[Reblog]Re-framing Drugs as a Public Health Issue

Re-framing Drugs as a Public Health Issue.

From the Criminal Injustice Blog item of April 2, 2013

By Louellyn Lambros

It is time that drug use be viewed as a public health issue, rather than a matter for the criminal justice system. Too many drug users are saddled unnecessarily with criminal records, making it extraordinarily difficult to have fulfilling lives including being able to work and to make other kinds of valuable contributions to their families and society.

The skyrocketing incarceration rate in our country has been an outgrowth of the War on Drugs, which began over thirty years ago and had its roots in a political strategy to gain the votes of disaffected whites, in the wake of a successful Civil Rights struggle. Since outright discrimination on the basis of race was no longer acceptable or legal, an alternative route was to label African-Americans as criminals, thereby opening the door to reintroduce all the same forms of discrimination – in employment, housing, voting rights, and so on.

As the number of incarcerated people in the US grew from 300,000 in the last half of the 20th century to over 2.2 million today, racism continues to fuel the revolving door of our fellow citizens into the criminal justice system. In addition, the system has become big business, employing a growing number of judges, lawyers, prosecutors, and all types of ancillary personnel. Prisons themselves are becoming increasingly privatized, run as money-making corporations which sell shares on the NYSE. In thirty-seven states, prison labor is contracted to major corporations who pay 16 to 28 cents an hour, ensuring astronomical profits.

While the majority of Americans, once educated on the issue, may be persuaded by the injustice of the situation as it affects minority communities and may be horrified by how the one percent is capable of turning anything into a lucrative business, it will take more time and effort to address the concerns of those whose loved ones have suffered from addiction and subsequent incarceration.

The truth is that no one, particularly the most vulnerable dealing with drug addiction, is served by the current system. Those who are susceptible to addiction are even more vulnerable and in need of self-soothing in the face of extreme stress. Why do therefore we respond to their difficulties with a system of incarceration which stresses them to the max and saddles them with second-class citizen status as a ‘felon’ upon release back into their home communities?

A policy of decriminalization, as has been in place in Portugal since 2001, would take the whole issue of drug addiction out of the criminal justice system and make it a civil and public health matter. A panel of three– made up of two individuals with a health background and one with a legal background–would make a determination: is this person’s drug use a problem? If not, perhaps a fine or a warning will suffice. If it is deemed a problem, treatment and rehabilitation are in order. Treatment facilities could easily be funded by resources reallocated from the criminal justice system.

Related articles

• A new day for the ‘war on drugs’ (maddowblog.msnbc.com)
• Jason Silverstein: More Treatment, Less War: The White House Drug Policy Reform (huffingtonpost.com)
• 21st Century Drug Policy (propresobama.org)
• Drug Policy Reform In Action: A 21st Century Approach (whitehouse.gov)
• Focusing On Prevention And Neuroscience, President Ends Reagan’s War On Drugs (newsone.com)

 

Reducing The Treatment Gap For Mental, Neurological, And Substance Use Disorders

From the 17 November Medical News Today report

In this week’s PLoS Medicine, Shekhar Saxena of the WHO in Geneva, Switzerland and colleagues summarize the recent WHO Mental Health Gap Action Programme (mhGAP) intervention guide that provides evidence-based management recommendations for mental, neurological, and substance use (MNS) disorders.

This guide is aimed at reducing the treatment gap for MNS disorders, which is more than 75% in many low- and middle-income countries (LMICs). Further details and background material to the guide can be accessed on the WHO website:http://bit.ly/vKPSRF

The authors recommend that: “In the near future, further efforts should be made to introduce formal evaluations of the capability of [treatment] programs to induce relevant and persistent changes, and to generate useful insights on how implementation in [low- and middle-income countries] should be conducted to maximize benefit at sustainable costs.”

Related articles

• Mental First Aid: How To Help In An Emotional Crisis (jflahiff.wordpress.com)
• Lagos begins free mental treatment (vanguardngr.com)
• Tulsa Specialty Hospital Fills Patient Service Gap (prweb.com)
• Linda Rosenberg: A Silent Public Health Crisis (huffingtonpost.com)

Drugs of Abuse – 2011 Edition

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Drugs of Abuse – 2011 Edition (US Drug Enforcement Agency) is designed to “be a reliable resource on the most popularly abused drugs. This publication delivers clear, scientific information about drugs in a factual, straightforward way, combined with scores of precise photographs shot to scale.”

Both legal and illegal substances are included. Familiar drugs include marijuana, heroin, cocaine and barbiturates. A drugs of concern section includes bath salts, DXM, and Salvia Divinorum.

Links are given to federal anti-drug organizations,  other anti-drug organizations, free anti-drug information sites, and youth anti-drug organizations.

Related articles

• Teen Drug Abuse of Cough Medicine (webmd.com)
• Pa. House approves bill to ban balt salts drug, fake marijuana (pennlive.com)
• The War on Drugs Turns 40: A Look at Its 10 Worst Side Effects (healthland.time.com)
• Synthetic drugs drive more DUI arrests (pennlive.com)
• ER Visits for Drug-Related Suicide Attempts Up in Men (webmd.com)
• New OxyContin Formula Foils Drug Abusers (newser.com)

Easy Online Availability Of Controlled Drugs May Contribute To Soaring Abuse Levels

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From a 12 May Medical News Today article

Increasing access to rogue online pharmacies – those which dispense medications without a doctor’s prescription – may be an important factor behind the rapid increase in the abuse of prescription drugs. In a report that was released today, 12th May, online by the journal Health Affairs and will also appear in its June edition, investigators from Massachusetts General Hospital (MGH) and the University of Southern California (USC) find that states with the greatest expansion in high-speed Internet access from 2000 to 2007 also had the largest increase in admissions for treatment of prescription drug abuse….

….The analysis indicated that each 10 percent increase in the availability of high-speed Internet service in a state was accompanied by an approximately 1 percent increase in admissions for prescription drug abuse. The increases were strongest for narcotic painkillers, followed by anti-anxiety drugs, stimulants and sedatives. During the same period admissions to treat abuse of alcohol, heroin or cocaine, substances not available online, showed minimal growth or actually decreased. …

Click here to read the entire  news article

The abstract and full text of the Health Affairs article Growing Internet Use May Help Explain The Rise In Prescription Drug Abuse In The United States may be found here.

Addiction As A Brain Disease

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From the 29 April 2011 Medical News Today article

One can look at drug addiction as a moral issue, a social ill, or a criminal problem. But Lynn Oswald’s experience studying the neuroscience of addiction tells her that it is something else entirely: a disease of the brain.

“Addiction is a brain disease because differences in the way our brains function make some people more likely to become addicted to drugs than others-just as differences in our bodies make some people more likely to develop cancer or heart disease,” says Oswald, PhD, RN, an assistant professor at the School of Nursing.

However, the neurobiological mechanisms that underlie a person’s risks for alcohol and drug abuse are not well understood by scientists. Oswald is hoping to change this. She is currently at work on a study funded by a five-year $3 million grant from the National Institute on Drug Abuse that aims to answer questions about why some people become addicted to drugs and others do not.

“There is growing evidence that vulnerability for substance abuse may stem from pre-existing variances in brain function,” she says.

“These variations could be something that a person is born with or the result of changes that take place later on. Like other chronic diseases such as diabetes and heart disease, risks for drug use disorders seem to be influenced by both genes and environment. Scientific evidence continues to grow about the effects of environmental stress on the body. We now know that the brain is a very plastic organ and various life experiences, such as severe stress, can also change the way the brain works.”

Related Articles

• What Is Addiction? (addictionts.com)
• NIDA on Drugs, Brain, and Behavior (addiction-dirkh.blogspot.com)
• Mouse Study Suggests Why Addictions Are Hard to Forget (scientificamerican.com)
• New finding may shed light on drug abuse and depression (news.bioscholar.com)
• Can Drug Rehabs Treat Mood Disorders? (psychcentral.com)
• All about addiction (eurekalert.org)

Doctors lax in monitoring potentially addicting drugs

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Doctors lax in monitoring potentially addicting drugs
Study: Missed opportunity to reduce opioid-related abuse, addiction and overdose

From a March 3 2011 Eureka news alert

March 3, 2011 — (BRONX, NY) — Few primary care physicians pay adequate attention to patients taking prescription opioid drugs — despite the potential for abuse, addiction and overdose, according to a new study by researchers at Albert Einstein College of Medicine of Yeshiva University.

The study, published in the March 2 online edition of the Journal of General Internal Medicine,*** found lax monitoring even of patients at high risk for opioid misuse, such as those with a history of drug abuse or dependence. The findings are especially concerning considering that prescription drug abuse now ranks second (after marijuana) among illicitly used drugs, with approximately 2.2 million Americans using pain relievers nonmedically for the first time in 2009, according to the National Institute on Drug Abuse (NIDA).

“Our study highlights a missed opportunity for identifying and reducing misuse of prescribed opioids in primary care settings,” said lead author Joanna Starrels, M.D., M.S. , assistant professor ofmedicine at Einstein. “The finding that physicians did not increase precautions for patients at highest risk for opioid misuse should be a call for a standardized approach to monitoring.”…

For suggestions on how to get this article for free or at low cost, click here

Related Articles

• Prescription drug deaths soar in Georgia (ajc.com)
• Combating Misuse and Abuse of Prescription Drugs: Q&A (everydayhealth.com)
• Study of Retired Football Players Reveals Higher Rates of Painkiller Misuse (psychweekly.wordpress.com)
• Teen Drug Addiction: Is Your Teen Misusing Meds? (aolhealth.com)
• Narcotic Pain Relief Drug Overdose Deaths a National Epidemic (addictionts.com)

Brain researcher recognized for contributions to understanding, treatment of drug dependence

Brain researcher recognized for contributions to understanding, treatment of drug dependence

Warren K. Bickel, director of the Center for Substance Abuse at the Virginia Tech Carilion Research Institute, examines decision-making processes in the brain that support dysfunctional decision-making, including addiction, and seeks novel therapeutic means to repair those processes.

From the February 11, 2011 Eureka news alert

Warren K. Bickel, director of the Center for Substance Abuse at the Virginia Tech Carilion Research Institute, has been selected as the 2011 recipient of the American Psychological Association Don Hake Translational Research Award. Sponsored by the Association for Behavior Analysis International, the award recognizes individuals whose work spans basic and applied research.

According to awards chair Cythia Pietras, the award is being presented to Bickel for his contributions to understanding drug dependence and treatment, impulsivity, and behavioral economics, and for disseminating that work to a wide audience.

Bickel, who is a professor with the research institute and professor of psychology at Virginia Tech, examines decision-making processes in the brain that support dysfunctional decision-making, including addiction, and seeks novel therapeutic means to repair those processes. One area of his research is directed at the process involved in preferring instant gratification over a future health benefit. His research demonstrating that this preference for immediate rewards can be changed with a novel therapeutic approach appears in the February 2011 issue of Biological Psychiatry.***

According to Virginia Tech Carilion Research Institute Executive Director Michael Friedlander, “Dr. Bickel’s research is blazing a new path to understanding how the brain’s temporal discounting system –the ability to differentially value things based on how far into the future they may occur — contributes to decisions regarding substance abuse, as well as how the executive processes in the human brain can be enhanced through rehabilitative training to potentially improve outcomes for those who are affected by substance abuse. He also has a commitment and well honed skill for effectively communicating the significance of his work to the scientific and medical communities and the general public. We are very fortunate to have such a talented scientist and communicator as part of the research institute here in Roanoke.”

***For suggestions on how to get this article for free or at low cost, click here

 

 

 

‘Bath salts’ pose new test for law enforcement – they also can lead to a flesh-eating bacterial disease that needs quick treatment to prevent amputations

‘Bath salts‘ pose new test for law enforcement

From a February 4 Stateline article

State and federal law enforcers already have their hands full trying to fight the use of methamphetamine, the highly addictive street drug that has wreaked havoc from Oregon to Maine. Now, other meth-like substances — which can produce a similarly dangerous and potentially violent high in those who take them — are prompting new concerns from government officials.

The substances are white, crystallized powders that are sold legally online and in many convenience stores and gas stations around the country as “bath salts.” Like meth or cocaine, the powders can be snorted or smoked, and are often marketed under names including “Ivory Wave,” “White Rush” or “Vanilla Sky.”

Ivory Wave is a powdery methamphetamine substance marketed as simple bath salts.
[http://www.ksl.com/?nid=148&sid=14298118]
The products are attracting scrutiny at every level, from the White House to local police departments. Gil Kerlikowski, the nation’s drug czar, warned last week that the powders can “pose a serious threat to the health and well-being of young people and anyone who uses them,”according to The Associated Press. At the state level, Florida recently joined Louisiana in banning their sale, reports National Public Radio.

The effects of abusing so-called “bath salts” can be dramatic, sources tell NPR.  Those who take them can experience a kind of “psychotic break,” in the words of Mark Ryan, director of the Louisiana Poison Center. “They’re extremely anxious and combative, they think there’s stuff trying to get them, they’re paranoid, they’re having hallucinations. So, the encounters are not pleasant.”

In Michigan, emergency departments have reported 18 cases involving “bath salts” in recent weeks, The Grand Rapids Press reports. “It certainly is nasty stuff,” a spokeswoman for the state community health department says. “It is something that has spread very quickly across the country.”

Related Articles

• ‘Bath Salts’ Identified As New Source Of Flesh-Eating Infection (MedicalNews Today, January 15, 2012)

   Article includes this paragraph
  ”
  A study led by Russell R. Russo, MD, a third-year Orthopaedic Surgery resident at LSU Health Sciences Center New Orleans School of Medicine, has identified a new source of life-threatening necrotizing fasciitis[bacterial infection which “eats” soft tissue and the fascae –  tissue surrounding muscles]  – “bath salts.” The study, describing the first known case of necrotizing fasciitis from an intramuscular injection of the street drug known as “bath salts,” is published in the January 2012 issue of Orthopedics, now available online. “
  “Necrotizing fasciitis is an orthopedic emergency. The ability to quickly and accurately diagnose this rapidly spreading disease can save a patient’s life and limb. However, the diagnosis is complex because necrotizing fasciitis usually manifests as a less severe cellulitis or abscess while the majority of the damage rages beneath the surface of the skin.”
  The article goes on to talk about a patient who developed the infection within 2 days after injecting bath salts.  At first she did not tell the emergency room doctors she had injected bath salts. So, they treated her for cellulitis. Her condition got so much worse they had to amputate her arm, shoulder, collar bone, and one of her breasts…
  …Necrotizing fasciitis has a rapid time-line to tissue destruction and loss of life. A 1995 study found the survival rate of those diagnosed with necrotizing fasciitis to be as low as 50%. However, wide ranges of death exist depending on a multitude of factors.Treatment for this virulent disease remains a swift diagnosis with extensive surgical debridement [removal of dead  and infected tissue] to obtain complete control of the organism and prevent death. However, the authors maintain, the best treatment is prevention with public, street-based education and early detection. ”

  Bath Salts: The Latest Drug Problem? (outsidethebeltway.com)

• San Francisco Bath Salt Company Educates the Public on Bath Salts
• Officials: ‘Bath Salts’ Are Growing Drug Problem –Ivory Wave and Bliss: Officials concerned chemicals sold as bath salts causing hallucinations
• Pot Use Might Speed Onset of Psychosis: Study
• States race to ban risky ‘bath salts’ drug (USA Today)
• ‘Ivory Wave’ May Be New Legal High After ‘Miaow Miaow’ (Mephedrone) Ban (Science Daily)
• Woman loses arm, shoulder after injecting bath salts (foxnews.com)
• Bath Salts Add Flesh Eating to Their Side Effects (humanbodyengineer.wordpress.com)
• Injecting Bath Salts Causes Woman to Lose Arm to Flesh Eating Bacteria [Gross] (jezebel.com)
• Hallucinogenic ‘bath salts’ entering Canada (cbc.ca)
• Woman Injects ‘Bath Salts,’ Loses Arm To Flesh-Eating Bacteria (npr.org)
• Horror With Bath Salts: Woman Injects Them And Loses Her Arm (blisstree.com)

Researchers lead search for better drug-addiction treatments

Researchers lead search for better drug-addiction treatments

From a February 2, 2011 Eureka news alert

DALLAS – Feb. 3, 2011 – UT Southwestern Medical Center psychiatry researchers(Division of Addictions)are leading the Texas arm of a national network that conducts clinical trials aimed at finding effective treatments for drug addiction.

More than 100 community treatment providers and academic medical centers throughout the country are funded in part through the National Institute on Drug Abuse’s Clinical Trials Network (CTN). The Texas component includes partnerships between academic and community treatment providers in Dallas, El Paso, Austin and Houston. It is led by Dr. Madhukar Trivedi, professor of psychiatry at UT Southwestern.

“The effects of drugs on the brain are very clear, but we still need long-term answers that cure people who abuse drugs and prevent them from relapse,” Dr. Trivedi said. “I applaud NIDA for funding the infrastructure at academic institutions to research therapies in real-world treatment centers that will lead to ready-to-launch cures. Drug abuse affects not just the person, but families and society as a whole.”

Each CTN study is conducted in multiple community treatment provider sites across the country, led by a CTN substance abuse researcher and supported by the researchers in the CTN academic institutions affiliated with each participating site.

“It is critical to find new treatments in the substance abuse field where current treatments result in only modest improvements. Finding effective interventions really requires larger, multicenter treatment trials like those occurring in the CTN,” Dr. Trivedi said.

One such national study within the CTN is the Stimulant Reduction Intervention Using Dose Exercise (STRIDE)**, led by Dr. Trivedi. It is a groundbreaking study that tests the short and longer term effectiveness of adding either exercise or health education to treatment as usual in adults who abuse stimulants such as cocaine or methamphetamine. Sites participating in this study in Texas include Nexus Recovery Center and Memorial Hermann Prevention and Recovery Center as well as multiple other sites across the country.

Other studies being conducted in the CTN in Texas include a trial that tests whether an interactive web-based therapy added to usual treatment improves abstinence from drug use, and a trial that examines whether medication, counseling, and incentives to quit smoking added to usual treatment improve abstinence from drug use.

Dr. Trivedi recently received a renewal of the National Institute on Drug Abuse‘s grant to continue contributions to improve the treatment of addiction for several additional years and said he expects to receive nearly $4 million over the next year.

A national CTN goal for the next few years is to engage other types of medical doctors and treatment settings who treat people addicted to drugs, in research, including primary care, internal medicine and emergency-room physicians. “We will be expanding our reach,” Dr. Trivedi said.

 

**ClinicalTrials.gov has information about federally and privately supported clinical trials, as quoted  news release item above.

Some clinical trials studies post their results at ClinicalTrials.gov.
Check the About page and Understanding Clinical Trials at Clinical Trials.gov for more information.

Related posts

Clinical Trials and Systematic Reviews: Managing Information Overload

Older adults often excluded from clinical trials –  US population ages, need grows for research to improve health and health care for seniors

 

 

Drug Abuse Treatment Rates on the Rise: U.S. Report

Drug Abuse Treatment Rates on the Rise: U.S. Report
A 15% drop for alcohol abuse while cases of marijuana, prescription painkiller abuse rise

From a December 29, 2010 Health Day news item by Randy Dotinga

WEDNESDAY, Dec. 29 (HealthDay News) — Admissions for alcohol abuse treatment have remained the same in parts of the Midwest and South while dropping elsewhere in the United States, while treatment rates for illegal drugs are increasing across the country, especially for marijuana abuse, according to a new report.

The report, issued by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), includes these findings:

• The overall rate of substance abuse admissions in the United States remained stable from 1998 to 2008, at about 770 admissions per 100,000 people.
• Admissions for alcohol use dropped by about 15 percent nationally, but stayed stable in Arkansas, Iowa, Kansas, Minnesota, Missouri, North Dakota, South Dakota and Nebraska.
• Admission rates for marijuana use rose by 30 percent nationwide, and were highest in the eight states listed above and in New York, New Jersey and Pennsylvania.
• An earlier SAMHSA report revealed that admission rates for abuse of opiates other than heroin — including some prescription painkillers such as Oxycontin — rose by 345 percent from 1998-2008. The new report says admission rates for painkiller abuse rose in every part of the country and were highest in the New England states (Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island and Vermont) and in Alabama, Kentucky, Mississippi and Tennessee.
• The admission rate for treatment of methamphetamine abuse was 53 percent higher in 2008 than in 1998, although it’s down from its peak in 2005.
• Admissions for cocaine abuse fell by 23 percent nationally.

“This study provides insight into the regional nature of substance abuse by highlighting the shifting trends in the reasons for admission to substance abuse treatment,” SAMHSA administrator Pamela S. Hyde said in an agency news release.

SOURCE: Substance Abuse and Mental Health Administration, news release, Dec. 23, 2010

The full report is available at: http://wwwdasis.samhsa.gov/teds08/teds2k8sweb.pdf. It provides detailed charts and tables showing the admission rates for a wide variety of substances for each state, the District of Columbia and Puerto Rico for each year over the course of this 11 year period. It also provides data by Census divisions — groups of states delineated by the Census Bureau. These materials allow easy analyses of changing admission trends for any state or region of the country.

The SAMHSA Web site includes numerous links with information about its products and services, as

• Treatment locators for substance abuse and mental health issues
• Prevention programs, services, and information
• Information and services for military families
• Health care reform initiatives
• Housing programs and assistance for the recovering homeless
• Statistics relating to mental health and drug abuse
• A trauma and justice page focusing on increasing support for recovery programs in place of criminal justice programs
• At NIDA for Teens, learn how drugs affect the body and hear from teens who’ve struggled with addiction. This interactive web site has quizzes, videos, games, and a blog that shows the science behind drug abuse.

Related Articles

• SAMHSA Outlines New Strategic Initiatives Paper For Advancing The Nation’s Behavioral Health

March 30, 2011

The Substance Abuse and Mental Health Services Administration (SAMHSA) published its strategic initiatives paper – an overview of SAMHSA’s goals, priorities and action steps for accomplishing its mission of reducing the impact of substance abuse and mental illness on America’s communities. Carefully developed from months of public discussion and input from a wide variety of SAMHSA’s stakeholders, the strategic initiatives paper lays out how SAMHSA will focus its resources in meeting the new opportunities and challenges it faces in the near future…

• Alcohol And Marijuana Were The Most Commonly Abused Substances By Those Referred To Treatment From Probation Or Parole (addictionts.com)
• ER Visits from Ecstasy Jump 75% from ’04 to ’08 (scienceblog.com)
• The Adolescent Brain and Substance Abuse | Drug Addiction Treatment (shammond.typepad.com)
• Medical Marijuana Might Slow Thinking Among MS Patients
• White House launches battle on prescription drug abuse (cnn.com)
• High rates of substance abuse exist among veterans with mental illness (eurekalert.org)
• Teen drug abuse: 14 mistakes parents make (cbsnews.com)
• SAMHSA Press Release on Block Grant Changes (asapnys.wordpress.com)
• Adults Represent A Majority Of Inhalant Treatment Admissions (addictionts.com)
• Marijuana Use May Hurt Intellectual Skills In MS Patients
• ADHS Establishes Rules For Medical Marijuana Program
• How Support Groups Can Aid in Addiction Treatment (everydayhealth.com)
• ‘New Ecstasy’ Poses Major Health Risks, Reveals Research, UK (Medical News Today, 3 April 2011)
• Nearly All American Adults With Untreated Alcohol Use Disorders Don’t Think They Need Treatment (addictionts.com)

Drug Overdoses on the Rise in Most Age Groups

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Pyschoactive_Drugs.jpg‎ (457 × 400 pixels, file size: 37 KB, MIME type: image/jpeg)

Image taken from English Wikipedia, originally uploaded by Thoric.

An arrangement of pyschoactive drugs including (counter-clockwise from top left): cocaine, crack, methylphenidate (Ritalin), ephedrine, MDMA (Ecstasy – lavender pill with smile),mescaline (green dried cactus flesh), LSD (2×2 blotter in tiny baggie), psilocybin (dried Psilocybe cubensis mushroom), Salvia divinorum (10X extract in small baggie), diphenhydramine(Benadryl – pink pill), Amanita muscaria (red dried mushroom cap piece), Tylenol #3 (contains codeine), codeine containing muscle relaxant, pipe tobacco (top), bupropion (Zyban – brownish-purple pill), cannabis (green bud center), hashish (brown rectangle)

From the December 23, 2010 Reuters health news item

NEW YORK (Reuters Health) — More and more people are dying from abusing or misusing drugs, including both prescription and illegal drugs, new research suggests.

In some groups, deaths from “accidental poisonings” — most the result of drug overdoses — are more than ten times higher than they were in the late 1960s, the study found.

While the notoriously drug-loving baby boomers account for part of the recent increase as they age and embrace prescription medications, death from accidental poisoning is higher across almost all age groups than it was a few decades ago, especially among white Americans. And the upward trend doesn’t appear to be leveling off.

“I went in expecting to see a blip (in increased accidental poisonings) with the baby boomer(s),” Dr. Richard Miech, the study’s lead author and head of Health and Behavioral Sciences at the University of Colorado Denver, told Reuters Health. After all, he said, “you’ve seen pictures of Woodstock.”

Miech was surprised that the boomer generation’s impact on the death rates was overshadowed by a “huge increase” in accidental poisoning deaths overall — an increase he attributes to the growing number of prescription drugs being taken in the United States by all age groups.

Miech and his colleagues analyzed data from the U.S. Census, which counts all people in the country, as well a register that tracks the number of deaths from different causes every year. Putting them together, the researchers could calculate the percentage of people of different ages and races dying from accidental poisonings annually.

Overall, white men and women were more than nine times as likely to die from an accidental poisoning in 2005 through 2007 than they were in 1968 and 1969 according to the analysis, which is published in the journal Addiction. Black men and women were about three times more likely to die from the same cause in recent years than they were 40 years ago.

Because of changes in the body or changes in drug use, the greatest proportion of overdoses happen in people in their 40’s and 50’s — and that age group, which currently includes the tail-end of the baby boom generation, is where some of the biggest changes in poisoning rates over time showed up.

In 1968, for example, about one in every 100,000 white women in their early 50’s died from accidental poisoning. In 2007, 15 out of 100,000 did so. Among black women of the same age, accidental poisoning deaths during the same timeframes increased from about two people in 100,000 to almost 17 in 100,000. Both white and black men had even larger jumps.

While the increases weren’t quite as striking in younger adults, the study found that deaths from accidental poisonings are significantly higher for almost every age group. That trend that was particularly clear among white Americans.

Although the authors couldn’t tell what drugs were responsible for the most accidental poisonings, the majority of prescription drug abuse involves painkillers, according to the Drug Enforcement Administration, and Vicodin (containing acetaminophen and the opiate drug hydrocodone) is the most commonly abused prescription drug in the U.S.

Such medications having become so common is likely one of the major drivers behind the increasing deaths, Miech said. According to a 2004 government report, almost half of all Americans take a prescription drug. With more prescriptions come more opportunities for people to get addicted, to take drugs that aren’t theirs, or to use drugs for non-medical purposes, all of which can have dangerous consequences.

Theodore Cicero, who studies drug abuse at Washington University in St. Louis, agrees. In general, he said, a certain percentage of the prescription drugs that are given to patients will be used for non-medical purposes. “Even if it’s a very small percentage, when the number of people (getting prescriptions) grows, obviously you’re going to have more drugs in the illicit market,” he told Reuters Health.

But it’s hard to tell someone with chronic pain, for example, that the risk of abuse or misuse isn’t worth a drug’s benefit, Miech said. And that leaves researchers and policy makers stuck.

What’s needed is for people to be more aware of the dangers these drugs pose, Miech said. Yet even with the deaths of celebrities like Heath Ledger and Michael Jackson, he pointed out, the public still hasn’t stopped to take a closer look at how prescription drug use can go wrong.

“You can, in fact, overdose on prescription meds just as easily as you can overdose on illegal drugs,” Cicero said. “Addiction is addiction no matter what the drug source is. That message has not yet come across.”

Death from prescription painkiller overdose has “been an epidemic in the last ten years,” Dr. Wilson Compton, director of the Division of Epidemiology, Services and Prevention Research at the National Institute on Drug Abuse, told Reuters Health.

But figuring out how to stop prescription drugs from ending up in the wrong hands is harder than it looks. The government, Compton said, can’t encourage people to flush their extra drugs down the toilet — that could harm the environment — and pharmacies aren’t set up to take them back.

Miech has the same fears. “Ultimately, I don’t have any silver bullets to come up with a way to reduce this huge increase” in deaths from accidental poisoning, he said.

Related MedlinePlus Pages

Poisoning

Prescription Drug Abuse

Related Articles

• Overdose Risk for Young Children on Prescription Pain Drugs (webmd.com)
• Prescription Narcotics Overdoses Kill More Than Heroin and Cocaine Combined (livescience.com)
• Narcotic pain relief drug overdose deaths a national epidemic (scienceblog.com)
• Prescription Drug Abuse Growth Linked To Increase In Internet Access (Medical News Today, May 2011)
• Patients on Higher Doses of Prescription Painkillers More Apt to Overdose (cherished79.wordpress.com)

FDA Tobbaco Products : Information Resources

FDA Tobacco Products provides information resources on tobacco products for consumers and healthcare professionals.

Resources include

• News and Events (updates, press releases, meetings,etc)
• Guidance, Compliance & Regulatory Information with links on legal, regulatory, and policy issues related to tobacco products.
• Protecting Kids from Tobacco with information on related regulations
• Resources for you with links to information on how to quit, tobacco prevention in youth, and information for health care providers

The Tools and Alerts section on the home page includes options for email alerts and Twitter. Contact information by phone and fax is also provided.

Teen marijuana use increases, especially among eighth-graders

Flahiff’s note: The item below states “Mixed messages about drug legalization, particularly marijuana, may be to blame [for the increase in teen marijuana use].
A  December 14 2010 Newshour segment included this concern. Interviewee Gil Kerlikowske, the director of the White House Office of National Drug Control Policy made several related comments. He stressed marijuana is not medicine, and drugs are not only criminal justice concerns but also education and public safety concerns.

Here is  the full text of the December 14 National Institute on Drug Abuse (NIDA) press release

Teen marijuana use increases, especially among eighth-graders
NIDA’s Monitoring the Future Survey shows increases in Ecstasy use and continued high levels of prescription drug abuse

WASHINGTON — Fueled by increases in marijuana use, the rate of eighth-graders saying they have used an illicit drug in the past year jumped to 16 percent, up from last year’s 14.5 percent, with daily marijuana use up in all grades surveyed, according to the 2010 Monitoring the Future Survey (MTF).

For 12th-graders, declines in cigarette use accompanied by recent increases in marijuana use have put marijuana ahead of cigarette smoking by some measures. In 2010, 21.4 percent of high school seniors used marijuana in the past 30 days, while 19.2 percent smoked cigarettes.

The survey, released today at a news conference at the National Press Club, also shows significant increases in use of Ecstasy. In addition, nonmedical use of prescription drugs remains high. MTF is an annual series of classroom surveys of eighth, 10th, and 12th-graders conducted by researchers at the University of Michigan, Ann Arbor, under a grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Most measures of marijuana use increased among eighth-graders, and daily marijuana use increased significantly among all three grades. The 2010 use rates were 6.1 percent of high school seniors, 3.3 percent of 10th -graders, and 1.2 percent of eighth-graders compared to 2009 rates of 5.2 percent, 2.8 percent, and 1.0 percent, respectively.

“These high rates of marijuana use during the teen and pre-teen years, when the brain continues to develop, places our young people at particular risk,” said NIDA Director Nora D. Volkow, M.D. “Not only does marijuana affect learning, judgment, and motor skills, but research tells us that about 1 in 6 people who start using it as adolescents become addicted.”

“The increases in youth drug use reflected in the Monitoring the Future Study are disappointing,” said Gil Kerlikowske, director of the White House Office of National Drug Control Policy. “Mixed messages about drug legalization, particularly marijuana, may be to blame. Such messages certainly don’t help parents who are trying to prevent kids from using drugs. The Obama administration is aggressively addressing the threat of drug use and its consequences through a balanced and comprehensive drug control strategy, but we need parents and other adults who influence children as full partners in teaching young people about the risks and harms associated with drug use, including marijuana.”

The MTF survey also showed a significant increase in the reported use of MDMA, or Ecstasy, with 2.4 percent of eighth-graders citing past-year use, compared to 1.3 percent in 2009. Similarly, past-year MDMA use among 10th-graders increased from 3.7 percent to 4.7 percent in 2010.

Also of concern is that the downward trend in cigarette smoking has stalled in all three grades after several years of marked improvement on most measures. Greater marketing of other forms of tobacco prompted the 2010 survey to add measures for 12th-graders’ use of small cigars (23.1 percent) and of tobacco with a smoking pipe known as a hookah (17.1 percent).

Prescription drug abuse remains a major problem. Although Vicodin abuse decreased in 12th graders this year to 8 percent, down from around 9.7 percent the past four years, other indicators confirm that nonmedical use of prescription drugs remains high. For example, the use of OxyContin, another prescription opiate, stayed about the same for 12th-graders at 5.1 percent in 2010. And six of the top 10 illicit drugs abused by 12th-graders in the year prior to the survey were prescribed or purchased over the counter. The survey again found that teens generally get these prescription drugs from friends and family, whether given, bought, or stolen.

However, the survey says binge drinking continued its downward trend. Among high school seniors, 23.2 percent report having five or more drinks in a row during the past two weeks, down from 25.2 percent in 2009 and from the peak of 31.5 percent in 1998. In addition, 2010 findings showed a drop in high school seniors’ past-year consumption of flavored alcoholic beverages, to 47.9 percent in 2010 from 53.4 percent in 2009. Past-year use of flavored alcohol by eighth- graders was at 21.9 percent, down from 27.9 percent in 2005.

The MTF survey also measures teen attitudes about drugs, including perceived harmfulness, perceived availability, and disapproval, all of which can predict future abuse. Related to its increased use, the perception that regular marijuana smoking is harmful decreased for 10th-graders (down from 59.5 percent in 2009 to 57.2 percent in 2010) and 12th-graders (from 52.4 percent in 2009 to 46.8 percent in 2010). Moreover, disapproval of smoking marijuana decreased significantly among eighth-graders.

“We should examine the extent to which the debate over medical marijuana and marijuana legalization for adults is affecting teens’ perceptions of risk,” said Dr. Volkow. “We must also find better ways to communicate to teens that marijuana use can harm their short-term performance as well as their long-term potential.”

Overall, 46,482 students from 396 public and private schools participated in this year’s survey. Since 1975, the MTF survey has measured drug, alcohol, and cigarette use and related attitudes in 12th-graders nationwide. Eighth and 10th-graders were added to the survey in 1991. Survey participants generally report their drug use behaviors across three time periods: lifetime, past year, and past month. The survey has been conducted since its inception by a team of investigators at the University of Michigan, led by NIDA grantee Dr. Lloyd Johnston. Additional information on the MTF Survey, as well as comments from Dr. Volkow can be found at http://www.drugabuse.gov/drugpages/MTF.html.

MTF is one of three major surveys sponsored by the U.S Department of Health and Human Services (HHS) that provide data on substance use among youth. The others are the National Survey on Drug Use and Health and the Youth Risk Behavior Survey. The MTF Web site is: http://monitoringthefuture.org. Follow Monitoring the Future 2010 news on Twitter at @NIDANews, or join the conversation by using: #MTF2010. Additional information on MTF can be found at http://www.hhs.gov/news; or http://www.whitehousedrugpolicy.gov.

The National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration, is the primary source of statistical information on substance use in the U.S. population 12 years of age and older. More information is available at http://www.drugabusestatistics.samhsa.gov.

The Youth Risk Behavior Survey, part of HHS’ Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System, is a school-based survey that collects data from students in grades 9-12. The survey includes questions on a wide variety of health-related risk behaviors, including substance abuse. More information is available at http://www.cdc.gov/nccdphp/dash/yrbs/index.htm.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at http://www.drugabuse.gov. To order publications in English or Spanish, call NIDA’s new DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax or email requests to 240-645-0227 ordrugpubs@nida.nih.gov. Online ordering is available at http://drugpubs.drugabuse.gov. NIDA’s new media guide can be found at http://drugabuse.gov/mediaguide.The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visitwww.nih.gov.

Related resources

• Drugs: Shatter the Myths (National Institute on Drug Abuse)

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