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Friday, November 22, 2013

ATOD & Advocacy Update - Week Ending November 22, 2013

Zohydro to be Manufactured by Same Company That Makes Addiction Medicine
The newly approved pure hydrocodone product, Zohydro ER (extended release), will be made by the same company that manufactures Vivitrol, a drug used to treat patients addicted to opioids or alcohol, The New York Times reports. The Food and Drug Administration (FDA) approved Zohydro ER last month for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Drugs such as Vicodin contain a combination of hydrocodone and other painkillers such as acetaminophen. Zohydro is expected to reach the market in early 2014. In December 2012, a panel of experts assembled by the FDA voted against recommending approval of Zohydro ER. The panel cited concerns over the potential for addiction. In the 11-2 vote against approval, the panel said that while the drug’s maker, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone. In 2010, Zogenix bought the right to market Zohydro in the United States from another company, Elan, the article notes. The following year, a company named Alkermes, which makes Vivitrol, bought a unit of Elan that included Zohydro. The deal included the existing agreement with Zogenix. Some law enforcement agencies and addiction experts have voiced concern that approval of a pure hydrocodone drug will lead to an increase in overdoses.

PCP-Related Visits to the Emergency Room Jumped 400% Between 2005 and 2011
PCP-related emergency room visits jumped 400 percent between 2005 and 2011, according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA). PCP (phencyclidine), also known as “angel dust,” can cause hallucinations when taken at high doses. The number of PCP-related visits to hospital emergency rooms jumped from 14,825 in 2005, to 75,538 in 2011, Medical News Today reports. The largest increase was seen among patients ages 25 to 34. In 2011, about two-thirds of PCP-related visits were made by males, and almost half were made by people ages 25 to 34. Other illegal drugs, including marijuana, cocaine and heroin, were involved in about half of PCP-related emergency room visits in 2011. PCP can be snorted, smoked, injected, or swallowed and is most commonly sold as a powder or liquid and applied to a leafy material such as mint, parsley, oregano, tobacco, or marijuana. Many people who use PCP may do it unknowingly because it is often used as an additive and can be found in marijuana, LSD, or methamphetamine. In a hospital or detention setting, a person on PCP may become violent or suicidal, and can become very dangerous to themselves and to others. “This report is a wake-up call that this dangerous drug may be making a comeback in communities throughout the nation,” Dr. Peter Delany, Director of SAMHSA’s Center for Behavioral Health Statistics and Quality, said in a news release. “PCP is a potentially deadly drug and can have devastating consequences not only for individuals, but also for families, friends and communities. We must take steps at every level to combat the spread of this public health threat.”

Addiction Treatment with a Dark Side
In Demand in Clinics and on the Street, ‘Bupe’ Can Be a Savior or a Menace.
For Shawn Schneider, a carpenter and rock musician, the descent into addiction began one Wisconsin winter with a fall from a rooftop construction site onto the frozen ground below. As the potent pain pills prescribed for his injuries became his obsessive focus, he lost everything: his band, his job, his wife, his will to live. Mr. Schneider was staying in his parents’ basement when he washed down 40 sleeping pills with NyQuil and beer. His father heard him gasping and intervened, a reprieve that led Mr. Schneider into rehab, not his first program, but the one where he discovered buprenorphine, a substitute opioid used to treat opioid addiction. In the two years since, by taking his “bupe” twice daily and meeting periodically with the prescribing psychiatrist, Mr. Schneider, 38, has rebounded. He is sober, remarried, employed building houses, half of a new acoustic duo and one of the many addicts who credit buprenorphine, sold mostly in a compound called Suboxone, with saving their lives. Continue reading here.

The benefits and health risks of beer and wine
More than a few baby boomers imbibed too much during their misspent youth, leaving them with a lifelong apprehension of what can come from drinking alcohol. But a raft of medical studies over the past generation shows that alcohol has proven health benefits, provided you drink in moderation — one or two drinks a day, three or four days a week. Many doctors say the findings are no longer in doubt, even if some boomers with long memories continue to be skeptical. “There’s no question that people who drink moderately have lower rates of heart attacks, lower rates of diabetes, and live longer,” said Dr. Eric Rimm, associate professor in the departments of epidemiology and nutrition at the Harvard School of Public Health in Boston. “If you ask most cardiologists, they would say drinking in moderation is beneficial.” Even more interesting: People who only drink occasionally, or on weekends, aren’t likely to enjoy the same health benefits as those who drink every other day, Rimm suggested. Alcohol reduces the risk of blood clotting in the 24 hours after drinking, for example, but not in the days after. Other benefits, such as a rise in good cholesterol, making it easier to process glucose, are more likely to extend throughout the week. Please click here to continue reading.

Alcohol Has Bigger Effect on People in Middle Age Due to Physical, Lifestyle Changes
Alcohol affects people more in middle age due to physical and lifestyle changes, according to The Wall Street Journal. As people start to take more medication in their 40s and 50s, the risk of alcohol and drug interactions also increases. As people reach middle age, they experience changes in body composition, brain sensitivity and liver functioning, the article notes. “All of the effects of alcohol are sort of amplified with age,” David W. Oslin, a professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania, told the newspaper. “Withdrawal is a little bit more complicated. Hangovers are a little bit more complicated.” Changes in body composition during middle age result in more alcohol circulating in the bloodstream. In addition, the liver, which metabolizes alcohol, gets less efficient as people age. The level of certain enzymes that break down alcohol decreases. Hormonal changes that women experience during menopause can increase their sensitivity to alcohol. In middle age, people tend to drink less than they did when they were younger, notes Robert Pandina, director of the Center of Alcohol Studies at Rutgers University. So when you do drink “you might have a more sensitive response to alcohol because you’ve lowered your exposure to alcohol over all,” he said. Drugs that can interact with alcohol include heartburn drugs such as Zantac, acetaminophen, and blood thinners like Coumadin. Mixing blood thinners with alcohol can cause bleeding. “People on Coumadin shouldn’t really drink at all,” Dr. Oslin noted. Combining alcohol with some pain medications and benzodiazepines can make a person “more prone to sedation, more prone to cardiovascular risk and more prone to overdose,” he added. According to the Centers for Diseases Control and Prevention, about 52 percent of people ages 45 to 64 had at least 12 drinks in the previous year.

Senate Passes Measure Establishing System to Track Prescription Drugs
The U.S. Senate this week passed a measure that will establish a system to track prescription drugs from the time they are manufactured until they are sold at a drugstore, The News & Observer reports. The bill awaits President Obama’s signature. Over the next seven years, The Drug Quality and Security Act calls for drug manufacturers, repackagers, wholesale distributors and dispensers to pass and hold onto key information about each drug’s distribution history. The goal is to allow unit-level product tracing within 10 years. Four years after the law is enacted, manufacturers will serialize drugs in a consistent way across the industry, to allow for efficient tracing to respond to recalls and notices of theft and counterfeiting. “This legislation will improve the safety of compounded drugs as well as establish an unprecedented tracing system that will, for the first time ever, track prescription drugs from manufacturing to distribution, thereby thwarting drug counterfeiters,” Senate Health, Education, Labor, and Pensions Committee Chairman Tom Harkin of Iowa said in a news release. “Americans must have the confidence that their drugs—whether obtained at a hospital, at a doctor’s office, or at the pharmacy counter—are safe, and that is exactly what this bill does.” John Castellani, President and CEO of the Pharmaceutical Research and Manufacturers of America, said in a statement, “The counterfeiting of prescription drugs is on the rise within the United States but oftentimes goes unnoticed or unreported, leaving many Americans unaware of this problem. In fact, some experts have cited the counterfeiting of these medicines as even more lucrative than the trafficking of illegal drugs like heroin and cocaine. This act will improve the security of the finished drug supply chain and reduce the impact of the patchwork of state laws related to the pedigree requirements for drug distribution.”

Poison Control Experts Warn of Danger From Detergent Capsules That Look Like Candy
Poison control experts are warning parents about single-dose detergent capsules that look like candy. These products were involved in about 10,000 cases of exposure involving young children, The Wall Street Journal reports. “Some children who have gotten the product in their mouths have had excessive vomiting, wheezing and gasping,” the American Association of Poison Control Centers notes on its website. “Some get very sleepy. Some have had breathing problems serious enough to need a ventilator to help them breathe. There have also been reports of corneal abrasions (scratches to the eyes) when the detergent gets into a child’s eyes.” Last year, single-dose detergent pods became popular, the article notes. Thousands of children who ate or otherwise came into contact with laundry pods received medical attention. Some had breathing problems that required days of hospitalization. A 7-month-old boy in Florida died in August after eating a laundry detergent capsule. Proctor & Gamble, which makes Tide Pods, was warned about possible problems three years ago by officials at an Italian poison control center. They contacted the company to report children were biting into small packets of the company’s concentrated liquid detergent called Dash Ecodosi. The poison control officials recommended making the capsules’ packaging opaque, and more difficult to open. After the company made the changes, reported poison cases fell by 60 percent over six months, according to the newspaper. While Proctor & Gamble studied the problem in Italy, it launched Tide Pods in the United States and Canada in clear containers. The company said it wanted to see whether making the packages opaque worked before trying them in North America. It changed the packaging in the United States and Canada this past spring. Clear packages are now largely phased out.

Office of the National Coordinator to help fight Rx drug abuse
Developing standards to bring prescription info from state databases into EHRs and HIEs
In an effort to combat the prescription drug abuse epidemic, the Office of the National Coordinator (ONC) has launched a new interoperability initiative to better link drug monitoring programs with health IT systems. In a blog post, Jennifer Frazier, ONC's behavioral health subject matter expert, says the new Standards & Interoperability Framework Initiative seeks to solve problems related to the lack of common technical standards and vocabularies that could help prescription drug monitoring programs "share computable information" with health IT systems. The PDMP & Health IT Integration framework "will bring together the PDMP and heath IT communities to establish a standardized approach to retrieve data stored in the PDMPs and deliver it to EHRs and HIEs," Frazier writes. Finding a better way to give care providers easy access to PDMP data "can't happen quickly enough, as clinicians across the country struggle to fight a growing national public health crisis," she adds. "Opioid painkillers, such as hydrocodone and oxycodone, are typically the most abused drugs. Patients are prescribed these drugs to help manage pain from injury or surgery. When taken as prescribed, these medications are generally safe; but when misused or abused, they can be highly addictive – even deadly." Please click here to continue.

New study identifies spiritual change among adolescents in treatment
A research team hopes that its latest study of factors that influence good outcomes in adolescents with substance use problems will lead more clinicians and programs to take a second look at spiritually based treatment approaches for youths. The study, which will be published next spring in Alcoholism Treatment Quarterly, found that daily spiritual experiences (encompassing more than formal religious practices alone) served as a strong predictor of sobriety in a youth population with complex problems. Strikingly, while one-third of study participants had self-identified as agnostic or atheist at the start of the study, two-thirds of those individuals would claim some spiritual identity two months later, after receiving substance use treatment. Continue here.

The bottom of the bottle: Alcoholism still tough to treat in an era of craft liquor
Evanston’s first craft brewery, Temperance Beer Company, started churning out batches of booze earlier this year; its first craft whiskey distillery, FEW Spirits, just won a $250,000 loan from the town for an expansion project. With 409 craft breweries opening in the U.S. in 2012 alone and five times as many U.S. micro-distilleries in 2012 as in 2005, it’s clear that the small-batch liquor industry is booming. For some people, however, one sip of alcohol is a sip too many. Read on here.

Researchers identify a group of 39 genes linked with alcoholism
There is good evidence from studies of families and twins that genetics plays an important role in the development of alcoholism. However, hundreds of genes likely are involved in this complex disorder, with each variant contributing only a very small effect. Thus, identifying individual risk genes is difficult. Using a new approach that combines genome-wide association studies (GWAS) with information about which human proteins interact with one another, researchers from the University of Iowa and Yale University Medical School have identified a group of 39 genes that together are strongly associated with alcoholism. "The discovery of these genes may open a new window into the biological mechanisms underlying this alcoholism disorder," says Shizhong Han, PhD, UI assistant professor of psychiatry and corresponding author of the study, which was published Nov. 21 in the American Journal of Human Genetics. "Eventually, it's our hope that the findings might help to develop drugs to treat or prevent this disorder." Han and his colleagues based their approach for identifying risk genes on the idea that genes may be "guilty by association" of contributing to the disease -- that although many different genes contribute to alcoholism, these genes, or more precisely, their protein products, are not independent of each other. "The proteins made by these genes could be neighbors, or they could be part of the same functional biological pathway," Han explains. "We took advantage of their biological relatedness to identify a network of genes that interact and together contribute to the susceptibility to alcoholism." The team conducted the study by using two large data sets collected for the genetic study of addiction -- the Collaborative Study on the Genetics of Alcoholism (COGA) and the Study of Addiction: Genetics and Environment (SAGE). These data sets document genome-wide common variants information from several thousand people linked to information about these individuals' alcohol dependence or other types of addiction\. The research team analyzed the merged SAGE and COGA datasets for genetic variants associated with alcoholism. No single variant was strongly associated with the condition, but when the researchers integrated information about protein-protein interactions from the Human Protein Interaction Network, they identified a network of 39 genes that was not only enriched for alcoholism-associated genes, but also was collectively strongly associated with alcoholism. This strong association held for both European Americans and African Americans. Furthermore, the team was able to replicate the finding in three additional genetic datasets, two of individuals of European ancestry and one of individuals of African ancestry, suggesting that the findings are robust. To minimize the possibility of the result being a false positive, the researchers also analyzed the gene network for associations with other complex human diseases - bipolar disorder, depressions and diabetes. The gene network was not associated with any of these conditions. In addition to finding the highly statistically significant association between the gene network and alcoholism, many of the genes identified also appear to be biologically relevant to brain processes likely to be affected in alcoholism. For example, the network contains genes for ion channel proteins that appear to be involved in tolerance toward some of the physiological effects of alcohol. Other genes code for proteins involved in general brain processes, including synaptic transmission, ion transport, and transmission of nerve impulses.

Drug testing is a great idea. Thanks, Rep. Radel.
Rep. Trey Radel voted in favor of drug-testing the folks who get food stamps. In that case, why don’t we drug-test all people who get federal money? Let’s start with members of Congress! Radel, the Florida Republican whose campaign was heavy on balancing the budget, would be the first to save the government some money on that plan. The 37-year-old congressman who describes himself on Twitter as a “Hip Hop Conservative” — whatever that is — lasted just 10 months in the nation’s capital before his Nose Snow Rewards Card balance tripped the radar of law enforcement. He was busted last month after buying $250 worth of cocaine from a federal agent. And it apparently wasn’t his first time on this particular sleigh ride. Continue reading here.

What’s So Bad About Casual Drug Use?
Most people who try cocaine don't go on to become addicts
So Representative Trey Radel, the Republican from Florida, a self-styled “conservative voice” in Congress, has pleaded guilty to a misdemeanor charge of cocaine possession. And Toronto’s city council has stripped Mayor Rob Ford of much of his power after it came out that he had smoked crack (never mind that Ford’s well-known drunken antics were not cause for such censure). Rather than arguing whether such figures are hypocrites (Radel voted in favor of mandatory drug testing for food-stamp beneficiaries) or debating how they should attempt damage control (he’s also pledged to enter a substance-abuse program after paying a fine and receiving a year’s probation), let’s ask a more basic question: What’s so scandalous about casual drug use?  Continue reading here.

More Than Half of Teens With Mental Health Disorders Do Not Receive Treatment: Study
More than half of teens in the United States who have mental health disorders do not receive treatment, according to a new study. The findings come from an analysis of more than 10,000 teens. Of those teens who do receive help, most are not treated by a mental health professional, HealthDay reports. They are treated by pediatricians, school counselors or probation officers. “It’s still the case in this country that people don’t take psychiatric conditions as seriously as they should,” lead researcher E. Jane Costello of Duke University said in a news release. “This, despite the fact that these conditions are linked to a whole host of other problems.” Overall, in the past year, 45 percent of teens with psychiatric disorders received some form of service. The most likely to receive help were those with attention deficit hyperactivity disorder (74 percent), conduct disorder (73 percent) or oppositional defiant disorder (71 percent). Those least likely to receive services were those with phobias (41 percent) and any anxiety disorder (41 percent). Black teens were much less likely than white teens to receive mental health treatment. There are not enough qualified pediatric mental health professionals in the United States, Costello said. “We need to train more child psychiatrists in this country,” she noted. “And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion’s share of the work.” The findings appear in the journal Psychiatric Services.

Friday, November 15, 2013

ATOD & Advocacy Update - Week Ending November 15, 2013

Addiction Treatment Experts Await Details of Parity Rules
Addiction and mental health treatment experts say they are hopeful new rules issued by the federal government that require parity between treatment for mental and physical illness will greatly expand access to care. They say a critical component of the rules’ success will be the criteria insurers use to include patients for addiction and mental health coverage. “This has been anxiously and long awaited,” Dr. Jeffrey Lieberman, President of the American Psychiatric Association, told NBC News. “Everything we’ve heard gives us a lot of encouragement. We just hope the rule goes far enough.” He said his organization will carefully review the new regulations, to see how much information insurers will be required to reveal about their coverage criteria, and how the rule will be enforced. The regulations will apply to almost all forms of insurance. Administration officials say the rules will ensure that health plans’ co-payments, deductibles and limits for visits to health care providers are the same for addiction and mental health services as they are for medical and surgical benefits—referred to as “parity.” The rules will put into effect the 2008 Mental Health Parity and Addiction Equity Act. Under the regulations, a health plan will not be able to restrict patients to in-state substance abuse treatment, while allowing them to go anywhere for medical or surgical treatment. “What it means for us is that we should see more people coming into the treatment world,” said Cynthia Moreno Tuohy, Executive Director of the National Association of Alcoholism and Drug Abuse Counselors. “One of the reasons people don’t come into treatment is that they don’t have health care. This takes those barriers away.”

Changes by Makers of Cold and Cough Medicines Reduced Children’s ER Visits
Changes made by makers of cold and cough medicines in 2007 have resulted in a significant decrease in visits by infants and toddlers to hospital emergency rooms due to these medicines, according to a new study. Drug makers voluntarily withdrew infant cold and cough medicines intended for children under age 2 from the market in 2007, and made changes in labeling on other products warning parents they should not be given to children under 4, The New York Times reports. The study, conducted by researchers at the Centers for Disease Control and Prevention, included data from 63 hospitals. The study estimated the number of visits to emergency rooms from 2004 to 2011 by young children who had taken cold and cough medicine. Before the 2007 changes, children under 2 accounted for 4.1 percent of emergency room visits for suspected drug-related effects. After the change, they accounted for 2.4 percent of the visits. Among children ages 2 to 3, ER visits related to cold and cough medicines dropped from 9.5 percent before the changes took effect, to 6.5 percent afterwards. There was no significant reduction in ER visits among children 4 to 11. Among children ages 4 and 5, visits related to cold and cough medicines increased from 5.6 percent to 6.5 percent. “We’re making great progress in under-2s, and we’re making relatively good progress in 2 to 3s,” said Dr. Don Shifrin, a spokesman for the American Academy of Pediatrics. “But we’d like better news for kids over 4.” Most infants and toddlers who end up in the ER for problems related to cold and cough medicines got hold of the medicines when a parent’s back was turned, the article notes. “Of adverse events still occurring, 90 percent in 2- to 3-year-olds were unsupervised ingestions,” said study senior author Dr. Daniel S. Budnitz. The findings are published in Pediatrics.

Advice for Small Employers Testing New Hires for Drugs
Question: How can a small company do drug testing for job applicants? How much does it cost? Do you send the employees to a local lab, or hire a contractor to handle the whole process?
Answer: Illicit drug users are significantly more likely to take time off for illness or injury, skip work, and change jobs frequently than employees who don’t use drugs, according to a 2007 report by the U.S. Department of Health and Human Services. Screening for substance abusers in the hiring process can boost companies’ productivity and retention rates. Government contractors and companies in safety-sensitive industries, such as public transportation, are legally mandated to test their employees. Most private companies are not, but many find it makes sense financially. The HHS report shows that nearly 43 percent of full-time American employees work for companies that do drug testing before hiring. Testing can be carried out randomly or after accidents, as well. Continue this article here.

More Colorado Students Bringing Marijuana to School, Anecdotal Reports Suggest
School officials, counselors and nurses in Colorado say they are seeing an increase in the number of students bringing marijuana to school, according to The Denver Post. The rise has taken place since the state regulated medical marijuana in 2010 and legalized recreational marijuana last year. Colorado’s marijuana laws forbid anyone under age 21 from using marijuana. Mike Dillon, a school resource officer with the Mesa County Sheriff’s Department, said he is seeing a growing number of younger students bringing marijuana to school. “When we have middle school kids show up with a half an ounce, that is shocking to me,” he told the newspaper. While school disciplinary statistics in the state do not isolate marijuana from general drug violations, anecdotal reports suggest an increase in marijuana-related incidents in middle schools and high schools around the state. “We have seen a sharp rise in drug-related disciplinary actions which, anecdotally, from credible sources, is being attributed to the changing social norms surrounding marijuana,” said Janelle Krueger, the program manager for Expelled and At-Risk Student Services for the Colorado Department of Education. She said school officials think the increase is linked to the message that legalization sends to children that marijuana is a medicine, and is a safe and accepted recreational activity. It is also believed to be more available, she adds. Parents or other adults may be less likely to hide marijuana now that it is legal, making it easier for students to obtain. Last year, a report about 720 student expulsions from public schools in Colorado found marijuana accounted for 32 percent of cases—more than any other drug. Christine Harms, Director of the Colorado School Safety Resource Center, said federal grants for drug abuse prevention have been cut, making it more difficult to counteract the message that legalization is sending to young people.

Homeless veterans discuss challenges of shaking addiction
On the job as a member of the Coast Guard, Ryan Kazmarek said he learned responsibility and discipline. But when he was off duty, the Dundalk man struggled with a "work hard, party hard lifestyle" that led him to alcoholism and — after he left the service — homelessness. To get back on his feet, Kazmarek joined Helping Up Mission, a Baltimore homeless shelter that provides housing, food and services to help its 500 members through long-term addiction recovery. Of that group, about 10 percent are military veterans, and Helping Up served a Veterans Day steak dinner Monday night to thank them for their service. After leading the group in prayer before dinner, Michael Sheppard talked about the similarities between his time in the Army National Guard and the homeless shelter. He said both have enriched his life and helped him grow as a person. Rest of this story is here.

No Easy Answer to Opioid Addiction Epidemic: Experts
There are no easy answers to solving the opioid addiction epidemic, according to experts at the American Association for the Treatment of Opioid Dependence annual meeting this week. Thomas McLellan, CEO of the Treatment Research Institute, told NBC Philadelphia a multi-faceted approach is needed. “You don’t have any alternatives [to opioids]. The only alternative is a non-steroidal anti-inflammatory; well it’s got liver toxicity and it’s not all that potent. There’s nothing between that and a very powerful opioid,” said Dr. McLellan, who served as the Deputy Director of the White House Office of National Drug Control Policy. “This is one of those problems that society has to manage. You can’t do away with it. Not with 70 million older Americans who vote and are aging and need them. You can’t ban them.” Doctors don’t have proper training to understand opioid addiction, Dr. McLellan noted. “They prescribe too much. They don’t manage them. About 70 percent of all the overdose deaths occur within 48 hours after the first prescription or after the first refill,” he said. He and Dr. Jeannemarie Perrone, Director of Toxicology in the Hospital of the University of Pennsylvania’s Emergency Medicine Department, recommend that doctors follow national guidelines from the American Academy of Pain Management. These guidelines recommend that patients sign a usage contract, and submit to an annual toxicology screening test to confirm they are taking the medicine and not taking other drugs before the doctor issues a prescription. Patients also need to be part of the solution to opioid abuse, Dr. McLellan says. “It has to be the joint responsibility of the patients to take medication as prescribed. Don’t give them to your sister, don’t leave them in your medicine cabinet, don’t take more than you need,” he added.

Head Shops See Business Increasing as Marijuana Legalization Spreads
Owners of stores that sell drug paraphernalia, known as head shops, say their business is growing as more states legalize the medical and recreational use of marijuana. These stores stay out of trouble with the law by saying their products are for tobacco use only, USA Today reports. The stores sell products including water pipes, rolling papers and vaporizers. Special Agent Erin Mulvey, spokeswoman for the Drug Enforcement Administration, said that under the federal Controlled Substances Act, head shop owners cannot be arrested for selling drug paraphernalia because they can claim their products are for tobacco use. “Our laws don’t just focus on paraphernalia, but the drugs themselves,” she said. According to a Pew Research Center survey released earlier this year, 12 percent of Americans say they have used marijuana in the past year. Among people younger than 30, the survey found 27 percent say they have used marijuana in the past year, at least three times the percentage in any other age group.

Who Is Responsible for the Pain-Pill Epidemic?
When I started working as a medical resident, in 2004, I heard from a patient I had inherited from a graduating resident. The patient had an appointment scheduled in a couple weeks. “But I need your help now,” he said. He was a former construction worker who had hurt himself on the job a couple of years earlier. He told me, “I also need some more OxyContin to tide me over until I can see you.” The hospital computer system told me that he had been taking twenty milligrams of OxyContin, three times a day, for at least the last couple of years. I had rarely seen such high doses of narcotics prescribed for such long periods of time. I’d seen narcotics prescribed in the hospital to patients who had been injured, or to those with pain from an operation or from cancer. But I didn’t have much experience with narcotics for outpatients. I figured that if the previous resident—now a fully licensed doctor—was doing this, then it must be O.K. What I didn’t know was that my time in medical school had coincided with a boom in the prescribing of narcotics by outpatient doctors, driven partly by the pharmaceutical companies that sold those drugs. Between 1999 and 2010, sales of these “opioid analgesics”—medications like Vicodin, Percocet, and OxyContin—quadrupled. Continue reading here.

Women have been particularly affected by the War on Drugs
Orange is the New Black and the disproportionate impact of drug policy on women
The wildly popular Netflix television series Orange Is the New Black has garnered an enthusiastic following for its frank portrayal of female inmates in a federal prison: their raunchy wit, their ingenuity, their desires and intimacies, their checkered pasts, and their suffering. The show features Piper Chapman, a fashionable yuppie blonde serving a 15-month sentence for a 12 year-old drug charge. OItNB follows, through Piper’s often na├»ve perspective, relationships among inmates and their experiences with bureaucracy, injustice, and abuse in the criminal justice (CJ) system. The series is based on the memoir by Piper Kerman, former inmate at the Federal Correctional Institution at Danbury, today a formidable figure speaking out for prison reform.  Her personal experience in a federal prison lends urgency to her calls for reform in women’s prisons, especially when it comes to prosecution and sentencing of drug offenses. Rest of the article is here.

Alcohol without the hangover? Scientist claims to invent alcohol substitute
A leading British neuroscientist says he has developed an alcohol substitute that mimics the drug's pleasurable sensations, yet when chased by a pill makes the user instantly sober without a hangover. David Nutt, a professor at Imperial College London and columnist at The Guardian, claims it is an initial discovery that could do for alcohol what e-cigarettes have done for smoking -- but he needs investors to fund his research. "I find it weird that we haven't been speaking about this before, as it's such a target for health improvement," he tells BBC. Please click here to continue.

Deaths From Drug Poisoning Rose by More Than 300% in Last 30 Years
Deaths due to drug poisoning have tripled in the last three decades, a new study concludes. The study included poisonings from both illegal and prescription drugs, according to U.S. News & World Report. Prescription drugs make up the majority of drug overdose deaths, the study concluded. The largest increase occurred in the last decade examined in the study. The researchers at the Centers for Disease Control and Prevention found the percentage of counties with drug poisoning death rates of more than 10 in 100,000 rose from 3 percent in 1999, to 54 percent in 2009. This is the first study to look at drug poisoning rates at the county level in the United States, the article notes. Previous studies have examined rates at the state or national level. “Mapping death rates associated with drug poisoning at the county level may help elucidate geographic patterns, highlight areas where drug-related poisoning deaths are higher than expected, and inform policies and programs designed to address the increase in drug-poisoning mortality and morbidity,” lead researcher Lauren Rossen said in a statement. Drug poisoning death rates rose by almost 400 percent in rural areas, and by almost 300 percent in large central metropolitan counties, the study found. Higher rates were found in the Pacific, Mountain, and East South Central regions of the nation. Lower rates were concentrated in the West North Central region, the article notes. The findings are published in the American Journal of Preventive Medicine.

Pain Relief is Goal in Most Cases of Teen Opioid Misuse: Study
Most teens who misuse prescription opioids are seeking pain relief, a new study concludes. University of Michigan researchers found four out of five teens who misused opioids said they did so to relieve pain. Thirty percent of teens who did not take their medication as directed, and 47 percent of those who used another person’s prescription, were also motivated by other reasons, such as wanting to get high. The study of 3,000 teens found teenage girls were almost twice as likely as boys to have misused prescription painkillers in the past year, HealthDay reports. The researchers did not find a gender difference in teens’ reasons for taking the drugs. The study, published in The Journal of Pain, found black teens were more likely than white teens to misuse their prescriptions. Three-fourths of black teens who misused their prescriptions said they did so to relieve pain. “The authors noted that racial differences observed in this study could be related to inadequate pain management, poor communication, insufficient opioid availability, and under prescribing among black patients,” a journal news release notes. Teens who misused their medications for reasons other than pain relief were more likely to divert their medications. The researchers said their findings indicate a need for close monitoring of opioids among teens.

One Thing Obamacare Can’t Fix: Bad Addiction Treatment
After weeks spent offering up increasingly desperate excuses for the glitchy rollout of Obamacare’s insurance exchanges, Health and Human Services Secretary Kathleen Sebelius seemed elated to change the subject, at least for a moment, when last week she announced regulations that will mean that almost all Americans with health insurance will be fully covered for the treatment of mental illness, including addiction, at least as well as they’re covered for physical diseases. The regulations were trumpeted as part of the President’s plans for curbing gun violence, but they have enormous implications for untreated addiction, which alone costs the nation $420 billion a year, mostly in health care, criminal justice and lost productivity. Click here for more.

Unique school to offer sanctuary, help to youths fighting drug addition
The nationwide epidemic of prescription-drug abuse has reached some of the most vulnerable populations, according to public health experts. Kids, some still in their preteens, are reaching into their parents’ medicine cabinets, the experts say, confounding teachers and counselors who often have little training in dealing with addiction. "There is an explosion of kids using prescription drugs, which leads to heroin use," said Pamela Capaci, executive director a Prevention Links, a private, nonprofit substance abuse treatment agency in Roselle.  Beginning in September, Union County will offer students recovering from alcohol and drug addiction a sanctuary, as well as a place to learn. "Public education is a constitutional right, and children with substance abuse problems are being denied that opportunity," state Sen. Raymond Lesniak (D-Union) said today as plans were unveiled for the Raymond Lesniak Recovery High School. The school, which will be housed at Kean University in Union Township, is being developed by the Housing Authority of Elizabeth in conjunction with Prevention Links. Capaci said the school will open with between 20 and 40 students. Plans call for enrollment to eventually grow to more than 100 students in grades 9-12. The school will provide recovery services throughout the school day, officials said. Students would attend based on referrals from their high schools and the amount of time they’d spend at Recovery High School would vary, the organizers said. It hasn’t been determined whether students from outside Union County would be able to attend. "Substance abuse at the high school level is a big deal and many, many times it is being swept under the rug," said William Jones, executive director of the housing authority. In September, the state Department of Education rejected an application to open the facility as a charter school, stating the financial plan appeared to be weak, and there was insufficient focus on classroom work. "The program’s emphasis is more on successful recovery than on academic rigor," state officials said in denying the application. "While recovery is a worthy goal in and of itself, the lack of clear focus or planning on the latter is a significant concern." Capaci disagreed with the criticism, saying there is a solid fund-raising strategy. She also said the application "demonstrated that our curriculum met the core educational requirements." Organizers now say the school will be a public-private partnership. This is the latest effort to start a "recovery high school" and something that has long been needed, said Frank Greenagle, who oversees recovery student housing at Rutgers University’s campuses in New Brunswick and Newark. "I applaud the effort, but I think it’s going to meet the same hurdles as the other attempts," said Greenagle.  Students often go through rehabilitation programs only to re-enter the same school and social settings that resulted in their addiction. "I think the relapse rate for a student going back to the same high school is like 95 percent," Greenagle said. A member of the Governor’s Council on Drug Abuse and Alcoholism, Greenagle said the former state Division of Youth and Family Services, now the Department of Children and Families, proposed a similar high school in 2002, but encountered legislative and roadblocks. Other attempts met opposition from local school districts, said Greenagle, adding that, "it was a not-in-my-back-yard syndrome." There are about 30 high schools nationwide serving youth suffering from substance abuse, including Daytop Preparatory School in Mendham, according to the website for the Association of Recovery Schools.

New drug rules could harm patients: Opposing view
Don't hinder doctors' ability to prescribe pain relief.
Prescription drug diversion and abuse is a serious public health problem that has reached crisis levels across the U.S. At the same time, patients suffering from pain too often must go without adequate access to effective pain medications, resulting in needless suffering. According to the Institute of Medicine, 100 million Americans suffer from chronic pain. We are dedicated to patient care and combating prescription drug abuse. But solutions must not discourage physicians from appropriately treating pain or reduce access to prescription drug therapies that reduce suffering. Policymakers should avoid untested strategies that inhibit legitimate access to pain treatments and impose an unnecessary burden on patients who must forgo treatment and endure symptoms of constant pain when every agonizing minute counts. Continue reading here.

Only 16% of Adults See Progress on Prescription Drug Abuse: Survey
A new Pew Research Center survey finds only 16 percent of Americans think the nation is making progress on prescription drug abuse, and 19 percent see progress in dealing with mental illness. In contrast, 54 percent of Americans say the nation is making progress on cancer. The survey found 35 percent of Americans say the nation is losing ground on mental illness, and 37 percent on prescription drug abuse. The public’s perception of progress against alcohol abuse is similarly gloomy. The survey found 17 percent see improvement in addressing alcohol abuse, while 23 percent say ground is being lost, and 58 percent say the problem is staying about the same. The public’s outlook on smoking is more positive—45 percent of adults surveyed see progress in this area, and 13 percent think the nation is losing ground. The findings are based on telephone interviews conducted among a national sample of 2,003 adults in all 50 states and the District of Columbia.

Most Medical Groups Agree on Opioid Prescribing Guidelines, Study Finds
A review of medical groups’ guidelines on prescribing opioids for chronic pain finds most of the organizations are in are agreement, Reuters reports. “There is widespread agreement about some basic ways of mitigating the risks associated with prescribing opioids for chronic pain,” said lead researcher Dr. Teryl Nuckols at the David Geffen School of Medicine at the University of California, Los Angeles. Nuckols reviewed recommendations for doctors about prescribing opioids to patients with non-cancer pain lasting for more than three months. Most of the guidelines recommend doctors not prescribe doses greater than 90 to 200 milligrams of “morphine equivalents” daily, and that they have additional knowledge to prescribe methadone. The guidelines agreed doctors should increase dosages slowly, and monitor patients for side effects when they first prescribe opioids. They advise reducing doses by at least 25 to 50 percent when switching opioids. The guidelines also recommend opioid risk assessment tools, written treatment agreements and urine drug testing to help manage the risk of overdose and misuse. The findings are published in the Annals of Internal Medicine. The study did not address how closely doctors are following the guidelines, the article notes. “Unfortunately, guidelines are not followed as often as they should be,” Nuckols said.