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Friday, April 26, 2013

ATOD and Advocacy Update - Week-Ending April 26, 2013



Middle School Prevention Program Helps Cut Later Prescription Drug Abuse: Study
Young adults who had participated in a community-based prevention program in middle school reduced their prescription drug misuse up to 65 percent, a new study finds. The researchers studied the effectiveness of the Iowa Strengthening Families Program, designed for parents and children ages 10 to 14. It aims to prevent teen substance abuse and other behavior problems, strengthen parenting skills and build family strengths. It consists of seven sessions for parents, youth and families, and includes videos, role-playing, discussions, learning games and family projects. The program reduced prescription drug abuse rates by 65 percent, the researchers report in the American Journal of Public Health. In a second study, published in Preventive Medicine, the researchers examined a prevention program for middle school students and their families called PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience). The researchers conducted follow-up surveys with families and teens for six years after they completed the program. They found that program reduced substance misuse rates up to 31 percent. Students who participated in the program had significantly reduced rates for use of marijuana, alcohol, cigarettes, methamphetamine and inhalants. Teens and young adults who had participated in PROSPER reported better relationships with parents, improved life skills and few problem behaviors, Newswise reports. “We think the programs work well because they reduce behaviors that place youth at higher risk for substance misuse and conduct problems,” lead author Richard Spoth said in a news release. “We time the implementation of these interventions so they’re developmentally appropriate. That’s not too early, not too late; about the time when they’re beginning to try out these new risky behaviors that ultimately can get them in trouble.”


Alcohol advertising in sports under fire for 'grooming child drinkers'
Doctors in Ireland are demanding a ban on alcohol sponsorship of sporting events, warning the beverage alcohol industry is “grooming child drinkers.” Sporting bodies are “very much in the alcohol industry’s pocket,” a communications regulatory committee was told April 17 by representatives of the College of Psychiatrists of Ireland (CPI). The proposed ban is similar to smoking advertising bans in the United States, which forced a sponsorship change for NASCAR's top racing series from the Winston Cup to the Sprint Cup. Click here for the rest of the story.


Growing Numbers of Americans Support Legalizing Pot Use
A group of high school friends known as "the Waldos" at a San Rafael, Calif., high school coined the term "4/20" in the 1970s as the designated time of the day to smoke pot after school. It's 4/20 time again this week. For those who aren't part of the millennial generation, 4/20 is unofficial "Weed Day" in America – a counter-culture phenomenon that has drawn up to 10,000 marijuana legalization activists at college campuses in the U.S. in recent years. In years past, Weed Day counter-culture "holiday" celebrations have taken place on April 20 at Golden Gate Park in San Francisco, in several Canadian cities, at the University of Colorado at Bolder and elsewhere. Weed Day has also migrated to other parts of the world. Rest of this story is here.


Researcher Uses Virtual Reality to Reduce Addiction Cravings
A Duke University researcher is studying whether virtual reality can be used to reduce cravings in people who are addicted. The goal is to help them develop coping strategies that they can use in the real world, Popular Science reports. A person using virtual reality for addiction treatment is hooked up to a simulator, and enters a virtual environment with one of their triggers, such as a crack pipe or bottle of alcohol. Someone in the scene offers them their drug of choice. Researchers slowly add cues to the virtual environment, or change the situation, based on the patient’s history. A voice tells the person to put down the joystick and look around the room without speaking, to allow their craving to dissipate. The voice asks them to rate their cravings periodically. The research is spearheaded by Zach Rosenthal, who receives funding from the National Institute on Drug Abuse and the Department of Defense. He uses virtual reality to trigger a reaction, and then teaches patients to cope with it. The method is called cue reactivity, which has long been used for treating phobias. Dr. Rosenthal believes virtual reality is more effective than showing someone a real-life trigger, such as a lighter or empty bottle, in a lab setting. His hope is that creating a virtual world that is similar to the patients’ environment will help them transfer the lessons to the real world. Rosenthal has been using virtual reality to treat substance abuse in veterans. The soldiers have post-traumatic stress syndrome. The program trains veterans’ minds not to respond to cravings when they are faced with temptations such as alcohol or drugs. Veterans participating in the research receive cell phone calls several times daily that transmit a tone to remind them about the steps they have learned to deal with their cravings.


National Study: Teen Misuse and Abuse of Prescription Drugs Up 33 Percent Since 2008, Stimulants Contributing to Sustained Rx Epidemic
New, nationally projectable survey results released today by The Partnership at Drugfree.org and MetLife Foundation confirmed that one in four teens has misused or abused a prescription (Rx) drug at least once in their lifetime – a 33 percent increase over the past five years. The Partnership Attitude Tracking Study (PATS) also found troubling data on teen misuse or abuse of prescription stimulants. One in eight teens (13 percent) now reports that they have taken the stimulants Ritalin or Adderall when it was not prescribed for them, at least once in their lifetime. Contributing to this sustained trend in teen medicine abuse are the lax attitudes and beliefs of parents and caregivers. In fact, nearly one-third of parents say they believe Rx stimulants like Ritalin or Adderall, normally prescribed for attention deficit hyperactivity disorder (ADHD), can improve a teen’s academic performance even if the teen does not have ADHD. Parents are not effectively communicating the dangers of Rx medicine misuse and abuse to their kids, nor are they safeguarding their medications at home and disposing of unused medications properly. (Read the full report here)

Hookah Smoking Poses Health Risks, Study Finds
Hookah smoking may be as harmful as cigarettes, but in a different way, a new study suggests. Researchers at the University of California, San Francisco, studied 13 volunteers who had experience with hookah, or water pipe, smoking and cigarettes. Each participant smoked either a hookah or cigarettes for four days, and then a week later switched. They smoked an average of three hookah sessions or 11 cigarettes daily. When participants’ nicotine blood levels were measured, the researchers found those who used a hookah had about half the nicotine levels of cigarette smokers. Carbon monoxide levels in participants’ breath were 2.5 times higher for hookah smokers, compared with cigarette smokers. Carbon monoxide can increase the risk of heart attacks, stroke and sudden death in people with heart or lung conditions, the Los Angeles Times reports. “People want to know if it is a lesser health risk if they switch from cigarettes to smoking a water pipe on a daily basis,” researcher Peyton Jacob III, PhD, said in a news release. “We found that water-pipe smoking is not a safe alternative to cigarette smoking, nor is it likely to be an effective harm-reduction strategy.” The study found hookah smokers had significantly higher levels of benzene, which is associated with an increased risk of leukemia. The study is published in Cancer Epidemiology, Biomarkers and Prevention. Hookah bars feature water pipes that are used to smoke a blend of tobacco, molasses and fruit called shisha. Researchers say that contrary to the belief of many hookah smokers, the water in the pipe does not filter all the harmful chemicals in tobacco smoke. The World Health Organization (WHO) noted in a report that the smoke inhaled in a typical one-hour hookah session can equal 100 cigarettes or more. The WHO report also stated that even after it has been passed through water, the tobacco smoke in a hookah pipe contains high levels of cancer-causing chemicals.


40 percent of parents give young kids medicine they shouldn't
Four in 10 U.S. parents give children age 4 and younger cough/cold medicine that is not recommended for young children, researchers say.  Dr. Matthew M. Davis, director of the C.S. Mott Children's Hospital National Poll on Children's Health, said children can get five to 10 colds each year, so adults often turn to over-the-counter cough and cold medicines. However, a University of Michigan C.S. Mott Children's Hospital National Poll showed more than 40 percent of parents reported giving their children age 4 and younger cough medicine and multi-symptom cough and cold medicine. Twenty-five percent gave decongestants. Read the rest here.



More Booze Please! The National Drive to Lift Restrictions on Alcohol-preneurs
The craft beer industry has been on a tear, boasting a 17% rise in sales last year and continued growth expected going forward. Lately, it looks like a big surge is on tap not only for craft breweries, but small businesses that make wine and spirits as well.  Like elected officials in virtually every state, Michigan Governor Rick Snyder has been an outspoken proponent of local businesses. Snyder even created something called the Office of Regulatory Reinvention a couple of years ago. It may sound like just another bureaucracy, but in fact its goal is to eliminate the red tape that snags entrepreneurs. In early 2013, a government newsletter was circulated boasting that the ORR had successfully helped to eliminate 1,000 regulations in Michigan since the office was opened. Apparently, most of these regulations were obsolete or pointless, and they were eliminated because they were burdens to local businesses. Rest of this story is here.


Controlling alcohol habits as students find 'release' may avoid later addiction
Current college culture allows for an environment where risks of addiction and alcohol dependency increase while mental health decreases. According to an American Psychological Association report, there is a rising number of students grappling with mental health problems. Similar to the data seen at Penn State’s Counseling and Psychological Services, the most common of the disorders seen in students are depression, anxiety, suicidal, ideation, alcohol abuse, eating disorders, and self-injury. According to a 2010 National Survey of Counseling Center Directors, 45.7 percent have reported an increased number of clients struggling with alcohol abuse. Click here for more.


To Crack Down On Prescription Drug Abuse, We May Need To Build A Better Pill Bottle
Over the past decade, deadly prescription drug overdoses have soared to record levels. But, since abusers often get their drugs from a friend or family member who obtained them legally, it’s difficult for authorities and public health advocates to effectively crack down on this issue. But new technologies could help — specifically, as group of Brigham Young University (BYU) students suggest, an electronic pill bottle that regulates how many painkiller pills can be dispensed at once. Read the rest of the story here.


Social change shows up in preteen brain
New research reveals which brain regions are active as kids on the brink of adolescence consider their identity and social status. In a study of 27 neurologically typical children who underwent functional magnetic resonance imaging (fMRI) at ages 10 and 13, activity in the brain’s ventromedial prefrontal cortex increased dramatically when the subjects responded to questions about how they view themselves. Read the rest here.


Low-achieving students don’t get top teachers
A study of a major urban school district reveals that high-achieving students tend to get the best teachers, leaving others to less experienced instructors. Even within the same school, lower-achieving students often are taught by less-experienced teachers, as well as by teachers who received their degrees from less-competitive colleges, according to a new study. Read the rest here.

First-Ever Nationwide Survey Documents Dramatic Improvements in All Areas of Life For People In Recovery From Addiction
The results from the first nationwide survey of persons in recovery from addiction to alcohol and other drugs released today by Faces & Voices of Recovery documents the heavy costs of addiction to the individual and the nation and for the first time, measures and quantifies the effects of recovery over time. During their active addiction, 50 percent of respondents had been fired or suspended once or more from jobs, 50 percent had been arrested at least once and a third had been incarcerated at least once, contributing to a total societal cost of $343 billion to our nation annually. Click here to read more.


23% of Teens Surveyed Admit to Driving Under Influence of Alcohol or Drugs
A new survey of teens finds 23 percent admit they have driven under the influence of alcohol, prescription drugs or marijuana. Almost 20 percent of teens who drink and drive say alcohol improves their driving, while 34 percent say the same about marijuana. Teens are more likely to drink when they are less heavily supervised, according to the survey by Students Against Destructive Decisions (SADD) and insurance company Liberty Mutual. The survey included 1,708 high school students in grades 11 and 12, USA Today reports. “The end of the school year and the summer months are exciting times for teens, but they are also the most dangerous,” Dave Melton, Managing Director of Global Safety for Liberty Mutual, said in a news release. “A celebratory toast can quickly lead to serious consequences down the line. These new data illustrate that there is clearly a strong need to increase the level of education around safe driving. More importantly, it’s a flag for parents to make sure they talk to their kids regularly about the importance of safe driving behavior.” He added, “The fact that an overwhelming number of teens admit to extremely unsafe driving habits and completely dismiss any risk concern yet still consider themselves safe drivers means either teens have a different definition of ‘safe’ or we need to do a better job of educating kids about the dangers of this type of behavior.” The survey found 11 percent of teens admitted to driving under the influence of alcohol or drugs during the summer in general; 8 percent on July 4th; 6 percent on prom night; and 5 percent to celebrate graduation. Earlier this year, the Governors Highway Safety Association released a report stating the number of 16- and 17-year-old driver deaths in passenger vehicles increased from 202 to 240 in the first six months of 2012—a 19 percent jump from same period the previous year.


What Can We Do To Reduce Substance Use Among Homeless Youth?
Homeless young people use and abuse drugs and alcohol at alarming rates, perhaps as high as 50 to 84 percent, according to some studies. Beyond the obvious fact that using substances is bad for young people’s health, researchers say that drug and alcohol abuse can pull homeless youth farther and farther away from family, friends, school and other positive support systems. Interventions to get young people to stop using substances (or never use them in the first place) are crucial. But to date, we know very little about what works to help homeless young people get off and stay off drugs and alcohol. Click here to read the rest of this story.

Liver Disease: New Studies Demonstrates Lethal Link Between Alcohol, Weight
Research announced today at the International Liver Congress 2013 has revealed the deadly impact that alcohol and body weight have on liver disease. Women should forgo the wine and doughnuts after a new study found the harmful combination of high alcohol intake and high body mass index (BMI) causes an increased risk of chronic liver disease. The study analysed a cohort of over 107,000 women to investigate how a female's weight and alcohol consumption affected their chances of suffering and dying from chronic liver disease. Click here for the rest of this story.

Analysis says patients, counselors pay the price for a lack of standards
While few of its individual findings will come as much of a surprise to seasoned professionals in the addiction field, a newly issued report from the National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) packs a punch in its assault on current substance use treatment practice. Perhaps the most stinging, if still not stunning, comment in the report is its statement that the medical profession is largely absent from addiction practice and that the counseling professionals who deliver most of the treatment services to patients are often subject to few or no qualification standards. Click here for the rest of this story.


Use of psychedelic drugs remains prevalent in the United States
In a recent F1000Research article, Teri S. Krebs and Pål-Ørjan Johansen from the Department of Neuroscience at Norwegian University of Science and Technology, use data from a randomly-selected sample of over 57,000 individuals surveyed for the 2010 National Survey on Drug Use and Health (NSDUH), to estimate lifetime prevalence of psychedelic use. The authors of “Over 30 million psychedelic users in the United States” estimate that approximately 32 million people have used LSD (lysergic acid diethylamide), psilocybin (“magic mushrooms”), or mescaline (peyote and other cacti) in their lifetime. This includes 17% of US adults aged 21 to 64 years. The highest rate of psychedelic use was in the 30 to 34 age group, with an overall rate of 20%, or 26% of males and 15% of females. Click here for more.


Breathing Test Device Used to Detect 12 Controlled Substances
Swedish researchers have found a commercially available breathing test device can be used to detect 12 controlled substances, including marijuana, cocaine, heroin and methamphetamine, US News reports. The device was tested on 47 people who had taken drugs in the previous 24 hours and were recovering at a drug addiction emergency clinic, the researchers report in the Journal of Breath Research. The test correctly detected drug use in 87 percent of cases, and was as accurate as blood and urine tests. Currently, police do not have a simple way to test drivers for drugs when they are suspected of driving under the influence (DUI), the article notes. Lead researcher Olof Beck of the Karolinska Institutet noted in a news release, “Considering the samples were taken 24 hours after the intake of drugs, we were surprised to find that there was still high detectability for most drugs.” Dr. Beck said police could use the test at the scene when DUI is suspected, and later confirm the findings with a blood test. The researchers collected breath samples using a currently available breath test called SensAbues, which consists of a mouthpiece and micro-particle filter. When a person breathes into the mouthpiece, the device separates saliva and larger particles from the tiny particles that are measured. The micro-particles pass through and deposit onto a filter, which is sealed and stored. The particles are then analyzed using lab tests known as liquid chromatography and mass spectrometry.


Friday, April 19, 2013

ATOD and Advocacy Update - Week-Ending April 19, 2013



Primary Sources: Using Cigarettes and Marijuana at an Early Age May Put Girls at Risk for Pregnancy
What it’s about: Researchers at the Washington University School of Medicine in St. Louis wanted to know what types of substance use might put teenage girls at risk for becoming pregnant at a very young age (under 15 years old). To find out, they studied data from the National Youth Risk Behavior Survey, which is conducted every two years by the Centers for Disease Control and Prevention. The survey takes stock of the risky health behaviors of U.S. high school students. Read the rest here.


Anxiety and alcohol use linked to Facebook
In a quest to learn what leads some people to turn to Facebook to connect with others, doctoral student Russell Clayton of the Missouri School of Journalism found that anxiety and alcohol use seem to play a big role. For his master's thesis, which appears in the May issue of Computers in Human Behavior, Clayton surveyed more than 225 college freshman about two emotions, anxiety and loneliness, and two behaviors, alcohol and marijuana use. He found that the students who reported both higher levels of anxiety and greater alcohol use also appeared the most emotionally connected with Facebook. Those who reported higher levels of loneliness, on the other hand, said they used Facebook to connect with others but were not emotionally connected to it. Read the rest here.


Teen Dating Abuse and Harassment in the Digital World
The Urban Institute's study on teen dating and digital abuse surveyed 5,647 teens to better understand how many have been affected by abuse and harassment. One in four dating teens is abused or harassed online or through texts by their partners, according  the largest survey to date on the subject.  Victims of digital abuse and harassment are 2 times as likely to be physically abused, 2.5 times as likely to be psychologically abused, and 5 times as likely to be sexually coerced. New technologies—social networking sites, texts, cell phones, and e-mails—have given abusers another way to control, degrade, and frighten their partners.  These tools haven’t pushed overall abuse rates up, but have allowed abusers to harass their victims anywhere and at any time, even when they’re apart.  Read more here.


Generic Drug Makers Await FDA Decision on OxyContin
Generic drug makers are waiting for the Food and Drug Administration (FDA) to decide whether they must make tamper-resistant forms of OxyContin, or if they can produce the original version, The Wall Street Journal reports. OxyContin’s first patent expires Tuesday. In making its decision, the FDA must weigh the significant problem of prescription drug abuse against the need for generic painkillers that are effective and inexpensive. The FDA’s decision could influence proposed federal legislation that would require most prescription painkillers to have tamper-resistant formulas. Annual sales of OxyContin, at $2.8 billion, represented about 30 percent of the painkiller market last year, according to the newspaper. The original version of OxyContin was easy to heat or crush, allowing users to inject, snort or smoke the drug. In 2010, the drug’s manufacturer, Purdue Pharma, introduced a tamper-resistant formula that made the pill harder to crush. The FDA could allow generic drug makers to produce the original version, which would be inexpensive to make. The agency might decide generic companies could only make versions that use Purdue’s abuse-deterrent formula, which does not come off patent until 2025. Or it could allow generic drug makers to make their own versions of abuse deterrents. Last month, the group representing the nation’s attorneys general called on the FDA to require manufacturers and marketers of generic prescription pain drugs to develop versions of their products that are resistant to tampering and abuse.


Commentary: ASAM Survey to Identify Where Patient Access to Addiction Treatment is at Risk
As a growing number of states have either passed new legislation or are considering legislation limiting payment for opioid treatment, the American Society of Addiction Medicine (ASAM) has launched the patient advocacy task force, which focuses on FDA-approved medications for opioid dependence. ASAM Acting President Dr. Stuart Gitlow explains the group is starting with a survey that will identify locations in which patient access to treatment is at risk. Over a decade ago, there were but two medications in the addiction specialist’s prescription pad: the relatively little-used, off-patent and inexpensive disulfiram, and the more frequently used but also off-patent and inexpensive methadone. Those accounting for the cost of treating addiction focused on the comparative expenses of various treatment modalities, saving funds for the short-term by preferring treatment at the least intensive level of care. Ambulatory treatment of addiction was not even a blip on the radar because it generally involved no procedures and no medication.Times have changed. We have many medications now indicated for use in various states of addictive disease. These medications are far more expensive than disulfiram and have been utilized extensively. Physicians across the country are prescribing a variety of medications such that outpatient addiction treatment no longer represents a mere blip on the accountants’ worksheets. Addiction treatment, and opioid dependence in particular, has risen to the upper part of the chart if we look only at the cost of ongoing medication prescribed to those afflicted. The question from the accounting perspective has always been, “How can we contain costs?” The big picture, of course, sees the cost of treatment as being only one side, with the other side represented by improved function, improved productivity, longer life and reduced costs associated with more rigorous treatment which might be necessitated if the illness is not addressed in an ongoing manner. But these gains take time to establish and are difficult to demonstrate within an election cycle, which unfortunately has become the important unit of time with which we are now concerned. State legislatures have noticed the impact on the balance sheet, and while it is highly unlikely that they would say, “You may treat hypertension for two years, but then must stop the antihypertensive,” or “I’m sorry about your 10-year-old’s diabetes, but she’s already been on insulin for two years and therefore must discontinue her medication,” they seem to have little difficulty asking our opioid dependent patients to discontinue or limit their dosage of medication. Utah, Michigan, Maine, Tennessee and Indiana have either passed new legislation or are considering legislation addressing buprenorphine specifically. The potential Tennessee legislation, not yet introduced, even has statements to the effect of requiring buprenorphine treatment to be terminated should there be positive urine drug test results. Imagine that: “Hmmm, your blood pressure is 200/120. I’m required by law to stop your antihypertensive.” The ASAM has launched the patient advocacy task force specifically focusing on FDA-approved medications for opioid dependence (methadone, buprenorphine, buprenorphine/naloxone and ER injectable naltrexone). We’ve started with a survey to identify examples of access which can serve as models for both public and private sectors, but also to identify locations in which patient access to treatment is at risk. Our first press conference is scheduled for June 20 at the National Press Club in Washington, D.C., but even before that time, we’re focusing on individual states where the risk is most immediate. An individual can have hypertension but not be hypertensive. An individual can be diabetic yet have a normal blood sugar. An individual can have addictive disease even while in recovery. And just to make matters more complex, an individual with addiction can be in recovery either while entirely abstinent from psychoactive substances or while taking a prescribed medication such as methadone or buprenorphine. Short-term economic considerations, combined with the stigma against treatment of those with addictive disease, should not drive treatment decisions or determinations.

Stuart Gitlow, MD MPH MBA is a member of the American Medical Association’s Council on Science & Public Health, and Acting President of the American Society of Addiction Medicine. 

Companies Use Data Analysis to Fight Prescription Drug Abuse
A growing number of companies are using data analysis to fight prescription drug abuse, The Wall Street Journal reports. Many of these firms were represented at last week’s National Rx Drug Abuse Summit in Orlando.They are combining medical research and guidelines with computer analysis. Most of the companies are insurers and medical bill review consultants for firms that pay workers’ compensation claims. They say their goal is to lower healthcare costs, improve safe use of medication and identify people who might abuse painkillers before they become addicted. Some doctors say they are concerned these companies may be more interested in lowering costs than in patients’ wellbeing. “One person doesn’t heal the same way another person does. Treatment has to be directed by the physician—not the insurer,” said Andrea Trescot, past president of the nonprofit industry group American Society of Interventional Pain Physicians. One company, Rising Medical Solutions Inc., uses algorithms to determine injured workers’ risk of abuse, based on a 30-question survey. They are asked about their optimism about recovery, previous history of injury, whether they smoke, and other risk factors for painkiller addiction. The company also evaluates the amount of time between when an injury occurs and when it was reported. A delay could signal a greater potential for abuse, the article notes. Another firm, PMSI Inc., creates a risk scorecard that compares a company’s results to other firms in the area, or in a similar industry. If PMSI determines a patient has the potential to abuse painkillers, a doctor employed by the company will call up the physician treating the patient to discuss the case.


Many Young Adults Use Parents’ Insurance to Treat Substance Abuse, Mental Illness
Young adults who receive health insurance through their parents’ plans because of the Affordable Care Act (ACA) are more likely to use the coverage to treat substance abuse, mental illness or pregnancy, compared with their peers who already had coverage, a new report finds. These three conditions accounted for 60 percent of hospital claims for young adults who were enrolled in their parents’ health plans in 2011, as a result of ACA, according to The Hill. The findings come from a study by the Employee Benefit Research Institute (EBRI). In contrast, substance abuse, mental illness and pregnancy accounted for about one-third of claims in a group of young people who were already enrolled in their parents’ plan before healthcare reform took effect. Under ACA, health plans that provide dependent coverage must let young adults remain on their parents’ plan until they are 26. As a result of the law, 3.1 million young adults have gained coverage, EBRI estimates. The uninsured rate among young people ages 19 to 25 has fallen significantly over the past several years. The EBRI study found young people enrolled in their parents’ plan after 2011, when the provision took effect, spent an average of 15 percent more on healthcare, compared with their peers who were already on their parents’ plan.


What your brain looks like on prescription pills
The famous TV commercial that showed an egg frying and warned Americans “this is your brain on drugs” was meant to focus on illicit substances, but its message is equally applicable to many popular prescription medications.\ That’s because these medications, just like drugs of abuse, hijack the brain circuits designed to make us feel pleasure when we’re doing the things that keep us alive or keep the species going. So, when we eat something tasty or have sex, the reward centers of the brain are stimulated and we feel good, which makes us want to go back and do it all over again. Similarly, pain relievers tap into the reward center – one of the oldest regions of the brain, often called the primitive brain – to make us feel better. And that may help explain how it is that pain killers take more lives than heroin and cocaine combined. Read the rest here.


Smack talk: Heroin addiction touches individuals, families, communities
Feb. 20 is the date Adam lost a parent. The date that pushed him further down the road of drugs and addiction. The date he got high to forget. Feb. 21 is a special day for one of his siblings. The date he couldn’t celebrate with his family anymore. The date he chose as his “clean date.” Read the rest here.


California panel advances bills targeting prescription drug abuse
A broad package of bills aimed at reducing prescription drug abuse and overdose deaths won approval from a key state Senate committee Monday. The bills, including a measure that would require coroners to report prescription-involved deaths to the Medical Board of California, followed a series of Times articles linking doctors to patient overdose deaths. Click here for the rest of the story.


Taste of Beer, Without Effect from Alcohol, Triggers Dopamine Release in the Brain
The taste of beer, without any effect from alcohol itself, can trigger dopamine release in the brain, which is associated with drinking and other drugs of abuse, according to Indiana University School of Medicine researchers. Rest of this article is here.


Heroin Use Increasingly Seen in Suburbs Across the Country
As prescription painkillers become more difficult to obtain and abuse, a growing number of people addicted to these drugs are switching to heroin, USA Today reports. The trend is increasingly being seen in the suburbs. Health officials and police report a significant rise in overdoses and crime, the newspaper notes. Last fall, the Northern New England Poison Center reported a jump in heroin overdoses in Maine, Vermont and New Hampshire. “When you switch to heroin, you don’t know what’s in there from batch to batch,” said the center’s director, Karen Simone. “It’s a big jump to go to heroin. It may be strong; it may be weak. They don’t know what they are getting. Suddenly, the whole game changes.” Heroin is popular in large part because it is cheap, officials say. While an 80-milligram OxyContin costs between $60 to $100 a pill on the black market, heroin costs $45 to $60 for a multiple-dose supply. OxyContin abuse has also been declining because the drug has been reformulated so it is more difficult to crush and snort. According to the 2011 National Survey on Drug Use and Health, the number of people who were past-year heroin users in 2011 (620,000) was higher than the number in 2007 (373,000). “Heroin is huge. We’ve never had anything like it in this state,” said Carol Falkowski, the former drug abuse strategy officer for Minnesota and a member of the Community Epidemiology Working Group at the National Institute on Drug Abuse, which tracks trends in drug use. “It’s very affordable. It’s very high purity. Most people did not believe that heroin would happen here in Lake Woebegone, but it really has a grip, not only in the Twin Cities, but all around the state.”


Drug overdose prevention could be right at our fingertips
What do you think is the leading cause of accidental death in California? If you said car accidents, you were wrong. In 2009, the most recent year for which statistics are available, 3,200 people in the state died in automobile crashes, while 3,561 people died of drug overdoses, the bulk of them involving prescription pills. That high number of deaths is particularly tragic because we have a powerful weapon against drug overdoses, and it isn't used nearly as often as it could be. Rest of the story is here.


FDA Will Not Approve Generic Versions of Original OxyContin
The Food and Drug Administration (FDA) announced Tuesday it will not approve any generic versions of the original form of OxyContin. The move is aimed at preventing prescription drug abuse, Reuters reports. The original version of OxyContin could be crushed and then snorted or injected. Its patent was set to expire on Tuesday. The FDA also approved new labeling for a reformulated version of the drug, which will indicate it is more difficult to crush, and thus harder to abuse than the original version. OxyContin’s manufacturer, Purdue Pharma, introduced the tamper-resistant formula in 2010. “The development of abuse-deterrent opioid analgesics is a public health priority for the FDA,” Douglas Throckmorton, MD, Deputy Director for Regulatory Programs in the FDA’s Center for Drug Evaluation and Research, said in a statement. “While both original and reformulated OxyContin are subject to abuse and misuse, the FDA has determined that reformulated OxyContin can be expected to make abuse by injection difficult and expected to reduce abuse by snorting compared to original OxyContin.” Representative Hal Rogers of Kentucky, Co-Chairman of the Congressional Caucus on Prescription Drug Abuse, said in a statement, “This is a huge win for our region and for the thousands of families who have seen painkillers become pain makers. The FDA undoubtedly saved our nation from another deadly tidal wave of oxycodone abuse and overdoses.”


Millions of New Patients Could Receive Addiction Treatment Under Health Law
Between 3 million and 5 million new patients could soon receive addiction treatment under the Affordable Care Act, according to the Associated Press. The change will have a major impact on treatment for drug and alcohol addiction. Currently only one cent of every health care dollar in the United States is dedicated to addiction treatment, the AP reports. Approximately 10 percent of the 23 million Americans with drug and alcohol problems receive treatment, government figures indicate. Until now, a major reason for the large number of people not receiving treatment has been a lack of health insurance. Under healthcare reform, millions of people will become eligible for insurance coverage starting in January. The number of people seeking addiction treatment could double, the article notes. “There is no illness currently being treated that will be more affected by the Affordable Care Act than addiction,” Tom McLellan, CEO of the nonprofit Treatment Research Institute, told the AP. “That’s because we have a system of treatment that was built for a time when they didn’t understand that addiction was an illness.” The change may overwhelm many treatment facilities. In more than two-thirds of states, treatment clinics are at 100 percent capacity or will reach that mark soon. The arrival of many new patients could lead to waiting lists of months or longer, according to treatment agencies. Many of them have been shrinking in recent years due to government budget cuts. The federal government is urging states to expand their Medicaid programs. If 20 states do so, an additional 3.8 million patients with addiction problems would receive insurance, the AP notes. If almost all of the states expanded their Medicaid program, that number could reach 5.5 million. The law also designates addiction treatment as an “essential health benefit” for most commercial health plans.


Medication-Assisted Treatment and Other Changes in the Addiction Field: A Q&A with Maia Szalavitz, Part III
Opioids (heroin and prescription pain relievers) are powerful drugs that act on specific receptors in the brain that are important in regulating pain. While prescription opioids can be highly beneficial if used as prescribed, as a class of drug, they have a high potential for abuse. In fact, the National Institute on Drug Abuse estimated that 1.9 million people in the U.S. were addicted to prescription opioid pain relievers in 2010 and 359,000 were addicted to heroin. Medication-assisted treatment for opiate dependence generally refers to the use of the medications buprenorphine, methadone or naltrexone to treat opiate dependence, in combination with counseling and recovery support services.  In this, Part 3 of a 4-part series of my Q&A with award winning journalist Maia Szalavitz, Ms. Szalavitz shares her views on the dominance and effectiveness of traditional AA/12 Step based rehab programs, as well as the changes she has seen in the addiction field with a special emphasis on medication-assisted treatment for those struggling with opioid dependency. Read the rest here.


Smack talk: Addiction a family disease
Heroin addiction is a family disease. “For every person affected with addiction, on average, there are at least four to five other people significantly impacted: parents, siblings, grandparents, spouses, children. "And then there’s another circle of about 7 to 15 other people: neighbors, coworkers, friends,” Dr. Neil Capretto, addiction psychiatrist and medical director at Gateway Rehabilitation Center in Center Township, said. Chris Payne of Center Township knows that well. Within the past two years, Payne's nephew, Ronald Kroskey, 26, of Beaver Falls, and then her son, Stephen Payne III, 22, died of drug overdoses involving heroin. Stephen Payne became addicted to opiates about a year before his death, when doctors prescribed him painkillers for back and arm injuries. Read the rest here.


Parents Can Help Their Children Avoid Alcohol Pitfalls During Transition from High School to College
Prior research has shown that the transition from high school to college is a particularly vulnerable time, associated with increased alcohol use and risk of negative alcohol-related consequences. While studies have examined the effectiveness of prevention programs to address this problem, few have examined which students may benefit the most. A study of student characteristics has found that parent-based interventions (PBIs) can be effective even among those students feeling high peer pressure to drink alcohol. Results will be published in the September 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View. "College matriculation is a vulnerable transition for many youth for many reasons," said Michael J. Cleveland, research assistant professor at the Prevention Research Center at The Pennsylvania State University and corresponding author for the study. "Increased freedoms and autonomy -- from parental control and from the structure of high school -- as well as instability -- as new friendships and romantic relationships form -- may lead to increased opportunities, and social pressures, for young people to experiment with alcohol and other substances." Rose Marie Ward, associate professor of health promotion at Miami University, Ohio, agreed. "The transition from high school to college is constantly marked as a crucial time for alcohol interventions," she said. "PBIs stress that during this crucial transition period, communication between the parent and teen … is highly important." Rest of this article is here.

Drunk driving not the only way alcohol leads to teen deaths, study says
The findings show the importance of preventing underage drinking even if there is no risk of drinking and driving, according to Mothers Against Drunk Driving (MADD). Analyzing 2010 federal government data, the group found that 32 percent of the drinking-related deaths among young people aged 15 to 20 involved traffic crashes, while 68 percent involved incidents such as murder (30 percent), suicide (14 percent), alcohol poisoning (9 percent) and other causes (15 percent). Read more here.

Governments Can Reduce Drinking by Limiting Density of Liquor Stores: Report
Local governments can reduce excessive drinking by regulating the density of stores that sell alcohol, according to a new report. The Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health in Baltimore says too few government officials use zoning laws to reduce the number of liquor stores. The report explains how government officials can use these laws to reduce alcohol abuse, according to The Baltimore Sun. Research has shown reducing the number of locations where people can purchase alcohol helps reduce excessive drinking, the article notes. Report author David Jernigan said excessive alcohol use is the third-leading cause of preventable death in the United States, causing 80,000 deaths annually. “Public health agencies are on the front lines of addressing the toll alcohol misuse has on the public’s health, and are therefore well-positioned to inform communities about the benefits of addressing alcohol outlet density in their communities,” he said in a news release. The report appears in the journal Preventing Chronic Disease.