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Friday, March 8, 2013

ATOD and Advocacy Update - Week-Ending March 8, 2013

Percentage of College Freshmen Drinking Beer in the Past Year Continues to Decline

The percentage of U.S. college freshmen reporting that they drank beer occasionally or frequently in the past year has declined significantly since the early 1980s, according to data from the Cooperative Institutional Research Program’s annual college freshman survey. In 1982, 73.7% of college freshmen reported drinking beer in the year before entering college. Since then this rate has declined nearly every year, reaching a record low of 33.4% in 2012. While the decline in beer consumption over the past three decades is encouraging, one-third of college freshmen still report drinking beer in the year before entering college. Research has shown that early alcohol use—particularly before the age of 18—is associated with a higher risk of alcohol abuse or dependence as an adult. NOTES: The 2012 results are based on the responses of 192,912 first-time, full-time, freshmen at 283 U.S. baccalaureate colleges and universities. The survey is typically administered during the freshmen orientation process. The data have been statistically adjusted to reflect the responses of the approximately 1.5 million first-time, full-time students entering 1,613 four-year college and universities as first-year students in 2012.

SOURCE: Adapted by CESAR from data from the Higher Education Research Institute (HERI), Cooperative Institutional Research Program (CIRP), The Freshman Survey. Available online at For additional information, contact the Higher Education Research Institute at

Federal Judges Work With Prosecutors to Create Drug Courts
Following decades of success for drug courts at the state level, federal judges around the nation are collaborating with prosecutors to create the special treatment programs for defendants who are addicted to drugs, The New York Times reports. These defendants normally would face significant time in prison, the article notes. The judges hope to work around drug laws that are often seen as too harsh and inflexible. The Justice Department is permitting U.S. attorneys to reduce or even dismiss charges in some drug cases. Defendants in drug court must accept responsibility for their crime, and agree to receive drug treatment and other social services. They must attend regular meetings with judges, who monitor their progress. If they successfully participate in the program, they receive a reduced sentence, or even no jail time. Failure to successfully complete the program results in them being sent to prison. Defendants facing more serious charges are not eligible for drug court. Legal experts say drug courts are a less costly and more effective option than prison for many low-level repeat offenders. According to the Office of National Drug Control Policy, every dollar spent on drug courts yields more than two dollars in savings in the criminal justice system alone. Federal judges have instituted drug court programs in California, Connecticut, Illinois, New Hampshire, New York, South Carolina, Virginia and Washington. So far, about 400 defendants have been involved in federal drug court programs. The United States Sentencing Commission has established guidelines for sentencing since 1984, after studies found federal judges were giving different sentences for similar crimes. Judges feel the guidelines interfere with their judicial independence, according to the article. “When you impose a sentence that you believe is unjust, it is a very difficult thing to do,” Stefan R. Underhill, a federal judge in Connecticut, told the newspaper. “It feels wrong.”

Doctors Disagree on Best Way to Prevent Prescription Painkiller Abuse
There is disagreement among doctors about the best way to prevent prescription painkiller abuse, sometimes even among physicians in the same hospital, according to The Plain Dealer. The Cleveland Clinic is among the institutions where colleagues disagree on the best approach to the problem. Some doctors want stricter rules for prescribing opioids, arguing this could decrease addiction and drug abuse. Others are concerned tougher rules could penalize patients with long-term pain, particularly if the new rules call for opioid treatment only for those in severe pain, rather than moderate pain. This is a personal and subjective call, they say. One Cleveland Clinic pain management specialist, Dr. Riad Laham, wrote a letter to the Food and Drug Administration (FDA) arguing that such a rule could lead patients to lie about their pain to meet higher thresholds, and could result in more illegal street sales of opioids. Dr. Andrew Kolodny, who heads Physicians for Responsible Opioid Prescribing (PROP), says opioids are overprescribed. “We’re not trying to take these people’s opioids away from them, we’re trying to prevent new starts,” he told the newspaper. Dr. Edward Covington, Director of the Cleveland Clinic’s Neurological Center for Pain, supports a PROP petition to the FDA that states “an increasing body of medical literature suggests that long-term use of opioids may be neither safe nor effective for many patients, especially when prescribed in high doses.” The group wants the FDA to change prescribing rules for opioids, so they are not indicated for moderate pain, to recommend a maximum daily dose, and to limit patients’ continuous use to a maximum of 90 days, the article notes. The FDA, in a letter dated January 22, told PROP that it “has been unable to reach a decision on your petition because it raises significant issues requiring extensive review and analysis by agency officials.” The FDA did not say when it expects to make a decision.

The Painful Truth About Prescriptions
Has American medicine gotten too good at treating pain? The profession once took pain to be a positive sign of healing. As recently as 50 years ago, even patients recovering from surgery went without medicine to relieve the ache and discomfort. Today, when patients complain of pain, doctors listen and respond, and in many ways that’s a good thing. Read the rest of the story here.

The Last All-Nighter
The first time I took Adderall I didn’t think twice. It was 2007. I was in my last year at UCLA, where I had come down with a bad case of senioritis, and found myself cramming for finals. I bought it from a gangly kid with yellow skin and bags under his eyes who lived in the dorms. His hair was stringy. There were papers on the floor and piles of clothes on all the furniture in the room. Above his desk was a poster of John Belushi from “Animal House,” chugging a bottle of Jack Daniels and wearing a sweatshirt that read COLLEGE. The rest of the story can be accessed here.

Thomas McLellan explains how Affordable Care Act will transform substance abuse treatment
Thomas McLellan, a Pennsylvania researcher who spent a year as President Barack Obama's deputy drug czar, predicted Friday that the Affordable Care Act will "transform" substance abuse treatment and lower health care costs, He spoke to 300 doctors, nurses, therapists and other health professionals at the annual Jon Nadherny/Calciano Memorial Youth Symposium at the Cocoanut Grove. A veteran addiction treatment researcher, he went to Washington after one of his sons died of an overdose of anti-anxiety medications and alcohol. He wrote the requirement for mental health and substance-use disorder services to be "essential," with the federal government picking up the tab for prevention. Please click here to read the rest of the story.

Limiting Access to Alcohol Reduces Violence
UC Riverside sociologists co-author book that advocates new approach to solving community violence

Alcohol plays a powerful role in U.S. social and cultural life — and has since colonial times — despite decades of research documenting it as more dangerous and physically destructive than heroin and cocaine, and a significant factor in violent crime. In a book published this month, “Alcohol and Violence: The Nature of the Relationship and the Promise of Prevention” (Lexington Books), University of California, Riverside sociologist Robert Nash Parker says that amending existing laws or adopting additional regulations to limit the availability of alcohol — a practice known as environmental prevention — would reduce community violence. So why would policymakers and politicians balk at such efforts? The rest of this article is available here.

Alcohol is Third Leading Cause of Global Disease and Injury, Study Finds
Alcohol is the third leading cause of disease and injury worldwide, even though the majority of adults do not drink, a new study concludes. Just over 40 percent of the world’s adult population consumes alcohol, said researchers at the Center for Addiction and Mental Health in Toronto, Canada. They noted alcohol causes liver cirrhosis and leads to traffic accidents, and has also been linked to several types of cancer, including female breast cancer. “Alcohol consumption has been found to cause more than 200 different diseases and injuries,” lead author Kevin Shield noted in a news release. Only high blood pressure and tobacco smoking caused more disease and injury, the study found. The researchers discovered wide regional variations in drinking patterns, MedicalXpress reports. For instance, drinkers in Europe and parts of sub-Saharan Africa consume the most alcohol, on average. People in southern sub-Saharan Africa frequently drink large quantities, drink until they become intoxicated, engage in prolonged binges, and drink mainly outside of meals. Drinking is lightest in North Africa, the Middle East and South Asia, the study found. North Americans drink more than 50 percent above the worldwide average, and binge drink more than people in Europe. Almost 30 percent of alcohol consumed in 2005 was “unrecorded,” meaning it was not meant for consumption, was home-brewed, or illegally produced. “The amount of unrecorded alcohol consumed is a particular problem, as its consumption is not impacted by public health alcohol policies, such as taxation, which can moderate consumption,” co-author Dr. J├╝rgen Rehm said. The study appears in the journal Addiction.

5 Things Parents Do That May Encourage Teen Substance Abuse
When a teenager starts using drugs, the finger-pointing begins. The first to get blamed is usually a parent, followed perhaps by a bad influence at school, an older sibling or a high-pressure coach or teacher. While there's no place for blame -- it's counterproductive and in most cases, misplaced -- there is room for understanding. Well-meaning parents sometimes do things that unwittingly encourage their teens to experiment with drugs and alcohol. Is there room for improvement in your parenting practices? Please click here to read the rest of this blog.

Study Examines New Treatment for Marijuana Dependence
A new potential treatment for marijuana dependence, and the success of network therapy, which engages family and friends in a patient’s substance abuse treatment, were two of the topics discussed at the recent annual meeting of the New York Society of Addiction Medicine. This is the second of a two-part report on the meeting, “Addiction Medicine 2013: Emerging Problems, Current Treatment.”Rest of the article is here.

Alcohol dependence pill approved in EU
Danish drug maker Lundbeck has been granted European marketing approval for Selincro (nalmefene) tablets to treat alcohol dependence. ‘Selincro represents the first major innovation in the treatment of alcohol dependence in many years,’ said Lundbeck executive vice president Anders Gersel Pedersen. ‘The approval of Selincro is exciting news for the many patients with alcohol dependence who otherwise may not seek treatment.’ The company expects to launch the product in mid-2013. According to Lundbeck, more than 90% of the 14 million patients with alcohol dependence in Europe are currently untreated. Nalmefene is an opioid receptor antagonist - it is designed to bind to the receptor and effectively deactivate it so that it cannot be triggered by the natural opioids produced during drinking. It is intended for use on an ‘as needed’ basis, with one tablet taken each day when the patient feels a risk of drinking. Nalmefene is similar in structure and reactivity to another drug, naltrexone, which has been marketed for treatment of alcohol problems for several years.

The Competition Drug
THIS is America’s college town par excellence. Kids from all over the world flock to Boston to learn. I have a son who is a freshman here. Last autumn, as he entered school, I listened to warnings about the dangers of binge drinking. I think they missed the point.  The real epidemic involves so-called smart drugs, particularly Adderall, an amphetamine prescribed for attention deficit hyperactivity disorder (A.D.H.D.) but so freely available as to be the pill to take whenever academic pressure requires pulling an all-nighter with zero procrastination to get a paper done. Click here to read the rest of this NY Times op-ed.

The Brain Adds New Cells During Puberty To Help Navigate The Complex Social World Of Adulthood

Two Michigan State University neuroscientists report in the current issue of the Proceedings of the National Academy of Sciences.  Scientists used to think the brain cells you're born with are all you get. After studies revealed the birth of new brain cells in adults, conventional wisdom held that such growth was limited to two brain regions associated with memory and smell. The rest of the article is here.

Advocacy Group: Push for Peer Recovery Support Services in Essential Health Benefits
Recovery groups should advocate for inclusion of peer recovery support services as part of essential health benefits that will be covered under the Affordable Care Act (ACA), according to Faces & Voices of Recovery. Peer recovery support services are delivered by individuals who have “lived experience” with addiction and recovery. Faces & Voices of Recovery, an advocacy group, has produced an issue brief that explains how recovery advocates can support inclusion of these non-clinical services that help people achieve long-term recovery from addiction. The ACA requires states to set up state health insurance exchanges, which will act like marketplaces, where each person can choose a plan that suits them. Through these exchanges, states must offer a core of what are called essential health benefits–services that will be reimbursed or covered by the new exchanges. Services for mental and substance use disorders must be included.  Each state can decide what specific services will be offered. If peer recovery support services are offered as an essential health benefit, they will be covered by insurance or Medicaid, and organizations that provide the services will be reimbursed for providing the services. According to Faces & Voices of Recovery, scientific evidence is growing to support the beneficial effects of peer recovery support services. To find out more about how you and your organization can advocate for inclusion of peer recovery support services, visit the Faces & Voices of Recovery website.

Positive Results for Pre-Employment Drug Testing Rose 5.7% in First Half of 2012
Positive pre-employment urine drug screening in the United States rose 5.7 percent in the first half of 2012, compared with all of 2011, according to a survey by Quest Diagnostics, a medical lab research company. In contrast, the positive rate from random drug testing in the general workforce decreased 5.8 percent, The Huffington Post reports. “Employers are having some difficulty finding employees who can pass their drug tests,” said Dr. Barry Sample, Director of Science and Technology for Quest. The drug most commonly used by job applicants continues to be marijuana, followed by amphetamines. The survey found 2 percent of the 3.4 million urine drug tests were positive for marijuana, compared with 0.86 percent for amphetamines. Dr. Sample said the company found no correlation between states that have decriminalized or legalized marijuana, and positivity rates for pre-employment drug tests.

Drug Testing of Middle-School Students May Help Prevent Substance Abuse: Study
Random drug testing of middle-school students may help prevent substance abuse, a six-year study of New Jersey students suggests. Students who were randomly tested for drugs were less likely to use them in later years, according to the study, conducted by the Partnership for a Drug-Free New Jersey and Fairleigh Dickinson University. The researchers found drug use by students in grades 6-8 is relatively rare, Newsworks reports. The study found that only about 1 percent of 8th graders say they have ever used illicit drugs, and only about 14 percent indicate that they have ever drunk alcohol, other than in circumstances where it’s allowed, such as religious ceremonies. Among students who were tested for drugs and alcohol, 6 percent said they had ever consumed alcohol. Lead researcher Dan Cassino said when middle-school students are tested for drugs, they realize drug use can get them in trouble. He noted expanding random drug testing, while it might be effective, would be costly. “We still see a spike around the junior year of high school,” Cassino said. “Once the kids get a car and get a job, all bets are off, and the rates of drug and alcohol use go through the roof; but that spike is much smaller among students who actually were randomly drug tested at some point.” “These results show that student drug testing changes the environment of the school community and show they serve as an effective prevention strategy for the abuse of drugs and alcohol in their future,” Angelo M. Valente, Executive Director of the Partnership for a Drug-Free New Jersey, said in a news release. “This study proves random drug testing in New Jersey middle schools helps prevent substance abuse.”

The Secret Under Your Addiction
Many people suffer from addictions. The usual problem makers include alcohol, street drugs such as heroin, cocaine, crack, and methamphetamine. Prescription drugs compete with street drugs and these include all of the oxy’s, as in oxycodone, as well as the hydro’s, as in hydrocodone. Addictions are stubborn and they are maintained because the desired effects work. People who have addictions are not a sub-class of human beings. They are your brother, sister, mother, father, friend, co-worker, boss, neighbor, postal worker, grocery clerk, school teacher, and physician. Every occupational group has individuals within those groups for which addictions have become an issue. After a point employment may cease or become interrupted due to the use of the drug or the inevitable legal consequences for which addictions are known or by death. Rest of the blog is here.

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