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Friday, January 18, 2013

ATOD Weekly Recap - Week-ending January 18th

Do College Students View Alcohol or Drug Use as a Problem?
Alcohol and drugs are present on college campuses virtually everywhere. So are symptoms of psychological issues, such as anxiety, depression, and post-traumatic stress. However, a small percentage of students who need help for these issues ever actually seek out mental health services. Is it that they don’t see drug and alcohol use as a problem? The answer to that question varies. According to a recent study led by Robert J. Lowinger of Bluefield State College in West Virginia, college men and college women perceive the effects and severity of drug and alcohol use differently. In his study, Lowinger interviewed 201 college students using a modified version of the Degree of Impairment Scale (DIS) to assess how drug use and alcohol consumption interfered with their lives with respect to academic performance, career, daily routine, social engagement, romantic relationships, and friendships. He looked at how the students rated severity of use and which types of impairments increased help seeking, and which students were most likely to seek help. He found that all of the participants viewed drug problems as more problematic than alcohol problems. Females were more likely than males to seek help for problems with drugs or alcohol and cited more academic and daily routine impairments as a result of drug or alcohol use. Even though the students listed minimal impairments with peer interactions and other social relationships, drug use related to this did not motivate them to seek help, but alcohol use that impaired social interaction did. This could be due to the fact that alcohol is more socially acceptable and present than drug use, and therefore more students have alcohol related problems than drug related problems. The results of this study were based solely on self-reports, which could distort the data. Additionally, the small sample size prohibited Lowinger from revealing any cultural, sexual orientation, or racial patterns. “Nevertheless, this study suggests that there are significant differences in the way that students’ perceive problems relating to drugs and alcohol use,” said Lowinger.= Reference: Lowinger, Robert J. College students’ perceptions of severity and willingness to seek psychological help for drug and alcohol problems. College Student Journal 46.4 (2012): 829-33.
Using Bath Salts: Playing Russian Roulette With Your Brain, Expert Say
Using the designer drugs known as “bath salts” is like playing Russian roulette with your brain, according to an expert at the National Institute on Drug Abuse (NIDA). Michael H. Baumann, PhD, Chief of the Designer Drug Research Unit at NIDA’s Intramural Research Program, recently published a study that explains how bath salts cause dangerous effects in the brain. Read the rest of the story here.
More Homeless Die From Drug Overdoses Than From AIDS
A greater percentage of homeless adults die from drug overdoses than from AIDS, according to a new study. Drug overdoses accounted for nearly 17 percent of all deaths among homeless patients studied, and 81 percent of the overdoses involved opioid painkillers and heroin. In contrast, 6 percent died of causes related to AIDS. Health issues related to substance abuse, such as alcoholism-associated heart disease, pneumonia and withdrawal, accounted for 8 percent of deaths. The results appear in JAMA Internal Medicine. Researchers studied 28,033 homeless adults in Boston over five years. The study authors and homeless advocates say their findings apply to homeless populations in many urban areas of the country, Reuters reports. In a similar study conducted 15 years earlier, 6 percent of deaths among homeless adults were due to drug overdoses, while 18 percent were due to AIDS. “Our findings are an unfortunate reminder of the high mortality rate of homeless people and a clarion call for the need to address the epidemic of drug overdose deaths in this vulnerable population,” lead researcher Travis Baggett, MD, MPH, of the Massachusetts General Hospital, said in a news release. Jessie Gaeta, Medical Director of the Boston Health Care for the Homeless Program, told Reuters her group is considering making changes as a result of the findings, including decreasing the amount of painkillers it prescribes, and providing patients with naloxone, which can be used as an overdose antidote. The program’s doctors prescribe painkillers to some homeless patients with chronic pain, she said. They are increasing efforts to counsel patients on how to properly use their medication, and how to protect against medication theft.
New Study Questions Finding of Earlier Research on Marijuana and IQ in Teens
A new study calls into question the results of a study published last year that concluded heavy marijuana use can permanently lower IQ by several points in teens. The new research suggests that the IQ drop may have been caused by factors related to economic class and home life, NBC News reports. The new study used a computer simulation to demonstrate that the same effects on IQ could have been caused by socioeconomic factors, according to researcher Ole Rogeberg of the Frisch Center in Norway. “The kinds of environments you are in do affect your IQ,” Rogeberg told NBC News. He noted that while a good education and challenging employment can increase intelligence, “if people are pushed out or decide to move out of these kinds of arenas, they will tend to see an IQ decline, and they will also be the type of people who tend to take up cannabis smoking during adolescence.” The findings are published in the Proceedings of the National Academy of Sciences. The original study included data from 1,037 New Zealanders who were followed for more than three decades, starting at age 7. The researchers found marijuana lowered IQ by as much as eight points for those who started using the drug in adolescence, and were heavy, lifelong users. The study found no effect on IQ in people who started using the drug as adults, which suggested marijuana was particularly harmful for developing brains. Rogeberg noted his new findings do not mean marijuana is harmless. He recommended the original researchers should more thoroughly analyze their data to prove marijuana, and not other factors related to the marijuana-smoking lifestyle, can lower IQ.
10 over-the-counter medicines abused by teens
Is your medicine cabinet a source for a teen’s legal “high?” Because a doctor’s prescription is not needed, many mistakenly believe that over-the-counter (OTC) medicines are safer than prescription medicines and illegal street drugs. They are in fact safe and effective when taken as directed, but even OTC medicines—including herbals—can cause serious and potentially fatal side effects when abused.  Read the rest of the story here.
Dieting and drinking a bad mix - Those calories can add up
The first rule of drinking on a diet is: Don’t. Surely you’ve heard that Americans get way too many calories — and nutritionally empty calories at that — from alcohol. But the second rule of drinking on a diet is that since you probably will ignore Rule No. 1, find a way to enjoy alcohol without letting it swamp your healthy intentions. Here are a few suggestions on how to go about that. Read the rest of the story here.
NASADAD Releases Statement on the Use of Medication for Substance Use Disorders

Association notes that medications represent an important tool to consider in the treatment of substance use disorders

The National Association of State Alcohol and Drug Abuse Directors’ (NASADAD) Board of Directors approved during its December Meeting a consensus statement regarding the benefits of using medications in the treatment of substance use disorders.  The statement points to research from the National Institutes of Health (NIH) demonstrating the effectiveness of FDA-approved medications when prescribed as part of a comprehensive and individualized treatment plan.  NASADAD concludes that public and private health insurance plans should cover medications for the treatment of opioid, alcohol, and nicotine dependence.   “We believe it is important to promote evidence based, clinically appropriate care,” said Mark Stringer, President of NASADAD.  “As a result, NASADAD moved forward to educate stakeholders on the fact that all FDA-approved medications should be made available to help certain people enter into and maintain recovery from substance use disorders,” said Stringer.  According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 20.6 million persons met criteria for substance dependence or abuse in 2011.  Prescription drug abuse and misuse represents a particular challenge in State substance abuse systems across the country:  from 1998 to 2008, there was a 400 percent increase in admissions to treatment for people 12 and older misusing prescription pain relievers (SAMHSA, 2010).  In addition, approximately 16.7 million Americans in 2011 were dependent on alcohol or had problems related to their use or abuse of alcohol (SAMHSA, 2012).  The good news is that advances in research and practice have shown people suffering from alcohol and opiate dependence – including heroin addiction – may benefit from a medication as an adjunct to treatment.  As noted in the NASADAD statement, “A growing body of research substantiates that the use of FDA-approved medications can play an important role for people with alcohol, opioid, or nicotine dependence, with continued research being done on medications for other substance use disorders.”  NASADAD also cites that for certain people, “…use of medication is recommended as a recovery tool.”  “Decisions are being made about the nature and scope of services that should be made available to people with substance use disorders,” said Robert Morrison, NASADAD’s Executive Director.  “We hope our work will help contribute to this dialogue and encourage informed choices.”  While the statement was approved by the Board of Directors, the document was developed by NASADAD’s National Treatment Network (NTN), in conjunction with its Opioid Treatment Network (OTN).  A workgroup met via conference calls, in-person meetings and electronically to write an initial draft.  In addition to the statement, the NTN and OTN have engaged in State-to-State learning opportunities regarding medication assisted treatment through meetings, topic calls and more.
New York Police Department to Use Decoy Pill Bottles to Track Painkiller Thieves
The New York Police Department has announced it will put decoy pill bottles with tracking devices on pharmacy shelves, in an effort to track stolen painkillers. The fake bottles will appear to contain oxycodone, The New York Times reports. The bottles will not actually contain painkillers, but will have a GPS device. “We would anticipate the burglar and robber will take numerous bottles, and among them will be the bait bottle,” said the department’s chief spokesman, Paul J. Browne. The fake bottles rattle when they are shaken, as if they contained pills. They sit on a special base. When the bottle is lifted from the base, it starts to send out a tracking signal. The department hopes to have the program in place by March, and is asking all of the city’s 1,800 pharmacies to participate. Purdue Pharma, which makes OxyContin, developed the bottles. They are already being used in some pharmacies around the country. Around the nation, pharmacies have been robbed by armed criminals looking for narcotics, anti-anxiety drugs and other controlled medications. Some are addicted to the drugs themselves, while others sell the pills.
Many Doctors Skip Alcohol Screening and Miss Patients’ Drinking Problems
Doctors miss drinking problems in almost three-fourths of patients because they don’t conduct alcohol screening, a new study finds. Instead, many doctors rely on gut feelings about whether a patient is engaging in problem drinking. By asking a few questions about drinking habits, doctors can spot alcohol problems, and help patients cut back on drinking, experts told CNN. Researchers asked almost 1,700 adults to complete questionnaires at the end of a primary care doctor’s visit. Several questions addressed drinking habits, such as how often they drank, how many drinks they usually had per day, and if their drinking ever put them at risk of being hurt or causing an accident. After the visit, doctors were asked whether they thought the patient had problems with alcohol. Doctors who relied on a hunch about whether the patient had a drinking problem, instead of conducting a screening, missed almost three-fourths of patients who screened positive for alcohol problems. Doctors who did suspect a drinking problem were usually correct, the study found. “I hope that by papers like this, it’s going to be a nudge to a physician to say … ‘Maybe I should start screening.’ It’s not that hard to do,” said study author Dr. Daniel Vinson of the University of Missouri School of Medicine. The study appears in the Annals of Family Medicine. Alcohol screening is recommended by the U.S. Preventive Services Task Force, but is often not part of routine care, according to the CNN report. Previous research has shown that screening and brief interventions by health care providers — asking patients about alcohol use and recommending they reduce risky drinking — can promote significant, lasting reductions in drinking levels and alcohol-related problems, according to the National Institute on Alcohol Abuse and Alcoholism.
States Should Use More Tobacco-Related Income for Prevention: Report
States use little of the income they receive from tobacco taxes or legal settlements with cigarette manufacturers to pay for smoking prevention or cessation programs, the American Lung Association concludes in a new report. Although states receive a total of $25.7 billion in tobacco settlement payments and tobacco taxes annually, more than 40 states do not invest even half of what is recommended by the Centers for Disease Control and Prevention (CDC) in proven tobacco prevention programs, according to the report. Some states receive money from tobacco companies under a 1998 anti-smoking agreement with tobacco companies, Reuters reports. States spent a total of $462.5 million on smoking prevention and cessation programs this fiscal year, about 12.5 percent of the CDC recommendation. North Dakota and Alaska were the only states that spent amounts close to the recommendation. Some states put most of their tobacco-related income toward their general budgets. The report notes that states and the federal government have not raised taxes on tobacco products other than cigarettes, which has led to a surge in the use of certain cheaper tobacco products, including flavored cigars popular among youth. “By not having a level playing field with tobacco taxes, we’re seeing market shifts from cigarettes to lesser taxed and subsequently more affordable tobacco products. This means candy flavored cigars and a new wave of smokeless products are enticing new, young customers to become addicted to nicotine,” Paul G. Billings, American Lung Association Senior Vice President for Advocacy and Education, said in a news release.
Mothers, Daughters and Alcohol
There seemed to be both collective surprise and some very intense buzz after a very recent report found that many more women have been drinking than was previously thought. According to this CDC report, approximately 13% of women in the U.S. over the age of 18 engage in binge drinking.  In this survey, a binge was defined as consuming four or more alcoholic beverages during one discrete episode or evening or event. The nation was even more surprised to learn that among the 7,536 females in grade 9-12 who were surveyed, there was also plenty of binge drinking. The likelihood of binge drinking increased by grade. In 9th grade, 13% of the girls reported binge drinking. By the time they were in 12th grade, up to 27% of the girls reported binge drinking. Read the rest of the blog here.
ER visits tied to energy drinks double since 2007
SAN FRANCISCO (AP) — The young man stumbled into the emergency room late one night after a house party, saying his heart wouldn't stop pounding and he could barely breathe after downing liquor mixed with energy drinks. Emergency physician Steve Sun soon found the patient was so dehydrated he was going into kidney failure — one of many troubling cases Sun says he has treated in recent years tied to energy drink consumption. Sun's changing caseload appears in line with a new government survey that suggests the number of people seeking emergency treatment after consuming energy drinks has doubled nationwide during the past four years, the same period in which the supercharged drink industry has surged in popularity in convenience stores, bars and on college campuses. Remainder of article is available here.
Prescription Drug Overdoses Number One Reason for ER Visits in Los Angeles County
Prescription drug overdoses are the number one reason for emergency room visits in Los Angeles County, according to public health officials. A new report finds the number of people who checked into publicly funded drug rehabilitation programs for prescription pain reliever abuse doubled from 2005 to 2010, NBC Los Angeles reports. More than 60 percent of drug-related deaths in 2011 were due to prescription drugs in Los Angeles County. The report found 11 percent of 9th graders and 14 percent of 11th graders said they had misused prescription drugs at least once. “Prescription drug abuse has become a growing public health concern in Los Angeles County. Many people are not aware that the misuse or abuse of prescription drugs can be as dangerous as illegal drugs, and can lead to unintended injury, addiction, and even death,” Jonathan E. Fielding, MD, MPH, Director of Public Health and Health Officer, said in a news release. “We need to ensure that we are addressing this growing concern by engaging and collaborating with our partners in the public and private sectors to reduce and prevent prescription drug abuse.”
Legalizing Pot Won't Make It Any Safer
Forgotten in the debate is the damage marijuana does to adolescent brains.
Pot is not legal—at least not yet. But it's not exactly illegal either—not anymore. More than a dozen states have decriminalized the possession of marijuana. Nearly a score of them sanction its medical use. Voters in Washington and Colorado have made recreational use of the drug legal in their states.  One way or another, all of these changes mean that there will be more marijuana in homes for young people to find and use. Granny may be smoking it for glaucoma, but there is nothing benign about the effects of pot on a juvenile brain. Whatever its legal status, pot is not harmless.  Marijuana hasn't achieved its present status of relative social acceptability by virtue of its virtues, but rather despite mounting evidence of the dangers it poses, especially to young users—and even more to users under age 18. While adults may be at risk, too, a considerable number of them appear to use marijuana in relative safety. So the case for prohibition has rested most securely on potential harm to adolescents.

Pot's potential for harm has as much to do with the nature of adolescence as it does with the nature of THC, the active ingredient in marijuana. That's because kids do foolish things because they are kids—and their brains are not yet fully developed. Unfortunately, the part of the brain that censors dumb and dangerous behavior is last to develop. It doesn't generally come fully on line until the mid-20s, but the pleasure-seeking part of the brain is fully functioning by puberty. So, kids do foolish things that are often risky—and get so much riskier when teenagers are high. Moreover, smoking marijuana is by itself a risky enterprise, and most addictive for the young. A study published in the Journal of Clinical and Experimental Pharmacology in 1994 found that one in 10 young people who use marijuana will go on to become addicted. Pot smoking puts the user at risk of psychosis, changes in the anatomy of the brain, and damage to the heart and lungs. It retards maturation and impairs learning, memory and judgment—no small matters during the adolescent years.
Among the many thousands of adolescents we have treated at the programs of Phoenix House over the past four decades, the overwhelming majority have used no drug more potent than marijuana. And for many of those young people, the course of their lives has been altered, sometimes permanently and often tragically, with suicides, car accidents and drownings—or with interrupted education, chronic depression and joblessness. Federal law still outlaws marijuana. Yet President Obama told Barbara Walters in December that "it does not make sense from a prioritization point of view for us to focus on recreational drug users in a state that has already said that under state law that's legal." Meanwhile, the Senate Judiciary Committee plans hearings to find some legislative route around the federal-state impasse. Given all that we know, the sensible strategy at this point is to send an unequivocal message that "legal" is not a synonym for "safe." This is not a novel concept. We have plenty of examples. Alcohol is legal and, in many ways, it can be even more threatening to teens than marijuana. Hand guns (and assault rifles) are also legal, but they are hardly benign.
While rational societies generally make some effort to protect children from obvious dangers, it is fundamentally a parental responsibility—and one that we humans share with the rest of the animal kingdom. It may be helpful if there is law on the parents' side. But this is not essential, nor does its absence diminish in any way a parent's familial obligations. There will be restriction on legal marijuana sales to children—following the alcohol template, states considering legalization use 21 as the legal age. But we cannot expect such restrictions to be any more effective in limiting teen marijuana use than they are in limiting teen smoking or drinking.  And then there is the issue of easier-than-ever access as more adults can buy or grow marijuana for their personal use. In 2000, a study commissioned by Phoenix House found that among 600 young people in treatment, only 1% were introduced to drugs by a dealer, and that a primary source of illicit drugs was relatives or family friends. At this point in the country's history, whether pot is legal or not is no longer the main issue. The issue is the danger that marijuana poses to kids, how parents can protect their children from that danger, and what the rest of society—absent the criminal justice system—can do to support them in that fight.

Dr. Rosenthal, a child psychiatrist, is the founder of Phoenix House, the nation's largest nonprofit substance-abuse treatment and prevention organization.
New Jersey lawmakers hear testimony on a drug that mitigates overdoses' effects
Drug overdose is the leading cause of accidental death in New Jersey. It surpassed traffic fatalities in 2009, when 752 people died, according to a drug policy advocacy group. Of those deaths, 75 percent involved heroin or prescription opiates, a growing addiction problem in New Jersey and the nation. Legislators tried to address the issue last year when they approved the Good Samaritan Emergency Response Act, a bill that offered limited criminal amnesty to drug users who call for help when someone has overdosed. They took up the issue again Monday, when the state Senate's Health, Human Services, and Senior Citizens Committee heard testimony on a bill that would expand access to a drug that treats opiate overdose. Of the 43 people who showed up to support the bill, at least 14 had lost a family member to an opioid overdose.
Gov. Christie, a Republican and former prosecutor, surprised drug-addiction treatment providers last year with his stance on addiction. He put $2.5 million toward a court-run program that would force low-level offenders with drug problems into treatment rather than prison. New Jersey is the first state to attempt to mandate the strict "drug court" program, which is practiced nationwide. Yet in October, Christie vetoed the Good Samaritan bill, instead asking his administration to study the problem and report back in 18 months. The veto perplexed supporters.

"He's talking about second chances. That's exactly what the Good Samaritan bill did," said Roseanne Scotti, New Jersey director of the Drug Policy Alliance. "You can't get a second chance if you're dead."
Since Christie blocked the bill, 17 municipalities have called on the Legislature to override his veto. The bill passed the Legislature with bipartisan support, but GOP lawmakers have prevented override attempts on previous bills. The Democratic-led body must achieve a two-thirds vote in each chamber to override a veto. Scotti hopes the Legislature will succeed in an override, but she knows the odds are long. In the meantime, Sen. Joseph Vitale (D., Middlesex), a primary sponsor of the Good Samaritan bill, is cosponsoring a bill that seeks to make an opioid antidote, naloxone, more readily available. Sen. Richard J. Codey (D., Essex) is cosponsoring the bill. The Senate panel unanimously agreed to move the bill from committee Monday. Michael Drewniak, a spokesman for Christie, did not respond to a request for comment.
Two-year MaineCare cutoff for opiate addiction drugs kicked in early January
Patients on Suboxone will need to prove the drug works to continue receiving it; those prescribed Methadone face a two-year time limit starting on Tuesday, January 1, 2013

Health officials say those who still need certain drugs to treat addiction won't be cut off entirely, even as a legislative bill aims to cut off treatment for some. Michelle Morin, a registered nurse at Merrimack River Medical Services in Portland, administers Methadone at a dosing window on Jan. 9, 2008. MaineCare coverage for Methadone and Suboxone is set to cease on Tuesday for treatment for those who have been covered for at least 24 months. A bill passed by the Maine Legislature established the 24 month lifetime limit. But a task force of medical providers, substance abuse treatment providers, government officials, and patient advocates have developed criteria for continued MaineCare coverage of medically necessary Methadone and Suboxone treatments. Rest of the story is available here.
Change and the Serenity Prayer
By Fred Holmquist, Director of The Lodge at Hazelden

By now, the momentum of some of our one-year-at-a-time resolutions has abated. For most of us, initiated changes in life far outnumber sustained changes in life. Mark Twain's quote nails it:
"Quitting smoking is easy. I've done it hundreds of times."

Let's look at how the Serenity Prayer offers important distinctions for more productive use of our life energy, yet doesn't highlight the key element for a transformed life.

  The serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference are priceless reminders for more efficient and effective living. Yet, they don't include the distinction for addressing the greatest challenge to our spiritual growth in recovery. Made clear on page 62 in Alcoholics Anonymous is an additional condition we can't change. Beyond the seemingly hopeless state of mind and body that gets our attention in active addiction is the wisdom in "How It Works," that over-reliance on self blocks us from the spiritual solution: page 62 "…[the alcoholic] is an extreme example of self-will run riot, though they usually don't think so." We also learn that, "Neither could we reduce our self-centeredness much, by wishing or trying on our own power."

Whew! We have bodies that can't tolerate what our minds can't leave alone AND we have a spiritual malady that disallows us from doing anything about it on our own.

Application of the serenity prayer to this third element of Step One's lethal trifecta would emphasize the need for serenity and acceptance, because we can't change our over-reliance on self "much" on our own. By page 66, we've learned the emotions generated by this immutable imbalance of humanness are what shut us off from the Sunlight of the Spirit. Since self can't change itself for the same reason a hammer can't hit itself or a foot can't kick itself, neither serenity nor courage, nor the wisdom to know the difference will get us unblocked. So what's implicit in the Serenity Prayer but missing from its text? Essentially, it's to do the things I can, that will bring about the changes I can't. One of the subtle, but frequent, clues is on page 64 in the sentence, "Though our decision (in Step Three) was a vital and crucial step, it could have little permanent effect unless at once followed by a strenuous effort to face (in Step Four), and be rid of (in Steps Five through Nine) the things in ourselves that had been blocking us." We're told clearly to face what's been blocking us in Step Four (with the courage [read fearless] to change the things we can). However, the text doesn't say "and get rid of the things in ourselves which had been blocking us," but rather says, "and be rid of the things in ourselves which had been blocking us." Thus the practice of Steps Five through Nine is following the directions for doing the things I can which will bring about the changes I can't.

I am not suggesting that we change the Serenity Prayer. I am suggesting that we be mindful each time we say it that the miracle of sustained change is the byproduct of spiritual practice, much of which lies somewhere far beyond the serenity to accept the things I cannot change and the courage to change the things I can.
One in three American adults have gone online to figure out a medical condition
Thirty-five percent of U.S. adults say that at one time or another they have gone online specifically to try to figure out what medical condition they or someone else might have.  These findings come from a national survey by the Pew Research Center’s Internet & American Life Project. Throughout this report, we call those who searched for answers on the internet "online diagnosers." When asked if the information found online led them to think they needed the attention of a medical professional, 46% of online diagnosers say that was the case. Thirty-eight percent of online diagnosers say it was something they could take care of at home and 11% say it was both or in-between. Rest of the story is here.
Bringing gambling problems to light
As the casino boats were coming into its immediate area in 1993, the Illinois Institute for Addiction Recovery was beginning to treat compulsive gambling.  Coleen Moore, Marketing and Admissions Manager at the treatment organization, remembers when it began.  She explains, “What we were finding was that many of our clients who were in treatment for alcoholism, were coming back to us were saying, ‘Okay, I’m not drinking, but I’m going to the boat and I’m gambling. And I feel like I’m not in recovery.’”  After these comments, Moore says the staff really began to grasp the mechanics of gambling as an addiction.  They found that although there are some differences, the behaviors of a person with gambling issues look very similar to the experiences of someone suffering from alcoholism.  Click here to read the remainder of the story.
Study: Replacing prison terms with treatment could save billions in criminal justice costs
Nearly half of all state prisoners are drug abusers or drug dependent, but only 10 percent receive medically based drug treatment during incarceration, according to a news release. Untreated or inadequately treated inmates are more likely to resume using drugs when released from prison, and commit crimes at a higher rate than non-abusers. The study, completed by researchers at RTI International and Temple University and published online in November in Crime & Delinquency, reports that the savings are driven by immediate reductions in the cost of incarceration and by subsequent reductions in the number of crimes committed by successfully-treated diverted offenders, which leads to fewer re-arrests and re-incarcerations. The criminal justice costs savings account for the extra cost of treating diverted offenders in the community. “Substance abuse among offenders continues to concern policy makers because of its high prevalence and its effect on criminal behavior,” said Gary Zarkin, Ph.D., vice president of the Behavioral Health and Criminal Justice Research Division at RTI and the study's lead author. “Given the obvious burden on the criminal justice system and society caused by substance abuse within this population, diverting offenders to effective and targeted substance abuse treatment leads to less drug use, fewer crimes committed, and costs savings.” The findings were based on a lifetime simulation model of a cohort of 1.14 million state prisoners representing the 2004 U.S. state prison population. The model accounts for substance abuse as a chronic disease, estimates the benefits of treatment over individuals’ lifetimes, and calculates the crime and criminal justice costs related to policing, trial and sentencing, and incarceration.  According to the model, if just 10% of eligible offenders were sent to community-based treatment programs rather than prison, the criminal justice system would save $4.8 billion when compared to current practices. Diverting 40% of eligible offenders would save $12.9 billion.  The authors also address a concern common with diversion programs, which is that instead of being incarcerated, offenders are released into the community where they may commit additional crimes. Their analysis showed an immediate, short-lived increase in crimes, however, by the end of the first year, fewer crimes were committed, generating cost savings.
Access to Health Care Services for Addiction Will Improve Dramatically
Once the Affordable Care Act (ACA) is fully implemented in 2014, access to effective health care services for addiction will improve dramatically, according to Faces & Voices of Recovery. In an issue brief, the advocacy group describes how the new legislation will make it possible for many in or seeking recovery to be included in the health care system for the first time. Those who will benefit from the new law include people who were previously enrolled in Medicaid, and then were disenrolled; those who are coming out of the criminal justice system; and people who have not been able to afford insurance. Under the ACA, a single enrollment application will determine if you are eligible for either Medicaid or the state insurance exchange, based on your reported annual income. People who do not qualify for Medicaid will be able to buy affordable health insurance through state health insurance exchanges. These are marketplaces that will be available to people who are not covered through their employer’s health plan, and those who work for small employers who provide employees with multiple health plan options. The law guarantees that insurance companies will not be allowed to deny someone coverage or place a lifetime cap on what is deemed reimbursable because of a pre-existing condition. According to the brief, “The new policy regarding pre-existing conditions, already in place for children, has direct applications to the recovery community. Addiction to alcohol and other drugs (or a substance use disorder, as it is sometimes called) has been considered a pre-existing condition by many insurers, and used as a means to deny claims and a disqualifier for coverage. That will no longer be legal.” Read the entire issue brief for more information on addiction treatment and the ACA.
Legalizing Marijuana Sends Wrong Message to Young People, Kerlikowske Says
Legalizing marijuana sends the wrong message to young people, R. Gil Kerlikowske, Director of the Office of National Drug Control Policy (ONDCP), said this week. “We are certainly not sending a very good message when we call it medicine and legalize it,” he told The Oregonian. ONDCP calls marijuana addictive and unsafe, especially for use by young people. Marijuana, which was recently legalized in Colorado and Washington, remains illegal under federal law. Kerlikowske pointed to a 2012 survey that found 7.4 percent of California drivers tested positive for marijuana use—more than for alcohol. In a recent ONDCP web post, Kerlikowske wrote, “it is clear that we’re in the midst of a serious national conversation about marijuana.”
Substance Abuse May Have Long-Term Negative Effect on Sexual Performance
A new study suggests substance abuse impairs sexual performance in men, even after they stop using drugs or alcohol. Earlier studies suggested men spontaneously recover their normal sexual performance several weeks after they end substance abuse, MedicalXpress reports. The study included 905 men, 549 of whom had been diagnosed with addiction to alcohol, cocaine, heroin, marijuana, or a combination of substances. The men who were diagnosed with addiction had an average of one year of abstinence. The researchers found the men who had been addicted had a moderately to significantly impaired sexual performance, in the areas of sexual desire, satisfaction, arousal and orgasm, compared with men who had not been addicted. The researchers wrote in the Journal of Sexual Medicine, “These results seem to contradict those that argue that drug use only impairs sexual functioning temporarily. Moreover, they suggest that sexual functioning does not improve just by stopping drug use.”
Lawmakers Ask Energy Drink Makers for Safety Information About Products
Three federal legislators have sent letters to 14 marketers of energy drinks, asking for information about the products’ ingredients and for studies showing their risks and benefits to youth, The New York Times reports. The Food and Drug Administration has received reports of 18 deaths and more than 150 injuries that mention the possible involvement of energy drinks, including 5-Hour Energy, Monster Energy and Red Bull. A new federal report found the number of emergency room visits involving energy drinks doubled from 2007 to 2011, reaching more than 20,000. The letters were sent by Senator Richard Durbin of Illinois, Senator Richard Blumenthal of Connecticut and Representative Edward Markey of Massachusetts to companies including Monster Beverage, Red Bull, Rockstar and Living Essentials, which makes 5-Hour Energy. The lawmakers asked the companies to explain how much caffeine was in their drinks. They also asked for studies the companies had run or underwritten on the effects of the drinks on children or young adults. “There is very clearly a lack of understanding about the health effects of energy drinks and their ingredients especially on children and adolescents,” Senator Blumenthal said in a news release. “Energy drink makers are mistaken if they believe they have escaped regulatory oversight to safeguard consumer health.” “Energy drink companies need to be clear with consumers about what they think their product is, what it contains, and what it can do,” added Representative Markey. “The broad claims made by these products and their blurred classification in the marketplace make it difficult for consumers, particularly young consumers, from making informed decisions about their consumption.”

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