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Friday, November 8, 2013

ATOD & Advocacy Update - Week Ending November 8, 2013



Should colleges be liable when binge drinking leads to rape?
Recently cyberspace erupted into the feminist equivalent of a civil war over the connection between binge drinking and sexual assault. After Slate columnist Emily Yoffe wrote a column using statistics that showed a link between drinking on college campuses and incidents of sexual assault, and arguing that we have to warn young women on the very real  dangers of excessive drinking, she was pilloried by some female writers. Continue reading here.

With Rise of Painkiller Abuse, a Closer Look at Heroin
Abuse of prescription painkillers is a "," according to the Centers for Disease Control and Prevention. On Oct. 24, the Food and Drug Administration recommended putting new , sold as Vicodin and other brand names. Dr. Andrew Kolodny believes the restrictions are necessary and will prevent new people from developing addiction. But, he says, there are millions who already have the disease and need access to effective treatment. "If they don't have access to legal sources [for painkillers], many of them will turn to the black market," he tells NPR's Arun Rath. "And if they can't find black-market pills, they'll buy heroin on the black market." So while the abuse of painkillers has become a focus for concern, the corresponding rise in heroin use is also prompting calls for action. Click here to continue.


Use of Marijuana, Inhalants Higher in Teens in Child Welfare System: Study
Use of marijuana and inhalants is more common in teens in the child welfare system compared with other teens, a new study finds. Researchers found 18 percent of teens in the welfare system admitted to ever smoking marijuana, compared with 14 percent of other teens. The researchers found 12 percent of teens in the welfare system said they had abused inhalants, compared with 6 percent of other teens, MedicalXpress reports. Six percent of teens in child welfare admitted to ever using cocaine or heroin, compared with 4 percent of other teens. Teens who admitted to shoplifting, theft, running away or using a weapon were more likely to use drugs and alcohol. Teens who lived in two-parent homes, and those who said they felt close to their parents or guardian, were less likely to report drug use. “When youth perceive that their parents or caregivers are actively engaged in their lives, this may steer them away from drugs,” lead researcher Danielle L. Fettes, Ph.D., of the University of California, San Diego, said in a news release. “Youth who feel supported by parents tend to have a better sense of self and better mental health and, in this case, are less likely to engage in high-risk behaviors—which is important for this already high-risk population.” Fettes said the findings are not surprising, since children who enter the welfare system often have risk factors for drug use, such as a history of domestic abuse or mental health issues. This study quantifies the actual rates of substance abuse in this population, she noted. The study appears in the November issue of the Journal of Studies on Alcohol and Drugs.

Marijuana and Alcohol - NY Times Editorial
Americans are growing more comfortable with marijuana, with 58 percent favoring legalization, according to the latest Gallup poll. At the same time, some researchers believe they have identified a side benefit to increasing availability of the drug: It could lead to decreased consumption of alcohol among young people. In a paper in the winter issue of the Journal of Policy Analysis and Management, two researchers — D. Mark Anderson of Montana State University and Daniel Rees of the University of Colorado at Denver — report that legalization of marijuana for medical purposes has been associated with reductions in heavy drinking, especially among 18- to 29-year-olds, and with an almost 5 percent decrease in beer sales. In addition, the increase in the legal drinking age from 18 to 21 seems to encourage greater marijuana use among people under 21, usage that drops sharply when they reach the legal drinking age. Click here to read more.

Teen Boys Concerned with Body Image More Likely to Use Drugs and Alcohol
Teenage boys concerned with their body image are at increased risk of using drugs and alcohol, according to researchers at the Harvard School of Public Health. Overall, 17.9 percent of teen boys were extremely concerned about their weight and physique. These boys were more likely than their peers to engage in risky behaviors, including drug use and frequent binge drinking. Male teens with high concerns about muscularity, who used supplements and other products to enhance their physique, were twice as likely to start binge drinking and using drugs. “Our findings show that there are males out there who are extremely concerned with their weight and shape, and they may be doing really unhealthy behaviors to achieve their ideal physique,” lead researcher Alison Field told HealthDay. “But they are not trying to get thinner, they’re using products to help them be bigger.” The findings come from a study of more than 5,000 teen boys. The researchers found 2.4 percent were very concerned about their muscularity and also used supplements such as growth hormones or steroids to enhance their physique. The results are published in JAMA Pediatrics.

Latest Synthetic Drug to Hit St. Louis: “N-Bomb”
The synthetic drug known as “N-Bomb” is being seen on the streets of St. Louis, KMOX reports. The drug is also known as “Smiles,” according to Dan Duncan, with the local office of the National Council of Alcoholism and Drug Abuse. The drug is often called N-Bomb because its chemical name is 25I-NBOMe. It is made from mescaline, and is similar to LSD. It is ingested as a liquid, powder, or on a blotter, the article notes. The drug can be harmful to kidneys, and can trigger mental health issues. Last month, WHTM reported N-Bomb was believed to be responsible for the death of a high school student in Harrisburg, Pennsylvania. In May, police in Scottsdale, Arizona said they were investigating whether the deaths of two 18-year-olds were linked to N-Bomb.

Access to Dentists and Pharmacists Predicts Higher Rates of Opioid Abuse: Study
People who live in counties with higher concentrations of dentists and pharmacists are at increased risk of abusing prescription opioids, a new study suggests. The study of opioid abuse in Indiana counties was presented this week at the annual meeting of the American Public Health Association, Everyday Health reports. The researchers found counties in Indiana with higher rates of dentists and pharmacists had more per-capita opioid prescriptions, which in turn is associated with increased rates of opioid abuse. The most widely prescribed opioid was hydrocodone (Vicodin), which accounted for 69 percent of all opioid prescriptions. Oxycodone prescriptions accounted for 12 percent of opioid prescriptions, followed by codeine-containing products at 8.5 percent, and fentanyl at 3 percent. “We must be cautious and work with public health and health care leaders to avoid ‘overcorrecting,’ unnecessarily restricting the supply of opioids, or inadvertently vilifying or punishing providers who are struggling to meet patients’ legitimate clinical needs,” lead researcher Eric Wright of Indiana University noted in a news release. He added the study underscores the need to work with healthcare provider groups to help them dispense needed medication, while avoiding potential diversion or misuse. “It is unlikely that efforts to educate and regulate individual providers, patients, or suppliers of opioids alone will be sufficient to reverse the growing supply or demand for prescription pain relievers,” he wrote in the study. “It is time for public health and healthcare leaders to develop more comprehensive, community-level strategies that address system- and individual-level factors that are driving the epidemic of prescription opioid abuse.”

Watch as heroin addict comes back to life from overdose thanks to emergency shot
In a video taken by addiction outreach volunteers, a 29-year-old woman is revived from a heroin overdose with a shot of the drug Naloxone. Click here for the rest of this story and the video.

Will Legalizing Pot Result In More Or Less Drinking?
Among the eight “enforcement priorities” that the Justice Department expects states to address in exchange for prosecutorial restraint vis-รก-vis newly legal pot businesses is “preventing drugged driving and the exacerbation of other adverse public health consequences associated with marijuana use.” Rest of this article is here.


ER study finds 1 in 10 older teens misuse Rx painkillers and sedatives
If confirmed, findings suggest an opportunity to screen for prescription drug abuse risk – and reduce potential for addiction or overdose
With prescription drug abuse at epidemic levels nationwide, and overdoses killing more people than auto accidents in many states, a new University of Michigan study provides striking new data about the misuse of potent prescription painkillers and sedatives by teens and young adults. Continue reading here.


Addicts May Be Seeking Relief from Emotional Lows More than Euphoric Highs
Rutgers study could lead to a better understanding of human addiction – alcohol, tobacco and food – as well as substance abuse.
Cocaine addicts may become trapped in drug binges – not because of the euphoric highs they are chasing but rather the unbearable emotional lows they desperately want to avoid.
In a study published online in Psychopharmacology, Rutgers University Behavioral and Systems Neuroscience Professor Mark West, and doctoral student David Barker in the Department of Psychology, in the School of Arts and Sciences, challenge the commonly held view that drug addiction occurs because users are always going after the high. Based on new animal studies, they discovered that the initial positive feelings of intoxication are short lived – quickly replaced by negative emotional responses whenever drug levels begin to fall. Continue reading here.

Alcohol Is Really Pissed Off at Marijuana Right Now
The marijuana industry is convincing Americans its substance is safer than alcohol, and booze lobbyists don't like it. Continue reading here.

Alcoholism may be fostered by colleges.
Growing up for Susan Hornecker meant a life that was out of control. Now a housewife in the suburbs of New Jersey and a mother of a former Purdue student, Hornecker recounts growing up with an alcoholic and abusive father as “scary.” “You never knew what the house would be like when you walked in,” Hornecker said. “We called the police sometimes. I remember saying (to them) ‘You have to take him out of here.’” Continue reading here.

Some sober homes move dangerously close to treatment
In the largely unregulated but burgeoning market of recovery residences in Florida, one of the most egregious business scenarios involves a crossing of boundaries, with many sober home operators now opening up intensive outpatient programs (IOPs) in an attempt to secure insurance dollars. “Unlawful practices have sprung up like weeds as more IOP licenses are issued in Palm Beach, St. Lucie and Broward counties,” says John Lehman, an advisory board member for the Florida Association of Recovery Residences (FARR), which in the state is trying to get sober home operators to adhere to national standards for recovery residence operations. “Everyone is chasing the insurance dollar.” This article continues here.

Training Course Designed to Curb Prescription Drug Abuse Shows Early Promise
An online training program designed to reduce prescription drug abuse shows promise in early results, HealthCanal reports. A three-month follow-up survey shows providers who participated in the program have changed their chronic pain management practices based on what they learned. Of those who currently manage pain patients, 84 percent said they have changed the way they practice. Almost 80 percent agreed or strongly agreed they increased their knowledge about the treatment and management of non-cancer chronic pain. In addition, 75 percent said they are more confident in managing chronic, non-cancer pain patients. Among providers who took the course but are not managing chronic pain patients, 79 percent said they now coordinate care with providers who do manage chronic patients, based on what they learned in the course. The course, called “The Opioid Crisis: Guidelines and Tools for Improving Chronic Pain Management,” was developed by a team of researchers and health care providers at the Center for Worker Health and Environment at the Colorado School of Public Health. It is designed to retrain health care providers on updated state and federal chronic pain management guidelines. It provides instructions for which evidence-based best practices should be used before prescribing opioids. Since launching last November, more than 1,000 Colorado health care providers have been enrolled.

Thursday, October 31, 2013

ATOD & Advocacy Update - Week Ending November 1, 2013



First Single-Ingredient Hydrocodone Drug Receives FDA Approval
The Food and Drug Administration on Friday approved the first pure hydrocodone drug in the United States. The drug, Zohydro ER (extended release), was approved for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Drugs such as Vicodin contain a combination of hydrocodone and other painkillers such as acetaminophen, the Associated Press reports. In December, a panel of experts assembled by the FDA voted against recommending approval of Zohydro ER. The panel cited concerns over the potential for addiction. In the 11-2 vote against approval, the panel said that while the drug’s maker, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone. Patient safety advocates criticized the FDA’s decision. “We’re just going to kill more kids and then the FDA is going to come back and say, ‘oh, we made a mistake,’” said Avi Israel, whose son Michael committed suicide while struggling with painkiller addiction. Israel is the founder of a group that aims to combat painkiller abuse in young people. In a statement, the FDA noted, “Zohydro ER will offer prescribers an additional therapeutic option to treat pain, which is important because individual patients may respond differently to different opioids.” The agency will require postmarketing studies of Zohydro ER to evaluate the known serious risks of misuse, abuse, increased sensitivity to pain, addiction, overdose, and death associated with long-term use beyond 12 weeks.

Treating Trauma and Addiction in Health Care Professionals
Health care professionals who are dealing with substance use disorders face particular challenges, according to the executive director of an organization dedicated to serving this population. These professionals must learn to cope with the emotional challenges of having ready access to medications, says Maureen Sullivan Dinnan, J.D. of HAVEN. “The disease of addiction is the same for everyone, but for health care professionals, relapse prevention strategies need to be different because of their access to drugs,” she says. “They need to be prepared to deal with how they will feel when they administer medication and see the patient’s pain is relieved, while they are also suffering emotional or physical pain.” As with many other people, health care professionals who abuse drugs often do so not to get high, but to self-medicate to help them deal with having suffered trauma, Dinnan says. “When their coping mechanism is taken away, they may lapse because they have no other way to deal with the trauma.” Her Connecticut-based organization is holding a symposium on Trauma and Recovery for health care professionals on November 1 at Quinnipiac University in North Haven. HAVEN is a voluntary confidential assistance program for health care professionals facing the challenges of physical illness, mental illness, chemical dependence or emotional disorder. It is designed as a peer-based process to encourage early identification of health care professionals who are at risk for impairment. The program helps health care professionals manage their own well-being in addition to the well-being of their patients. “Over the last decade there has been a growing understanding that if health care professionals don’t get care for themselves, it not only hurts them, but may impact the quality of care they can deliver,” Dinnan says, adding there is a misperception that health care professionals are stronger or more able-minded than other people, and are therefore better equipped to deal with the consequences of trauma. HAVEN has a high success rate that is due in large part to the monitoring they conduct, according to Dinnan. “We make sure if the person’s plan requires therapy, that they are engaged in therapy, and if a person doesn’t commit to therapy, we are notified.” The program also conducts random drug testing. They partner with a workplace monitor who is aware of the health care professional’s treatment, and can notify HAVEN if the person appears stressed and needs extra support.

Doctors Try New Non-Narcotic Approach to Pain Management After Surgery
Doctors are trying a new approach to pain management after surgery, in an attempt to reduce patients’ reliance on narcotic painkillers, according to The Wall Street Journal. This “multimodal” approach includes cocktails of medications given to patients before, during and after surgery. The medication is delivered orally, intravenously and through injection into the tissues and nerves around the surgical site. By avoiding giving patients heavy doses of opioids, doctors hope to prevent the risk that patients will become addicted to painkillers. They also avoid the grogginess, nausea, hallucinations and constipation that can result from taking opioids. Martin Clark Jr., an orthopedic surgeon at Sharon Hospital in Sharon, Connecticut, says when his patients rely entirely on narcotics, they are “drowsy and apathetic, they aren’t into physical therapy and they sit in bed.” In contrast, patients being treated with the new pain protocols are more able to stick with physical rehabilitation regimens to regain muscle strength and range of motion. Patients undergoing knee replacement surgery at Canton-Potsdam Hospital in Potsdam, New York, receive medication before surgery including the anti-inflammatory Celebrex, and Lyrica, which treats nerve pain and blocks pain impulses to the central nervous system. During surgery, patients receive anesthesia in the lower spine, as well as a sedative, intravenous Tylenol and an anti-nausea medication. The anesthesia lasts up to 24 hours after surgery. The surgeon also injects medications into the tissues around the knee, including a numbing agent, a drug to control bleeding and another anti-inflammatory agent. Once patients are in recovery, they receive a continuous cooling pad to decrease swelling and stimulate nerve endings, which reduces pain. They receive 24 hours of intravenous Tylenol and more Celebrex and Lyrica. Patients are given oral narcotics such as oxycodone, but they generally don’t need them for more than two weeks, and often stop taking them after several days.

A Year After Federal Legislation Bans Synthetic Drugs, More Than 250 Types Still Sold
A little more than a year after President Obama signed legislation banning the sale of 26 designer drugs, more than 250 types of these synthetic drugs are still sold in the United States, Roll Call reports. Legislators and law enforcement agencies are trying to keep up with drug makers, who are continually introducing slight variations of their products to keep one step ahead of the law. They say the federal law was an important step in fighting designer drugs, but it was not enough. “A change of a molecule or two to a banned drug is sometimes enough to make a new and legal alternative,” said Senator Charles E. Grassley of Iowa during a recent hearing of the Senate Caucus on International Narcotics Control, of which he is co-chairman. After the law was passed, law enforcement officials saw a slight reduction in calls to poison control centers and visits to emergency rooms related to synthetic drugs. Usage appears to be on the rise once again as drug manufacturers continue to modify their products. Legislators are introducing more bills to stem the tide, but it is unclear what Congress can do to help law enforcement battle these drugs, the article notes. Synthetic drugs are popular because they are easily available and less detectable by standard drug tests. Users may incorrectly assume these drugs are less harmful than regular drugs. Joseph Rannazzisi, Deputy Assistant Administrator of the Drug Enforcement Administration’s (DEA) Office of Diversion Control, told senators at the hearing, “DEA is constantly behind the clandestine chemists and traffickers who quickly and easily replace newly controlled substances with new, non-controlled substances.” He noted from January to August 2013, poison control centers received 1,821 calls regarding exposures to synthetic marijuana. Because synthetic drugs are unregulated, users don’t know what they are actually getting when they buy the products in gas stations or online, Rannazzisi said.

Epilepsy Medication Could Help Treat Cocaine Dependence: Study
The drug topiramate, used to treat epilepsy and migraine headaches, may be an effective treatment for cocaine dependence, a new study suggests. There are currently no medications approved by the Food and Drug Administration to treat cocaine addiction, Science Daily reports. The study was conducted by Dr. Bankole A. Johnson of the University of Maryland School of Medicine, who previously found topiramate was a safe and effective treatment for alcohol dependence. The new study, published in JAMA Psychiatry, included 142 adults who were seeking treatment for cocaine dependence. They were randomly assigned to receive either topiramate or a placebo. The researchers found topiramate was more effective at increasing the likelihood that participants would have cocaine-free weeks. The drug was also significantly associated with a decrease in cocaine craving, and an improvement in participants’ overall functioning. Side effects of the drug were mild, and included abnormal tingling skin sensations, taste distortions, anorexia, and difficulty concentrating. “Our findings reveal that topiramate is a safe and robustly efficacious medicine for the treatment of cocaine dependence, and has the potential to make a major contribution to the global health crisis of addiction,” Dr. Johnson said in a news release. “However, topiramate treatment also is associated with glaucoma, and higher doses of the drug can increase the risk of side effects; therefore, caution must be exercised when prescribing the drug, especially when given in high doses.” A study published in July 2013 found topiramate may help reduce cocaine use in people addicted to cocaine and alcohol.


Why doesn't alcohol have nutrition labels?
A recently proposed change could mean uniform nutritional labels across all consumable goodies (including booze).
How much fiber is in your shot of Jim Beam? What vitamins are in your gin? If those questions sound odd, get ready: The same nutritional information you see on Gatorade may soon be coming to raspberry vodka. It turns out the government has different regulatory bodies for food and spirits, but a recently proposed change could mean uniform nutritional labels across all consumable goodies (including booze). It all stems from some fairly complicated legal designations that separate food (headed up by the FDA) from some, but not all, alcohol (which is regulated by the Department of the Treasury's Alcohol and Tobacco Tax and Trade Bureau). Continue reading here.

Study finds about 20% of Md. college students show signs of alcohol abuse or dependency
A new report has found that about 19 percent of underage and 22 percent of college students ages 21 to 24 in Maryland show signs of alcohol abuse or dependency. The report was done by a collaborative of Maryland's higher education institutions that have joined forces to address excessive drinking in college. The University System of Maryland and the Bloomberg School of Public Health at the Johns Hopkins University have formed a coalition of 10 college presidents from across the state to establish the Maryland Collaborative to Reduce College Drinking and Related Practices. According to a new report issued by the group, Maryland college students drink at levels similar to the national average, but its highest risk drinkers drink more than their peers and are less likely to seek help. The report also found that nearly one-third of Maryland college students drove under the influence of alcohol and drugs. The coalition said Maryland colleges will be encouraged to develop “multi-level” interventions at colleges where campus drinking occurs. Officials said that while most Maryland schools offer alcohol programs and basic training, the collaborative recommends going the extra step to help change students’ behavior and “modifying the settings that influence students’ drinking decisions.”

New insights on college drinking - Psychologists' research is pinpointing who is most at risk for drinking problems in college and developing more targeted, evidence-based interventions.
At the University at Albany in 2000, Chad Waxman fit the profile of a college student primed for risky drinking: A freshman male fraternity brother who drank in high school, Waxman chose Albany in part for its balance between work and play. "I wanted that time to let loose," he says. Despite the predictors, Waxman sailed through college in health and happiness, even serving in student government and winning multiple leadership awards at the university before graduating in 2003. He went on to earn his master's degree in counseling psychology and school counseling from Albany in 2005 and is now a PsyD candidate at Nova Southeastern University.  How did Waxman, now 33, avoid the pitfalls of drinking common among college students? That's a question psychologists are probing deeply. After all, each year, more than 1,825 college students die from alcohol-related accidents and nearly 600,000 are injured while drunk, according to a 2009 study in the Journal of Studies on Alcohol and Drugs. Another 696,000 are assaulted by another student who has been drinking, and 97,000 are victims of alcohol-related sexual assault or date rape, the study found. Then there's the 25 percent of college students who report academic consequences related to alcohol — a hangover can quickly derail plans for class or study — and the 11 percent who admit damaging property after a night of drinking (Journal of American College Health, 2002). An estimated 5 percent get into legal trouble as a result of alcohol, the same study found. In all, of the 80 percent of college students who drink alcohol, half "binge drink," or consume about four drinks in two hours for women and five in two hours for men, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Click here to read the full article.

FDA and Opioids: What's Going On Here?
Against the recommendation of its own advisors, the U.S. Food and Drug Administration approved a new high-dose narcotic painkiller, a drug that the FDA concedes has a high risk for abuse and one which was using a method that critics say may give the drug the appearance of greater efficacy. Zohydro ER will be the first hydrocodone-only opioid, and it will come in doses packing five to 10 times more heroin-like narcotic than traditional hydrocodone products such as Vicodin that combine hydrocodone with over-the-counter pain relievers such as acetaminophen or ibuprofen. Continue reading here.

Study: 10% of Teens Treated in the ER Admit to Misusing Prescription Drugs
Ten percent of 14- to 20-year-olds treated in the emergency room for any reason say they have misused prescription drugs at least once in the last year, a new study finds. The researchers at the University of Michigan found most of the teens who admitted to misusing prescription drugs used other people’s medications. Teens who misused prescription drugs were significantly more likely to also have abused alcohol and non-prescription drugs such as cough medicine, or to have used marijuana, in the past year, the study found. They were also more likely to have ridden with a drinking driver. The findings appear in the journal Pediatrics. The researchers say this is the first time prescription drug abuse in teens has been studied in an emergency department setting, even though opioid painkillers and sedatives are often prescribed by emergency department doctors, PsychCentral reports. While school-based studies have found rates of prescription drug misuse among young people to be around 8 percent, these studies do not include teens who have dropped out of school or did not continue their education past high school, the article notes. Study author Lauren Whiteside, M.D., said the findings suggest that emergency departments could be an effective place to screen teens and young adults for prescription drug misuse, and for intervening early before problems begin. “These patients are often using the emergency department for their medical care, not primary care settings,” she noted in a news release. “So, in order to curb this problem and address overdose and addiction, the ED is a good place to start.”