Study finds troubling
relationship between drinking and PTSD symptoms in college students
The estimated 9 percent of college students who have
symptoms of post-traumatic stress disorder (PTSD) are likely to drink more
alcohol than peers without the psychological condition. In turn, heavy alcohol
consumption exacerbates their PTSD symptoms over time, prolonging a vicious
cycle. Please
click to continue reading.
In Their Own Words:
Melissa Batie Johnson: My version of health care reform
I’m a drug dealer, in a very literal sense. I spend my days
operating, with my father, a business that sells drugs, albeit legal ones,
prescribed by local physicians to members of our community. The vast majority
of prescriptions we fill each day don’t cause much excitement; they lower blood
pressure and cholesterol, maintain healthy blood sugar and address a multitude
of digestive issues. But Oxycodone and his pals — Xanax, Adderall and others —
have wrought havoc nationwide. Our community is no different. In 2010, more
Americans died of prescription overdoses than would have died if a fully loaded
747 crashed, killing everyone on board, every week for a year. Please
click to continue reading.
Prescription drugs a
'tipping point' for dating violence among urban youth
A new University of Michigan Injury Center study recently
found a link between misuse of prescription drugs and physical violence among
dating partners. Alcohol and other drugs have been a well-studied health
concern among youth with a history of substance use. Previous studies asking
youth about daily use over the course of a month show that alcohol and drugs
are more likely to be used on days in which violence, both dating and
nondating, occurs than on days when there was no violence. Please
click to continue reading.
Study Links Misuse of
Prescription Drugs and Violence Among Dating Partners
A new study suggests a connection between misuse of
prescription drugs and incidents of dating violence. Researchers at the
University of Michigan Injury Center found misusing prescription sedatives and
opioids was more common prior to dating violence, while alcohol use or a
combination of alcohol and marijuana use were more common prior to non-dating
violence, HealthCanal reports. “Without the alcohol or prescription drugs
involved, they simply might walk away from a potentially violent situation,”
lead researcher Quyen Epstein-Ngo said in a news release. “The alcohol and
other substance use may be the tipping points.” The researchers looked at use
of prescription sedatives and opioids immediately preceding violent dating
conflicts, on the day of the conflict, among high-risk urban youth. The study
included 575 participants, ages 14 to 24, over a one-year period. Women were
more likely to be involved in dating violence. Of the 1,262 incidents reported
in the study, substance use occurred immediately before 44 percent of
conflicts. About half of dating violence incidents involved drug use. “Our
findings indicate that interventions that address violence among youth should
address substance use and psychological factors, as well as be tailored by type
of violence—dating versus non-dating—and by gender,” Epstein-Ngo said. The
results are published in the journal Addictive Behaviors.
Why "Just Say
No" Doesn't Work
“Just say no.” In 1982 First Lady Nancy Reagan uttered those
three words in response to a schoolgirl who wanted to know what she should say
if someone offered her drugs. The first lady's suggestion soon became the
clarion call for the adolescent drug prevention movement in the 1980s and
beyond. Since then, schools around the country have instituted programs
designed to discourage alcohol and drug use among youth—most of them targeting
older elementary schoolchildren and a few addressing adolescents. Please
click to continue reading.
Understanding New Rules
That Widen Mental Health Coverage
Long-awaited improvements in insurance coverage for mental
conditions and addictions are expected to become more widely available this
year as a result of two major steps that the Obama administration has taken.
The president’s signature Affordable Care Act includes mental health care and
substance abuse treatment among its 10 “essential” benefits, which means plans
sold on the public health care exchanges must include coverage. In addition,
rules to fully carry out an older law — the Mental Health Parity and Addiction
Equity Act of 2008 — were issued in November, after a long delay. The parity
law says that when health insurance plans provide coverage for mental ailments,
it must be comparable to coverage for physical ailments. For instance, plans
cannot set higher deductibles or charge higher co-payments for mental health
visits than for medical visits, and cannot set more restrictive limits on the
number of visits allowed. The new parity rules apply to most health plans and
are effective beginning July 1, although many plans will not have to comply
until January of next year. Please
click to continue reading.
Alcohol consumption is a
necessary cause of nearly 80,000 deaths per year in the Americas
A new study published in the scientific journal Addiction by
the Pan American Health Organization, a branch of the World Health
Organization, has measured the number and pattern of deaths caused by alcohol
consumption in 16 North and Latin American countries. The study reveals that
between 2007 and 2009, alcohol was a 'necessary' cause of death (i.e., death
would not have occurred in the absence of alcohol consumption) in an average of
79,456 cases per year. Liver disease was the main culprit in most countries. Please
click to continue reading.
The last drop: the history
of alcohol in medicine
For hundreds of years alcohol claimed a prized place amongst
the pills, potions and purportedly healing herbs of British pharmaceutical
history. A drop of gin was once advised to ward-off the plague, a glug of wine
thought to "defend the body from corruption" and a sip of absinthe
considered to cure the body of round-worms. Of course all this has changed. As
our understanding of the harms of alcohol on society and the individual has
grown, it has given up its place on prescription pads - instead to be
superseded by advice to refrain from all but cautious use. An exhibition at the
Royal College of Physicians in London traces its use and sometimes fatal misuse
by medical men and women of the past, up to the calls for greater regulation
today. Please click to
continue reading.
Why Is Heroin Abuse Rising
While Other Drug Abuse Is Falling?
Peter Shumlin, Democratic governor of Vermont, moved heroin
addiction to the front burner of national news by devoting his entire State of
the State address last week to his state’s dramatic increase in heroin abuse.
Shumlin described the situation as an “epidemic,” with heroin abuse increasing
770 percent in Vermont since 2000. Vermont is a microcosm of the nation. Across
the U.S., heroin abuse among first-time users has increased by nearly 60
percent in the last decade, from about 90,000 to 156,000 new users a year,
according to the U.S. Substance Abuse and Mental Health Services Administration
(SAMHSA). Please
click to continue reading.
Let's
Not Kid Ourselves About Marijuana
Colorado
makes pot legal, 'Rocky Mountain high' jokes follow. Now watch the tragedies
start piling up.
By MITCHELL S. ROSENTHAL
Pot is always good for a
giggle, and that makes it hard to take marijuana seriously. The news and
entertainment media couldn't resist puns on "Rocky Mountain high"
when Colorado started the year with legal sales of marijuana for recreational
purposes. TV stations across the country featured chuckling coverage of long
lines outside Denver's new state-licensed pot shops. Legalizing marijuana isn't just amusing. It's
increasingly popular with legislators and the public. And why not? No matter
how high stoners get, they're nowhere near as scary as out-of-control boozers,
right? Stoners don't brawl in bars. They're not into domestic violence. A Gallup poll last year found 58% of Americans
favoring legalization (although other surveys report more slender majorities).
Decriminalization of pot possession is widespread: 20 states sanction marijuana
use for medical or quasi-medical reasons, and, following Colorado's and
Washington's lead, proponents of legalization are targeting Alaska and Oregon
for ballot initiatives in the near future, and six other states after that.
Yet marijuana is far from safe, despite the
widespread effort to make it seem benign. Pot damages the heart and lungs,
increases the incidence of anxiety, depression and schizophrenia, and it can
trigger acute psychotic episodes. Many adults appear to be able to use
marijuana with relatively little harm, but the same cannot be said of
adolescents, who are about twice as likely as adults to become addicted to
marijuana. The new Colorado law limits pot sales to people 21 or older, but
making marijuana available for recreational use normalizes it in society. The
drug will be made more easily available to those under 21, and how long until
the age limit is dropped to 18? Adolescents
are vulnerable—and not just to pot. That's how they are programmed. They make
rash and risky choices because their brains aren't fully developed. The part of
the brain that censors dumb or dangerous behavior is last to come on line
(generally not before the mid-20s). Meanwhile, the brain's pleasure-seeking
structures are up and running strong by puberty. When you link adolescent
pleasure-seeking and risk-taking to marijuana's impairment of perception and
judgment, it isn't surprising that a 2004 study of seriously injured drivers in
Maryland found half the teens tested positive for pot. Marijuana impairs learning, judgment and memory—no
small matters during the adolescent years—and it can do lasting harm to the
brain. Dr. Nora Volkow, director of the National Institute on Drug Abuse, has
found that marijuana can damage cognitive function in adolescents by disrupting
the normal development of the white-matter that brain cells need to communicate
with each other. Most disturbing is a
discovery about marijuana last month at Northwestern University's Feinberg
School of Medicine. Researchers there have found lasting changes in
"working memory," brain structures critical to memory and reasoning.
A source of ready recall for basic information, like telephone numbers, and
solutions to everyday problems, working memory is also a strong predictor of academic
achievement. Dr. Volkow and most other
experts are troubled by changing teen attitudes about marijuana. Barely 40% of
adolescents now believe regular use is harmful—down from 80% two decades ago.
Teen drinking and cigarette smoking have declined, and their abuse of
prescription painkillers has fallen off sharply, but teen marijuana use
continues to increase. The University of Michigan's Monitoring the Future
survey last year found that more than 45% of high-school seniors have smoked
pot and 6.5% now smoke it daily (a rate that has tripled over the past two
decades). At the substance-abuse programs of Phoenix House, and at similar
programs across the country, marijuana is the primary drug of abuse for close
to 70% of teens in treatment. No one can
say how marijuana legalization will play out. A perception of legal marijuana
as safe, combined with sophisticated marketing, may well double or triple pot
use. Warning of aggressive promotion, drug-policy expert Mark Kleiman, who
studied potential issues of a legal marijuana market for the Seattle City
Council, pointed out last year: "The only way to sell a lot of pot is to
create a lot of potheads." As we
learn more about the realities of legalizing recreational marijuana, I suspect
pot won't seem so funny anymore. Remember, drunks used to be good for a laugh
too. A hiccupping, stumbling tosspot was a staple of Hollywood's screwball
comedies in the 1930s and '40s. Smoking cigarettes was considered cool. The
reality of wrecked lives and ruined health eventually changed public
perceptions of these addictions. Now marijuana is becoming more widely regarded
as a harmless amusement. That's not funny, it's tragic.
Dr. Rosenthal is a child
psychiatrist and the founder of the nonprofit substance-abuse treatment and prevention
organization Phoenix House.
Commentary:
Interstate PMP Data-Sharing Technologies Assist States, Health Care Providers
in Protecting Patient Health
With nearly half of state prescription monitoring programs
(PMPs) sharing data via the National Association of Boards of Pharmacy® (NABP®)
PMP InterConnect® program, the system is successfully helping states in their
efforts to protect patient health and lower rates of prescription drug abuse
and diversion. Since its launch in July 2011, the NABP InterConnect program has
enabled participating state PMPs to quickly and securely share information
about controlled substance prescriptions across state lines while ensuring
individual state rules are enforced. Currently 21 states are sharing data, with
Nevada and Idaho expected to go live soon. To encourage use of PMP data by
health care providers, NABP and several NABP InterConnect participants have
piloted projects to add seamless integration of PMP data into the workflow of
health care providers in multiple environments. In 2012, NABP partnered with
Indiana Health Information Exchange on behalf of Indiana’s PMP to create a
pilot that enabled prescribers in the emergency department at Wishard Memorial
Hospital to automatically access PMP data, streamlining the process. The pilot
was extended through June 2013, and recent data has correlated the electronic
health record integration with a drop in doctor shopping in the first six
months of 2013 compared to that same period in 2012. NABP completed work on a
similar pilot with Michigan’s PMP – another NABP InterConnect participant –
that successfully made PMP data more readily available to physicians and other
authorized users in the general practitioner setting. In Michigan’s pilot,
e-prescribing company DrFirst connected to the NABP InterConnect hub the same
way a state PMP would, thus allowing authorized prescribers to access PMP data
through the e-prescribing system without the additional step of logging into
the PMP. Following the success of these programs, NABP is currently working
with 14 additional states to develop similar integration-centric programs. Even
as growing state participation and the success of workflow integration projects
illustrate the high demand for interstate PMP data, challenges remain in
expanding access to data. In some cases, a state’s processes or laws may
prevent or prohibit the sharing of data with another state’s PMP. Laws on who
can access data, for example, may differ from state to state. Such limitations
lead to situations like that in Louisiana, where information is only shared
with four states, while its neighbor, Mississippi, may share with 20. Such
issues must be addressed through state legislative processes and, thus, will
take time to resolve. Additional information on the NABP InterConnect program,
including the most up-to-date information about state participation, is
available in the programs section of the NABP Web site.
Carmen A. Catizone, MS, RPh, DPh. Executive
Director/Secretary, National Association of Boards of Pharmacy
Alcoholics Anonymous vs.
the Doctors - Could new addiction medications replace mutual-help groups?
alcoholics Anonymous is, by far, the largest and most
venerable addiction recovery group in the world. Founded nearly 80 years ago,
AA now boasts 2.1 million worldwide members, many of whom attribute their very
survival to the organization. In the United States, where the 12-step program
originated, AA is viewed by many as a national treasure of sorts. Social
workers send patients to AA meetings. Judges condition people’s freedom on
meeting attendance. Desperate spouses condition marriages on it. Everyone loves
Alcoholics Anonymous. Or almost everyone.
Many patients and doctors have grumbled for years about the
religion inherent in the Alcoholics Anonymous process: Half of the 12 steps
involve God or “a Power greater than ourselves.” Please
click to continue reading.
Adult illicit drug users
are far more likely to seriously consider suicide
Adults using illicit drugs are far more likely to seriously consider suicide than the general adult population according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report finds that 3.9 percent of the nation’s adult population aged 18 or older had serious thoughts about suicide in the past year, but that the rate among adult illicit drug users was 9.4 percent. According to SAMHSA’s report, the percentage of adults who had serious thoughts of suicide varied by the type of illicit substance used. For example, while 9.6 percent of adults who had used marijuana in the past year had serious thoughts of suicide during that period, the level was 20.9 percent for adults who had used sedatives non-medically in the past year. The complete survey findings are available on the SAMHSA web site at: http://www.samhsa.gov/data/spotlight/spot129-suicide-thoughts-drug-use-2014.pdf
Adults using illicit drugs are far more likely to seriously consider suicide than the general adult population according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report finds that 3.9 percent of the nation’s adult population aged 18 or older had serious thoughts about suicide in the past year, but that the rate among adult illicit drug users was 9.4 percent. According to SAMHSA’s report, the percentage of adults who had serious thoughts of suicide varied by the type of illicit substance used. For example, while 9.6 percent of adults who had used marijuana in the past year had serious thoughts of suicide during that period, the level was 20.9 percent for adults who had used sedatives non-medically in the past year. The complete survey findings are available on the SAMHSA web site at: http://www.samhsa.gov/data/spotlight/spot129-suicide-thoughts-drug-use-2014.pdf
Phoenix House, TRI will test widespread screening of high schoolers
The CEO of Phoenix House Foundation sees numerous factors converging to make high schools an ideal setting for screening and brief intervention efforts targeting young people. With marijuana policy changes and the persistent opioid crisis threatening to fuel increases in adolescent substance use, the time could be ripe for widespread screening that now can be reimbursed through healthcare as opposed to school system funding. .” Please click to continue reading.
The CEO of Phoenix House Foundation sees numerous factors converging to make high schools an ideal setting for screening and brief intervention efforts targeting young people. With marijuana policy changes and the persistent opioid crisis threatening to fuel increases in adolescent substance use, the time could be ripe for widespread screening that now can be reimbursed through healthcare as opposed to school system funding. .” Please click to continue reading.
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