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Friday, January 18, 2013

ATOD Weekly Recap - Week-ending January 18th

Do College Students View Alcohol or Drug Use as a Problem?
Alcohol and drugs are present on college campuses virtually everywhere. So are symptoms of psychological issues, such as anxiety, depression, and post-traumatic stress. However, a small percentage of students who need help for these issues ever actually seek out mental health services. Is it that they don’t see drug and alcohol use as a problem? The answer to that question varies. According to a recent study led by Robert J. Lowinger of Bluefield State College in West Virginia, college men and college women perceive the effects and severity of drug and alcohol use differently. In his study, Lowinger interviewed 201 college students using a modified version of the Degree of Impairment Scale (DIS) to assess how drug use and alcohol consumption interfered with their lives with respect to academic performance, career, daily routine, social engagement, romantic relationships, and friendships. He looked at how the students rated severity of use and which types of impairments increased help seeking, and which students were most likely to seek help. He found that all of the participants viewed drug problems as more problematic than alcohol problems. Females were more likely than males to seek help for problems with drugs or alcohol and cited more academic and daily routine impairments as a result of drug or alcohol use. Even though the students listed minimal impairments with peer interactions and other social relationships, drug use related to this did not motivate them to seek help, but alcohol use that impaired social interaction did. This could be due to the fact that alcohol is more socially acceptable and present than drug use, and therefore more students have alcohol related problems than drug related problems. The results of this study were based solely on self-reports, which could distort the data. Additionally, the small sample size prohibited Lowinger from revealing any cultural, sexual orientation, or racial patterns. “Nevertheless, this study suggests that there are significant differences in the way that students’ perceive problems relating to drugs and alcohol use,” said Lowinger.= Reference: Lowinger, Robert J. College students’ perceptions of severity and willingness to seek psychological help for drug and alcohol problems. College Student Journal 46.4 (2012): 829-33.
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Using Bath Salts: Playing Russian Roulette With Your Brain, Expert Say
Using the designer drugs known as “bath salts” is like playing Russian roulette with your brain, according to an expert at the National Institute on Drug Abuse (NIDA). Michael H. Baumann, PhD, Chief of the Designer Drug Research Unit at NIDA’s Intramural Research Program, recently published a study that explains how bath salts cause dangerous effects in the brain. Read the rest of the story here.
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More Homeless Die From Drug Overdoses Than From AIDS
A greater percentage of homeless adults die from drug overdoses than from AIDS, according to a new study. Drug overdoses accounted for nearly 17 percent of all deaths among homeless patients studied, and 81 percent of the overdoses involved opioid painkillers and heroin. In contrast, 6 percent died of causes related to AIDS. Health issues related to substance abuse, such as alcoholism-associated heart disease, pneumonia and withdrawal, accounted for 8 percent of deaths. The results appear in JAMA Internal Medicine. Researchers studied 28,033 homeless adults in Boston over five years. The study authors and homeless advocates say their findings apply to homeless populations in many urban areas of the country, Reuters reports. In a similar study conducted 15 years earlier, 6 percent of deaths among homeless adults were due to drug overdoses, while 18 percent were due to AIDS. “Our findings are an unfortunate reminder of the high mortality rate of homeless people and a clarion call for the need to address the epidemic of drug overdose deaths in this vulnerable population,” lead researcher Travis Baggett, MD, MPH, of the Massachusetts General Hospital, said in a news release. Jessie Gaeta, Medical Director of the Boston Health Care for the Homeless Program, told Reuters her group is considering making changes as a result of the findings, including decreasing the amount of painkillers it prescribes, and providing patients with naloxone, which can be used as an overdose antidote. The program’s doctors prescribe painkillers to some homeless patients with chronic pain, she said. They are increasing efforts to counsel patients on how to properly use their medication, and how to protect against medication theft.
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New Study Questions Finding of Earlier Research on Marijuana and IQ in Teens
A new study calls into question the results of a study published last year that concluded heavy marijuana use can permanently lower IQ by several points in teens. The new research suggests that the IQ drop may have been caused by factors related to economic class and home life, NBC News reports. The new study used a computer simulation to demonstrate that the same effects on IQ could have been caused by socioeconomic factors, according to researcher Ole Rogeberg of the Frisch Center in Norway. “The kinds of environments you are in do affect your IQ,” Rogeberg told NBC News. He noted that while a good education and challenging employment can increase intelligence, “if people are pushed out or decide to move out of these kinds of arenas, they will tend to see an IQ decline, and they will also be the type of people who tend to take up cannabis smoking during adolescence.” The findings are published in the Proceedings of the National Academy of Sciences. The original study included data from 1,037 New Zealanders who were followed for more than three decades, starting at age 7. The researchers found marijuana lowered IQ by as much as eight points for those who started using the drug in adolescence, and were heavy, lifelong users. The study found no effect on IQ in people who started using the drug as adults, which suggested marijuana was particularly harmful for developing brains. Rogeberg noted his new findings do not mean marijuana is harmless. He recommended the original researchers should more thoroughly analyze their data to prove marijuana, and not other factors related to the marijuana-smoking lifestyle, can lower IQ.
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10 over-the-counter medicines abused by teens
Is your medicine cabinet a source for a teen’s legal “high?” Because a doctor’s prescription is not needed, many mistakenly believe that over-the-counter (OTC) medicines are safer than prescription medicines and illegal street drugs. They are in fact safe and effective when taken as directed, but even OTC medicines—including herbals—can cause serious and potentially fatal side effects when abused.  Read the rest of the story here.
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Dieting and drinking a bad mix - Those calories can add up
The first rule of drinking on a diet is: Don’t. Surely you’ve heard that Americans get way too many calories — and nutritionally empty calories at that — from alcohol. But the second rule of drinking on a diet is that since you probably will ignore Rule No. 1, find a way to enjoy alcohol without letting it swamp your healthy intentions. Here are a few suggestions on how to go about that. Read the rest of the story here.
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NASADAD Releases Statement on the Use of Medication for Substance Use Disorders

Association notes that medications represent an important tool to consider in the treatment of substance use disorders

The National Association of State Alcohol and Drug Abuse Directors’ (NASADAD) Board of Directors approved during its December Meeting a consensus statement regarding the benefits of using medications in the treatment of substance use disorders.  The statement points to research from the National Institutes of Health (NIH) demonstrating the effectiveness of FDA-approved medications when prescribed as part of a comprehensive and individualized treatment plan.  NASADAD concludes that public and private health insurance plans should cover medications for the treatment of opioid, alcohol, and nicotine dependence.   “We believe it is important to promote evidence based, clinically appropriate care,” said Mark Stringer, President of NASADAD.  “As a result, NASADAD moved forward to educate stakeholders on the fact that all FDA-approved medications should be made available to help certain people enter into and maintain recovery from substance use disorders,” said Stringer.  According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 20.6 million persons met criteria for substance dependence or abuse in 2011.  Prescription drug abuse and misuse represents a particular challenge in State substance abuse systems across the country:  from 1998 to 2008, there was a 400 percent increase in admissions to treatment for people 12 and older misusing prescription pain relievers (SAMHSA, 2010).  In addition, approximately 16.7 million Americans in 2011 were dependent on alcohol or had problems related to their use or abuse of alcohol (SAMHSA, 2012).  The good news is that advances in research and practice have shown people suffering from alcohol and opiate dependence – including heroin addiction – may benefit from a medication as an adjunct to treatment.  As noted in the NASADAD statement, “A growing body of research substantiates that the use of FDA-approved medications can play an important role for people with alcohol, opioid, or nicotine dependence, with continued research being done on medications for other substance use disorders.”  NASADAD also cites that for certain people, “…use of medication is recommended as a recovery tool.”  “Decisions are being made about the nature and scope of services that should be made available to people with substance use disorders,” said Robert Morrison, NASADAD’s Executive Director.  “We hope our work will help contribute to this dialogue and encourage informed choices.”  While the statement was approved by the Board of Directors, the document was developed by NASADAD’s National Treatment Network (NTN), in conjunction with its Opioid Treatment Network (OTN).  A workgroup met via conference calls, in-person meetings and electronically to write an initial draft.  In addition to the statement, the NTN and OTN have engaged in State-to-State learning opportunities regarding medication assisted treatment through meetings, topic calls and more.
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New York Police Department to Use Decoy Pill Bottles to Track Painkiller Thieves
The New York Police Department has announced it will put decoy pill bottles with tracking devices on pharmacy shelves, in an effort to track stolen painkillers. The fake bottles will appear to contain oxycodone, The New York Times reports. The bottles will not actually contain painkillers, but will have a GPS device. “We would anticipate the burglar and robber will take numerous bottles, and among them will be the bait bottle,” said the department’s chief spokesman, Paul J. Browne. The fake bottles rattle when they are shaken, as if they contained pills. They sit on a special base. When the bottle is lifted from the base, it starts to send out a tracking signal. The department hopes to have the program in place by March, and is asking all of the city’s 1,800 pharmacies to participate. Purdue Pharma, which makes OxyContin, developed the bottles. They are already being used in some pharmacies around the country. Around the nation, pharmacies have been robbed by armed criminals looking for narcotics, anti-anxiety drugs and other controlled medications. Some are addicted to the drugs themselves, while others sell the pills.
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Many Doctors Skip Alcohol Screening and Miss Patients’ Drinking Problems
Doctors miss drinking problems in almost three-fourths of patients because they don’t conduct alcohol screening, a new study finds. Instead, many doctors rely on gut feelings about whether a patient is engaging in problem drinking. By asking a few questions about drinking habits, doctors can spot alcohol problems, and help patients cut back on drinking, experts told CNN. Researchers asked almost 1,700 adults to complete questionnaires at the end of a primary care doctor’s visit. Several questions addressed drinking habits, such as how often they drank, how many drinks they usually had per day, and if their drinking ever put them at risk of being hurt or causing an accident. After the visit, doctors were asked whether they thought the patient had problems with alcohol. Doctors who relied on a hunch about whether the patient had a drinking problem, instead of conducting a screening, missed almost three-fourths of patients who screened positive for alcohol problems. Doctors who did suspect a drinking problem were usually correct, the study found. “I hope that by papers like this, it’s going to be a nudge to a physician to say … ‘Maybe I should start screening.’ It’s not that hard to do,” said study author Dr. Daniel Vinson of the University of Missouri School of Medicine. The study appears in the Annals of Family Medicine. Alcohol screening is recommended by the U.S. Preventive Services Task Force, but is often not part of routine care, according to the CNN report. Previous research has shown that screening and brief interventions by health care providers — asking patients about alcohol use and recommending they reduce risky drinking — can promote significant, lasting reductions in drinking levels and alcohol-related problems, according to the National Institute on Alcohol Abuse and Alcoholism.
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States Should Use More Tobacco-Related Income for Prevention: Report
States use little of the income they receive from tobacco taxes or legal settlements with cigarette manufacturers to pay for smoking prevention or cessation programs, the American Lung Association concludes in a new report. Although states receive a total of $25.7 billion in tobacco settlement payments and tobacco taxes annually, more than 40 states do not invest even half of what is recommended by the Centers for Disease Control and Prevention (CDC) in proven tobacco prevention programs, according to the report. Some states receive money from tobacco companies under a 1998 anti-smoking agreement with tobacco companies, Reuters reports. States spent a total of $462.5 million on smoking prevention and cessation programs this fiscal year, about 12.5 percent of the CDC recommendation. North Dakota and Alaska were the only states that spent amounts close to the recommendation. Some states put most of their tobacco-related income toward their general budgets. The report notes that states and the federal government have not raised taxes on tobacco products other than cigarettes, which has led to a surge in the use of certain cheaper tobacco products, including flavored cigars popular among youth. “By not having a level playing field with tobacco taxes, we’re seeing market shifts from cigarettes to lesser taxed and subsequently more affordable tobacco products. This means candy flavored cigars and a new wave of smokeless products are enticing new, young customers to become addicted to nicotine,” Paul G. Billings, American Lung Association Senior Vice President for Advocacy and Education, said in a news release.
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Mothers, Daughters and Alcohol
There seemed to be both collective surprise and some very intense buzz after a very recent report found that many more women have been drinking than was previously thought. According to this CDC report, approximately 13% of women in the U.S. over the age of 18 engage in binge drinking.  In this survey, a binge was defined as consuming four or more alcoholic beverages during one discrete episode or evening or event. The nation was even more surprised to learn that among the 7,536 females in grade 9-12 who were surveyed, there was also plenty of binge drinking. The likelihood of binge drinking increased by grade. In 9th grade, 13% of the girls reported binge drinking. By the time they were in 12th grade, up to 27% of the girls reported binge drinking. Read the rest of the blog here.
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ER visits tied to energy drinks double since 2007
SAN FRANCISCO (AP) — The young man stumbled into the emergency room late one night after a house party, saying his heart wouldn't stop pounding and he could barely breathe after downing liquor mixed with energy drinks. Emergency physician Steve Sun soon found the patient was so dehydrated he was going into kidney failure — one of many troubling cases Sun says he has treated in recent years tied to energy drink consumption. Sun's changing caseload appears in line with a new government survey that suggests the number of people seeking emergency treatment after consuming energy drinks has doubled nationwide during the past four years, the same period in which the supercharged drink industry has surged in popularity in convenience stores, bars and on college campuses. Remainder of article is available here.
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Prescription Drug Overdoses Number One Reason for ER Visits in Los Angeles County
Prescription drug overdoses are the number one reason for emergency room visits in Los Angeles County, according to public health officials. A new report finds the number of people who checked into publicly funded drug rehabilitation programs for prescription pain reliever abuse doubled from 2005 to 2010, NBC Los Angeles reports. More than 60 percent of drug-related deaths in 2011 were due to prescription drugs in Los Angeles County. The report found 11 percent of 9th graders and 14 percent of 11th graders said they had misused prescription drugs at least once. “Prescription drug abuse has become a growing public health concern in Los Angeles County. Many people are not aware that the misuse or abuse of prescription drugs can be as dangerous as illegal drugs, and can lead to unintended injury, addiction, and even death,” Jonathan E. Fielding, MD, MPH, Director of Public Health and Health Officer, said in a news release. “We need to ensure that we are addressing this growing concern by engaging and collaborating with our partners in the public and private sectors to reduce and prevent prescription drug abuse.”
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Legalizing Pot Won't Make It Any Safer
Forgotten in the debate is the damage marijuana does to adolescent brains.
Pot is not legal—at least not yet. But it's not exactly illegal either—not anymore. More than a dozen states have decriminalized the possession of marijuana. Nearly a score of them sanction its medical use. Voters in Washington and Colorado have made recreational use of the drug legal in their states.  One way or another, all of these changes mean that there will be more marijuana in homes for young people to find and use. Granny may be smoking it for glaucoma, but there is nothing benign about the effects of pot on a juvenile brain. Whatever its legal status, pot is not harmless.  Marijuana hasn't achieved its present status of relative social acceptability by virtue of its virtues, but rather despite mounting evidence of the dangers it poses, especially to young users—and even more to users under age 18. While adults may be at risk, too, a considerable number of them appear to use marijuana in relative safety. So the case for prohibition has rested most securely on potential harm to adolescents.

Pot's potential for harm has as much to do with the nature of adolescence as it does with the nature of THC, the active ingredient in marijuana. That's because kids do foolish things because they are kids—and their brains are not yet fully developed. Unfortunately, the part of the brain that censors dumb and dangerous behavior is last to develop. It doesn't generally come fully on line until the mid-20s, but the pleasure-seeking part of the brain is fully functioning by puberty. So, kids do foolish things that are often risky—and get so much riskier when teenagers are high. Moreover, smoking marijuana is by itself a risky enterprise, and most addictive for the young. A study published in the Journal of Clinical and Experimental Pharmacology in 1994 found that one in 10 young people who use marijuana will go on to become addicted. Pot smoking puts the user at risk of psychosis, changes in the anatomy of the brain, and damage to the heart and lungs. It retards maturation and impairs learning, memory and judgment—no small matters during the adolescent years.
Among the many thousands of adolescents we have treated at the programs of Phoenix House over the past four decades, the overwhelming majority have used no drug more potent than marijuana. And for many of those young people, the course of their lives has been altered, sometimes permanently and often tragically, with suicides, car accidents and drownings—or with interrupted education, chronic depression and joblessness. Federal law still outlaws marijuana. Yet President Obama told Barbara Walters in December that "it does not make sense from a prioritization point of view for us to focus on recreational drug users in a state that has already said that under state law that's legal." Meanwhile, the Senate Judiciary Committee plans hearings to find some legislative route around the federal-state impasse. Given all that we know, the sensible strategy at this point is to send an unequivocal message that "legal" is not a synonym for "safe." This is not a novel concept. We have plenty of examples. Alcohol is legal and, in many ways, it can be even more threatening to teens than marijuana. Hand guns (and assault rifles) are also legal, but they are hardly benign.
While rational societies generally make some effort to protect children from obvious dangers, it is fundamentally a parental responsibility—and one that we humans share with the rest of the animal kingdom. It may be helpful if there is law on the parents' side. But this is not essential, nor does its absence diminish in any way a parent's familial obligations. There will be restriction on legal marijuana sales to children—following the alcohol template, states considering legalization use 21 as the legal age. But we cannot expect such restrictions to be any more effective in limiting teen marijuana use than they are in limiting teen smoking or drinking.  And then there is the issue of easier-than-ever access as more adults can buy or grow marijuana for their personal use. In 2000, a study commissioned by Phoenix House found that among 600 young people in treatment, only 1% were introduced to drugs by a dealer, and that a primary source of illicit drugs was relatives or family friends. At this point in the country's history, whether pot is legal or not is no longer the main issue. The issue is the danger that marijuana poses to kids, how parents can protect their children from that danger, and what the rest of society—absent the criminal justice system—can do to support them in that fight.

Dr. Rosenthal, a child psychiatrist, is the founder of Phoenix House, the nation's largest nonprofit substance-abuse treatment and prevention organization.
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New Jersey lawmakers hear testimony on a drug that mitigates overdoses' effects
Drug overdose is the leading cause of accidental death in New Jersey. It surpassed traffic fatalities in 2009, when 752 people died, according to a drug policy advocacy group. Of those deaths, 75 percent involved heroin or prescription opiates, a growing addiction problem in New Jersey and the nation. Legislators tried to address the issue last year when they approved the Good Samaritan Emergency Response Act, a bill that offered limited criminal amnesty to drug users who call for help when someone has overdosed. They took up the issue again Monday, when the state Senate's Health, Human Services, and Senior Citizens Committee heard testimony on a bill that would expand access to a drug that treats opiate overdose. Of the 43 people who showed up to support the bill, at least 14 had lost a family member to an opioid overdose.
Gov. Christie, a Republican and former prosecutor, surprised drug-addiction treatment providers last year with his stance on addiction. He put $2.5 million toward a court-run program that would force low-level offenders with drug problems into treatment rather than prison. New Jersey is the first state to attempt to mandate the strict "drug court" program, which is practiced nationwide. Yet in October, Christie vetoed the Good Samaritan bill, instead asking his administration to study the problem and report back in 18 months. The veto perplexed supporters.

"He's talking about second chances. That's exactly what the Good Samaritan bill did," said Roseanne Scotti, New Jersey director of the Drug Policy Alliance. "You can't get a second chance if you're dead."
Since Christie blocked the bill, 17 municipalities have called on the Legislature to override his veto. The bill passed the Legislature with bipartisan support, but GOP lawmakers have prevented override attempts on previous bills. The Democratic-led body must achieve a two-thirds vote in each chamber to override a veto. Scotti hopes the Legislature will succeed in an override, but she knows the odds are long. In the meantime, Sen. Joseph Vitale (D., Middlesex), a primary sponsor of the Good Samaritan bill, is cosponsoring a bill that seeks to make an opioid antidote, naloxone, more readily available. Sen. Richard J. Codey (D., Essex) is cosponsoring the bill. The Senate panel unanimously agreed to move the bill from committee Monday. Michael Drewniak, a spokesman for Christie, did not respond to a request for comment.
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Two-year MaineCare cutoff for opiate addiction drugs kicked in early January
Patients on Suboxone will need to prove the drug works to continue receiving it; those prescribed Methadone face a two-year time limit starting on Tuesday, January 1, 2013

Health officials say those who still need certain drugs to treat addiction won't be cut off entirely, even as a legislative bill aims to cut off treatment for some. Michelle Morin, a registered nurse at Merrimack River Medical Services in Portland, administers Methadone at a dosing window on Jan. 9, 2008. MaineCare coverage for Methadone and Suboxone is set to cease on Tuesday for treatment for those who have been covered for at least 24 months. A bill passed by the Maine Legislature established the 24 month lifetime limit. But a task force of medical providers, substance abuse treatment providers, government officials, and patient advocates have developed criteria for continued MaineCare coverage of medically necessary Methadone and Suboxone treatments. Rest of the story is available here.
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Change and the Serenity Prayer
By Fred Holmquist, Director of The Lodge at Hazelden

By now, the momentum of some of our one-year-at-a-time resolutions has abated. For most of us, initiated changes in life far outnumber sustained changes in life. Mark Twain's quote nails it:
"Quitting smoking is easy. I've done it hundreds of times."

Let's look at how the Serenity Prayer offers important distinctions for more productive use of our life energy, yet doesn't highlight the key element for a transformed life.

  The serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference are priceless reminders for more efficient and effective living. Yet, they don't include the distinction for addressing the greatest challenge to our spiritual growth in recovery. Made clear on page 62 in Alcoholics Anonymous is an additional condition we can't change. Beyond the seemingly hopeless state of mind and body that gets our attention in active addiction is the wisdom in "How It Works," that over-reliance on self blocks us from the spiritual solution: page 62 "…[the alcoholic] is an extreme example of self-will run riot, though they usually don't think so." We also learn that, "Neither could we reduce our self-centeredness much, by wishing or trying on our own power."

Whew! We have bodies that can't tolerate what our minds can't leave alone AND we have a spiritual malady that disallows us from doing anything about it on our own.

Application of the serenity prayer to this third element of Step One's lethal trifecta would emphasize the need for serenity and acceptance, because we can't change our over-reliance on self "much" on our own. By page 66, we've learned the emotions generated by this immutable imbalance of humanness are what shut us off from the Sunlight of the Spirit. Since self can't change itself for the same reason a hammer can't hit itself or a foot can't kick itself, neither serenity nor courage, nor the wisdom to know the difference will get us unblocked. So what's implicit in the Serenity Prayer but missing from its text? Essentially, it's to do the things I can, that will bring about the changes I can't. One of the subtle, but frequent, clues is on page 64 in the sentence, "Though our decision (in Step Three) was a vital and crucial step, it could have little permanent effect unless at once followed by a strenuous effort to face (in Step Four), and be rid of (in Steps Five through Nine) the things in ourselves that had been blocking us." We're told clearly to face what's been blocking us in Step Four (with the courage [read fearless] to change the things we can). However, the text doesn't say "and get rid of the things in ourselves which had been blocking us," but rather says, "and be rid of the things in ourselves which had been blocking us." Thus the practice of Steps Five through Nine is following the directions for doing the things I can which will bring about the changes I can't.

I am not suggesting that we change the Serenity Prayer. I am suggesting that we be mindful each time we say it that the miracle of sustained change is the byproduct of spiritual practice, much of which lies somewhere far beyond the serenity to accept the things I cannot change and the courage to change the things I can.
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One in three American adults have gone online to figure out a medical condition
Thirty-five percent of U.S. adults say that at one time or another they have gone online specifically to try to figure out what medical condition they or someone else might have.  These findings come from a national survey by the Pew Research Center’s Internet & American Life Project. Throughout this report, we call those who searched for answers on the internet "online diagnosers." When asked if the information found online led them to think they needed the attention of a medical professional, 46% of online diagnosers say that was the case. Thirty-eight percent of online diagnosers say it was something they could take care of at home and 11% say it was both or in-between. Rest of the story is here.
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Bringing gambling problems to light
As the casino boats were coming into its immediate area in 1993, the Illinois Institute for Addiction Recovery was beginning to treat compulsive gambling.  Coleen Moore, Marketing and Admissions Manager at the treatment organization, remembers when it began.  She explains, “What we were finding was that many of our clients who were in treatment for alcoholism, were coming back to us were saying, ‘Okay, I’m not drinking, but I’m going to the boat and I’m gambling. And I feel like I’m not in recovery.’”  After these comments, Moore says the staff really began to grasp the mechanics of gambling as an addiction.  They found that although there are some differences, the behaviors of a person with gambling issues look very similar to the experiences of someone suffering from alcoholism.  Click here to read the remainder of the story.
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Study: Replacing prison terms with treatment could save billions in criminal justice costs
Nearly half of all state prisoners are drug abusers or drug dependent, but only 10 percent receive medically based drug treatment during incarceration, according to a news release. Untreated or inadequately treated inmates are more likely to resume using drugs when released from prison, and commit crimes at a higher rate than non-abusers. The study, completed by researchers at RTI International and Temple University and published online in November in Crime & Delinquency, reports that the savings are driven by immediate reductions in the cost of incarceration and by subsequent reductions in the number of crimes committed by successfully-treated diverted offenders, which leads to fewer re-arrests and re-incarcerations. The criminal justice costs savings account for the extra cost of treating diverted offenders in the community. “Substance abuse among offenders continues to concern policy makers because of its high prevalence and its effect on criminal behavior,” said Gary Zarkin, Ph.D., vice president of the Behavioral Health and Criminal Justice Research Division at RTI and the study's lead author. “Given the obvious burden on the criminal justice system and society caused by substance abuse within this population, diverting offenders to effective and targeted substance abuse treatment leads to less drug use, fewer crimes committed, and costs savings.” The findings were based on a lifetime simulation model of a cohort of 1.14 million state prisoners representing the 2004 U.S. state prison population. The model accounts for substance abuse as a chronic disease, estimates the benefits of treatment over individuals’ lifetimes, and calculates the crime and criminal justice costs related to policing, trial and sentencing, and incarceration.  According to the model, if just 10% of eligible offenders were sent to community-based treatment programs rather than prison, the criminal justice system would save $4.8 billion when compared to current practices. Diverting 40% of eligible offenders would save $12.9 billion.  The authors also address a concern common with diversion programs, which is that instead of being incarcerated, offenders are released into the community where they may commit additional crimes. Their analysis showed an immediate, short-lived increase in crimes, however, by the end of the first year, fewer crimes were committed, generating cost savings.
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Access to Health Care Services for Addiction Will Improve Dramatically
Once the Affordable Care Act (ACA) is fully implemented in 2014, access to effective health care services for addiction will improve dramatically, according to Faces & Voices of Recovery. In an issue brief, the advocacy group describes how the new legislation will make it possible for many in or seeking recovery to be included in the health care system for the first time. Those who will benefit from the new law include people who were previously enrolled in Medicaid, and then were disenrolled; those who are coming out of the criminal justice system; and people who have not been able to afford insurance. Under the ACA, a single enrollment application will determine if you are eligible for either Medicaid or the state insurance exchange, based on your reported annual income. People who do not qualify for Medicaid will be able to buy affordable health insurance through state health insurance exchanges. These are marketplaces that will be available to people who are not covered through their employer’s health plan, and those who work for small employers who provide employees with multiple health plan options. The law guarantees that insurance companies will not be allowed to deny someone coverage or place a lifetime cap on what is deemed reimbursable because of a pre-existing condition. According to the brief, “The new policy regarding pre-existing conditions, already in place for children, has direct applications to the recovery community. Addiction to alcohol and other drugs (or a substance use disorder, as it is sometimes called) has been considered a pre-existing condition by many insurers, and used as a means to deny claims and a disqualifier for coverage. That will no longer be legal.” Read the entire issue brief for more information on addiction treatment and the ACA.
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Legalizing Marijuana Sends Wrong Message to Young People, Kerlikowske Says
Legalizing marijuana sends the wrong message to young people, R. Gil Kerlikowske, Director of the Office of National Drug Control Policy (ONDCP), said this week. “We are certainly not sending a very good message when we call it medicine and legalize it,” he told The Oregonian. ONDCP calls marijuana addictive and unsafe, especially for use by young people. Marijuana, which was recently legalized in Colorado and Washington, remains illegal under federal law. Kerlikowske pointed to a 2012 survey that found 7.4 percent of California drivers tested positive for marijuana use—more than for alcohol. In a recent ONDCP web post, Kerlikowske wrote, “it is clear that we’re in the midst of a serious national conversation about marijuana.”
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Substance Abuse May Have Long-Term Negative Effect on Sexual Performance
A new study suggests substance abuse impairs sexual performance in men, even after they stop using drugs or alcohol. Earlier studies suggested men spontaneously recover their normal sexual performance several weeks after they end substance abuse, MedicalXpress reports. The study included 905 men, 549 of whom had been diagnosed with addiction to alcohol, cocaine, heroin, marijuana, or a combination of substances. The men who were diagnosed with addiction had an average of one year of abstinence. The researchers found the men who had been addicted had a moderately to significantly impaired sexual performance, in the areas of sexual desire, satisfaction, arousal and orgasm, compared with men who had not been addicted. The researchers wrote in the Journal of Sexual Medicine, “These results seem to contradict those that argue that drug use only impairs sexual functioning temporarily. Moreover, they suggest that sexual functioning does not improve just by stopping drug use.”
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Lawmakers Ask Energy Drink Makers for Safety Information About Products
Three federal legislators have sent letters to 14 marketers of energy drinks, asking for information about the products’ ingredients and for studies showing their risks and benefits to youth, The New York Times reports. The Food and Drug Administration has received reports of 18 deaths and more than 150 injuries that mention the possible involvement of energy drinks, including 5-Hour Energy, Monster Energy and Red Bull. A new federal report found the number of emergency room visits involving energy drinks doubled from 2007 to 2011, reaching more than 20,000. The letters were sent by Senator Richard Durbin of Illinois, Senator Richard Blumenthal of Connecticut and Representative Edward Markey of Massachusetts to companies including Monster Beverage, Red Bull, Rockstar and Living Essentials, which makes 5-Hour Energy. The lawmakers asked the companies to explain how much caffeine was in their drinks. They also asked for studies the companies had run or underwritten on the effects of the drinks on children or young adults. “There is very clearly a lack of understanding about the health effects of energy drinks and their ingredients especially on children and adolescents,” Senator Blumenthal said in a news release. “Energy drink makers are mistaken if they believe they have escaped regulatory oversight to safeguard consumer health.” “Energy drink companies need to be clear with consumers about what they think their product is, what it contains, and what it can do,” added Representative Markey. “The broad claims made by these products and their blurred classification in the marketplace make it difficult for consumers, particularly young consumers, from making informed decisions about their consumption.”

Friday, January 11, 2013

ATOD Weekly Recap - Week-ending January 11th

"Weed Candy" dubbed newest street drug
Marijuana is a hot topic in Tampa.  At least 18 states have legalized pot in some form, but there's always someone out there willing to take advantage, and the newest street treat is actually an old fashioned recipe - candy made out of pot.

"Well there's different forms of it. There's hard candy and taffy and gums, and it comes in all different colors and flavors," says Cristal Bermudez -Nuñez, spokesperson for Hillsborough County Sheriff's Office. "Weed candy", as its called on the street, has been popping up in cities like Los Angeles, New York and Philly.  Foods like brownies and cakes have been made for decades, but the latest reincarnation could contain much more than just marijuana.   Drug dealers can add ingredients to it to give it a kick, and THAT is where the real danger lies. "Just like when they make weed brownies and other items that contain marijuana, it all depends on the person making it, and whether they add things that could make it potentially even more dangerous," says Nuñez.  The candy comes in all forms and has names that play off real candy products like Munchie Way, Green Gummies, and Soda Pot.  They look real, but no one would ever know, so law enforcement is giving parents a heads up. "As a good parent, you always want to be sure what your kids are into, and make them aware that products like these are circulating," Nuñez says.
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Vital Signs: Binge Drinking Among Women and High School Girls — United States, 2011
A Morbidity and Mortality Weekly Report (MMWR)

Excessive alcohol use accounted for an estimated average of 23,000 deaths and 633,000 years of potential life lost (YPLL) among women and girls in the United States each year during 2001–2005. Binge drinking accounted for more than half of those deaths and YPLL. Binge drinking also is a risk factor for many health and social problems among women and girls, including unintended and alcohol-exposed pregnancy, sexually transmitted diseases, and breast cancer. Read the full report here.
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Commentary: Learning As We Go: Critical Assessment of Addiction Research and Practice
A recent Join Together article, entitled “Half of Addiction Counselors Say It’s OK for Some Patients to Drink Occasionally,” drew attention to the fact that some substance abuse counselors believe moderate drinking is an option for individuals with substance use disorders. As a researcher and an advocate in our field, I reacted with mixed feelings to this news. Rest of the story is available here.
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Smokers Can Lower Anxiety Levels by Quitting, Study Suggests
Smokers can lower their anxiety levels by quitting, a new study suggests. The decrease is particularly noticeable among people who used smoking to cope, instead of for pleasure. Researchers studied 491 smokers enrolled in smoking cessation clinics in England. They received nicotine patches, and attended weekly appointments. About 22 percent had been diagnosed with mental health problems before they tried quitting, mostly anxiety and mood disorders, PsychCentral reports. Participants’ anxiety levels were evaluated at the start of the study, and they were asked why they smoked. After six months, 14 percent were smoke free; 10 had a current psychiatric disorder. Those who were able to quit smoking had lower levels of anxiety, the researchers reported in the British Journal of Psychiatry. The decrease was most marked among those who had used smoking to cope, compared with those who smoked for pleasure. Among study participants who began to smoke again, those who smoked for pleasure reported no change in their anxiety levels. Those who took up smoking again to cope, as well as those with a diagnosed mental health disorder, reported an increase in anxiety. “The commonly held belief that smoking helps relieve stress is almost certainly wrong,” noted lead author Dr. Mairtin McDermott of King’s Institute of Psychiatry in a press release. “Smokers need to understand how their experience of smoking affects them, and that in many people, smoking actually increases levels of anxiety.”
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Study Shows Racial Disparities in Completion of Substance Abuse Treatment
Black and Hispanic patients who enter publicly funded alcohol and drug treatment programs are less likely to complete treatment, compared with white patients, a new study finds. The disparities are likely related to greater unemployment rates and housing instability for black and Hispanic patients, according to the researchers. The study found about half of all black and Hispanic patients who entered publicly funded alcohol treatment programs do not complete treatment, compared with 62 percent of white patients. Similar disparities were found for drug treatment programs, ScienceDaily reports. The researchers analyzed data from more than one million discharges from substance abuse treatment programs. The researchers write in Health Affairs that funding for integrated services and increased Medicaid coverage under the Affordable Care Act could help improve minorities’ access to treatment programs. “Our findings show troubling racial disparities in the completion of alcohol and drug abuse programs, and they point specifically to socioeconomic barriers that make it difficult for minority groups to access and sustain treatment,” researcher Brendan Saloner, PhD, of the University of Pennsylvania, said in a news release. “For example, in both alcohol and drug treatment groups, black and Hispanic patients were more likely than white patients to be homeless. But, disparities among the groups were found to be lower in residential treatment settings, indicating that access to residential treatment could be particularly valuable for these patients.”
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Tobacco Companies Move into E-Cigarette Business
Tobacco manufacturers are moving into the manufacture and sale of electronic cigarettes, according to CNBC. The business, which brought in $400 million to $500 million in sales in 2012, is expected to at least double this year, one expert predicts. “We’re actually predicting that consumption of e-cigs could surpass consumption of traditional cigarettes in the next decade,” said Bonnie Herzog of Wells Fargo. Last year, tobacco giant Lorillard paid $135 million for the e-cigarette company Blu, while RJ Reynolds created its own e-cigarette brand. E-cigarettes are designed to deliver nicotine in the form of a vapor, which is inhaled by the user. They usually have a rechargeable, battery-operated heating element, a replaceable cartridge with nicotine or other chemicals and a device called an atomizer that converts the contents of the cartridge into a vapor when heated. E-cigarettes often are made to look like regular cigarettes. John Cameron, CEO of the e-cigarette company Safecig, says people who want to quit smoking often are not satisfied by using nicotine gum or patches, because they miss the act of smoking. E-cigarettes do have potential downsides, Herzog notes. She says some critics are concerned there could be potential health risks. The products are expensive, she added. One e-cigarette made by the company Njoy cost almost $9 at a California convenience store. The product claims to be the equivalent of two packs of cigarettes.
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Have We Lost the War on Drugs?
After more than four decades of a failed experiment, the human cost has become too high. It is time to consider the decriminalization of drug use and the drug market.

President Richard Nixon declared a "war on drugs" in 1971. The expectation then was that drug trafficking in the United States could be greatly reduced in a short time through federal policing—and yet the war on drugs continues to this day. The cost has been large in terms of lives, money and the well-being of many Americans, especially the poor and less educated. By most accounts, the gains from the war have been modest at best. The direct monetary cost to American taxpayers of the war on drugs includes spending on police, the court personnel used to try drug users and traffickers, and the guards and other resources spent on imprisoning and punishing those convicted of drug offenses. Total current spending is estimated at over $40 billion a year. These costs don't include many other harmful effects of the war on drugs that are difficult to quantify. For example, over the past 40 years the fraction of students who have dropped out of American high schools has remained large, at about 25%. Dropout rates are not high for middle-class white children, but they are very high for black and Hispanic children living in poor neighborhoods. Many factors explain the high dropout rates, especially bad schools and weak family support. But another important factor in inner-city neighborhoods is the temptation to drop out of school in order to profit from the drug trade.  Read the rest of the article here.
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Rising painkiller addiction shows damage from drugmakers’ role in shaping medical opinion
Over much of the past decade, the official word on OxyContin was that it rarely posed problems of addiction for patients. The label on the drug, which was approved by the FDA, said the risks of addiction were “reported to be small.” Prescriptions for opioid painkillers are rising. The New England Journal of Medicine, the nation’s premier medical publication, informed readers that studies indicated that such painkillers pose “a minimal risk of addiction.” Another important journal study, which the manufacturer of OxyContin reprinted 10,000 times, indicated that in a trial of arthritis patients, only a handful showed withdrawal symptoms. Those reassuring claims, which became part of a scientific consensus, have been quietly dropped or called into question in recent years, as many in the medical profession rediscovered the destructive power of opiates. But the damage arising from those misconceptions may have been vast.The nation is confronting an ongoing epidemic of addiction to prescription painkillers — more widespread than cocaine or heroin — that has left nearly 2 million in its grip, according to federal statistics. The rest of the article is available here.
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Binge Drinking a Big Problem Among High School Girls, CDC Reports
One in five high school girls binge drink, according to a new report by the Centers for Disease Control and Prevention (CDC). The report finds almost 14 million women in the United States binge drink about three times a month. The binge drinking rate among high school girls is almost as high as their male peers, according to CNN. About 62 percent of high school senior girls said they engaged in binge drinking in 2011. For females, binge drinking is defined as having four or more drinks on one occasion. “It is alarming to see that binge drinking is so common among women and girls, and that women and girls are drinking so much when they do,” Robert Brewer, MD, MSPH, of the Alcohol Program at CDC, noted in a news release. “The good news is that the same scientifically proven strategies for communities and clinical settings that we know can prevent binge drinking in the overall population can also work to prevent binge drinking among women and girls.” Binge drinking was responsible for more than half of the 23,000 deaths attributed to excessive alcohol use among women and girls in 2011, the report found. Women are more susceptible to the effects of drinking, because they can be physically smaller, according to the CNN article.
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Prescription Drug Abuse Decreasing in Some States
A new government report shows prescription drug abuse decreased in 10 states from 2010 to 2011, and did not increase in any state. The report by the Substance Abuse and Mental Health Services Administration (SAMHSA) found 22 million people began the nonmedical use of pain-relieving drugs since 2002. Prescription drug abuse is just behind marijuana as the country’s most widespread drug issue, the report concludes. Iowa had the lowest rate of prescription drug abuse, at 3.6 percent, while Oregon had the highest rate, at 6.4 percent. Seven of the 10 states with the highest levels of prescription painkiller abuse were in the West—Washington, Oregon, Nevada, New Mexico, Idaho, Colorado, and Arizona, according to Medical News Today. “Addressing prescription drug misuse remains a top public health priority, as we’ve seen inconsistent progress in addressing the issue across the states,” SAMHSA Administrator Pamela S. Hyde said in a news release. “Data from this report helps us better understand geographic variations in use, and should help with the development of more targeted and effective prevention and treatment programs. The key is educating the public on the serious health risks involved, and ensuring that we are providing the necessary treatment to those who need it.”
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Supreme Court Hears Case About Forced Blood Alcohol Test for Drunk Driving
The U.S. Supreme Court will hear a case Wednesday on the question of whether police must obtain a warrant before forcing suspected drunk drivers to submit to a blood alcohol test. State supreme courts are divided on whether these forced tests violate the Fourth Amendment, which protects again unreasonable searches and seizures, according to The Christian Science Monitor. The case centers on Tyler McNeely, who was pulled over for speeding by a Missouri highway patrolman, and was taken to a hospital. About 25 minutes after McNeely was pulled over, a technician measured his blood-alcohol content at 0.154 percent, nearly twice the legal limit. The Missouri police in the case argued they should not have to wait for approval to give a blood test, because alcohol dissipates quickly in the bloodstream. Last year, the Missouri Supreme Court rejected that argument. It ruled the blood test violated the Fourth Amendment. The court found there were no special circumstances to justify obtaining the blood test so quickly. State high courts in Iowa and Utah also have made similar rulings. The Supreme Courts of Wisconsin, Minnesota and Oregon have all ruled in favor of warrantless blood tests, the article notes. The Obama Administration and attorneys general from 32 states are asking the U.S. Supreme Court to declare that warrantless blood tests are not in violation of the Fourth Amendment.
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From Party Girl to Plugged In: My Journey Through Addiction to Recovery
As a little girl, Mom and Dad promised I could be anything I wanted — police officer, teacher, journalist — and that no matter what, my life would be a good one if I followed my heart. Hard work, dedication, honest effort and the Golden Rule were required but, according to my folks, a small price to pay for happiness. Their words, spoken in earnest to their oldest child, fell across my ears and under my radar as the years passed. Conceptually, I referenced the ideas from time to time, but my world was much too complex to be reduced to old-world, Horatio Alger charm. I did work hard. I did get the coveted college degree from the prestigious undergrad program. I did land the first job in my field two weeks before the commencement ceremony. I did return to my hometown in triumphant victory as the first of my mother’s kin to brandish the sheepskin of higher education. Read the rest of this posting here.
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FDA issues draft guidance on abuse-deterrent opioids

The U.S. Food and Drug Administration today issued a draft guidance document to assist industry in developing new formulations of opioid drugs with abuse-deterrent properties. The document “Guidance for Industry: Abuse-Deterrent Opioids – Evaluation and Labeling,” explains the FDA’s current thinking about the studies that should be conducted to demonstrate that a given formulation has abuse-deterrent properties, how those studies will be evaluated by the agency, and what labeling claims may be approved based on the results of those studies. Opioids can be abused in a number of ways. Abuse-deterrent formulations target the known or expected routes of abuse, such as crushing in order to snort or dissolving in order to inject, for the specific opioid drug substance in that formulation. The science of abuse deterrence is relatively new, and both the formulation technologies and the analytical, clinical, and statistical methods for evaluating those technologies are rapidly evolving. In working with industry, the FDA will take a flexible, adaptive approach to the evaluation and labeling of potentially abuse-deterrent products. The FDA continues to encourage the development of abuse-deterrent formulations of opioids and believes that these products have promise to help reduce prescription drug abuse. At the same time, the FDA remains committed to ensuring that patients with pain have appropriate access to opioid analgesics. This draft guidance fulfills mandates under the Food and Drug Administration Safety and Innovation Act (FDASIA) and the Office of National Drug Control Policy’s (ONDCP) Prescription Drug Abuse Prevention Plan. FDA is seeking public comment on the draft guidance for 60 days and encourages additional scientific and clinical research that will advance the development and assessment of abuse-deterrent technologies. Instructions on how to submit comments will be announced in an upcoming Federal Register notice. The FDA will also hold a public meeting to discuss and receive feedback on the draft guidance. In finalizing the guidance document, the agency will consider the information received from the public. For more information:
•    FDA: Draft Guidance for Industry: Abuse-Deterrent Opioids – Evaluation and Labeling
•    ONDCP: Prescription Drug Abuse
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Caring Community May Help Reduce Teen Alcohol Use, Study Suggests
Teens who live in a caring community may be less likely to abuse alcohol than their peers who report fewer positive experiences in their community, a new study suggests. Spending time with antisocial peers can increase the risk of alcohol abuse, researchers from Penn State report. The researchers evaluated risk factors for adolescent alcohol abuse, including antisocial attitudes and behaviors, associating with antisocial peers, and family risk, ScienceDaily reports. They also looked at positive factors such as community experiences, school experiences and family strengths. They examined results for more than 200,000 students, to determine how these factors predicted alcohol use. In the American Journal of Public Health, the researchers reported family and school protective factors had less influence than other factors, when all were considered together. “We found that when you put all of the major risk and protective factors into the same predictive model, certain risk factors, such as antisocial peer risk, tended to be more highly predictive of alcohol use than other factors like positive school experiences,” researcher Damon Jones said in a news release. The study concludes positive experiences in the community can help minimize the link between risk factors and underage drinking.
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Choosing Substance Abuse Treatment Over Prison Could Save Billions: Study
Sending substance-abusing state prisoners to community-based treatment programs instead of prisons could reduce crime and save billions of dollars, a new study concludes. The savings would result from immediate reductions in the cost of incarceration, and by subsequent reductions in the number of crimes committed by successfully treated offenders, which leads to fewer re-arrests and re-incarcerations, according to the researchers. Almost half of all state prisoners abuse drugs or are drug-dependent, but only 10 percent received medically based drug treatment while they are incarcerated, according to Newswise. Inmates who are untreated or not adequately treated are more likely to start using drugs when they are released from prison, and commit crimes at a higher rate than those who do not abuse drugs, the article notes. The researchers built a simulation model of 1.14 million state prisoners, representing the 2004 U.S. state prison population. The model estimated the benefits of substance abuse treatment over individuals’ lifetimes, and calculated the crime and criminal justice costs related to policing, trial and sentencing, and incarceration. The model tracked individuals’ substance abuse, criminal activity, employment and health care use until death or until they reached age 60, whichever came first. They estimated the costs of sending 10 percent or 40 percent of drug-abusing inmates to community-based substance abuse treatment instead of prison. In the journal Crime & Delinquency, the researchers found that if just 10 percent of eligible offenders were treated in community-based programs instead of going to prison, the criminal justice system would save $4.8 billion, compared with current practices. If 40 percent of eligible offenders received treatment, the savings would total $12.9 billion.
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FDA to Consider Tighter Regulations for Hydrocodone
The Food and Drug Administration (FDA) will soon consider whether prescription painkillers containing hydrocodone should be more tightly regulated, as the Drug Enforcement Administration (DEA) has urged, USA Today reports. A committee of the FDA will meet January 24 and 25 to consider the DEA’s request. The committee will assess the DEA’s evidence, hear comments from the public, and then vote on its recommendation to the FDA commissioner and the Department of Health and Human Services, according to the newspaper. Emergency room visits related to hydrocodone, the key ingredient in Vicodin and other painkillers, have soared since 2000. Vicodin, which also contains acetaminophen, is subject to fewer regulations than pure hydrocodone. For almost a decade, the DEA has called for stricter regulation of Vicodin, in order to reduce abuse of the drug, the article notes. The DEA wants to change the way drugs that combine hydrocodone with other products are classified, to require patients to have more interaction with doctors in order to obtain prescriptions for them. The FDA and DEA have repeatedly passed information back and forth about hydrocodone, without making any final decisions about the drug. The DEA classifies drugs on a five-stage scale, which takes into account the potential for addiction. Currently, hydrocodone is considered by the DEA to be a Schedule II controlled substance, the second-highest level. Hydrocodone combinations, such as Vicodin, are Schedule III, and therefore have fewer restrictions on sales. Schedule II drugs must be locked up at pharmacies. Physicians can only prescribe one bottle at a time and patients must have an original prescription in order to obtain the medication. Schedule III drugs can be refilled up to six times without visiting a doctor, who can phone or fax in a prescription to the pharmacy.
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Update on Emergency Department Visits Involving Energy Drinks: A Continuing Public Health Concern
Energy drinks are flavored beverages containing high amounts of caffeine and typically other additives, such as vitamins, taurine, herbal supplements, creatine, sugars, and guarana, a plant product containing concentrated caffeine. These drinks are sold in cans and bottles and are readily available in grocery stores, vending machines, convenience stores, and bars and other venues where alcohol is sold. These beverages provide high doses of caffeine that stimulate the central nervous system and cardiovascular system. The total amount of caffeine in a can or bottle of an energy drink varies from about 80 to more than 500 milligrams (mg), compared with about 100 mg in a 5-ounce cup of coffee or 50 mg in a 12-ounce cola.1 Research suggests that certain additives may compound the stimulant effects of caffeine. Some types of energy drinks may also contain alcohol, producing a hazardous combination; however, this report focuses only on the dangerous effects of energy drinks that do not have alcohol. You can download the Dawn Report at http://www.samhsa.gov/data/2k13/DAWN126/sr126-energy-drinks-use.pdf.
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One in 25 U.S. teens has attempted suicide: study
About one in 25 U.S. teens has attempted suicide, and one in eight has thought about it, according to a national study based on interviews with thousands of teens. Researchers, whose findings appeared in the journal JAMA Psychiatry, said those numbers are similar to the prevalence of lifetime suicidal thinking and attempts reported by adults, suggesting that the teenage years are an especially vulnerable time. Read the rest of the story here!
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Using Texting to Improve Teen Health
A new study leverages teens’ relationships with cell phones and text messages as a method to enhance health literacy and improve health behaviors. According to the Nielsen consumer research group, U.S. teens receive an average of 3,417 text messages per month or a whopping 114 texts per day. Teens also have notoriously have poor diets, with the U.S. Centers for Disease Control and Prevention reporting that high school students’ consumption of fruit and vegetables is, on average, 1.2 times per day (much lower than the recommended 5 a day). More on this story is here.
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Prescription painkillers trail only marijuana in abuse rates, report shows
Some 22 million Americans have misused prescription painkillers since 2002, according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). "Any time you have 2 percent of the population using medications like this there is a lot to do, but we are doing a lot with a combination of putting tighter controls on who can get these drugs and public education," said Peter Delany, director of SAMHSA's Center for Behavioral Health Statistics and Quality. Also, programs such as the Prescription Drug Monitoring Program, which allows doctors to track patients who may be getting painkillers from several sources, has helped get a handle on the problem, he added. Read more at: http://medicalxpress.com/news/2013-01-prescription-painkillers-trail-marijuana-abuse.html#jCp
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An often-ignored recovery issue: child support
While non-custodial fathers are often court-mandated to pay child support, back unpaid child support has remained a little-discussed issue in substance abuse treatment. Because the credentials of many men in recovery qualify them mostly for low-prestige, seasonal or menial low-paying jobs in our service economy, these men may find it difficult to secure a socially affirming job or to earn a livable wage. As a result, it is not unusual for some men to fall behind on their child support payments or to deliberately forego over-the-table employment in the name of self-preservation to avoid having their wages garnished. Read the rest of the story here.
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For some opioid patients, medication with minimal support works well
A new study published in the American Journal of Medicine offers a clear indication that not all opioid-dependent patients require the same approach to treatment, with one subset of patients clearly benefiting from medication-assisted therapy with rather modest physician support. What is important to note in interpreting the results of this study in a primary care setting is that it does not conclude that cognitive-behavioral therapy (CBT) is not useful as an adjunct to medication treatment—only that for the particular subgroup of medication-using patients that made up this study sample, adding CBT to physician support did not improve drug-using outcomes. Rest of the article is available here.
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MIT Student Invents LED Ice Cubes to Track Alcohol Intake

An MIT grad student is turning a bad party night into a product with potential.  It was fall semester last year when 23-year-old Dhairya Dand decided to hit up a party at the Massachusetts Institute of Technology. Several hours later, he found himself in the hospital. He'd had an alcohol-induced blackout. From the hospital room, Dand went back to MIT's Media Lab, where he's a researcher, and spent the next three weeks inventing Cheers - alcohol-aware ice cubes that glow and groove to ambient music. More important, the ice cubes change colors if you've had a few too many. When he presented the idea to his friends, they weren't so cool on the idea.  "They joked around when I told them I was going to make these ice cubes in reflection to what I went through at the party," said Dand. "That's normal. With every new thing there is resistance."  In an online video, Dand demonstrates how the cubes change as they respond to the amount of alcohol a person consumes. An accelerometer keeps track of how often the glass is raised to someone's lips; a timer helps estimate how intoxicated the person is. The LED inside each cube will light up in green, yellow or red. Green signals a first drink; yellow is a warning that your alcohol level is getting high. Red is a warning to stop drinking - you've probably had too much. Dand housed the electronics in waterproof cubes.  "Being an inventor, the feeling when you see your invention working for the first time is comparable to that of a mother seeing her newborn baby," said Dand. "It's elation of the highest order, you're numb enough to not feel anything, then it slowly sinks in."  The cubes can even send a text message to friends if the person drinking needs help.  "The cubes talk to your phone to make the call. They communicate over IR [infrared] with a custom removable IR receiver fitted on the smartphone's audio jack, " said Dand.  Since he came out with his invention, Dand said, "Everyone wants a dozen now!" And since he only spent $50 plus his own time creating it, Dand may have an idea that's budget-friendly for grad students.  This isn't Dand's first invention. He's also built educational toys for children and is currently working on "super shoes" (he didn't say what they do). As for patenting  his "Cheers" invention, Dand said he believes patents are "20th century jargon."  "I believe in open-source. My inventions are open to be hacked, developed and played around," said Dand. "True innovation are like ideas with wings, once they take birth in a mind, nothing, not even the inventor, can stop them."
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New Tools Identify Substance Use Treatment Needs in Criminal Justice System
People in prisons and jails are four times more likely to have a substance use disorder than the general public, yet services for this population are sorely lacking, according to experts at George Mason University. They have developed several screening tools designed to improve substance use treatment in the criminal justice system. Read the rest of this article here.
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Baseball to Conduct In-Season Blood Testing for Human Growth Hormone
Major League Baseball and its players union announced they have reached an agreement to conduct in-season blood testing of players for human growth hormone. Players also will be tested for synthetic testosterone, which is increasingly popular because it washes out of the body fairly quickly after being used. The announcement comes soon after members of the Baseball Writers’ Association of America voted against inducting Barry Bonds and Roger Clemens into the Baseball Hall of Fame, because of their links to steroids, The New York Times reports. Major League Baseball was the first major sport in the United States to agree to human growth hormone testing. It reached an agreement with its union in November 2011 to test for the substance, but only in spring training and the off-season. The new agreement expands the testing into the baseball season. Human growth hormone can help players build muscle mass, and to recover quickly from extended physical activity. It cannot be used legally without a prescription.

Friday, January 4, 2013

ATOD Weekly Recap - Week-ending January 4th


Studying Marijuana and Its Loftier Purpose

Among the rows of plants growing at a government-approved medical marijuana farm in the Galilee hills in northern Israel, one strain is said to have the strongest psychoactive effect of any cannabis in the world. Another, rich in anti-inflammatory properties, will not get you high at all.  Marijuana is illegal in Israel, but farms like this one, at a secret location near the city of Safed, are at the cutting edge of the debate on the legality, benefits and risks of medicinal cannabis. Its staff members wear white lab coats, its growing facilities are fitted with state-of-the-art equipment for controlling light and humidity, and its grounds are protected by security cameras and guards.  But in addition to the high-tech atmosphere, there is a spiritual one. The plantation, Israel’s largest and most established medical marijuana farm — and now a thriving commercial enterprise — is imbued with a higher sense of purpose, reflected by the aura of Safed, an age-old center of Jewish mysticism, as well as by its name, Tikkun Olam, a reference to the Jewish concept of repairing or healing the world.  There is an on-site synagogue in a trailer, a sweet aroma of freshly harvested cannabis that infuses the atmosphere and, halfway up a wooded hillside overlooking the farm, a blue-domed tomb of a rabbinic sage and his wife.  In the United States, medical marijuana programs exist in 18 states but remain illegal under federal law. In Israel, the law defines marijuana as an illegal and dangerous drug, and there is still no legislation regulating its use for medicinal purposes. The rest of the article is available here.




Opioid-Overdose Antidote Can Save Lives and Money, Study Concludes

The opioid-overdose antidote naloxone can save lives and money when distributed to heroin users, a new study finds. Researchers at the San Francisco Department of Public Health concluded that one death may be prevented for every 164 naloxone injection kits given to heroin users, Reuters reports. They estimate the kits would cost approximately $400 for every year of healthy life gained. Rest of the article is available here.




Drug Companies Want Ban on Generic Painkillers, Arguing Safety is at Stake

Drug companies that manufacture the painkillers OxyContin and Opana are trying to block generic drug makers’ efforts to produce cheaper versions of the drugs. They argue these newer drugs will not have the tamper-resistant designs used in making the brand-name pills, according to The New York Times. Generic versions of the two painkillers are expected to be significantly less expensive than the brand-name drugs. Read the rest of the story here.




Energy Drinks Provide Little or No Benefit, Experts Say

Energy drinks, under investigation by the Food and Drug Administration (FDA) after reports of deaths and serious injuries, offer little or no benefit to consumers, experts say. According to The New York Times, energy drinks sales topped more than $10 billion in 2012 in the United States. While the companies that make the drinks advertise their products as providing a mental and physical edge, a cup of coffee has the same effect, experts told the newspaper. The drinks, such as Red Bull, Monster Energy and Rockstar Energy, claim the drinks are specially engineered. U.S. Representative Edward Markey of Massachusetts has asked the federal government to investigate the industry’s marketing claims. “These are caffeine delivery systems,” Dr. Roland Griffiths of Johns Hopkins University, who has studied energy drinks, told the newspaper. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.” In 2011, the Substance Abuse and Mental Health Services Administration issued a report that found a sharp rise in the number of emergency department visits linked with the use of non-alcohol energy drinks, from 1,128 visits in 2005, to 13,114 in 2009. The report noted that energy drinks are marketed to appeal to youth, and are consumed by up to half of children, teenagers and young adults. The FDA said it has not established a connection between energy drinks and the reported deaths. The FDA can regulate caffeine levels in soft drinks. The limit in a 12-ounce soda is about 71 milligrams. The caffeine levels in most energy drinks exceed that level, because they are labeled dietary supplements.




Addiction on the Streets: Frequently Asked Questions

This post is part of a collaborative narrative series composed of my writing and Chris Arnade’s photos exploring issues of addiction, poverty and prostitution in Hunts Point, Bronx. For more on the series, look here.
I’ve become more tied to street-level addiction in 2012, and I often get many queries in life and in email– some good, insightful questions, some woefully uninformed and some offensive. It’s odd for one’s thoughts and time to be dedicated to something so out of the mainstream, so here’s my attempt at answering. Click here to read the rest of Chris’ blog.




Pill Mills & The Endless Game of Whac-A-Mole

I was troubled, but not surprised to read that the crackdown on ‘pill mills’ in my state of Florida has set off a boom in Georgia.  Now that Florida has established tougher regulations, ‘pill mill’ operators are simply opening businesses elsewhere—and taking customers with them.  As Ohio Senator Sherrod Brown put it, efforts to shut down sham pain clinics have “become like a game of Whac-A-Mole—as soon as one disappears, another one pops up.” Rest of the story is available here.




A lifeline for parents concerned about a child's mental health

NAMI is a valuable resource for parents searching for help in a labyrinthine and bewildering mental health care system.

Lynn Goodloe saw her son's grades begin to fall as he developed a knack for getting into mischief at a private Westside high school. Was it a phase, drugs or something more troubling? Harold Turner didn't know what to make of his daughter's disorganized thinking and erratic behavior at Loyola Marymount University. Was her high level of stress typical of the college experience, or was something wrong? "Being a teenager is by definition a crazy time," said Turner, so it can be hard for parents to know whether to be patient or persistent. The eventual diagnosis for Goodloe's son and Turner's daughter was severe mental illness, and both are now in treatment. And for the past several years, Goodloe and Turner have devoted themselves to helping others identify mental health problems and begin the daunting task of figuring out how to get help. Click here to read the rest of the story.




Alcohol detecting technology could save 10,000 a year from drunk-driving death

Scientists outside Boston are developing a technology that could bring drunk driving to a halt.

The federal government and the 16 major automobile makers are funding QinetiQ North America's $10 million Driver Alcohol Detection System for Safety (DADSS) project.
"This is the single best opportunity we have to prevent 10,000 people from dying a year - the equivalent of the seat belt of our generation," project leader Bud Zaouck told CBS This Morning.  The breath-based approach, called distant spectrometry, would detect the alcohol on a driver's breath before allowing that person to operate the car.

The researchers have narrowed down the solution to two technologies - one breath-based, the other touch-based - that evaluate a person's blood alcohol content.  Both approaches will require the driver to pass a sobriety test before starting a vehicle. One is a sensor mounted close to the steering wheel that assesses whether the driver's breath is above the U.S. legal limit of 0.08.  The other is a start and stop button that will gauge each driver's alcohol level with infrared light sent into the fingertip. The sensor will also detect whether someone from the passenger seat is leaning over to press the button, Zaouck said. The touch-based approach, called tissue spectrometry, would estimate a driver's alcohol level when he or she presses the vehicle's start-stop button.

The American Beverage Institute (ABI), however, strongly opposes placing alcohol detectors in all cars. The institute, which represents more than 8,000 U.S. restaurants, claims to be worried that even if the technology is accurate over 99.9 percent of the time, it could still result in preventing thousands of sober drivers from operating their vehicles.  "DADSS supporters claim the alcohol detectors would be voluntary and set at 0.08," said Sarah Longwell, managing director of ABI, "but there is a growing mountain of evidence showing that their true goal is to put alcohol-sensing technology in all cars as original equipment, set well below the 0.08 level."  The DADSS project started in 2008 but the organization says that the technology will not be implemented for about eight to 10 years.






Do alcohol and marijuana mix? Colorado is about to find out

In the debate over what marijuana legalization means for Colorado, the best drug-policy brains in the nation say there is one question getting short shrift: If people can more easily toke, does that mean they will drink less? It is, for now, a question without an answer. But what that answer is, the experts say, will be a big factor in determining whether marijuana legalization is worth it. Read more: Do alcohol and marijuana mix? Colorado is about to find out - The Denver Post http://www.denverpost.com/news/marijuana/ci_22300820/do-alcohol-and-marijuana-mix-colorado-is-about#ixzz2Gv3vKjOl




DEA Proposes New Regulations to Dispose of Unwanted Prescription Drugs

The Drug Enforcement Administration (DEA) has proposed new regulations to give the public more options for disposing of unwanted prescription drugs, such as painkillers and sedatives. The new rules are designed to reduce the amount of highly abused prescription drugs on the streets, the Orlando Sentinel reports. The DEA wants law enforcement agencies and pharmacies to maintain collection boxes for certain medications. The agency also recommends implementing mail-back programs to safely dispose of the drugs. Under the proposed rules, for the first time, groups outside of law enforcement would be allowed to collect unused drugs for disposal, the article notes. According to a DEA news release, the proposal would allow authorized retail pharmacies to voluntarily maintain collection boxes at long-term care facilities. The DEA also calls for continued use of prescription drug “take-back” events. The public can comment on the proposed regulations until February 19. Congress subsequently will vote on the measure.





Anonymity Of Addiction Hurts More Than It Helps

I often wished that state legislators who knew the most about addiction would band together and speak out as one during budget debates. Who better to advocate for treatment and chip away at public denial than the recovering alcoholics I knew who were also members of the General Assembly? Yet the answer was as close as my nearest mirror. Despite being a journalist and writing opinion for years, I was no more likely to publish a column about my own 20-plus years' recovery from alcoholism than lawmakers were prepared to out themselves on the floor of the legislature. Whether springing from shame or shyness, my decision not to write about my addiction was a mistake. The same goes for most of my 20 million-plus fellow citizens who are in sustained recovery from addiction. Rest of the article is available here.




Study: No Added Benefit From Cognitive Behavioral Therapy for Opioid Dependence

People who are dependent on opioids and are being treated with buprenorphine do not receive additional benefit from cognitive behavioral therapy, a new study finds. The study could change how opioid dependence is viewed and treated, according to MedicalXpress. Buprenorphine is the most commonly prescribed drug of its kind to treat opioid dependence, the article notes. Cognitive behavioral therapy is used to treat many psychiatric conditions and substance use disorders. The researchers from Yale University studied 141 people with opioid dependence. They were divided into two groups. One group received buprenorphine treatment alone, and the second group received the drug treatment plus cognitive behavioral therapy. Both treatments were similarly effective. Patients in both groups had a significant reduction in self-reported frequency of opioid use. Those receiving cognitive behavioral therapy did not have a greater reduction in use than those receiving buprenorphine treatment alone. The findings appear in the American Journal of Medicine. “This study demonstrates that some patients can do very well with buprenorphine and minimal physician support,” lead author Dr. David A. Fiellin noted in a news release. “This treatment represents an important tool to help reduce the adverse impact of addiction, HIV, and overdose due to heroin and prescription opioids.”




Privacy factors contribute to success of online treatment program

The co-founders of the online treatment program Lionrock Recovery knew about addiction (from family experience) and knew about technology (they routinely used videoconferencing in their previous lines of work) as they embarked on their new venture. What they didn’t quite anticipate was the mechanism by which the marriage of treatment and technology could have such a great impact on individuals for whom conventional care might prove ineffective. What Peter K. Loeb and Iain D. Crabb originally envisioned as an addiction treatment alternative emphasizing convenience has developed more as an option guaranteeing privacy. Loeb, Lionrock’s president and CEO, says the confidential nature of Lionrock’s services has been the attraction for numerous individuals, such as the woman in her 60s who said, “If my daughter found out I was in treatment, I would never get to see my grandchild again.” “We focus on being a safe haven,” says Loeb, who with Crabb launched Lionrock about a year ago. Read the rest of the story here.