed depression and anxiety for their substance use. Thirty percent said economic and financial stress was to blame, while 20 percent cited retirement as contributing factors to dependency. Almost half of survey respondents named both prescription drugs and alcohol as their substance of choice, according to a press release by the Caron Treatment Centers, which owns the Hanley Center.
“Older adults face a distinct set of changes and challenges as they enter their golden years,” said Dr. Barbara Krantz, Medical Director of Hanley Center. “This transitional period of life is challenging, and may lead to difficulty in dealing with stressful situations, such as an early retirement or new financial strains, which in turn may lead to serious anxiety and depression. Without the proper tools to manage their emotions, baby boomers and seniors may turn to quick fixes such as alcohol and drugs, creating the perfect storm for dependency.” Treatment admissions doubled in adults age 50 and over between 1992 and 2008, according to the Substance Abuse and Mental Health Services Administration. The Miami Herald reports that senior adult admissions in centers such as Hanley for prescription drug abuse have jumped 450 percent since 2000. Unintentional overdose is the second leading injury-related cause of death among seniors, the article notes.

The elderly often suffer from memory loss, mild cognitive impairment or Alzheimers, leading them to take too much medication, mix incompatible medications, or forget to take them. If they drink alcohol and take medication, the combination can be dangerous.
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Teen Use of Ecstasy and Speed Linked With Developing Depression

A new study links teenagers’ use of Ecstasy and speed (methamphetamine and/or amphetamine) with a higher risk of developing depression. The study did not prove the drugs caused depression, according to HealthDay. The study of almost 3,900 10th graders in Quebec found that, compared with teens who didn’t use the drugs, those who said they used either speed or Ecstasy had a 60 to 70 percent increased risk of showing signs of depression a year later. Those who had tried both speed and Ecstasy had twice the risk for developing depressive symptoms, the researchers report. They note the drugs could have an effect on hormone levels involved in mood control. It is also possible that those who use the drugs are influenced by other users who have their own issues and mood problems. “Our findings are consistent with other human and animal studies that suggest long-term negative influences of synthetic drug use,” co-author Frédéric N. Brière of the University of Montreal said in a news release. The study is scheduled to appear in the Journal of Epidemiology and Community Health.
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Understanding the Marijuana Withdrawal Syndrome

For many years now, addiction professionals have proclaimed of a noticeable syndrome developing with users who suddenly stop smoking marijuana. A hallmark phenomenon that occurs with the use of powerful stimulant and depressant drugs, withdrawal syndrome is an uncomfortable and often painful experience that results from extended, chronic administration of a drug. Typically a withdrawal syndrome presents with symptoms that appear to be the exact opposite of an abused drug's direct effects. Until recently, DSM-IV failed to include marijuana withdrawal as a syndrome worthy of diagnosis and treatment. But the National Epidemiologic Survey on Alcohol and Related Conditions examined a group of over 1100 regular marijuana users who did not binge drink or regularly use other drugs or narcotics. The respondents in the survey pointed to a marked set of symptoms that were experienced when they suddenly stopped the consumption of marijuana, the symptoms immediately resolved when marijuana use was restarted [1]. Withdrawal and abstinence syndrome symptoms are attributed to the action that THC and other cannabinoids have on sensitive receptors in the mid-brain. Cannabinoid receptors and relevant transmitters are not entirely understood but are known to influence serotonin, dopamine, acetylcholine and GABA in the brain.

Respondents to the marijuana withdrawal syndromes survey represented 44% of all those who admitted to regular use of marijuana. Those who responded to the survey reported three or more symptoms of cannabis withdrawal syndrome. Two types of withdrawal symptoms emerged in the survey: somatic and psychological. Somatic-related symptoms of withdrawal included weakness, psychomotor retardation and sleep disturbances. Psychological symptoms included depression, hyper anxiety and panic disorder. Respondents who experienced personality disorders concurrent to the use of cannabis found that the underlying personality problem was exacerbated and more pronounced upon withdrawal from marijuana.

This study points to the difficulties that a substantial number of marijuana users have in trying to stop using the drug and/or in maintaining periods of sobriety or non-use. Not all marijuana users experience this syndrome when they try to quit, but this survey reveals that a very substantial minority does have to weather the symptoms and discomfort. Motivated addicts may find it very difficult to stop marijuana use and may need pharmacologic assistance in completing the task. Additionally, the research indicates that people seeking to stop marijuana abuse may switch to other drugs of abuse to ease the discomfort and pain of withdrawal. Authors and experts associated with this study argue for cannabis withdrawal syndrome inclusion in DSM-V.

For community corrections and rehabilitation professionals, marijuana abuse is no laughing matter. Ignoring use and abuse of marijuana as nothing more than a harmless vice is unwise, especially in light of still increasing purity in THC concentration of commercial grade marijuana sold on the street. Prior essays in the MEDTOX Journal have cast light on the profound effects that cannabis use has on the anatomy of the brain and the functioning of the limbic system. Marijuana abuse should be taken seriously by all professionals who work with those who smoke it. Efforts should be made to guide marijuana users to programs and experts who specialize in the treatment of that type of addiction and dependency.
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U.S. Loss Due to Child Abuse and Neglect Is a Staggering $124 Billion
Knowledge of the link between child maltreatment and physical, behavioral, and emotional problems is widespread. But what hasn't been so transparent is the financial impact of child abuse and neglect. That is, until a recent study conducted by the Centers for Disease Control and Prevention (CDC). According to the CDC report, the total lifetime estimated financial costs associated with one year of confirmed cases of child maltreatment is approximately $124 billion. This estimated figure is based on:
• childhood health-care costs
• adult medical costs
• productivity losses
• criminal justice costs
• special education costs

"Federal, state, and local public health agencies as well as policymakers must advance the awareness of the lifetime economic impact of child maltreatment and take immediate action with the same momentum and intensity dedicated to other high profile public health problems -- in order to save lives, protect the public's health, and save money," said Dr. Degutis, director of the CDC's National Center for Injury Prevention and Control.
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FDA Issues Warning on Children’s Accidental Exposure to Fentanyl Pain Patches

The Food and Drug Administration (FDA) has issued a safety alert about fentanyl painkiller patches, warning that young children are at risk of death if they are accidentally exposed to the patches. The FDA said a majority of the 26 cases of accidental exposure to the patches since 1997 have involved children below the age of 2, Reuters reports.

Fentanyl is sold under the brand name Duragesic, and is also available as a generic product, according to the FDA. Fentanyl is a powerful opioid pain reliever. It releases the medication over the course of three days. If a child swallows the patch or applies it to his or her skin, it can cause death, by slowing breathing and raising carbon dioxide levels in the blood. A partially detached patch worn by an adult holding an infant could end up becoming attached to the child, the FDA notes. Toddlers can find lost, discarded or improperly stored patches and swallow them or stick them on themselves, thinking they are a sticker or bandage. Fentantyl patch users should keep them in a secure location that is out of children’s sight and reach, the FDA advises. Cover the patch with adhesive film so it does not come off, and check throughout the day to ensure it is still in place.

To dispose of a patch, fold it in half with the sticky sides meeting, and flush it down the toilet. Do not put patches in the household trash, where they can be found by children or pets.
“FDA recognizes that there are environmental concerns about flushing medicines down the toilet,” the agency said on its website. “However, FDA believes that the risk associated with accidental exposure to this strong narcotic medicine outweighs any potential risk associated with disposal by flushing.”
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Commentary: Teen Alcohol Use — Parents Have More Influence Than They Think

Underage drinking is in part a youth problem, but it’s also an adult issue. Over half of all high school age drinkers get their alcohol from an adult, according to SAMHSA’s National Survey on Drug Use and Health. Plus, half of those adults providing alcohol are parents or other family members. Although adults can be part of the underage drinking problem, they can also be part of the solution. About three-quarters of teens say parents are the biggest influence on their decision on whether or not to drink.

Most parents want to do the right thing, but don’t know how. Part of that can be knowledge – one out of every five teens binge drink, but only one out of every 100 parents think their teen binge drinks. Sometimes parents take an authoritarian style of parenting that causes them to lose their ability to influence their teen through reason. While others take a hands-off approach, or allow their teen to drink under their supervision, which makes it even more likely that their teen will drink more when away from their parents.

Fortunately, Mothers Against Drunk Driving (MADD) has teamed up with Dr. Robert Turrisi of Pennsylvania State University to create the Power of Parents handbook. Based on Dr. Turrisi’s research, this handbook gives proven tips on how to talk with your teens about alcohol in a productive, positive way. Parents who read the handbook and have the intentional conversation with their teens about alcohol can reduce underage drinking behaviors by as much as 30 percent. We encourage you to start the conversation this Saturday, April 21st, PowerTalk 21 day — the national day for parents to start talking with their kids about alcohol.

Here are some tips from Dr. Turrisi’s research:
  1. Communicate before a problem starts. It’s important to have discussions before incidents happen – prior to any blaming, anger, or punishment.
  2. Discuss rules and consequences. Explaining how and why you expect your teen to behave, should allow for rational discussion of a sometimes emotional issue. Still, it’s important to impart that you don’t want your teen drinking. Discuss and agree on consequences of broken rules.
  3. Show you care. Sometimes a gentle touch can help show affection for your teen during this tough conversation. Telling your teen you love them and want them to be healthy and safe is the reason why it’s important to talk about the dangers of underage drinking together.
  4. Pay attention. Even when life is stressful, it’s important to make time to listen to your teen, know where your teen is and what your teen is doing.
  5. Share family activities, including events such as dinner, to build a bond with your teen.
  6. Give and get respect. When your teen talks to you, it’s important to listen and reply respectfully, and to insist your teen do likewise.
  7. Enforce consequences consistently. If your teen breaks the rules, stay calm and enforce the consequences you’ve agreed upon.
Jan Withers, MADD National President
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If Gambling, Games, and Sex Are Addictive, What Is Addiction?

By Stanton Peele, Addiction expert

DSM 5's announcement that the psychiatric diagnostic manual will, for the first time, call something addictive that doesn't involve substance abuse -- gambling -- has opened the floodgates. It is intriguing to consider how gambling was placed in this category, since there isn't an "addiction" task force for DSM 5, only a substance-related-disorders one. So who decided gambling was the one thing people did, other than to consume drugs and alcohol, that was addictive and how did they decide that?

Charles O'Brien, M.D., a leading "addiction = chronic-brain-disease" proponent and chair of the substance-disorders group, announced the inclusion of gambling because "pathological gambling and substance-use disorders are very similar in the way they affect the brain and neurological reward system." Thus it seems O'Brien, rather than the task force of consulting substance abuse specialists, perhaps in league with colleagues at the pinnacle of the "addiction = chronic-brain-disease" movement (like Nora Volkow), spearheaded the adoption of this position.
Where does that leave all the other candidates for inclusion in the addiction category -- leading entries for which are sex and games? For them to be included, will they also have to be "shown" to affect the same "brain and neurological reward system" as drugs and gambling? Is there any powerful experience that does not affect this system? Did O'Brien really scrutinize reams of PET scans of gamblers to find that their reward systems were impacted in the same addictive way as cocaine and alcohol abusers?

I ask because an awful lot of people claim that they are, or have been, addicted to games or to sex. Are they crazy? Didn't we discover gambling was addictive because people gave heartfelt testimony that they were addicted to gambling? Are they right while the people who claim to be addicted to games and sex are just deluded slackers?

A sensible person who is asked, "Are gambling, sex, and games addictive?" will answer, "Anything can be addictive, or not, depending on how engrossed people become in them, and how much they are damaged by it." In other words, it isn't which activities we focus on and call addictive, it is how the person engages in the experience (compulsively, unable to halt or to cut back, in ways that interfere with their functioning and that harm them) that counts.
Think about OCD and its diagnosis. Do we really care what people obsess or behave compulsively around? If a person endlessly organizes shoes, or washes his or her hands repeatedly, or locks and unlocks the door ad infinitum -- the thing they obsess over and behave compulsively towards is not really the matter. It is the pattern of behavior they engage in and its consequences for them.

Same with addiction.

Is this view of addiction "scientific"? It is actually more so than claiming -- without adequate evidence -- that a wide variety of behaviors are all traceable to some posited brain or neurochemical mechanism defined broadly enough to envelop such biologically diverse activity.

Friday, April 13, 2012

420 Provides a Chance to Counter Marijuana’s Harmful Influence on Communities

Coalitions are “re-mixing” what “420” means to youth, changing the perception that marijuana is not harmful, and are re-claiming April 20th from an unofficial marijuana smokers’ “holiday.”

Marijuana use among teens rose last year for the fourth straight year, according to the Monitoring the Future survey. In states where marijuana use is viewed by many teens as harmless, and where efforts to legalize the drug have surfaced, such as in California and Colorado, it’s not unusual to hear the local DJ do fake bong hits on air when youth are listening, at 4:20 p.m. or on April 20th.

The most widely accepted theory of "420's" origination is that in the 1970s, high school-age stoners in Northern California congregated at 4:20 p.m. daily. "420" has evolved into an unofficial marijuana holiday.

Rather than celebrating such a "holiday," educators, law enforcement officers and health advocates in Vista, Calif. want students to bungee and bounce their way to a sober and drug-free life choice at their ninth annual anti-420 event, “420 Remix, A Celebration of Sober and Drug-Free Life Choices,” on April 20.

The event, coordinated by the North Coastal Prevention Coalition, will invite 1,000 sixth-through ninth-grade students to participate in positive alternative activities after school, instead of smoking marijuana. And their parents can attend an optional presentation on “420.”

Their 420 Remix event started when counselors noted that several students in drug treatment relapsed on that day. Organizers hope that events like this will change societal norms and influence public policy, but above all, they just want kids to be kids, and enjoy themselves, substance-free, for the afternoon.

In Colorado, the Substance Abuse Coalition of Douglas County is encouraging students to “Take Back 420″ by volunteering on April 20.

The coalition organized “Take Back 420″ as a positive way for teens to reclaim April 20 as a day of rejuvenation and restoration, a day when they take their day-off to give and share. The organization is helping to coordinate day-long volunteer opportunities for Douglas County youth at various non-profit organizations and local agencies on April 20.

“The date is two days before Earth Day, and it’s the same weekend as Global Youth Service Day. These are days when people all over put their hands and hearts to work for the good of the planet and our fellow planet-dwellers,” said Carla Turner, organizer of the event and member of SAC-DC, in a news release.

“We’d like to see the youth of Douglas County make April 20th memorable for service. We’d like to emphasize the good things our teens do and celebrate all that is wonderful about our teens,” Turner said.

Marijuana is a topic of significant public discourse in the United States, and while many are familiar with the discussions, it is not always easy to find the latest, research-based information on marijuana to answer to the common questions about its health effects, or the differences between federal and state laws concerning the drug.

Confusing messages being presented by popular culture, media, proponents of “medical” marijuana, and political campaigns to legalize all marijuana use perpetuate the false notion that marijuana is harmless. This significantly diminishes efforts to keep young people drug free and hampers the struggle of those recovering from addiction.

The Office of National Drug Control Policy opposes legalization of marijuana and other drugs because legalization would increase the availability and use of illicit drugs, and pose significant health and safety risks to all Americans, particularly young people. This web-based resource center provides the general public, community leaders, and other interested people with the facts, knowledge, and tools to better understand and address marijuana in their communities.

This resource center will be regularly updated and expanded to address emerging issues, research, and prevention tools, and highlight successful local efforts to reduce marijuana use.

For more information, click here.

Wednesday, April 11, 2012

In fight against prescription drug abuse, docs need more information

By Peter W. Carmel, M.D., president, American Medical Association

Prescription drug abuse is an epidemic that cannot be ignored. According to the Centers for Disease Control and Prevention, prescription drugs are now involved in more overdose deaths than heroin and cocaine combined. Physicians are serious about combating this epidemic, but we can’t do it alone.

The National All Schedules Prescription Electronic Reporting (NASPER) bill was signed into law in 2005 to give physicians an effective tool to help address drug diversion. This legislation was designed to create prescription drug monitoring programs (PDMPs) in each state so physicians could access important information to help them appropriately treat their patients’ pain or illness while helping to prevent the abuse and diversion of controlled substances. Unfortunately, the program was never fully funded and never realized its full potential.

When properly constructed and operated, PDMPs have proven extremely effective in fighting diversion while ensuring that individuals in need of treatment for pain and suffering receive care. Due to inadequate funding, the majority of PDMPs today do not operate in real-time, are not interoperable between states and are not available to physicians at the point of care. Absent this information, patients who are intent on diverting controlled substances or “doctor shoppers” are difficult to identify.

The AMA urges passage of NASPER 2011 legislation to establish and modernize existing PDMPs so that states can ensure interstate interoperability and real time access for prescribers at the point of care. We also support efforts to harness health information technology capabilities that could make PMDP data available to physicians as part of the normal work flow of their office and emergency departments.

While access to patient prescribing information at the point of care is important, continuing medical education (CME) will also help the appropriate physicians combat prescription drug abuse, provide information about trends in abuse and help physicians work with patients on proper storage of controlled substances. The AMA offers an online CME focused on pain management and is also preparing a series of webinars on responsible opioid prescribing as part of a prescriber clinical support system led by the American Academy of Addiction Psychiatry.

We believe strongly that profession-developed educational efforts like these, rather than government mandated training programs as suggested by some, can help address this problem meaningfully while reinforcing the patient-physician relationship.

Finally, the public needs to know how and where to properly and safely dispose of controlled substances. Prescription drugs in the home are highly susceptible to diversion, misuse and abuse, and improper drug disposal can also pose a threat to the environment.

The DEA hosts periodic events to safely retrieve unused prescription drugs, and the next National Prescription Drug Take-Back Day is April 28, but there is no place for people to return unused drugs safely and legally all year. The AMA supports legislation that would address this issue, as this is an important part of the overall strategy for combating diversion.

The AMA is deeply involved and committed to efforts that will curb prescription drug abuse and diversion. We will continue to work with physicians, Congress and the public in order to find solutions that will truly help stem an epidemic that has already claimed too many lives.

Carmel, M.D., is the president of the American Medical Association. He is a pediatric neurosurgeon who practices in Newark, NJ.
Source: The Hill

Friday, April 6, 2012

ATOD News Recap for week-ending 4/6/2012

New Webzine Featuring Underage Alcohol Research
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has recently released Spectrum. This electronic publication is NIAAA’s first-ever webzine with engaging feature articles, short news updates, and colorful graphics, NIAAA Spectrum offers accessible and relevant information on NIAAA and the alcohol research field for a wide range of audiences. Each issue includes feature-length stories, news updates from the field, articles and photo essays, and an interview with an NIAAA staff member or alcohol researcher. NIAAA Spectrum is published three times a year. To view this new resources visit: http://www.spectrum.niaaa.nih.gov
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Stop Bullying.gov Relaunches
The U.S. Department of Health and Human Services and the Department of Education have unveiled an enhanced StopBullying.gov. The site encourages everyone to take action to prevent and respond to bullying.
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Study Finds Widespread Use of Alcohol and Drugs Among U.S. Teenagers
A survey of more than 10,000 U.S. teenagers found that by late adolescence, 78 percent had consumed alcohol, and about 15 percent met the criteria for alcohol abuse. The survey also found 81 percent said they had the opportunity to use illicit drugs, and 42.5 percent actually did so. Among those surveyed, 16 percent were abusing drugs, HealthDay reports. The median starting age for alcohol use was 14. For teens who were dependent on drugs, the median starting age was 14; for those who abused drugs but were not dependent, the average starting age was 15. The findings are published in the Archives of General Psychiatry. Bruce Goldman, Director of Substance Abuse Services at The Zucker Hillside Hospital in Glen Oaks, New York, who was not involved in the study, told HealthDay, “It is imperative that families, schools, police, youth groups, and communities all join together to prevent or delay the onset of substance use as long as possible. Social norms have a very powerful impact on drug-use patterns. We need to create norms where substance use and availability, especially for young people, is not acceptable.”
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New Anti-Smoking Ad Campaign Leads to Doubling of Calls to Quit Line
A new government-sponsored ad campaign, which features former smokers who discuss the negative health consequences of smoking, has led to a doubling of calls to a toll-free telephone hotline designed to help people quit smoking. The Centers for Disease Control and Prevention (CDC) said Friday that calls to 1-800-QUIT-NOW totaled more than 33,000 in the first week of the ad campaign, compared with less than 14,500 the week before. USA Today reports that during the same week, clicks to the government’s www.smokefree.gov website rose to about 66,000, from about 20,000. The campaign, which runs for 12 weeks, will cost $54 million. The CDC estimates the ad campaign will help about 50,000 smokers quit smoking.
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Tobacco Companies Must Report Levels of Dangerous Chemicals in Products
The Food and Drug Administration (FDA) says tobacco companies will have to report levels of 20 dangerous chemicals found in its products. The chemicals have been associated with cancer, lung disease and other health problems, the Associated Press reports. Companies will be required to display the information about the chemicals in a consumer-friendly format by April 2013. The substances covered by the new rule include carbon monoxide, formaldehyde and ammonia. The agency has established a list of 93 harmful and potentially harmful constituents in tobacco products, according to an FDA statement. Because the tobacco industry may be unable to make information available for all of those substances by the deadline due to current testing limitations, the FDA chose to focus initially on 20 that are representative of the full list. The FDA will take comments on the new ruling until June 4, before finalizing them, according to the AP. The 2009 Family Smoking Prevention and Tobacco Control Act gives the FDA authority to regulate the content, marketing and sale of tobacco products. The FDA also described the studies it will require before a company can market a modified-risk tobacco product. These are tobacco products that are sold, distributed, or marketed with a claim to reduce harm or the risk of tobacco-related disease. Companies will have to submit extensive data on health risks, behavior of users, and consumer understanding of marketing materials for any of these new products.
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The Truth About “Molly”
With the recent reported celebrity chatter about the drug MDMA—commonly known as Ecstasy or “Molly”—in the news SAMHSA would like to join the discussion by providing some facts about the drug and its dangers. Ecstasy is a synthetic, psychoactive drug that is chemically similar to the stimulant methamphetamine and the hallucinogen mescaline. It produces feelings of increased energy, euphoria, emotional warmth, and distortions in time, perception, and tactile experiences.
While some consider this to be a party drug, it is illegal and carries potentially dangerous side effects. Ecstasy use can produce psychedelic and stimulant side effects such as anxiety attacks, tachycardia (the heart beating more than 100 beats per minute), hypertension and hyperthermia. The variety and severity of adverse reactions associated with Ecstasy use can increase when the drug is used in combination with other substances of abuse – a common occurrence among Ecstasy users. According to a SAMHSA study, 74 percent of emergency department visits involving Ecstasy use also involve the use of at least one or more other substances of abuse. Alarmingly, this same study also shows that emergency department visits related to Ecstasy use increased nearly 123 percent from 2004 to 2009 with two-thirds of these visits involving patients aged 18 to 29.

If you or someone you know struggles with Ecstasy abuse, SAMHSA offers an online treatment locator service that can be accessed at www.samhsa.gov/treatment or by calling 1-800-662-HELP (4357).
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New Jersey Measure Would Expand Access to Court-Supervised Drug Treatment
A measure advancing in the New Jersey legislature would expand the number of criminal offenders who are eligible for court-supervised drug and alcohol treatment.
State Senator Raymond Lesniak, who was robbed at home by two men on drugs, has become the leading advocate for the legislation. The bill also would launch a pilot program in several counties that would automatically enroll low-level drug offenders in a recovery program, the Associated Press reports.

The measure was approved by the state Senate Budget Committee, and now heads to the full Senate. A similar bill is under consideration in the Assembly.
Governor Chris Christie has proposed mandatory drug treatment for all nonviolent drug offenders in New Jersey. He said his plan frees up prison space for more serious criminals, while saving the state money, by stopping the warehousing of people with drug problems.
The bill under consideration in the legislature is not as large in scope as the governor’s proposal, the AP notes. Lesniak’s bill would start with a pilot program in two counties, along with expanded statewide eligibility for offenders who volunteer for treatment.
“We don’t know that mandatory treatment is effective,” Lesniak said. He noted there are not enough treatment beds and professionals to handle a large number of new clients. “We don’t want to deny someone who volunteers for treatment because someone else was forced into treatment,” he added.
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New Technology Aims to Prevent Drunk Driving
Cars and trucks one day may have built-in blood alcohol detectors, The Wall Street Journal reports. Research on the Driver Alcohol Detection System for Safety (DADSS) is progressing more quickly than expected, and could be available within eight to 10 years, experts say.
The technology could be built into a vehicle’s dashboard or controls. It would check a driver’s blood alcohol level, and would not start if the level were above the legal limit. Researchers developing the system are working with the Alliance of Automobile Manufacturers and the National Highway Traffic Safety Administration (NHTSA).

The next goal would be to develop a commercially produced vehicle that could drive a drunk owner home, the article notes.

About one-third of drivers killed in car crashes have blood alcohol levels of 0.08 or higher, according to the Insurance Institute for Highway Safety.
Devices called alcohol interlocks are already available to disable a car if the driver is intoxicated. They are primarily used for people who have been caught with blood alcohol levels above the legal limit. About 16 states require people convicted of drunk driving to install these devices in their vehicles. Drivers must blow into a tube to verify they are sober before they can start the car.

The new technology being developed would not require blowing into a tube. It could be embedded in a starter button or shift lever.
A proposed federal transportation bill would give the NHTSA’s alcohol detector program $24 million over two years. The funding would allow the agency to equip 100 or more cars with prototypes of the new alcohol detection devices. One device would measure alcohol in the driver’s breath, while the other would take a reading from the driver’s skin.
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Underage Females Drinkers Now as Likely to Die in Car Crash as Male Peers
Underage female drinkers are now as likely to die in an alcohol-related car crash as their male counterparts, a new study suggests. In 1996, underage males had a higher risk of a fatal car crash than underage females. By 2007, the gender gap had closed, according to HealthDay.
The total number of young men who are involved in deadly alcohol-related crashes is still greater, because males drink more, the study notes. At any given blood alcohol level, however, young women have the same risk of a fatal car crash as males.

While the reasons for the increase are not clear, young female drinkers may be taking greater risks while driving, said lead researcher Robert B. Voas, PhD, of the Pacific Institute for Research and Evaluation in Calverton, Maryland. “Young women who drink and drive may be behaving more like young men who drink and drive,” he said in a news release.

The study found drivers ages 16 to 20 with a blood alcohol level of .02 percent to .049 percent were almost three times as likely to be involved in a fatal crash, compared with sober drivers of the same age. Their risk of dying in a single-vehicle crash was almost four times as high as that of sober drivers.

Sober male drivers in the study were twice as likely to be involved in a fatal car crash in 2007 compared with 1996. While the reason is not clear, the researchers speculate that distracted driving, including texting, may be the cause.

They reported their findings in the Journal of Studies on Alcohol and Drugs.
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Sales of Prescription Painkillers Increasing Across the United States, Analysis Shows
Sales of oxycodone and hydrocodone are sharply rising in areas of the United States where these prescription painkillers were not as popular in the past, according to an analysis by the Associated Press. The rise in sales is driven by an aging population with pain issues, as well as an increase in addiction, experts say.

The AP found a dramatic increase in the distribution of oxycodone between 2000 and 2010 in areas including New York’s Staten Island and Santa Fe, New Mexico. Hydrocodone use is rising in Appalachia and in the Midwest, the AP found, after analyzing data from the Drug Enforcement Administration. Painkiller sales are spreading rapidly in areas where there are few resources to treat people who become addicted.

The increase in prescription painkiller use coincides with a rise in overdose deaths and pharmacy robberies, the article notes.

The number of Americans who died from overdoses of prescription painkillers more than tripled in the past decade, according to the Centers for Disease Control and Prevention (CDC). More people now die from painkillers than from heroin and cocaine combined. An estimated 14,800 people died in the United States from painkiller overdoses in 2008, a more than threefold jump from the 4,000 deaths recorded in 1999, the CDC said in a report released last November.
While 40 states have prescription drug monitoring programs, many are not linked together, according to the AP. That means patients can go from one state to another shopping for pills. Currently there is no federal monitoring of prescription drugs at the patient level.
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For the third consecutive year, the University of Wisconsin and the Robert Wood Johnson Foundation have jointly published the County Health Rankings -- http://www.countyhealthrankings.org/ -- which measure the health of every county in the United States. The Rankings illustrate how factors such as education, income, access to healthy foods, and air quality - factors that influence health outside of the doctor's office - play a major role with respect to how long and how well people live.
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The Parent Toolkit
With 90% of addictions starting in the teen years, it's crucial to tackle substance abuse early. But preventing, detecting, and stopping dangerous behaviors can seem overwhelming. Trust us: it's not as hard as it looks. The Partnership at Drugfree.org created the Parent Toolkit to help, and you can make a huge impact by sharing it with parents you know.

The Parent Toolkit is an easy-to-use website with tips and guidelines from experts. It includes:
• Step-by-step guides on how to talk to a teen about drugs and alcohol
• Advice organized by age
• What to do if you find out that your teen is already using
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Prescription Drug Abuse Leads to Rise in Armed Robberies of Pharmacies
Law enforcement officials are reporting a rise in armed robberies of pharmacies, by drug dealers and people desperate for prescription painkillers, ABC News reports.

There has been an 82 percent increase in pharmacy robberies, from 385 in 2006, to 701 in 2011. During that time, 3,535 pharmacies have been robbed, according to the news report.

In one well-publicized case, a man in search of drugs killed four people in Long Island, New York, in June 2011. He left the pharmacy with a backpack filled with prescription painkillers.
Pharmacy robbers generally are drug dealers looking to make a profit, but some are addicted to drugs and want the pills for themselves. Prescription painkillers can fetch up to $80 a pill on the street.
In response to the robberies, pharmacies are increasing security. They are adding guards and watchdogs, and are storing drugs in safes. Some pharmacists are getting guns to protect themselves, or are refusing to stock certain prescription painkillers.

In January, New York Senator Charles Schumer called for improved security for pharmacies, and longer sentences for pharmacy thefts. In a letter to the Drug Enforcement Administration, he said that in Washington State, after time-sensitive safes and staggered inventories were introduced at many drug stores, pharmacy robberies dropped in half from 2008 to 2010.
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Seven Minutes of Counseling by ER Doctor Can Help Reduce Drinking
People who engage in hazardous and harmful drinking are more likely to reduce their consumption of alcohol for at least one year if they receive just seven minutes of counseling from an emergency room physician, a new study finds. Physician counseling can also reduce drinking and driving.

The study included 740 people considered hazardous and harmful drinkers, defined as men who had more than 14 drinks a week, or more than four drinks at a time, and women who had more than seven drinks a week, or more than three at a time. They were divided into three groups. One group received brief counseling aimed at limiting alcohol consumption, the second group received the counseling plus a follow-up phone call, and the third received standard care alone.
HealthDay reports patients who received the counseling reduced their average number of drinks from almost 20 a week to 13 a week within six months. One year later, they drank slightly more than 14 drinks a week.

Participants who received the counseling reduced binge drinking episodes, from about seven per month to fewer than five, within six months. They engaged in slightly more than five episodes a month one year later. Among patients who received counseling, rates of driving after having more than three drinks dropped from 38 percent to 29 percent after one year.

Follow-up phone calls were found to have little benefit in reducing drinking.

“So many of the tragedies we see in the emergency department are due to problem drinking. Our study shows that brief counseling of patients can improve outcomes and have a life-saving impact,” lead researcher Gail D’Onofrio of the Yale University School of Medicine said in a news release.

The findings are published in the Annals of Emergency Medicine.