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Friday, October 18, 2013

ATOD & Advocacy Update - Week Ending October 18, 2013

Popular sports supplements contain meth-like compound
A popular and controversial sports supplement widely sold in the USA and other countries is secretly spiked with a chemical similar to methamphetamine that appears to have its origins as an illicit designer recreational drug, according to new tests by scientists in the USA and South Korea. The test results on samples of Craze, a pre-workout powder made by New York-based Driven Sports and marketed as containing only natural ingredients, raise significant health and regulatory concerns, the researchers said. Please continue here.

Ritalin Successfully Treats ADHD in People with Substance Dependence: Study
A new study finds Ritalin can successfully treat attention deficit hyperactivity disorder (ADHD) in people with substance dependence. People with both conditions often do not respond well to ADHD medication, according to MedicalXpress. The study by Swedish researchers finds ADHD treatment in people with substance dependence works well if Ritalin is administered in higher doses. The drug, methylphenidate, is also sold under several other brand names, including Concerta. ADHD is much more common in people with substance dependence issues than in the population at large, the article notes. It is possible that standard doses of methylphenidate are not effective in people with both ADHD and long-standing substance dependence because they have developed a tolerance to the drugs, the researchers said. In the study, researchers studied the effect of the medication on 54 prison inmates who had ADHD and dependence on amphetamines. One group of prisoners was given a placebo, while the other group was given up to double the dose of methylphenidate used in previous studies. The study lasted for 24 weeks. Prisoners given the drug had fewer relapses into drug use, fewer symptoms of ADHD, and adhered to their treatment regimen for longer, compared with prisoners given a placebo. “We’ve shown for the first time that ADHD in these patients is treatable,” lead author Dr Maija Konstenius of the Karolinska Institute said in a news release. “Moreover, the treatment led to fewer relapses to drug use, which is a very significant finding since a return to crime is often linked to drug abuse in this group.” The findings are published in the journal Addiction.

States Try Variety of Tactics to Fight Prescription Drug Abuse
States are trying a variety of strategies to fight prescription drug abuse, from tightening regulations on pain management clinics to increasing access to prescription monitoring program databases, USA Today reports. Indiana has given the state Attorney General increased oversight powers on pain management clinics. The state is also considering mandatory yearly drug screenings for people prescribed opioids, to ensure they are taking the medication as instructed. Alabama’s governor signed into law measures that provide increased access to the state’s prescription monitoring program database for medical personnel, as well as the state’s Medicaid agency. The state has made “doctor shopping” punishable by up to a year in jail. In Kentucky, law enforcement officials now have greater access to the state’s prescription drug monitoring database. A law signed by the governor last year requires doctors to examine patients and check electronic prescription records before they write a prescription for opioid painkillers. A law enacted last year in Washington State sets dosage limits for physicians who prescribe opioids. Prescriptions over a certain amount require a second opinion from a pain specialist, the article notes. New York has instituted the I-STOP program, which requires doctors and pharmacists to check the state’s drug monitoring database before they prescribe opioids. “I think the next big step is to get it done at the national level so people can’t be moving from state to state and getting prescriptions that way,” New York Attorney General Eric Schneiderman told the newspaper.

Teens Who Start Puberty Early More Likely to Experiment with Substance Use
A new survey of teens finds those who start puberty early are more likely to try cigarettes, alcohol and marijuana, compared with those who begin on time or late. The survey of almost 6,500 boys and girls ages 11 to 17 included questions about substance use in the last three months and the age when they began puberty, HealthDay reports. “While puberty is often thought of as a solely biological process, our research has shown that pubertal development is a combination of biological, psychological and social processes that all likely interact to influence risk-taking behavior like substance use,” study author Jessica Duncan Cance of the University of Texas at Austin said in a university news release. “Our study suggests that being the first girl in the class to need a bra, for example, prompts or exacerbates existing psychological and social aspects that can, in turn, lead to substance use and other risky behaviors early in life,” she said. The findings are published in the journal Addiction.

“Crazy Clown” and Three Other Synthetic Drugs Outlawed in Florida
Four new synthetic drugs, including one called “Crazy Clown,” were outlawed in Florida this week under an emergency rule filed by state Attorney General Pam Bondi. Under the emergency rule, these drugs are designated as Schedule I of controlled substances, meaning it is a third-degree felony to “sell, manufacture, deliver or possess with intent to sell, manufacture or deliver” these drugs, WCTV reports. Bondi said she will work with the Florida Legislature to permanently ban these drugs. Cities and counties throughout South Florida passed bans on synthetic drugs last year. In December 2012, Bondi signed an emergency rule that outlawed 22 new synthetic drugs throughout the state. In 2011, the state legislature banned a number of synthetic drugs. Last year, the legislature banned additional versions of the drugs. Law enforcement officials and prosecutors around the country are finding it difficult to win convictions against makers of synthetic drugs, who are constantly changing the chemistry of the products to stay one step ahead of the law. In order to convict a synthetic drug maker, officials must prove the person sold the drug, and that the drug was substantially similar to a specifically banned substance. All a drug maker has to do is make small chemical changes to the products so they are not considered “analogues,” or chemical compounds that are similar to banned drugs.

Only One-Fifth of Physicians in an Urban Emergency Department Felt Prepared to Treat Patients with Synthetic Marijuana Intoxication in 2010
During a period of growth in the use of synthetic cannabinoids, emergency department physicians were unfamiliar and inexperienced with the nature and effects of the substances, according to a 2010 internet-based survey of emergency physicians at a large urban emergency department. Synthetic cannabinoid (SC) products, also known as Spice or K2, were first identified in the U.S. in December 2008 and there were an estimated 11,206 emergency department visits related to SC use in 2010. Despite the growing prevalence of SC use, less than half of the emergency physicians (EPs) surveyed in December 2010 had ever heard of Spice (34%) or K2 (49%), and only 20% felt they were prepared to take care of a patient with acute Spice or K2 intoxication. Even those with some knowledge of SC had misconceptions about the nature of these drugs and their effects. For example, 25% were not aware that Spice or K2 were synthetic drugs and 47% said that they would not expect to see anxiety, sedation, or psychosis in a patient who had used SC—all potential symptoms of SC intoxication. While EPs likely have more knowledge of SC now than they did at the time of the survey, the findings illustrate the difficulty physicians face when treating patients who are using any new drugs of abuse. The medical literature on the effects and complications of using novel drugs is typically limited, leaving physicians to rely on other sources of information, such as lay publications, the internet, patients, and colleagues. The authors suggest that “[w]ith the seemingly limitless designer drug compounds available for use and with no information on relative toxicity of each compound, [the] connection to toxicologists, poison centers, or other experts in emerging drugs of abuse will be crucial to EPs dealing with the constantly changing world of designer drugs”.  SOURCE:  Adapted by CESAR from data from Lank, P.M., Pines, E., Mycyk, M.B., “Emergency Physicians’ Knowledge of Cannabinoid Designer Drugs,” Western Journal of Emergency Medicine, 2013.

VA Opiate Overdose Rate Almost Double the National Average: Report
The death rate from opiate overdoses among Veterans Affairs (VA) patients is almost double the national average, according to a report by the Center for Investigative Reporting (CIR). Prescriptions for hydrocodone, oxycodone, methadone and morphine have jumped 270 percent in the past 12 years among VA patients, the report found. The VA continues to prescribe increasing amounts of opiates to many patients, PBS NewsHour reports. The agency has issued, on average, more than one opiate prescription per patient for the past two years. Experts and advocates told CIR the VA is overmedicating patients as it tries to meet the demand for more complex treatment. “Giving a prescription, which they know how to do and are trained to do, is almost a default,” said Dr. Stephen Xenakis, a psychiatrist and retired brigadier general who served as commanding general of the Army’s Southeast Regional Medical Command. He added opiates hurt more veterans than they help. The VA said in a statement it is engaged in multiple, ongoing efforts to address prescription drug abuse among veterans seen in our healthcare system.” Regulations issued by the agency in 2009 required doctors to follow an integrated approach to helping veterans in pain. The regulations call for a stronger focus on treating the causes of pain, instead of using narcotics to reduce symptoms, the article notes. Adoption of the regulations varies widely across the country. Doctors at a VA hospital in rural southern Oregon prescribed eight times as many opiates per patient as those in the VA hospital in Manhattan, N.Y. A study published last year found veterans with post-traumatic stress disorder were more than twice as likely to receive opiates compared with veterans without mental health problems. These patients are at greater risk of overdose and suicide.

Doctors Who Self-Medicate Want Relief from Physical or Emotional Pain: Study
Doctors who self-medicate with prescription drugs often do so to relieve physical or emotional pain, or to relieve stress, according to a survey of doctors in recovery. The survey included 55 doctors who were being monitored for substance abuse as part of their state’s physician health program, Science Daily reports. The University of Florida researchers report in the Journal of Addiction Medicine that 69 percent of the doctors had abused prescription drugs in addition to alcohol and illicit drugs. Many of the doctors began abusing prescription drugs while using medications prescribed for chronic pain after surgery or trauma, the article notes. Some doctors used the drugs to gain relief from anxiety or depression, while others used them to relieve stress related to their professional or personal life. Some doctors said they also used drugs recreationally, while others said they used prescription medications to treatment symptoms of drug withdrawal. Prevention efforts that target prescription drug misuse by doctors should begin during medical training, and continuing education should be required throughout their careers, the researchers recommend. They wrote, “All physicians should learn the signs of substance abuse and the procedure for intervening with a colleague suspected of substance-related impairment.”

College Students’ Drinking Habits Formed in First Six Weeks of College: Expert
College freshmen’s drinking habits are often formed during the first six weeks of school, according to an expert from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). In the first six weeks, first-semester freshmen often start drinking or increase the amount they drink, says Aaron White, Program Director of NIAAA’s College and Underage Drinking Prevention Research. They may drink because of student expectations and social pressures, he notes. “Students show up with all these expectations about the role that alcohol is going to play in their lives in college, and they just get a little bit nuts with the freedom,” he said. In many cases, college freshmen are living away from their parents for the first time, and they often have easier access to alcohol, even though drinking is illegal for those under 21. However, many new college students already have experience with alcohol by the time they arrive, White said. “Colleges more or less inherit the problem than create it,” he said. “But the college environment can nurture (it), certainly.” Students’ drinking often tapers off throughout the rest of a student’s college years, the Associated Press reports. “You show up (to college) and you start doing what you think you’re supposed to be doing, and then find out that there’s no way to sustain that without flunking out,” White observed. About four out of five college students drink alcohol, according to NIAAA. About half of college students who drink also consume alcohol through binge drinking. An estimated 1,825 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries.

Crystal Meth Use Increases Risk of Injecting Drugs
A new study finds a link between crystal meth use and an increased risk of injecting drugs. The Canadian study included 395 young people living on the street in Vancouver. The study participants, ages 14 to 26, initially used crystal meth but were not injection drug users. Over the next five years, 16 percent started injecting drugs for the first time. Crystal meth was the drug most commonly used in the first injection, HealthDay reports. The average age when young people began using crystal meth was 14. The findings are published in CMAJ, the Canadian Medical Association Journal. “Addressing the impact of crystal methamphetamine use in increasing the risk of injection initiation among injection-naive street-involved youth represents an urgent public health priority,” study co-author Dr. Evan Wood of the University of British Columbia said in a news release. Crystal meth is a very pure, smokeable form of methamphetamine. It is a powerful and extremely addictive man-made stimulant. Its use can lead to severe physiological and psychological dependence. The drug’s effects are similar to those of cocaine, but longer lasting. Crystal meth can cause erratic, violent behavior among its users. Effects include suppressed appetite, interference with sleeping behavior, mood swings and unpredictability, tremors and convulsions, increased blood pressure and irregular heart rate. Users may also experience homicidal or suicidal thoughts, prolonged anxiety, paranoia and insomnia.

New York Court to Decide Whether Drivers Can Be Too Drunk to be Found Guilty
New York State’s highest court this week heard arguments from lawyers of three drivers who claimed they were too drunk to understand what they were doing or the threat they posed to others. The judges will decide whether drivers can be considered too drunk to be found guilty. In all three cases, juries convicted the drivers of second-degree murder, after prosecutors successfully argued they had shown a “depraved indifference to human life,” The New York Times reports. The cases were brought to the Court of Appeals for review on Tuesday. Prosecutors argued the drivers knew they were endangering other drivers, but did not care. Several judges seemed hesitant to create a defense of extreme drunkenness for drivers who caused severe accidents, the article notes. A decision on the cases is expected next month. In 2006, the New York Court of Appeals ruled that depraved indifference is a state of mind, forcing prosecutors to prove a defendant consciously and willingly showed “an utter disregard for the value of human life” when they are trying to prove second-degree homicides, particularly in cases pertaining to drunk driving.

Fraternity Group Opposes Bans on Freshman Rush Designed to Reduce Alcohol Deaths
A group that represents 75 national fraternities has been successful in opposing college rules that are designed to reduce alcohol-related deaths by postponing freshman recruiting, according to Bloomberg. The North-American Interfraternity Conference opposed a rule imposed by California Polytechnic State University in 2010 that banned fraternities from recruiting new students. The rule was instituted after a freshman died from drinking beer, rum and 151-proof liquor in an initiation ritual. The conference met with college administrators, paid for a study that opposed the rule, and supported a campaign against it by student leaders. The school lifted the ban this year. In 2011, nationwide fraternity membership rose to 327,260, from 253,148 in 2005. Currently only 80 of about 800 U.S. colleges with fraternities defer recruiting, according to the conference. Aaron White, program director for college and underage drinking prevention research at the National Institute on Alcohol Abuse and Alcoholism, says the youngest students are most likely to engage in binge drinking. White male fraternity members drink more heavily than any other group of students, he notes. “The first couple of months of school are a particularly vulnerable time for students with regard to heavy drinking,” White told Bloomberg. “Delaying rush makes a lot of sense.” Last year, the Interfraternity Conference opposed a federal anti-hazing bill. The group encouraged fraternity leaders at Case Western Reserve University in Cleveland to reject a plan to defer recruiting freshmen. The conference also supported the decision by fraternities at the University of Colorado at Boulder to operate without university recognition. The fraternities chose reduced access to campus facilities in order to avoid deferring recruitment and accepting live-in advisers. After the conference threatened the sue the University of Central Florida for violating students’ freedom-of-association rights, the school lifted a recruitment moratorium that had been put into place in response to excessive drinking at fraternities and sororities.

College Women: Stop Getting Drunk
In one awful high-profile case after another—the U.S. Naval Academy; Steubenville, Ohio; now the allegations in Maryville, Mo.—we read about a young woman, sometimes only a girl, who goes to a party and ends up being raped. As soon as the school year begins, so do reports of female students sexually assaulted by their male classmates. A common denominator in these cases is alcohol, often copious amounts, enough to render the young woman incapacitated. But a misplaced fear of blaming the victim has made it somehow unacceptable to warn inexperienced young women that when they get wasted, they are putting themselves in potential peril. Continue here.

College Students’ Use of Fake IDs May Contribute to Risk for Alcohol Use Disorder
A study of college students finds false ID use may contribute to the risk of alcohol use disorder by making it easier for students to drink more frequently. The study found false IDs were used by almost two-thirds of students who had tried alcohol at least once before starting college. The study included 1,015 college students who were followed over four years. Researchers found false ID use led to increases in drinking frequency and quantity. The researchers noted that while underage students tend to drink less frequently than older students, using fake IDs may lead to more frequent drinking and increase their risk of developing an alcohol use disorder, HealthDay reports. Predictors of how often students used fake IDs included younger age at first drink of alcohol, greater levels of alcohol and drug involvement during high school, higher levels of sensation-seeking, fraternity/sorority involvement and living off-campus. The findings appear in Alcoholism: Clinical & Experimental Research. According to a journal news release, this study is the first to examine the association between false ID use and subsequent risk for developing alcohol use disorders. “Just knowing how common the use of false IDs is suggests that this, among other things, is something that parents should be monitoring and also talking with their kids about,” said Jennifer Read of the State University of New York at Buffalo, who was not involved in the study. ”Both parental monitoring and communication have been shown to buffer against problem drinking outcomes in young adults, and this is another area where parents might be encouraged to engage in these practices.”

High Marijuana Taxes Could Derail Legalization Plans
When Congress banned marijuana in 1937, it did so in the guise of taxation, imposing a prohibitive levy on cannabis and created criminal penalties for those who failed to pay it. Marijuana taxes also played a prominent role in what may be the beginning of the end for pot prohibition: the legalization measures that voters in Colorado and Washington approved last fall. Click here to continue reading.

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