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Friday, March 1, 2013

ATOD and Advocacy Update - Week-Ending March 1, 2013



8 Percent of Men, 3 Percent of Women are Heavy Drinkers, Study Finds
A new study finds 8 percent of men and 3 percent of women are heavy drinkers, according to government guidelines. On any given day, 18 percent of men and 11 percent of women drink more alcohol than advised by federal dietary guidelines, Reuters reports. The recommended limit is two drinks per day for men and one for women, the article notes. The study found 8 percent of men had five or more drinks, and 3 percent of women had four or more. “And in fact, most adults don’t drink at all on any given day. But the fact remains that it is a significant public health problem that many people do drink in excess,” Patricia Guenther, the lead study author and a nutritionist at the U.S. Department of Agriculture’s (USDA) Center for Nutrition Policy and Promotion, told Reuters. Among males, the largest percentage of heavy drinkers was found in the 31-to-50-year-old age group. Among women, the heaviest drinkers were ages 51 to 70. “People need to be aware that there are people of all ages who drink to excess,” Guenther said. The researchers studied data from about 5,400 adults over age 21. They found 64 percent of men and 79 percent of women did not drink any alcohol the day they were surveyed. They reported their findings in the Journal of the Academy of Nutrition and Dietetics.

FDA Approves Two Generic Versions of Suboxone
The Food and Drug Administration (FDA) informed the maker of the opioid addiction treatment Suboxone that it has approved two generic versions of the drug, according to Reuters. The company, Reckitt Benckiser, had asked the agency to block the generic products because of concerns over pediatric poisonings. Reckitt asked the FDA to refuse applications from generic drug makers unless they adopted stricter packaging standards. The FDA decided there was not enough evidence to support the need for stricter packaging, Reuters notes. The agency said it received comments that Reckitt’s request was an anti-competitive practice, and will refer the company to the Federal Trade Commission. The company voluntarily withdrew the sale of Suboxone tablets in the United States, and instead is selling individually sealed film strips, which melt under the tongue. Reckitt said tablets posed a risk of poisoning for children who accidentally got hold of them. In a statement, Reckitt noted it “is disappointed with the decision but will continue to work with the FDA on safety enhancements.” The company said it will carry on with the decision to discontinue the sale of tablets of Suboxone in the United States.


The addict's stigma: Perception of weakness hampers treatment: Editorial
If you’re diabetic and binge on birthday cake, you can go to the emergency room for treatment — and health insurance will pay for it. You get the same medical care for your third heart attack that you did for the first two, again, with full coverage.  But the underlying attitude in the United States, clouded by social and legal stigma, is that addicts get one shot. Get clean, but fall off the wagon, and you’re on your own.  Click here to read the rest of the editorial.


Multiple Sex Partners Increase Risk of Alcohol or Marijuana Dependence
A new study links the number of sex partners young adults have with their subsequent risk of developing alcohol or marijuana dependence disorders. The study found young women who had more than two or three sex partners when they were 18 to 20 years old were nearly 10 times more likely than those with one or no sexual partner to develop a substance dependence problem at age 21. Time.com reports researchers at the University of Otago in New Zealand found the risk of developing substance dependence disorders increased, the more sexual partners a person had. Having more than two or three partners from age 21 to 25 raised the risk of addiction at age 26 sevenfold. At age 32, women had a nearly 18 times greater risk if they had two or three partners when they were 26 to 31, compared with their peers with one or no sexual partner during that period. Men’s risk also increased, but not as dramatically. Men who had one sex partner from age 18 to 20 had nearly three times the risk of a serious substance use disorder at age 21. Having more than two or three partners increased their risk fourfold. The findings appear in the Archives of Sexual Behavior.

The researchers said multiple sex partners and later substance abuse could be linked because they are part of a cluster of risk-taking behaviors that happens in adolescence and young adulthood. Alcohol and marijuana use may encourage sexual behavior, they added. Study lead author Dr. Sandhya Ramrakha noted in a news release that pubs and bars are places where one can easily meet partners. “The role of the alcohol industry in encouraging the view that alcohol is entertainment, targeting young women in particular, is disturbing. Young women are also encouraged to ‘keep up’ with young men in relation to their drinking,” Dr. Ramrakha noted.

New Report Recommends Public Health Focus on Harmful Drinking vs. Eliminating
The traditional public health perspective on alcohol and noncommunicable diseases is indicted in a new report from the International Center for Alcohol Policies (ICAP). "Alcohol misuse and global health: The case for an inclusive approach to harmful drinking" discredits the traditional public health perspective that focuses on a narrow group of stakeholders and ignores individual factors and social norms. Rest of the story is here.

Study: Lowering drinking age leads to more binge drinking
There is new evidence that lowering the drinking age may result in more binge drinking and not just among the young.  Researchers at the Washington University Medical School in St. Louis followed 39,000 people who came of age in the 1970s when 18 or 19 was the minimum drinking age in many states. They found that those who could get a drink legally before they turned 21 were more likely to be binge drinkers years later. Click here to read the rest of the story.


'It's a poison': Trend of inhaling alcohol vapors alarms doctors
Instead of doing shots for a quick buzz, people are inhaling their liquor to get high while also curbing their calorie intake. But experts warn that inhaling alcohol vapors could be dangerous - even deadly. You can pack on 700 calories indulging in just one Colorado Bulldog. But instead of blowing your diet on one drink, a company has come up with a way for you to inhale your spirits instead of swallowing all those calories. The Vaportini is being marketed as "a revolutionary new way of consuming alcohol." It consists of a glass globe, a metal ring, a plastic funnel, a straw and a candle. The combination is used to heat the liquor for five minutes. A clear vapor appears, which are then deeply inhaled. The rest of the story is here.

Affordable Care Act to Provide Substance Abuse Treatment to Millions of New Patients
The Affordable Care Act (ACA) will revolutionize the field of substance abuse treatment, according to A. Thomas McLellan, PhD, CEO and co-founder of the Treatment Research Institute. “It will have more far-reaching positive consequences for substance abuse treatment than anything in my lifetime, including the discovery of methadone,” he said at the recent annual meeting of the New York Society of Addiction Medicine. “It will integrate substance abuse treatment into the rest of health care.” See more here.

What Drug Policy Reform Looks Like
President Obama believes in the pursuit of an America built to last – a Nation founded on an educated, skilled workforce with the knowledge, energy, and expertise to succeed in a highly competitive global marketplace. Yet, for too many Americans, this vision is hampered by drug use and addiction, which inhibits their ability to live healthy lives and achieve their full potential. While the harms caused by substance use and substance use disorders may seem obvious, here’s a reminder of what the data show: According to the CDC, drug overdose deaths are the second leading cause of injury death, surpassed only by suicides. Making matters worse, studies show that among the 22 million Americans who need treatment for substance use disorders, only about 2 million—only about one-in-10—receive it. What has caused this disparity? For a start, not all health insurance plans have been required to cover drug treatment on par with other medical problems. That’s unacceptable. You can read the rest of the article here.


Simple packaging change can reduce Rx drug diversion
We get a lot of complaints from consumers who tell us their pharmacy shorted them on the number of tablets or capsules they were supposed to get when they had their prescription filled. A report we got last week is typical. A young patient who had dental surgery received a prescription for the opral opioid Lortab 7.5 mg. The amount the dentist listed on the prescription was 24 pills. The patient’s mom had the prescription filled at a local pharmacy. Then, later on at home she counted only 21 pills. Mom called the pharmacy because she wanted to make sure the pharmacist was aware that a mistake had been made in the count. But the pharmacist became defensive, even suggesting that her daughter must have diverted the pills. Click here to read the rest of this story.

Parity Act Leads to Gains in Substance Abuse Treatment, but With Cost Increases
The Mental Health Parity and Addiction Equity Act, which makes it easier to gain access to substance abuse and mental health treatment, has increased care, but at an added cost, a new study concludes. The additional costs could prevent many people from obtaining treatment, according to Forbes. The act was signed into law in 2008. Most employers began following the new rules in 2011, the article notes. The law requires employers offering mental health and substance abuse services to offer those services at the same level as other health-related services. The Health Care Cost Institute study found there was a 19.5 percent increase in hospital admissions for substance abuse treatment in 2011, compared with a 11.8 percent rise from 2009 to 2010. In contrast, medical and surgical hospital admissions decreased 2.3 percent in 2011, the study found. The average total price paid by an employer and employee for a substance abuse admission in 2011 was $7,230. The employee’s share of out-of-pocket costs was $889, or 12 percent of the total. For an average medical/surgical admission, patients paid 4 percent of the share of out-of-pocket costs. “While it is too soon to understand the full impact of the Parity Act, we need to be looking carefully to make sure we understand why these hospital out-of-pocket payments may be growing at a faster pace than medical spending,” Health Care Cost Institute executive director David Newman said in a news release.


Children of Women With Alcohol Disorder in Pregnancy Have Greater SIDS Risk
Children whose mothers are diagnosed with an alcohol disorder in pregnancy, or within a year after giving birth, are three times more likely to die from Sudden Infant Death Syndrome (SIDS), compared with infants whose mothers do not have an alcohol disorder, a new study finds. Australian researchers found drinking was associated with about one of every six SIDS deaths, HealthDay reports. About 3 percent of non-SIDS deaths were also linked with alcohol abuse by mothers. The findings are published in the journal Pediatrics. The researchers analyzed almost 78,000 live births from 1983 to 2005, and found almost 22,000 of the mothers had an alcohol diagnosis. More than 300 children died from SIDS, and almost 600 died of other causes. They concluded maternal alcohol use disorder is a significant risk factor for SIDS, as well as non-SIDS infant deaths. The researchers could not explain the exact link between alcohol abuse and SIDS, but suggested alcohol has a detrimental effect on the fetal brainstem during pregnancy. Each year in the United States, more than 4,500 infants die suddenly of no immediate, obvious cause, according to the Centers for Disease Control and Prevention. Half of these deaths are due to SIDS.


Too Many Pills in Pregnancy
The thalidomide disaster of the early 1960s left thousands of babies with deformed limbs because their mothers innocently took a sleeping pill thought to be safe during pregnancy, In its well-publicized wake, countless pregnant women avoided all medications, fearing that any drug they took could jeopardize their babies’ development. Continue reading here.

Kids and Anxiety: The Parents' Role in Treatment. Teaching families how to help kids fight back
When you're the parent of an anxious child, you assume that your role is to provide reassurance, comfort, and a sense of safety. Of course you want to support and protect a child who is distressed and, as much as possible, avert her suffering. But in fact, when it comes to a child with an anxiety disorder like Obsessive Compulsive Disorder, trying to shield her from things that trigger her fears can be counterproductive for the child. By doing what comes naturally to a parent, you are inadvertently accommodating the disorder, and allowing it to take over your child's life. The rest of the story is here.


The Good Behavior Game Helps Improve Behavior In Elementary School Classrooms, Reduce Substance Abuse
Afterschool programs seem to be most effective when their organization and implementation is supported by both organizational and community resources, according to Penn State human development researchers.  Using a tool to help bridge the gap between research and real life, the researchers evaluated an afterschool program called the Good Behavior Game. Click here to read the rest.

Youth Involved in AA-Related Helping Less Likely to Test Positive for Alcohol and Drugs
Youth who become active in Alcoholics Anonymous-related helping (AAH) while they are in treatment are less likely to test positive for alcohol and drugs during treatment, a new study finds. Researchers at Case Western Reserve University studied almost 200 juvenile offenders. The study also evaluated a questionnaire, called the SOS tool, which helps clinicians identify youths low in service participation and suggests AAH activities to promote their recovery, MedicalXpress reports. Such activities include acts of good citizenship, formal service positions, public outreach and sharing personal experience to another person struggling with addiction. These activities are free, available seven days a week, and do not require a long-term commitment, prior experience, special skills or a specific length of time sober, the article notes. “The SOS tool provides a snapshot of a patient’s level of service participation. An SOS score of 40 or higher is associated with greater abstinence as measured by urine toxicology screens,” lead researcher Maria Pagano said in a news release. “Given AAH participation during treatment significantly improves the likelihood of long-term abstinence, interventions that facilitate early engagement in service are critical during the few weeks of treatment when motivation to change behavior is the highest.”  The findings appear in The American Journal on Addictions. In 2010, Dr. Pagano published a study that found adults who became involved in Alcoholics Anonymous-related service-type work were more likely to stay sober 10 years after treatment.


Alcohol Therapy May Improve Domestic Violence Problems in the Short Term
Male heavy drinkers arrested for domestic violence, who participate in a therapy session devoted to alcohol, were less aggressive toward their partners in the months after the counseling, according to a new study. Men arrested for domestic violence generally are referred by the court to group education sessions that don’t always address alcohol use, even though a high percentage of domestic violence involves drinking, Reuters reports. See more here.


Alcohol and Caffeine: No need to go Loko
We all enjoy going out for a few drinks, but sometimes, just when the party’s getting started, we feel like passing out! Wouldn’t it be great if we could keep our energy level up so the party could continue? Initially this may seem like a great idea, but in reality, drinkers who try to skip the alcohol-related sleepiness often get a lot more than they bargained for. Click here to read the rest of this blog.


BORN ADDICTED: Increasing number of babies hooked on drugs
The city’s newest resident is wailing inconsolably inside the neonatal intensive care unit at Middle Tennessee Medical Center, where nurse-manager Brooke Sherrell works. The baby boy is shaking, sweating, has diarrhea and is feeding so poorly that he needs intravenous fluids just to stay properly hydrated. Within hours after his birth, a clinician administers methadone to the innocent newborn and his symptoms slowly subside. He will need to be weaned off the methadone little by little to avoid recurrence of those symptoms. The entire process could take weeks to months. Click here to read the rest of the story.

Study Finds Marijuana and Alcohol Use Common among 10th Grade Students
A recent survey found high rates of regular alcohol and illicit and prescription drug use in tenth graders, reports a new study in the Journal of Adolescent Health.  Researchers used data from the NEXT Generation Health study, which surveyed 2,524 10th grade students in 80 schools and 9 U.S. school districts in the spring of 2010.  Twenty-six percent of the surveyed teens reported using marijuana, making it the most common illicit drug used in the previous 12-month period. Additionally, 35 percent of the teens had used alcohol, 27 percent had engaged in binge drinking and 19 percent had smoked cigarettes.  The study found that teens using multiple substances reported more physical ailments and symptoms of depression, anxiety or hopelessness and having difficulty sleeping. In addition, these adolescents reported more high-risk behaviors.  Dr. Kevin Conway, the study’s lead author from the National Institute on Drug Abuse, said the study had several important findings.  “First, the results show that there are multiple types or subgroups of adolescent substance users who differ in terms of use patterns, somatic complaints, and depressive symptoms. Second, one subgroup tended to abuse multiple different substances including marijuana, alcohol, and medications. Third, this same group also reported the highest levels of somatic complaints and depressive symptoms. Together, these findings implicate polysubstance use as a broad indicator of severity deserving research and clinical attention,” he explained.  Conway, NIDA’s Deputy Director of the Division of Epidemiology, Services, and Prevention Research, said that the high-risk profile of the polysubstance users indicates a need for mental health and substance use screening and referral. “This indication is one of the most important and actionable findings of this study,” he told CADCA.

Medication-assisted treatment is working
By necessity, many of us in the addiction treatment field have developed some special expertise in the management of opioid dependence over the past five years. An opiate epidemic is sweeping our nation, with some states hit particularly hard.  Ohio has been one of those states. Since 2009, annual deaths in Ohio from unintentional overdose (usually involving opioids) have exceeded the number of deaths occurring on our highways. Four people (most under the age of 30) die every single day in Ohio as a result of unintentional overdose. If four young people in Ohio died from meningitis every day, there would be an uproar of unimaginable proportions. Our outpatient (Northland) and residential (The Ridge) facilities are both situated in relatively upscale suburban communities outside Cincinnati, Ohio. Over the past 10 years we have seen a steady increase in the number of people seeking help for opioid dependence. Fully 60 to 70% of new patients identify an opiate as their drug of choice. This represents a complete reversal of our patient mix of 10 years ago, when most patients seeking help were primarily abusing alcohol. The rest of the article by Jeffrey A. Stuckert, MD is available 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.  The rest of the article is available here.

Alcohol marketing: grooming the next generation
Children are more exposed than adults and need much stronger protection
If protecting children from harm is the hallmark of a civilized society, the United Kingdom is failing the test when it comes to alcohol marketing. A new analysis conducted by the RAND Corporation for the European Commission shows that British regulatory structures are so flawed that teenagers, far from being shielded from alcohol promotion, are more exposed to it than are adults.1 It shows, for example, that 10-15 year olds in the UK see 10% more alcohol advertising on TV than their parents do. Even more shocking, when it comes to the specific sector of alcopops, they see 50% more. Read the full article here.


Doctors: urgent action on alcohol needed
Doctors' leaders want tough action to limit the sale and promotion of alcohol, including cigarette-style graphic warnings and an end to drinks firms sponsoring sport, to tackle the growing toll of drink-related problems. A coalition of medical organizations, including those representing GPs, A&E doctors and surgeons, urges ministers in a new report to implement an array of radical measures to reduce the £55bn annual cost of alcohol misuse. But the draconian proposals did not find much favor with either the drinks industry or the Department of Health, which immediately said that it did not support the introduction of graphic health warnings on bottles and tins. Click here to read the rest of this story.

When substance abuse hits teens
Have the morals of today's high school students lessened to a point of incorrigible measures? Or have the outside factors changed so drastically to affect their choices and reasoning? As a high school student, I think I can speak on behalf of the majority of high school students in this area when I say today's society has transformed the difference between the accepted and the exception. As a result of today's widely perceived acceptances, high school students follow a much more pliant path when associated with drugs and alcohol than previous generations. According to The Center for Prevention and Counseling of those surveyed 48 percent of seniors in high school have admitted to drinking alcohol, while 20 percent have admitted to marijuana. The writer of this column is a junior at Rutherford High School and writes for the school newspaper.  Read the rest of this interesting article here.


Suboxone Tablets Off the Market in March
New formulations of Suboxone, and crystal meth’s impact on the gay community were two of the topics discussed at the recent annual meeting of the New York Society of Addiction Medicine. This is the first of a two-part report on the meeting, “Addiction Medicine 2013: Emerging Problems, Current Treatment.” Suboxone (buprenorphine and naloxone), used to treat opioid dependence, will no longer be available in tablet form starting in March, because of the risk of children becoming poisoned after swallowing the drug. The company has switched to making a film version of the medication, which is put under the tongue. See more here.

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