Pick Your Poison: Intoxicating Pleasures and Medical Prescriptions

Pick Your Poison: Intoxicating Pleasures and Medical Prescriptions
·http://www.nlm.nih.gov/exhibition/pickyourpoison/

 

It’s not hard to see why our readers loved this thought-provoking expose of America’s long history with mind-altering substances. In fact, the ad for Cocaine Toothache Drops (contemporarily priced at 15 cents) alone is worth a trip to this colorful and well curated site. Lesson plans and online activities help educators illustrate how the United States has handled the thin and shifting line between useful medical prescriptions and harmful, illicit substances.

Over a century ago, it was not uncommon to find cocaine in treatments for asthma, cannabis offered up as a cure for colds, and other contentious substances offered as medical prescriptions. This engaging collection from the U.S. National Library of Medicine brings together sections on tobacco, alcohol, opium, and marijuana. Visitors can learn about how these substances were marketed and also view a selection of digitized items culled from its voluminous holdings, including advertisements, doctor’s prescriptions, and early government documents. In the Education section, educators can look over lesson plans, check out online activities, and explore online resources from the National Institutes of Health, such as, “A Guide to Safe Use of Pain Medicine” and “College Drinking: Changing the Culture.”

[Free Webinar] Hookah Lounges Today. Marijuana or E-cigarette Lounges Tomorrow?

 

 

English: Teenagers at a hookah lounge (Photo credit: Wikipedia)

 

 

 

From the description at Northwest Center for Public Health Practice

 

In this one hour webinar  which is part of the Hot Topics series, representatives from four health jurisdictions in Washington State discuss their experiences developing policies and enforcing laws to promote smoke-free air in public places.

Air date: December 17, 2013

[recording will be freely available after Dec 17]

Learning Objectives

• Describe how public health agencies are being challenged by the presence of hookah lounges, vapor-producing products, and possibly marijuana lounges.

• List effective public policy or enforcement strategies for combating hookah lounges, vapor-producing products, and potential marijuana lounges.

• List three considerations when deciding whether to take legal proceedings against an establishment for violating Smoking in Public Places laws.

Intended Audience

Local, state, and tribal public health practitioners; board of health members; health department legal counsel

Slides and Resources

• Slides will be posted immediately before the session.
• An Introduction to E-Cigarettes for States and Locals, Tobacco Control Network

 

Substance use by adolescents on an average day is alarming

 

I am all for decriminalizing illegal drug use. However, I am very concerned about substance abuse, especially among folks whose brains are still developing (and this goes on until age 25 or so).

From the abstract of the report at Full Text Reports

On an average day, 881,684 teenagers aged 12 to 17 smoked cigarettes, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA).   The report also says that on average day 646,707 adolescents smoked marijuana and 457,672 drank alcohol.

To provide some perspective, the number of adolescents using marijuana on an average day could almost fill the Indianapolis Speedway (seating capacity 250,000 seats) two and a half times.

“This data about adolescents sheds new light on how deeply substance use pervades the lives of many young people and their families,” said SAMHSA Administrator Pamela S. Hyde. “While other studies indicate that significant progress has been made in lowering the levels of some forms of substance use among adolescents in the past decade, this report shows that far too many young people are still at risk.”

The report, which highlights the substance abuse behavior and addiction treatment activities that occur among adolescents on an average day, draws on a variety of SAMHSA data sets.

The report also sheds light on how many adolescents aged 12 to 17 used illegal substances for the first time.  On an average day:

• 7,639 drank alcohol for the first time;

• 4,594 used an illicit drug for the first time;

• 4,000 adolescents used marijuana for the first time;

• 3,701 smoked cigarettes for the first time; and

• 2,151 misused prescription pain relievers for the first time.

Using data from SAMHSA Treatment Episode Data Set (TEDS), the report also analyzes how many adolescents aged 12 to 17 were receiving treatment for a substance abuse problem during an average day.  These numbers included:

• Over 71,000 in outpatient treatment,

• More than 9,302 in non-hospital residential treatment, and

• Over 1,258 in hospital inpatient treatment.

In terms of hospital emergency department visits involving adolescents aged 12 to 17, on an average day marijuana is involved in 165 visits, alcohol is involved in 187 visits and misuse of prescription or nonprescription pain relievers is implicated in 74 visits.

SAMHSA’s National Helpline is a confidential, free, 24-hour-a-day, 365-day-a-year, information service that people – including adolescents and their family members — can contact when facing substance abuse and mental health issues. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information in print on substance abuse and mental health issues. Call 1-800-662-HELP (4357) or visit the online treatment locators at http://findtreatment.samhsa.gov/.

The complete report contains many other facts about the scope and nature of adolescent substance abuse, treatment and treatment admissions patterns and is available at: http://www.samhsa.gov/data/2K13/CBHSQ128/sr128-typical-day-adolescents-2013.pdf. It was drawn from analyses of SAMHSA’s National Survey on Drug Use and Health, Treatment Episode Data Set, and National Survey of Substance Abuse Treatment Services, and Drug Abuse Warning Network.

Related articles

• Substance Use by Adolescents On an Average Day Is Alarming (abbeyswalk.wordpress.com)
• Stimulant-Related Emergency Department Visits Rise 300 Percent among Younger Adults (samhsa.gov)
• Hundreds of Thousands of Teens Use Pot, Alcohol Each Day: Report (news.health.com)
• Marijuana use by kids probs (medfield02052.wordpress.com)
• Drug Abuse Warning Network, 2011: National Estimates of Drug – Related Emergency Department Visits (jflahiff.wordpress.com)
• Bump Seen in Substance Abuse Treatment During Pregnancy (nlm.nih.gov)
• Does Adolescent Drug Use Affect You As An Adult (narcononarrowheadreviews.wordpress.com)
• Nonmedical Use of Prescription Pain Relievers May Raise the Risk of Turning to Heroin Use (samhsa.gov)
• Fact: Teen Pot Use Dropped Amid Rise of Medical Marijuana (sfgate.com)
• Shocking! (addictionandrecoverynews.wordpress.com)

 

High school years hard on adolescent health, with spikes in drinking, smoking and drug use: Canada study

Medicaid anti-smoking program saved big money, study says

 

Image via Wikipedia Date 14 June 2010Source Fast Facts: Smoking Cessation, by Robert West and Saul Shiffman, p. 59

Medicaid anti-smoking program saved big money, study says

Excerpt from the 13 January Stateline Daily article

Numerous studies have shown that investments in programs aimed at helping people quit smoking reap significant long-term reductions in health care costs. Even so, fiscal stress has caused states to dramatically reduce spending on anything that does not yield immediate returns.

 
Now new data suggests that states may not have to wait so long for the returns. According to astudy conducted by George Washington University, a Massachusetts Medicaid program saved $3 in Medicaid hospitalization expenses for every dollar it invested in a comprehensive smoking cessation counseling and treatment program — and the savings accrued in the first 16 months of the program.

While not all Medicaid patients who underwent the treatment were able to quit smoking permanently, the group as a whole had far fewer hospital admissions for cardiovascular problems than it did before entering the program. According to the report, the annual medical savings attributable to even a brief reduction in smoking was $571 per participant, far outweighing the $183-per-person cost of the program.

“The good news from a state budget perspective is that even if people stop smoking temporarily, there can be immediate savings,” says Leighton Ku, one of the study’s authors. “From a public health perspective we’d like to help people stop smoking for good,” Ku says. “But the study showed a rapid reduction in the number of people having heart attacks and other cardiovascular problems, and that led to immediate savings.”

Related articles

• Nicotine patches and gum don’t work long-term for smokers, Harvard study finds (boston.com)
• Study: Smoking Cessation Programs Produce $3 In Savings For Every $1 Spent (thinkprogress.org)
• Alberta working on youth anti-smoking policy (cbc.ca)
• Parents Show Modest Gains After Smoking Programs (nlm.nih.gov)
• Quitting smoking cold turkey just as effective as using the patch (dvice.com)
• Nicotine patches, gum don’t prevent relapse, study finds – Los Angeles Times (latimes.com)
• Pay people to stop smoking? (cnn.com)
• The Process of Vaping (eciganywhere.wordpress.com)
• Dutch government backtracks on anti-smoking (sfgate.com)

States could see substantial savings with tobacco control programs

States could see substantial savings with tobacco control programs

From the Eureka News Alert, Mon Nov 28, 2011 00:00

(San Francisco State University) States that have shifted funds away from tobacco control programs may be missing out on millions of dollars of savings in the form of medical costs, Medicaid payments and lost productivity by workers. Results of a cost-benefit analysis, published in the journal Contemporary Economic Policy, show that if tobacco control programs are funded at the levels recommended by the CDC, states could save 14-20 times more than the cost of implementing the programs.

Related articles

• Call to enforce tobacco control ord (nation.com.pk)
• case study: tobacco control in South Africa (gph2110.wordpress.com)
• Tobacco Control In South Africa (gph2110.wordpress.com)
• Taxes and Tobacco Control in South Africa (gph2110.wordpress.com)
• Tobacco Use Prevention and Global Health Effectiveness (gph2110.wordpress.com)
• CDC: States with Strong Tobacco Control Programs More Likely to Reduce Smoking Rate (ibtimes.com)
• Smoking Down Over Five-Year Period (prweb.com)
• The economic benefits of tobacco control rapidly outweigh tobacco tax revenues (gizmag.com)

Fatherhood Can Help Change a Man’s Bad Habits

From the 7 November 2011 Science Daily article

After men become fathers for the first time, they show significant decreases in crime, tobacco and alcohol use, according to a new, 19-year study.

Researchers assessed more than 200 at-risk boys annually from the age of 12 to 31, and examined how men’s crime, tobacco, alcohol, and marijuana use changed over time. While previous studies showed that marriage can change a man’s negative behavior, they had not isolated the additional effects of fatherhood.

“These decreases were in addition to the general tendency of boys to engage less in these types of behaviors as they approach and enter adulthood,” said David Kerr, assistant professor of psychology at Oregon State University and lead author of the study. “Controlling for the aging process, fatherhood was an independent factor in predicting decreases in crime, alcohol and tobacco use.”…

…

 

Related articles

• Do US men value fatherhood over their careers? (esciencenews.com)
• Fatherhood decreases testosterone. (mindblog.dericbownds.net)

World’s Leading Scientists Join Forces To Set Priority Interventions To Save 36 Million Lives From Non-Communicable Diseases

http://www.who.int/nmh/events/un_ncd_summit2011/en/index.html

World’s Leading Scientists Join Forces To Set Priority Interventions To Save 36 Million Lives From Non-Communicable Diseases***

From the April 5 2011 article

NCDs (non-communicable diseases), mainly heart disease, stroke, diabetes,cancers, and chronic respiratory disease, are responsible for two out of every three deaths worldwide and the toll is rising.***A landmark global alliance between leading scientists and four of the world’s largest NGOs brings together evidence from a 5-year collaboration with almost 100 of the world’s best NCD experts and proposes a short-list of five priority interventions to tackle this increasing global crisis. Reducing tobacco and salt use, improving diets and physical activity, reducing hazardous alcohol intake, and achieving universal access to essential drugs and technologies have been chosen for their health effects, cost-effectiveness, low costs of implementation, and political and financial feasibility….

….The top priority must be to reduce tobacco use followed by lowering salt intake, say the authors. Key to the success of this intervention will be the accelerated implementation of the Framework Convention on Tobacco Control (FCTC) to achieve the proposed goal, “a world essentially free from tobacco by 2040”, where less than 5% of the population uses tobacco; achieving this goal would prevent at least 5.5 million premature deaths over 10 years.

By 2025, they would like to see salt intake reduced to less than 5 g per person. They point out that reducing global salt consumption by just 15% through mass-media campaigns and reformulation of processed foods and salt substitution could prevent an estimated 8.5 million deaths in just 10 years.

Importantly, the costs of these interventions will be small, say the authors. The yearly cost to implement tobacco control and salt reduction will be less than US 50 cents per person per year in countries like India and China. The total package of priority interventions will require a new global commitment of about $9 billion per year.

*** The free full text of this Lancet article may be found here, however registration is required.

Related Articles

• Health Crisis in South Asia : World Bank (itsinfoworld.wordpress.com)
• GRAND CHALLENGES IN GLOBAL HEALTH – “Rising Stars” (openmedicine.ca)
• Report says economic development could change worldwide face of cancer (eurekalert.org)
• NCD Alliance Unveils Ground-Breaking Document For Successful UN Summit On Non-Communicable Diseases (NCDS) (medicalnewstoday.com)
• Non-Communicable Disease Deaths Increasing Globally, Especially In Developing Nations (medicalnewstoday.com)
• Global Events Take Aim At Health’s Biggest Enemy: Non-Communicable Diseases (donttradeourlivesaway.wordpress.com)
• Chronic diseases now leading global killer: WHO (ctv.ca)
• Heart disease and cancer – the global threat omitted from the MDGs (guardian.co.uk)
• Headway is being made fighting communicable diseases globally, research suggests (jflahiff.wordpress.com)
• Emerging Global Mandate To Save 36 Million Lives From Non-Communicable Diseases (NCDs) (medicalnewstoday.com)
• Eat Healthy To Reduce The Risk Of Non-communicable Diseases (NCDs)
• Patients must set the agenda on non-communicable diseases (International Alliance of Patient Organizations, 17 May 2011)

“Geneva, Switzerland, 17 May 2011 – Patient advocates have called for a stronger role in setting the agenda in the design and delivery of strategies to prevent and manage non-communicable diseases (NCDs), and chronic diseases more broadly. This call was made at a Side Meeting to the World Health Organization (WHO) World Health Assembly in Geneva, Switzerland. The meeting was hosted by the International Alliance of Patients’ Organizations (IAPO) and two of its member patient groups; Alzheimer’s Disease International (ADI) and the Multiple Sclerosis International Federation (MSIF) and attended by over 50 participants including member state representatives, health professionals and WHO representatives…

…Speakers from Africa, Latin America and Europe highlighted, with practical examples, how patient advocates are contributing knowledge, experience and resources to support efforts to tackle chronic disease. Across the world in high, middle and low income countries, patient groups routinely provide health information and training to patients and health professionals. These have been shown to support prevention strategies and effective disease management to ensure that patients’ needs are met. ….

Secondhand smoke laws may reduce childhood ear infections

Secondhand smoke laws may reduce childhood ear infections

From a January 26, 2011 Eureka news alert

Boston, MA — Harvard School of Public Health (HSPH) researchers and colleagues from Research Institute for a Tobacco Free Society have found that a reduction in secondhand smoking in American homes was associated with fewer cases of otitis media, the scientific name for middle ear infection. The study appears on January 26, 2011, as an online first article on the website of the journal Tobacco Control.

“Our study is the first to demonstrate the public health benefits to children of the increase in smoke-free homes across the nation. It also is the first study to quantify over the past 13 years a reversal in what had been a long-term increasing trend in middle ear infections among children,” said lead author Hillel Alpert, research scientist in HSPH’s Department of Society, Human Development, and Health. “If parents avoid smoking at home, they can protect their children from the disease that is the most common cause of visits to physicians and hospitals for medical care,” he said.

Secondhand smoke (smoke from a burning cigarette combined with smoke exhaled by a smoker) has been shown to increase the level of unhealthy particles in the air, including nicotine and other toxins. In 2006 the U.S. Surgeon General stated that enough evidence existed to suggest a link between parents’ smoking and children’s ear infections.

Otitis media is the leading reason for visits to medical practices and hospitals among U.S. children, with an annual estimated economic burden of $3 billion to $5 billion. Children’s visits for otitis media increased steadily from 9.9 million in 1975 to 24.5 million visits in 1990. However, the researchers found the average annual number of outpatient visits for otitis media in children aged 6 years and younger dropped 5%, and hospital discharges fell by 10% per year from 1993 to 2006. (The researchers note that other factors may have contributed to the decline, including a pneumonia vaccine that was introduced in 2000.)

To determine the number of smoke-free households, the researchers used data from the National Cancer Institute‘s Tobacco Use Supplement to the Current Population Survey. They found voluntary no-smoking rules in households nearly doubled from 45% in 1993 to 86% in 2006, most likely due to increased awareness of secondhand smoke hazards and a reduction in the number of people smoking in homes.

“Smoke-free rules in homes are extremely important to protect children, given the many adverse effects that secondhand tobacco smoke exposure has on child health,” Alpert said.

 

 

‘A stark warning:’ Smoking causes genetic damage within minutes after inhaling

From a January 15, 2011 Eureka news alert

WASHINGTON, Jan. 15, 2011 — In research described as “a stark warning” to those tempted to start smoking, scientists are reporting that cigarette smoke begins to cause genetic damage within minutes — not years — after inhalation into the lungs.

Their report, the first human study to detail the way certain substances in tobacco cause DNA damage linked to cancer, appears in Chemical Research in Toxicology***, one of 38 peer-reviewed scientific journals published by the American Chemical Society.

Stephen S. Hecht, Ph.D., and colleagues point out in the report that lung cancer claims a global toll of 3,000 lives each day, largely as a result of cigarette smoking. Smoking also is linked to at least 18 other types of cancer. Evidence indicates that harmful substances in tobacco smoke termed polycyclic aromatic hydrocarbons, or PAHs, are one of the culprits in causing lung cancer. Until now, however, scientists had not detailed the specific way in which the PAHs in cigarette smoke cause DNA damage in humans.

The scientists added a labeled PAH, phenanthrene, to cigarettes and tracked its fate in 12 volunteers who smoked the cigarettes. They found that phenanthrene quickly forms a toxic substance in the blood known to trash DNA, causing mutations that can cause cancer. The smokers developed maximum levels of the substance in a time frame that surprised even the researchers: Just 15-30 minutes after the volunteers finished smoking. Researchers said the effect is so fast that it’s equivalent to injecting the substance directly into the bloodstream.

“This study is unique,” writes Hecht, an internationally recognized expert on cancer-causing substances found in cigarette smoke and smokeless tobacco. “It is the first to investigate human metabolism of a PAH specifically delivered by inhalation in cigarette smoke, without interference by other sources of exposure such as air pollution or the diet. The results reported here should serve as a stark warning to those who are considering starting to smoke cigarettes,” the article notes.

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.

Communities Putting Prevention to Work Program Launches New Website

From the US Centers for Disease Control and Prevention (CDC) Web site “Communities Putting Prevention to Work”

CDC’s Communities Putting Prevention to Work program was developed to highly impact the nation’s health by reducing chronic diseases related to obesity and tobacco using a prescribed set of effective strategies to build public health policies, strengthen the community environment to support health, and establish successful and sustainable interventions over the long term.

The Communities Putting Prevention to Work program is focused on preventing chronic disease by producing sustainable, positive and improved health outcomes through the implementation of programmatic efforts through policy, systems, and environmental level change.

Communities of the Communities Putting Prevention to Work program are funded under a 2-year cooperative agreement to implement evidence and practice based MAPPS (Media, Access, Point of decision information, Price, and Social support services) strategies that are expected to have lasting healthful effects in the years following the end of the 2-year funding period.

Highlights from this Web site

Tools and Resources for community planning , including both general information and specific resources on the topics of physical activity, nutrition, obesity, and tobacco

MAPPS Strategies which give advice on how to change individual behaviors through avenues as the media, social support services, and signage (as billboards)

Media Resource Center has specific resources related to physical activity, nutrition, obesity and tobacco

 

 

 

You Can Quit Smoking Now

SmokeFree.gov includes a step-by-step quit guide, tools to help you quit, and a talk to an expert feature for personalized assistance.

The US government has an extensive smoking cessation Web site at Smoking and Tobacco Use.. Information is separately tailored for individuals, health care workers, scientists, and children/adolescents. Tools and resources include reports, fact sheets, and programs.