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Friday, January 31, 2014

ATOD & Advocacy Recap - Week ending January 31, 2014

College freshman alcohol interventions effective
Intervention is an effective ways for colleges to mitigate common drinking patterns -- binge drinking -- among freshman, U.S. researchers say. Lead author Lori Scott-Sheldon, an assistant professor at Brown University and researcher at the Centers for Behavioral and Preventive Medicine at The Miriam, and colleagues recommended colleges screen all freshmen within their first few weeks for alcohol risk and offer interventions for those who reported drinking. The team examined the efficacy of 62 interventions delivered in randomized, controlled clinical trials involving more than 24,000 freshmen around the country during the last decade. Please click here for the rest of the article.

Marijuana and Patients: It’s time for another conversation
The whole world is watching how state-legalization experiments work out in Washington and Colorado.  Of great interest must be how we reconcile our previously existing medical marijuana landscapes with our new recreational landscape, made possible by the will of the voters through Initiative 502. Although I-502 made no mention of medical marijuana, the process of creating regulatory frameworks for its implementation has arrived at a key crossroad that will undoubtedly be faced elsewhere: how to reconcile medical marijuana patient access with a strongly regulated “recreational” cannabis consumer system. Currently, the road ahead appears to favor recreational cannabis markets at the expense of medical marijuana patient rights to health and safe, reliable access to medicine.  At the same time that medical marijuana research, practice, and patient access are being enabled across the nation and in diverse countries such as Israel and Uruguay, patients in Washington State face the absurd possibility that our new legal cannabis system will conflict with rather than complement emerging medical paradigms. Please click here for the rest of the article.

Drinking During Pregnancy: Even a Little Impairs Childhood Academics
There is conflicting advice out there about drinking a small amount, particularly of wine, during pregnancy. Some research has said it may even be beneficial. Today the National Bureau of Economic Research says that's wrong. Please click here for the rest of the article.

Cannabis Legal, Localities Begin to Just Say No
The momentum toward legalized marijuana might seem like an inevitable tide, with states from Florida to New York considering easing laws for medical use, and a full-blown recreational industry rapidly emerging in Colorado and here in Washington State. But across the country, resistance to legal marijuana is also rising, with an increasing number of towns and counties moving to ban legal sales. The efforts, still largely local, have been fueled by the opening, or imminent opening, of retail marijuana stores here and in Colorado, as well as by recent legal opinions that have supported such bans in some states. Please click here for the rest of the article.

Parity law has little effect on spending for substance abuse treatment
Despite predictions that requiring health insurers to provide equal coverage for substance use disorder treatment would raise costs, a Yale study finds that the economic impact so far has been minimal. The study is published online in The American Journal of Managed Care. A team of researchers led by Susan Busch of the Yale School of Public Health studied the first year of the federal parity law's implementation and found that it did not result in an increase in the proportion of enrollees seeking treatment for substance use disorders (SUDs). Their analysis also identified only a modest increase in spending for substance use disorder treatment—$10 annually per health plan enrollee. Please click here for the rest of the article.

Why It’s Still a Big Deal If Your Teen Smokes Pot
With the president coming out in favor of legalization, parents are wondering whether telling their kids not to use marijuana is futile. But some sobering data about the effects of pot on developing brains can help make the case. Please click here for the rest of the article.

The blunt truth — White house drug czar contradicts Obama on marijuana
White House docs say pot causes brain damage and lower IQ in teens, alcohol does not. President Obama’s latest claims about marijuana are contradicted by research and official positions of the Office of National Drug Control Policy, which is part of the White House. And Mr. Obama’s words have anti-drug leaders worried about negative repercussions among youth. Mr. Obama claimed to The New Yorker magazine that marijuana is no worse than cigarettes or alcohol and he promoted state efforts by Colorado and Washington to legalize marijuana, which remains illegal under federal law. Please click here for the rest of the article.

Alcohol linked to skin cancer risk
Scientists believe drinking too much alcohol could set off a chain of reactions in the body that makes the skin more vulnerable to cancer. Ethanol is converted to acetaldehyde soon after ingestion and this compound may render the skin more sensitive to harmful UV light, they say. Please click here for the rest of the article.

War on drugs meets rule of law at Supreme Court
Justices strike down additional 20-year sentence given to heroin dealer because the client died. The war on drugs ran afoul of the Supreme Court on Monday. The justices ruled unanimously that a heroin dealer cannot be held liable for a client's death and given a longer sentence if the heroin was only a contributing factor, and not necessarily the sole cause. Not only does that likely mean a reduced sentence for Marcus Burrage, who received 20 additional years in prison because of the death, but a tougher time for prosecutors in general when it comes to extending drug sentences -- something the Obama administration had argued in November. Please click here for the rest of the article.

Studies suggest that alcohol use more likely to cause violence between partners
Alcohol use is more likely than marijuana use to lead to violence between partners, according to studies done at the University of Tennessee, Knoxville. Research among college students found that men under the influence of alcohol are more likely to perpetrate physical, psychological or sexual aggression against their partners than men under the influence of marijuana. Women, on the other hand, were more likely to be physically and psychologically aggressive under the influence of alcohol but, unlike men, they were also more likely to be psychologically aggressive under the influence of marijuana. The research has implications for domestic violence intervention and prevention programs. Please click here for the rest of the article.

There’s something about Molly - How a supposedly safe party drug turned lethal.
MULTICOLORED LASER LIGHTS search the darkness, picking out bodies crowded into the tight, hot space of Rise. Located in the Theatre District, the city’s only after-hours dance club is packed at 3 a.m., full of people swaying to a pounding bass line, music you can feel in your chest. Most are in their late teens or 20s, and many are clearly rolling — they’re under the influence of a drug called MDMA, sometimes called Molly, that causes a flood, or “cascade,” of serotonin and other neurotransmitters to the brain. Please click here for the rest of the article.

Attorney General Holder: All Drugs, Including Alcohol, Are “Potentially Harmful”
Attorney General Eric Holder told a Senate committee Wednesday that all drugs, including alcohol, are “potentially harmful.” He was responding to a question about whether he agreed with President Obama’s recent comment that smoking marijuana was less dangerous than alcohol “in terms of its impact on the individual consumer.” Senator Jeff Sessions of Alabama, in a hearing of the Senate Judiciary Committee, said, “It’s difficult for me to conceive how the President of the United States could make such a statement.” President Obama made his comment about marijuana in an interview with The New Yorker. He told the magazine he does not think marijuana is more dangerous than alcohol. He added smoking marijuana is “not something I encourage.” He acknowledged he smoked marijuana in his youth. “I view it as a bad habit and a vice, not very different from the cigarettes that I smoked as a young person up through a big chunk of my adult life,” he said. Obama added he has told his daughters he thinks smoking marijuana is “a bad idea, a waste of time, not very healthy.” CNN reports Holder told the Senate committee, “I think that any drug used in an inappropriate way can be harmful. And alcohol is among those.” Marijuana is illegal under federal law. Colorado and Washington state have approved the recreational use of marijuana for adults 21 and older. At the hearing, Holder reaffirmed that the federal government will not challenge state laws legalizing marijuana, and will focus enforcement efforts on preventing marijuana use in minors.

Study: Liberals drink more alcohol than conservatives
A sobering new study published by the Journal of Wine Economics — yes, there is a Journal of Wine Economics — finds that alcohol consumption in American states rises as the population’s politics becomes more liberal. The study by Pavel Yakovlev and Walter P. Guessford of Duquesne University in Pennsylvania shows a direct correlation between political beliefs and the demand for alcohol. The study compares sales of alcoholic beverages against the political leanings of a state's members of Congress, as ranked by liberal organizations Americans for Democratic Action (ADA) and the AFL-CIO Committee on Political Education (COPE). Please click here for the rest of the article.

Friday, January 24, 2014

ATOD & Advocacy Recap - Week ending January 24, 2014

The problem of symptoms and signs
One of the first things you learn about in medical school is the difference between symptoms and signs. Symptoms stem from patients’ subjective experiences — how they’ve been feeling or what seems off to them. For example, “my stomach hurts,” “I feel tired,” or “my arm itches.” These complaints cannot be verified by lab tests or imaging. We simply have to rely on the patient’s word. On the other hand, there are signs. Fever. Rapid heart rate. Abnormal white blood cell counts. Doctors and nurses can objectively identify these characteristics, using everything from physical exams to high-tech gadgets. These findings independently clarify the patient’s condition from both inside and out. As medical students, we spend our four years learning to match the sets of symptoms with the right signs. When a patient presents with chronic headache, we take a neurological exam or recommend a brain scan. If others come in with shortness of breath, we listen to their lungs for crackles and other sounds. But what happens when there’s a complete mismatch between symptoms and signs? When the patient’s feelings defy every swab, blood culture, and beeping hospital machine? It’s a situation that neither physicians nor patients want to find themselves in. And one that pushes medicine to the limits of its design. Please click here to read the rest of this story.

Alcoholics Anonymous vs. the Doctors - Could new addiction medications replace mutual-help groups?
Alcoholics Anonymous is, by far, the largest and most venerable addiction recovery group in the world. Founded nearly 80 years ago, AA now boasts 2.1 million worldwide members, many of whom attribute their very survival to the organization. In the United States, where the 12-step program originated, AA is viewed by many as a national treasure of sorts. Social workers send patients to AA meetings. Judges condition people’s freedom on meeting attendance. Desperate spouses condition marriages on it. Everyone loves Alcoholics Anonymous. Or almost everyone. Please click here to read the rest of this story.

New Thinking on Women And Alcohol
Alcoholics Anonymous is commonly considered the gold standard for helping people control their drinking problems.
But there’s a growing school of thought that there are problem drinkers who can cut back — as opposed to severely dependent drinkers who must cut out drinking altogether. There are new tools, such as medication and online support. Severely alcohol-dependent people should consider an abstinence program, Glaser tells Here & Now’s Robin Young, but research has shown there are far milder to moderate problem drinkers than severe problem drinkers. Please click here to read the rest of this story.

Fact Check: Is Marijuana Safer Than Alcohol?
This fall, voters in Oregon and Washington will decide whether to legalize marijuana. Washington’s Initiative 502 would allow pot to be sold in state-licensed stores. So would Oregon’s Measure 80. But it would go one step further: The Oregon ballot measure would allow people to grow their own marijuana. In both campaigns, there's no shortage of claims about the drug. Chris Lehman has been fact-checking two of those claims. Today, he takes on this question: Is marijuana a safer drug than alcohol? To Paul Stanford, this isn't really a question. "Marijuana by any measure is much safer," he says. Please click here to read the rest of this story.

Anti-Pot Group Regrets The Repeal Of Alcohol Prohibition
The anti-pot group Project SAM was not pleased by President Obama’s recent observation that marijuana is less dangerous than alcohol. “We take issue with the President’s comparisons between marijuana and alcohol,” says Project SAM Chairman Patrick J, Kennedy in a press release. He does not argue that Obama’s statement was inaccurate—just that it was unhelpful to the prohibitionist cause. Kennedy explains that “two wrongs don’t make a right: just because our already legal drugs may have very dangerous impacts on society it does not mean that other drugs should follow the same path.” Note that the first “wrong,” according to Kennedy, was making alcohol legal. Please click here to read the rest of this story.

Colorado Shop Owners Can't Keep Marijuana Edibles in Stock
Colorado residents may wind up with "pot bellies" if they keep filling up on marijuana edibles at this pace. Ever since recreational marijuana sales began in the state on Jan. 1, many shop owners said they have been unable to keep pot-infused candies, cookies and sodas in stock. "Edibles have been really huge with the recreational market," Linda Andrews, owner of LoDo Wellness Center in Denver, told "They're great if you're not a [marijuana] connoisseur and you want something more palatable," she said. "And they are certainly more discreet." Andrews estimates edible sales are up 300 percent at her store, which previously only served medical marijuana patients. Please click here to read the rest of this story.

Adults Who Use Illicit Drugs More Likely to Think About Suicide: Survey
Thoughts of suicide are more common among adults who use illicit drugs, compared with the general population, according to a new government survey. The Substance Abuse and Mental Health Services Administration (SAMHSA) found 9.4 percent of people using illicit drugs had suicidal thoughts, compared with 3.9 percent of the general population, HealthDay reports. The rate of suicidal thoughts varied depending on the type of drug people use. The survey found 20.9 percent of people who use sedatives for nonmedical purposes had suicidal thoughts, compared with 9.6 percent of people who use marijuana, 13 percent of people who use pain relievers nonmedically, and 14.7 percent of people who use cocaine. The survey included about 70,000 people ages 12 and older. “Suicide takes a devastating toll on individuals, families and communities across our nation,” Dr. Peter Delany, Director of SAMHSA’s Center for Behavioral Health Statistics and Quality, said in a news release. “We must reach out to all segments of our community to provide them with the support and treatment they need so that we can help prevent more needless deaths and shattered lives.”

Dangerous new trend: kids snorting Smarties candy
There's a dangerous new trend that involves the popular candy Smarties. Instead of eating them, kids are snorting them. They're crushing the candy and inhaling it, in videos seen all over YouTube. The motivation behind the crushing and snorting of Smarties isn't known. The bizarre trend is happening across the nation, including at a Rhode Island middle school, where the principal sent an email about it to students. And a health expert is warning about the dangers. "Anytime you snort or inhale a substance into your lungs that is not meant to be it is definitely hazardous to your health and could have significant health consequences for individuals," said behavioral care expert Rebecca Boss. Some of the negative side effects of snorting Smarties include infection and scarring of the nasal cavity.

One Question May Gauge Severity of Unhealthy Drug, Alcohol Use
Primary care physicians seeking to determine whether a patient's drug or alcohol use is problematic often have to rely on lengthy questionnaires containing dozens of items with multiple response options. Please click here to read the rest of this story.

Krokodil Crock: How Rumors Of A 'Flesh-Eating Zombie Drug' Swept The Nation
By now you probably have heard that krokodil, a nasty homemade version of the narcotic painkiller desomorphine, is starting to catch on in the United States. Having eaten its way through the flesh of myriad Russian opiate addicts, the caustic concoction—notorious for the ghastly side effects caused by its corrosive contaminants, including abscesses and gangrene—is reportedly burning its way through Arizona, Texas, Nevada, Utah, Oklahoma, Colorado, Illinois, Missouri, Ohio, Pennsylvania, and Massachusetts. “The monster has crossed the ocean,” Time declared last month. Please click here to read the rest of this story.

Should there be a word for an 'almost alcoholic'?
Everybody thinks they know what an "alcoholic" is, but what about those who drink too much but fall short of the common definitions of alcoholism? Should there be a word that bridges the gap between alcoholic and non-alcoholic? The term alcoholic - on its own to denote someone addicted to alcohol - was first used in 1852 in the Scottish Temperance Review. Since then, millions of heavy drinkers have been confronted by friends and families with the stark question: "Are you an alcoholic?" And millions have denied it. Rejected the label. Confessed only to maybe, possibly drinking too much. But utterly denied the A-word. Alcoholics are people who fall asleep in skips. Alcoholics get into fights. Alcoholics start the day with a shot of whisky. Alcoholics are drunk all the time. Alcoholics can't hold down jobs. Please click here to read the rest of this story.

Science, Save Medical Marijuana!
In 1998, the voters of Washington state said yes to the question “Shall the medical use of marijuana for certain terminal or debilitating conditions be permitted and physicians authorized to advise patients about the medical use of marijuana?” by passing ballot proposition I-692. In 2012, the voters passed a measure that “removes state-law prohibitions against producing, processing and selling marijuana, subject to licensing and regulation by the liquor board.” Now the state liquor board assumes powers over the regulation of medical marijuana, regulation that could essentially eradicate the voter-approved measure and force patients to become consumers of the commercial marijuana industry. Please click here to read the rest of this story.

Does Plan to Require Tougher Controls on Painkillers Go Too Far?
Proposed tighter monitoring of opioids and other dangerous drugs has doctors and others worried that it may result in unnecessary suffering for patients who really need the powerful painkillers. Those concerns were front and center at a recent meeting of the State Board of Medical Examiners, whose members raised concerns about requiring all doctors who prescribe potentially addictive painkillers to check on whether their patient has already gotten the drugs from another source. Please click here to read the rest of this story.

Pot is not ‘more dangerous than alcohol’? Science lacking on Obama’s claim
When President Obama declared in a recent New Yorker magazine interview that he doesn’t think pot “is more dangerous than alcohol,” he seemed to contradict his own administration’s policy that’s firmly against the legalization of marijuana. He also seemed to indicate that the pot smoking he did in his teens had no major health impact. “I view it as a bad habit and a vice,” he told the New Yorker’s David Remnick, “not very different from the cigarettes that I smoked as a young person up through a big chunk of my adult life.” That’s a position a lot of teens take today, judging by the fact that more teenagers smoke pot than cigarettes, according to a 2012 survey from the federal Centers for Disease Control and Prevention. But there’s a scarcity of research to determine just how risky it is to use marijuana purely for recreational purposes—which is legal in Colorado and will be soon in Washington. Please click here to read the rest of this story.

Surge in Synthetic Marijuana Emergency Room Visits Reported in Denver
Emergency rooms in Denver, Colorado reported a surge in visits related to synthetic marijuana in the late summer and early fall, according to the Los Angeles Times. Experts say similar patterns may emerge in other parts of the country. Between August 24 and September 19, area emergency rooms saw 263 patients, mostly young men, with symptoms related to synthetic marijuana. Most patients were treated in the emergency room, but seven were admitted to intensive care units. Synthetic marijuana is sold under names including K2, Spice and Black Mamba. It is made with dried herbs and spices that are sprayed with chemicals that induce a marijuana-type high when smoked, the article notes. The products are widely available, despite laws prohibiting them. In September, the Colorado Department of Public Health and the Centers for Disease Control and Prevention announced they were investigating whether three deaths and 75 hospitalizations were caused by synthetic marijuana. Short-term effects of using synthetic marijuana include loss of control, lack of pain response, increased agitation, pale skin, seizures, vomiting, profuse sweating, uncontrolled/spastic body movements, elevated blood pressure, heart rate and palpitations.

Researchers suggest effective ways to mitigate drinking problems among new students in colleges
A new systematic review of data published in more than 40 studies of freshman alcohol interventions finds that there are many effective ways for colleges to mitigate common drinking patterns and problems among new students. Based on their findings, published online Jan. 20 in the Journal of Consulting and Clinical Psychology, the team of researchers at Brown University and The Miriam Hospital recommend that colleges screen all freshmen within their first few weeks for alcohol risk and offer effective combinations of interventions for those who report drinking. Please click here to read the rest of this story.

A winding spiritual path
Raised in a strict Jewish household but then living for years as what he describes as a largely non-spiritual cynic, Mitch Feld continues on an intriguing journey that has returned to faith. Now an ordained rabbi in South Florida who offers spiritual counseling to addicts and non-addicts alike, Feld happily acknowledges that he still doesn’t have everything figured out when it comes to the spiritual. “The victory is in the effort, not the result,” Feld is fond of telling his clients, and this rings true in his own life. In fact, he doesn’t even use precise language to describe the major turnaround moment he experienced, when he awoke in 1988 from a two-week coma after a high-speed car accident that was the culmination of years of alcohol and cocaine abuse. Please click here to read the rest of this story.

A most stigmatized population
Addiction professionals are well aware of the controversy surrounding diagnostic changes for addictive disorders in the DSM-5. Some are not aware, however, of an equally vociferous controversy regarding the diagnosis of gender identity disorder (GID), which was changed to gender dysphoria in the DSM’s most recent edition. This change harkens back to the 1973 removal of homosexuality from the field’s diagnostic manual. According to Robin Rosenberg, a clinical psychologist and co-author of the psychology textbook Abnormal Psychology, “The concept underlying eliminating homosexuality from the DSM was recognizing that you can be homosexual and psychologically healthy or be homosexual and psychologically screwed up. Being homosexual didn’t have to be the issue.” In the same way, the new DSM recognizes that there are many transgender individuals who are living healthy and productive lives. For those who aren’t, it is not necessarily because of their transgender identity but possibly a result of living in a culture that stigmatizes those who do not conform to traditional norms. . Please click here to read the rest of this story.