Addiction: Are women at
greater risk?
Q & A with addiction counselor and author Brenda J.
Iliff, MA. Click
here to read the full interview.
Don't lower blood alcohol
content to .05%: Our view - The Editorial Board, USA TODAY
The battle against drunken driving is one of the great success stories of recent years. Over three decades, the number of annual deaths has been cut in half, from more than 20,000 to less than 10,000. Even so, on average one person still dies every hour in a drinking-related traffic accident in the United States, leaving plenty of room to reduce the toll further. That's what the National Transportation Safety Board had in mind this month when it recommended that all states cut their legal drinking limit from .08% blood alcohol content (BAC) to .05%. You can't argue with the NTSB's motives, but you can argue with its logic. A 170-pound man could hit .05 by consuming three beers or glasses of wine in an hour, and a 137-pound woman by consuming just two. So lowering the legal limit would turn a lot of responsible social drinkers into criminals. More important, it probably wouldn't do much to reduce drunken driving deaths. According to statistics the NTSB cites, drivers with a .05 to .08 BAC represent just 8% of all drivers involved in fatal accidents. And that number doesn't even reflect whether alcohol-impairment caused the crash. The NTSB also points to reduced fatalities in some European countries with .05 limits. But drivers in these countries also face huge fines or frequent sobriety checkpoints, so it's impossible to credit the .05 BAC limit for the decline. In any event, there's no political stomach in the USA for going down to .05%, and even the influential Mothers Against Drunk Driving hasn't endorsed the NTSB proposal.
The battle against drunken driving is one of the great success stories of recent years. Over three decades, the number of annual deaths has been cut in half, from more than 20,000 to less than 10,000. Even so, on average one person still dies every hour in a drinking-related traffic accident in the United States, leaving plenty of room to reduce the toll further. That's what the National Transportation Safety Board had in mind this month when it recommended that all states cut their legal drinking limit from .08% blood alcohol content (BAC) to .05%. You can't argue with the NTSB's motives, but you can argue with its logic. A 170-pound man could hit .05 by consuming three beers or glasses of wine in an hour, and a 137-pound woman by consuming just two. So lowering the legal limit would turn a lot of responsible social drinkers into criminals. More important, it probably wouldn't do much to reduce drunken driving deaths. According to statistics the NTSB cites, drivers with a .05 to .08 BAC represent just 8% of all drivers involved in fatal accidents. And that number doesn't even reflect whether alcohol-impairment caused the crash. The NTSB also points to reduced fatalities in some European countries with .05 limits. But drivers in these countries also face huge fines or frequent sobriety checkpoints, so it's impossible to credit the .05 BAC limit for the decline. In any event, there's no political stomach in the USA for going down to .05%, and even the influential Mothers Against Drunk Driving hasn't endorsed the NTSB proposal.
So how to maintain the progress?
One promising option is to expand use of ignition interlocks, alcohol detection devices that drivers must blow into to start their cars. According to the Centers for Disease Control and Prevention, interlocks lower the re-arrest rate of drunken drivers by two-thirds. In fact, drivers with ignition interlocks had fewer alcohol-related accidents than those who were punished by having their licenses suspended. Some states have had great success with interlocks. After approving strict interlock laws in 2007, Arizona and Louisiana both cut drunken driving deaths by more than 36% in just four years. This month, Tennessee joined them, becoming the 18th state to mandate interlocks for all convicted drunken drivers, even first offenders. Too many other states, however, have interlock laws that do more to appease convicted drunken drivers than control them. Colorado, for example, mandates them only for drivers convicted with a BAC of .17 or above, more than double the legal limit. Alabama requires any DUI offender with a child under 15 to install an interlock device. So is the message that it's OK to kill a 15-year-old in a drunken driving accident? The carnage produced by drunken driving will never be eradicated, but the nation can get closer by employing strategies already proven to work.
One promising option is to expand use of ignition interlocks, alcohol detection devices that drivers must blow into to start their cars. According to the Centers for Disease Control and Prevention, interlocks lower the re-arrest rate of drunken drivers by two-thirds. In fact, drivers with ignition interlocks had fewer alcohol-related accidents than those who were punished by having their licenses suspended. Some states have had great success with interlocks. After approving strict interlock laws in 2007, Arizona and Louisiana both cut drunken driving deaths by more than 36% in just four years. This month, Tennessee joined them, becoming the 18th state to mandate interlocks for all convicted drunken drivers, even first offenders. Too many other states, however, have interlock laws that do more to appease convicted drunken drivers than control them. Colorado, for example, mandates them only for drivers convicted with a BAC of .17 or above, more than double the legal limit. Alabama requires any DUI offender with a child under 15 to install an interlock device. So is the message that it's OK to kill a 15-year-old in a drunken driving accident? The carnage produced by drunken driving will never be eradicated, but the nation can get closer by employing strategies already proven to work.
USA TODAY's editorial opinions are decided by its Editorial
Board, separate from the news staff. Most editorials are coupled with an
opposing view -- a unique USA TODAY feature.
Marijuana Dependence
Researcher: Important to Focus on Teens
A drug used to treat liver toxicity in Tylenol overdoses may
be helpful in treating teens dependent on marijuana, when it is combined with
behavioral therapy, according to an expert speaking at the recent American
Psychiatric Association annual meeting. The drug is one of a number of new
treatments being tested for marijuana dependence, but is the only one so far
tested solely in adolescents. Continue
reading here.
How OxyContin's Pain
Relief Built 'A World Of Hurt'
Prescription painkillers are among the most widely used
drugs in America. In the decade since New York Times reporter Barry Meier began
investigating their use and abuse, he says he has seen the number of people
dying from overdoses quadruple — an increase Meier calls
"staggering." "The current statistic is that about 16,000 people
a year die of overdoses involving prescription narcotics. ... It's a huge
problem. The number of people dying from these drugs is second only to the
number of people that die in car accidents," he tells Fresh Air's Terry
Gross. Meier's new e-book, A World of Hurt: Fixing Pain Medicine's Biggest
Mistake, is published by The New York Times Co. and explores opiate painkillers
and the consequences of long-term use. He focuses in particular on OxyContin —
how it came to be prescribed for chronic pain, what the consequences have been,
and how it became a street drug. The
rest of the story is here.
Tougher sledding for
recovering professionals
While treating recovering professionals, Philip Hemphill,
PhD, has found that many times these individuals encounter problems by virtue
of some of their character qualities. The people who are drawn into
professional schools have a tendency in their training to be extremely
competitive; forced to make difficult decisions; expected to lack limits and
suppress emotions; and feel the need to live up to something. These tendencies,
can oftentimes spill over into their practice, and the expectation of perfectionism
can lead to a lack of balance and social isolation, he explains. Although the
majority of professionals Hemphill works with are from the healthcare field,
others come from areas of law, business, academia and clergy. Hemphill is
program director of the Professional Enhancement Program at Mississippi-based
Pine Grove. Hemphill says the typical professional in treatment tends to be a
40-55 year-old male. They’re usually about 10 years post-training and
experiencing some life crisis, or a change in the workplace culture. Continue
reading here.
64 Percent of Asian and Pacific Islander Treatment Admissions Name
Alcohol as Their Problem
Alcohol abuse is a
common problem in the United States.1 When
Asians and Pacific Islanders (APIs) go to treatment, alcohol is their most
common substance of abuse. In 2010, 19,000 (1 percent) of the 1.8 million
substance abuse admissions were APIs. Among all admissions, 60 percent named
alcohol as a problem. However, among API admissions, 64 percent named alcohol
as a problem. Sixty-six percent of male API admissions and 60 percent of API
female admissions said alcohol was a problem. More information about substance
use among the API population may be found at http://www.samhsa.gov/obhe/AANHPI.aspx.
Government Approves
Voluntary Nutrition Information on Alcohol Labels
The U.S. Treasury Department announced alcohol manufacturers
can place nutrition labels on beer, wine and spirits. The labels are voluntary,
according to the Associated Press. The labels will include information such as
calories, servings per container, serving size and carbohydrates. Some alcohol
companies want to use the labels to display low calories and carbohydrates.
Beer companies may be less likely to use them, because they don’t want to
emphasize how many calories their products have, the article notes. Some
winemakers won’t want the labels to detract from the appearance of their
bottles. Michael Jacobson, Director of the Center for Science in the Public
Interest, said alcohol manufacturers should be required to list alcohol
contents on the label. He said in a statement, “Including fat and carbohydrates
on a label could imply that an alcoholic beverage is positively healthful,
especially when the drink’s alcohol content isn’t prominently labeled. In this
era of obesity, calorie labeling is critically important to inform or remind
consumers that alcoholic drinks are not ‘free’ when it comes to calories.
Finally, a really useful alcohol label would state the government’s definition
of moderate drinking as no more than one drink per day for women or two drinks
per day for men.” Currently, alcohol makers do not have to list ingredients on
the label, but they must list substances a person could be sensitive to, such
as sulfites, aspartame and certain food colorings.
Addictive Behaviour - A
Choice Or A Brain Disease?
New research shows that craving drugs such as nicotine can
be visualized in specific regions of the brain that are implicated in
determining the value of actions, in planning actions and in motivation. Dr.
Alain Dagher, from McGill University, suggests abnormal interactions between
these decision-making brain regions could underlie addiction. These results
were presented at the 2013 Canadian Neuroscience Meeting, the annual meeting of
the Canadian Association for Neuroscience - Association Canadienne des
Neurosciences (CAN-ACN). Neuroeconomics is a field of research which seeks to
explain decision making in humans based on calculating costs and likely rewards
or benefits of choices individuals make. Previous studies have suggested
addicted individuals place greater value on immediate rewards (cigarette
smoking) over delayed rewards (health benefits). Research done by Dr. Dagher
and colleagues show how the value of the drug, which is indicated by the degree
of craving, varies based on drug availability, decision to quit and other
factors. He also shows that this perceived value of the drug at a given time
can be visualized in the brains of addicted individuals by functional Magnetic
Resonance Imaging (fMRI), and that imaging results can be used to predict
subsequent consumption. Dr. Dagher showed that a specific brain region called
the dorsolateral prefrontal cortex (abbreviated DLPFC) regulates cigarette
craving in response to drug cues - seeing people smoke, or smelling cigarettes
- and that these induced cravings could be altered by inactivating the DLPFC by
Transcranial Magnetic Stimulation (TMS). He suggests addiction may result from
abberrant connections between the DLFPC and other brain regions in susceptible
individuals. These results could provide a rational basis for novel
interventions to reduce cravings in addicted individuals, such as cognitive
behavioral therapy or transcranial stimulation of the DLFPC. Concluding quote
from Dr. Dagher: "Policy debates have often centred on whether addictive
behaviour is a choice or a brain disease. This research allows us to view addiction
as a pathology of choice. Dysfunction in brain regions that assign value to
possible options may lead to choosing harmful behaviours." Source: http://www.medicalnewstoday.com/releases/260905.php
Alcoholism's Gender Gap is
Closing Fast
As women rapidly chase down men in the drinking stakes, one
Harvard professor says alcoholism progresses faster in females—and that
all-women treatment groups are vital. Read
the rest here.
AA's Female Troubles
Ella Bard finds The Big Book's male-centric focus both
alienating and archaic. Apparently she's not the only woman who thinks so. Continue here.
More Women Attempting
Suicide with OxyContin
Suicide attempts by women using OxyContin rose a staggering
210% between 2005 and 2009. Continue
here.
Obama: Bring Mental
Illness Out of the Shadows
President Obama on Monday said it is time to bring mental
illness “out of the shadows.” At the National Conference on Mental Health,
sponsored by the White House, Obama spoke about the stigma associated with
mental illness. The White House has focused on mental illness after a string of
mass shootings last year generated interest in improving the country’s mental
health services, The Washington Post reports. In a speech delivered at the
conference, Obama said most suicides each year involve someone with a mental
health or substance abuse disorder. “And in some cases, when a condition goes
untreated, it can lead to tragedy on a larger scale,” he added. “Too many
Americans who struggle with mental health illnesses are still suffering in
silence, rather than seeking help,” Obama said. “And we need to see [to] it
that men and women who would never hesitate to go see a doctor if they had a
broken arm or came down with the flu, that they have that same attitude when it
comes to their mental health.” Under the Affordable Care Act, health insurers
are required to cover mental health services as an essential health benefit.
This means all insurance plans must cover these services, and pay for them at
the same rate that they pay for medical and surgical services. Several new projects
were unveiled in conjunction with the conference, the article notes. These
include youth-oriented public services announcements on MTV, a media campaign
aimed at veterans, and information about mental health services posted on video
gamer online message boards.
Grumpy Cat Is No Lush:
Famous Feline in Alcohol-Free Prom Promotion
Grumpy Cat went to prom once, and it was awful. Or at least,
we think so, because the frowning feline’s face is plastered all over a
billboard promoting “alcohol-free” prom in Elizabeth, Pennsylvania (south of
Pittsburgh). Click
here to read the rest of the story and see the image of the billboard.
Lab Test Results Suggest
Majority of Patients Do Not Take Prescription Drugs as Prescribed
A large percentage of patients do not take their prescription drugs as prescribed, according to data from Quest Diagnostics prescription drug monitoring service. Of 151,405 urine test results from patients referred by their physicians for drug testing in 2012, 40% tested positive only for the drugs that were prescribed for them. The remaining 60% of specimens had inconsistent results, suggesting that the patient misused their medication in one of three ways: 1) by not using the prescribed drug (those testing negative for any drug, 25%); 2) by using other drugs instead (those testing negative for prescribed drugs and positive for other drugs, 15%); or 3) by combining the prescribed drug with other drugs (those testing positive for both prescribed and other drugs, 20%). According to the authors, “each of the three patterns of misuse has the potential to put a patient’s health at risk. A patient who does not take a prescribed drug will not receive potentially efficacious treatment for a medical condition and contributes to healthcare waste. A patient who uses non-prescribed drugs does so without a clinician’s supervision. And a patient who combines drugs without a physician's guidance increases the potential for dangerous drug combinations”
NOTE: The Quest Diagnostics prescription drug monitoring service tests for up to 26 commonly prescribed and abused drugs, including pain medications, central nervous system medications and amphetamines, as well as certain illicit drugs, such as marijuana and cocaine. Data presented here include results of 1) testing services ordered by physicians (such as family practitioners and internists) serving patients in a primary care setting; 2) testing services ordered by specialists that may be expected to use Quest’s prescription drug monitoring services (such as psychiatrists and neurologists); and 3) patients under care at pain management clinics and hospitals. Data do not include results of patients tested by drug rehabilitation clinics or those receiving treatment from clinicians focused on drug addiction, given the unusually high rates of drug inconsistency expected within this clinical segment.
A large percentage of patients do not take their prescription drugs as prescribed, according to data from Quest Diagnostics prescription drug monitoring service. Of 151,405 urine test results from patients referred by their physicians for drug testing in 2012, 40% tested positive only for the drugs that were prescribed for them. The remaining 60% of specimens had inconsistent results, suggesting that the patient misused their medication in one of three ways: 1) by not using the prescribed drug (those testing negative for any drug, 25%); 2) by using other drugs instead (those testing negative for prescribed drugs and positive for other drugs, 15%); or 3) by combining the prescribed drug with other drugs (those testing positive for both prescribed and other drugs, 20%). According to the authors, “each of the three patterns of misuse has the potential to put a patient’s health at risk. A patient who does not take a prescribed drug will not receive potentially efficacious treatment for a medical condition and contributes to healthcare waste. A patient who uses non-prescribed drugs does so without a clinician’s supervision. And a patient who combines drugs without a physician's guidance increases the potential for dangerous drug combinations”
NOTE: The Quest Diagnostics prescription drug monitoring service tests for up to 26 commonly prescribed and abused drugs, including pain medications, central nervous system medications and amphetamines, as well as certain illicit drugs, such as marijuana and cocaine. Data presented here include results of 1) testing services ordered by physicians (such as family practitioners and internists) serving patients in a primary care setting; 2) testing services ordered by specialists that may be expected to use Quest’s prescription drug monitoring services (such as psychiatrists and neurologists); and 3) patients under care at pain management clinics and hospitals. Data do not include results of patients tested by drug rehabilitation clinics or those receiving treatment from clinicians focused on drug addiction, given the unusually high rates of drug inconsistency expected within this clinical segment.
SOURCE: Adapted by CESAR from data from Quest
Diagnostics, Prescription Drug Misuse in America: A Report on Marijuana and
Prescription Drugs, 2013.
Prevention is often the best medicine, not only for physical health, but also public health, according to researchers at Penn State and Iowa State University. According to the researchers, young adults reduce their overall prescription drug misuse up to 65 percent if they are part of a community-based prevention effort while still in middle school. The reduced substance use is significant considering the dramatic increase in prescription drug abuse, said Richard Spoth, director of the Partnerships in Prevention Science Institute at Iowa State. The research, published in a recent issue of the American Journal of Public Health, focused on programs designed to reduce the risk for substance misuse. In a related study in a recent issue of Preventive Medicine, Penn State and Iowa State researchers found significant reduction rates for methamphetamine, marijuana, alcohol, cigarette and inhalant use. Teens and young adults also had better relationships with parents, improved life skills and few problem behaviors in general. The research is part of a partnership between Iowa State and Penn State known as PROSPER -- Promoting School-Community-University Partnerships to Enhance Resilience. PROSPER administers scientifically proven prevention programs in a community-based setting with the help of the extension systems in land grant universities. The results are based on follow-up surveys that teams conducted with families and teens during the six years after the teens completed PROSPER. Researchers developed the prevention programs in the 1980s and 1990s to target specific age groups. Understanding when and why adolescents experiment with drugs is a key to PROSPER's success, according to the researchers. PROSPER administers a combination of family-focused and school-based programs. The study involved 28 communities, evenly split between Iowa and Pennsylvania. The programs start with students in the sixth grade. The goal is to teach parents and children the skills they need to build better relationships and limit exposure to substance use. Source: http://www.sciencecodex.com/prosper_prevention_programs_dramatically_cut_substance_abuse_among_teens-113385
Are Smart Drugs a Smart
Way to Get Ahead?
School’s almost out and final exams are approaching. As the
economy slowly builds steam, hiring trends are looking hopeful and pay raises
and promotions are on the incline. And some people, young and old, are popping
pills to ensure they don’t get left behind. Among the most common
brain-boosting pills are prescription stimulants used to treat attention
deficit hyperactivity disorder (ADHD), such as Adderall and Ritalin, and the
wakefulness-promoting medication modafinil (Provigil). Dubbed “smart drugs,”
“study drugs,” “cognitive enhancers” and other terms that ring with positivity,
these pills have sparked a heated debate about the ethics of using drugs to get
ahead.
Read more here.
4 Ways You've Been Totally
Misinformed About Drugs
Whether it's the legendary "this is your brain
sunny-side up" commercial or the haggard face of one of Jesse Pinkman's
meth-slinging homies, we've all seen what drugs can do to us. Apparently, TV
occasionally doesn't tell the truth, according to Carl Hart, a neuroscientist
at Columbia University. As a matter of fact, a lot of the things that we accept
as common knowledge about drugs just aren't backed up by science, Hart says. Read
more here.
Teen Victims of
Cyberbullying More Likely to Abuse Drugs and Alcohol
Teens who are cyberbullied are more likely than their peers
who are not harassed online or through cell phone messages to develop symptoms
of substance abuse, depression and Internet addiction, a new study concludes.
Spanish researchers found victims of cyberbullying are at higher risk for
psychological and behavioral health problems, including substance abuse, after
six months of bullying, Health Behavior News Service reports. Manuel
Gamez-Guadix, PhD of the University of Deusto in Spain surveyed 845 teens, and
found 24 percent had been a victim of one cyberbullying behavior, 15.9 percent
had experienced two such behaviors, and 8 percent had experienced cyberbullying
three times. The researchers note in the Journal of Adolescent Health that
cyberbullying is a growing problem among teens. It can include hurtful and
harassing messages, rumors, inappropriate or fake photos and videos posted on
social networking sites, or in text messages or emails. Gamez-Guadix said, “It
is important to include strategies to prevent cyberbullying within
interventions for behavioral problems during adolescence. Mental health
professionals should pay special attention to these problems in the treatment
of victims of cyberbullying.”
Many Florida Pharmacists
and Doctors Ignore Prescription Drug Database
Two-thirds of pharmacists and 90 percent of doctors in
Florida are not using the state’s prescription drug database, according to
federal officials. Bills that would have required both professions to use the
database failed to pass during this year’s session. A state House bill would
have required doctors and pharmacists to check the database before writing or
filling a prescription for addictive medications. A state Senate bill would
have required doctors to consult the database. Florida approved $500,000 to
keep the database in operation for another year, WUSF reports. Florida
established the database in 2010 in an attempt to deter “doctor shopping” by
people trying to obtain multiple prescriptions for narcotic pain pills. The
database allows pharmacists and doctors to track how many pain pills patients
obtain. At a state Board of Pharmacy meeting this week, Susan Langston, who
manages the anti-diversion program of the Drug Enforcement Administration
office that covers South Florida, said the database has been effective in
shutting down pill mills and oxycodone abuse in South Florida. Problems remain
elsewhere in the state, she added. Many pharmacists dispense narcotic
medications after verifying the patient’s identity and confirming the doctor
wrote the prescription, but more thorough checks are needed, Langston said.
Michael Jackson, Executive Vice President of the Florida Pharmacy Association,
told WUSF pharmacists strongly support the database, but they don’t want to be
required to use it in every case. “It’s best to let pharmacists use their
professional judgment,” he said.
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