Sober Re-Sources

Initiative urges thinking before drinking

2009-04-19T10:02:00.000-04:00

Web site lets people learn what type of drinker they are

By Mary Brophy Marcus
USA Today

Many young adults socialize on weekends and weeknights at bars and parties where cocktails and beers flow, but most don't give much thought to their drinking habits, said Mark Willenbring, director of the Division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism. If they did, he said, it's likely that fewer people would develop problems with alcohol abuse later in life.

To that end, Willenbring and other experts at NIAAA have developed a "Rethinking Drinking" Web site — Rethinking Drinking.niaaa.nih.gov — to help people who drink alcoholic beverages determine what type of drinker they are and whether they are at a risk for developing a drinking problem.

reducing risks

"Not everybody who drinks more than is medically healthy or recommended realizes they are doing it," Willenbring said. About 30 percent of Americans have too many drinks in one day at least once a year, he says.

The heaviest drinkers are primarily between the ages of 18 and 30, and they are the target population for "Rethinking Drinking," Willenbring said.

"They are a group that drinks more than is healthy, but doesn't have the health problems yet."

Willenbring likens the interactive Web site to a prevention tool. The approach is similar to how a doctor might focus on groups at risk for heart disease — those with high blood pressure or cholesterol — but who haven't had a heart attack yet. "We're really doing risk reduction," he said.

In any given year, about 4 percent of the population has alcohol dependence, or alcoholism, according to Willenbring. About 26 percent are heavy drinkers. "Even if these folks, the heavy drinkers, reduce their drinking, the public health impact is great," he said.

While many associate heavy drinking with liver problems, it can also increase the risk for heart disease, sleep disorders, depression, stroke and stomach bleeding. Consumed during pregnancy, it can cause fetal brain damage, said Fulton Crews, director of the Bowles Center for Alcohol Studies at the University of North Carolina-Chapel Hill School of Medicine. It's also linked to cancer.

"We know if you're a heavy drinker but not alcohol dependent, your risk of oral cavity cancer and also breast cancer are increased," Crews said.

at-risk drinking

The "Rethinking Drinking" site asks if visitors know what constitutes at-risk drinking. Many might be surprised to learn what does, said alcohol-abuse expert Charles O'Brien, a professor of psychiatry at the University of Pennsylvania.

"A heavy drinking day is a lot less than most people think it is," O'Brien said. "We have in college and universities many who do binge drinking and they don't even realize it. When I told my students the daily limits, they laughed at me. Many said that's barely getting started — that they have a few drinks in their dorm rooms even before going out drinking for the night."

The site provides illustrations and tables showing the amount of alcohol in a variety of drinks, including beer, wine and liquor. A calculator can help one estimate how much a typical toddy includes. Drinkers who want to make changes can find some helpful tools and resources, too.

The site isn't meant to promote abstinence, Willenbring says. It doesn't demonize alcohol. In fact, it even points out that light to moderate drinking on a regular basis can lower the risk for heart disease for some.

Schoolteacher, soccer mom, athlete, physician, husband — anyone who cares to find out if their drinking habits are risky or not can now do so on their own, Willenbring said.

Drug Research and Recovery Act of 2009

2009-03-10T12:26:00.000-04:00

What's in the budget for addiction scientists?

Scientists were among the likely beneficiaries of President Obama’s American Recovery and Reinvestment Act of 2009.

The National Institutes of Health (NIH) is slated to receive $10 billion for use over the next two years. A yet-to-be-determined portion of the grant will end up with the National Institute on Drug Abuse (NIDA).

Here is a sampling of NIDA’s wish, or “Challenge Topics” for which the agency is seeking grant proposals. The application due date is April 27, 2009.

--Dietary treatment of substance disorders.
“There is abundant preclinical and clinical evidence that suggest dietary therapies and behavioral interventions can promote neurogenesis, diminish susceptibility to metabolic and excitotoxic injury (e.g., diets rich in antioxidants), and/or counteract stress responses within the brain. Dietary regimens or supplements can be evaluated as individual treatments or as adjuncts to FDA-approved medications.”

--Drug genetics and informed consent.
“Address ethical issues related to access to broad sharing and use of new genetic information and technologies for addiction research to improve treatment and prevention options for addicts.”

--Addiction drugs combined in treatment.
“Network biological analysis predicts that modification of a single target by a drug is not nearly as likely to affect disease outcome as would rational combinations of drugs that target multiple, complementary mechanisms. Applications will focus on combination of medication strategies for the treatment of substance use disorders.”

--Neurobiology of opioid addiction.
“There is an urgent need for research that will more thoroughly delineate the neurobiological implications of long-term opioid use. This knowledge gap is of particular concern when it comes to the developing brain - and the urgency is underscored by the fact that increasing numbers of adolescents and young adults are using opioid medications, prescribed and otherwise.”

--Research on addiction drugs for pregnant women.
“Substance abuse during pregnancy often occurs in the context of complex environmental factors and poly-drug exposure, as well as medical conditions which are associated with adverse neonatal consequences. Much is known in regard to the negative effects of substances of abuse on the pregnant/post partum women and their substance exposed neonates but relatively little is known in regard to medication treatment strategies and research methodology.”

--Internet-based prevention and treatment in rural locations.
“Many persons living in remote or rural locations have limited opportunities to obtain drug abuse treatment services, due to a lack of available service settings, the barrier of traveling long distances, and/or the perceived lack of private and confidential treatment options. This program seeks to develop web-based drug abuse treatment interventions that do not necessitate frequent in-person visits to a central facility.”

--Finding new molecular targets for addiction treatment drugs.
“Projects may utilize techniques ranging from gene knockout technologies, behavioral evaluations, assay development, and targeted library synthesis and screening that could lead to the development of medications for drug addiction treatment. The focus may be on the identification of new molecular targets, and/or the discovery of small molecule selective ligands for previously identified targets, such as muscarinic M5 antagonists, neuropeptide Y antagonists, and neurotensin agonists.”

For general information on the National Institute on Drug Abuse implementation of NIH Challenge Grants, contact:

Christine Colvis, Ph.D.
NIDA Challenge Grant Program Coordinator
National Institute on Drug Abuse
National Institutes of Health
Phone 301-443-6480
Email ccolvis@nida.nih.gov
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source: Addiction Inbox

Drunken driving connected to mental problems

2009-02-20T07:38:00.000-05:00

Stockholm (IANS): Drunken driving is not just an indication of a deeply seated alcohol problem but is also very often connected to psychological disease and chronic criminal background, says a doctoral thesis presented at the Karolinska Institute (KI).

Psychologist Beata Hubicka has in collaboration with the Swedish traffic authority, Vagverket, and the police, carried out a nationwide study involving 1,200 drivers who were charged with drunken driving.

The suspect alcoholic offenders, along with a research group of 786 assuredly sober drivers, were called upon to answer a questionnaire on their alcohol consumption habits. The psychosocial and psychotic health condition of some of the drunken drivers was examined too.

"Earlier research in this area has mostly been undertaken in the US," Hubicka told IANS, after her dissertation at the KI. "However, it became essential to carry out an entirely Swedish study since we have different promille (alcohol in the blood permissible for driving) limits and different attitudes towards drunken driving compared to the US. Such variables have also to be taken into account when dealing with this problem in other countries."

The well-received study shows that "more than a half of the suspected alcohol abusers had earlier committed criminal offences. A large number among the abusers were also found to be suffering serious psychotic problems."

"Since such a large number have psychotic problems and a criminal background," says Hubicka, "one should not direct attention solely towards their alcohol problem in any preemptive efforts to resolve drunken driving".

Hubicka said: "The current limit for drunken driving of 0.2 promille (in Sweden, among the strictest globally) is based on physiological studies in which it has been observed and recorded that our capacity for reaction (reflexes) is dangerously impaired with such an alcohol level (in the blood). Since alcohol abuse is such a big risk factor (cause) for drunken criminality, the result of our study should perhaps form the basis for a reconsidered alcohol limit for driving. I would rather suggest that we follow the few countries that have established zero-tolerance."

One-Third of Americans Have an Addicted Relative

2009-02-10T12:46:00.000-05:00

Nearly 1/3 of Americans have an immediate family member who has or have had an alcohol or drug abuse problem and almost half of those families have more than one member who had an addiction problem. For most of those families the most significant negative consequence of that addiction is the embarrassment or social stigma.

These finds were part of the "Attitudes Toward Addiction Survey" conducted by the Hazelden organization.

The telephone survey of 1,000 adults revealed some lingering stigma associated with alcoholism and drug addiction in spite of the fact 78% of those surveyed agreed that drug addiction is a chronic disease rather than a personal failing.

According to Hazelden, when survey participants were asked to describe people who have problems with drugs or alcohol included: "sinner," "irresponsible," "selfish, "stupid," "uncaring," "loser," "undisciplined," "pitiful," "pathetic," "weak," "criminal," "derelict," "washed up" and "crazy."

"What Hazelden's new survey brought home to me is that Americans understand addiction is a disease, yet much more work must be done to explain how effective treatment can be for addicts and to bring an end to the stigma that prevents addicts from pursuing treatment," said William Cope Moyers, executive director of Hazelden's Center for Public Advocacy in a news release.

The Prevalence of Addiction

Here are some of the survey findings about the prevalence of addiction:

* Nearly one-third of Americans reported past abuse of alcohol or drugs in their immediate family.

* Of those households with an immediate family member who had an addiction problem, 44% reported more than one family member with a drug problem.

* A third of the families which reported a drug problem in their immediate family say that a majority of their family members have problems with drugs.

* With one in six of the respondents dealing with substance abuse in their family, every member of the family has a problem with drugs or alcohol.

* When asked about extended family, virtually half of Americans surveyed reported three or more family members have experienced a problem with drugs during their lives.

Attitudes About Prevention, Treatment

The survey also revealed attitudes about prevention and treatment efforts:

* 79% percent feel the War on Drugs has not been successful.

* 83% agree that much more should be done to prevent addiction.

* 83% believe that first-time drug offenders should get chemical dependency treatment rather than prison time.

* 77 percent agree that many addicts who complete treatment go on to lead useful lives.

* 71% agree health insurance should cover addiction treatment, but most have no idea if their own insurance will pay.

As a result of the survey, Hazelden's Center for Public Advocacy will launch a public advocacy campaign in Washington, D.C. and across the United States this year.
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source: http://alcoholism.about.com

New Recovery

2009-01-27T08:58:00.002-05:00

ALL ADDICTS ARE DIFFERENT — NOW THERE'S A TREATMENT THAT IS TOO

As a professional experienced with alcohol and drug addiction, you know those struggling with this debilitating disease face a long journey towards sobriety – one that requires a customized, leading-edge recovery program with a personalized approach. Unfortunately, there are few programs today that go above and beyond the standardized treatment formula to improve the odds for long-term sobriety. That's why Enterhealth, a premier alcohol and drug addiction recovery center, with its proven therapeutic approaches, neurology, technology, and leading anti-addiction medications, is earning a reputation as the better way to recover.

Here are just a few reasons why Enterhealth stands out from more traditional alcohol and drug addiction treatment programs. To learn more on how Enterhealth can help you and your clients, call 800.388.4601 or visit us at enterhealth.com.

Reason 1: Neuro therapy. In order to help clients overcome physical trauma to the brain caused by addiction, Enterhealth utilizes neurological therapy techniques. This integration of state-of-the-art diagnostics of the brain with clinical therapies involves an MRI to assess any damage caused to the brain by alcohol and/or drug use, an EEG to assess risk level of seizure, and a written neuro-psych test to check for cognitive brain function loss. The results of this evaluation support a personalized treatment plan.

Reason 2: Anti-addiction medications. Rather than rely on talk therapy alone, Enterhealth offers clients access to the latest, most effective anti-addiction medications such as Suboxone, Campral, and Vivitrol. This can help not only repair damage to the brain caused by alcohol and drug use, but also reduce cravings, providing them the opportunity to more fully participate and benefit from treatment.

Reason 3: Length of stay. In contrast to most residential treatment facilities that offer a typical length of stay of 28-30 days, Enterhealth recommends a customized length of stay based on the client's unique needs and recovery progress. This better ensures the client has the tools they need to continue sobriety post residential treatment.

Reason 4: Dual diagnosis. The Enterhealth facility is designed to diagnosis and treat both the addiction as well as other mental health disorders – which in most cases is what creates the desire for alcohol or drugs in the first place. By treating the mental disorder in tandem, typically with personalized, private therapy, the odds for relapse are greatly reduced.

Reason 5: Wellness emphasis. Enterhealth's personalized wellness program includes individual time with a trainer as well as a dietician to address physical and dietary patterns that are recommended for balance and healthy living.

Reason 6: Balance of group & private therapy. The Enterhealth facility is limited to 16 clients, offering an industry-low therapist-to-client ratio of 1:3. This intimate setting allows more focus to be placed on individualized, one-on-one therapy, while also supporting a menu of both small and large group therapies.

Reason 7: Post Residential Support. As your clients transitioned back to your care from the residential addiction treatment program, Enterhealth’s online Life Care program can assist them in continued recovery through access of Enterhealth's online recovery tools 24 hours a day from anywhere in the world.

We invite you to schedule a tour and meet our team. To learn more about what makes Enterhealth a better way to recovery and how it can help your clients, call 800.388.4601 or visit us at www.enterhealth.com

JOIN TOGETHER MERGES INTO CASA

2009-01-16T09:20:00.000-05:00

NEW YORK, N.Y., January 15, 2009 – The National Center on Addiction and Substance Abuse (CASA) at Columbia University announced today that Join Togethertm will be merged into CASA and David L. Rosenbloom, Ph.D., will become the President and Chief Executive Officer of CASA on May 1, 2009, succeeding Joseph A. Califano, Jr., the former U.S. Secretary of Health, Education, and Welfare who founded CASA in 1992 and has been its Chairman and President since that time. Califano will continue to serve as CASA chairman.

“Naming David Rosenbloom CASA’s new president is the result of more than two years of work by the Board which involved an analysis of CASA’s first 16 years, discussions with 100 individuals and institutions about CASA achievements and potential, the needs of the substance abuse field, and an intensive search involving a number of qualified candidates. The Board and I are convinced that David Rosenbloom is the individual best suited to move CASA forward and increase its influence and activities,” said Califano. “Merging Join Together into CASA will greatly strengthen CASA’s ability to inform the American people of the economic and social costs of substance abuse and its impact on their lives, make CASA’s research findings and recommendations widely available to those working on the front lines to prevent and treat substance abuse and addiction, and significantly expand our nationwide advocacy capacity. The combination of CASA and Join Together will produce a total far greater than the sum of the parts.”

Rosenbloom, 64, has been Director of Join Togethertm since he founded it in 1991. He is a Professor of Public Health at the Boston University School of Public Health. For eight years, from 1973 to 1985, he was Commissioner of the Department Health and Hospitals for the city of Boston and CEO of Boston City Hospital. For several years after that he was president and CEO of Health Data Institute, a company that pioneered the clinical analysis of medical claims data and developed managed care techniques. He received his BA from Colgate University in 1965 and his Ph.D. from the Massachusetts Institute of Technology in 1970.

“Progress in addiction prevention and treatment is essential in order to reform America’s health care system and address most other critical social problems facing the nation. Combining the resources of CASA and Join Together creates the critical mass needed to focus the attention of our nation and its leaders on the need for effective prevention and treatment policies to achieve such progress. It blends the formidable research of CASA and the public and policy attention that CASA has attracted with the unique web based education and advocacy and tools of Join Together. I am excited by the opportunity to combine and lead these talented teams and work with Joe Califano,” said Rosenbloom.

Join Togethertm is the leading provider of news, information and continuing education on tobacco, alcohol and illegal, prescription and performance enhancing drugs to policy makers, community leaders, parents, and front line prevention and treatment practitioners; all free of charge to more than 50,000 subscribers and 7,000 daily users of its website http://www.jointogether.org/. Its advocacy campaigns promote adoption of prevention and treatment policies and practices that research has shown to be effective.

“CASA is the premier think/action tank in the field with the brightest group of professionals ever assembled under one roof to research and combat substance abuse and addiction. David has the right experience, talent and creativity to enhance this national asset. We are fortunate that he has accepted this challenge,” said Califano. “I look forward to working with him.”

CASA is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA and its staff of more than 50 professionals has issued 66 reports and white papers, published one book, conducted demonstration programs focused on children, families and schools at 224 sites in 87 cities and counties in 34 states plus Washington, DC and two Native American tribal reservations, held 17 conferences attended by professionals and others from 49 states, and has been evaluating the effectiveness of drug and alcohol treatment in a variety of programs and drug courts. CASA is the creator of the nationwide initiative Family Day—A Day to Eat Dinner With Your Childrentm –the fourth Monday in September—the 28th in 2009—that promotes parental engagement as a simple and effective way to reduce children’s risk of smoking, drinking and using illegal drugs. In May 2007, CASA’s Chairman Joseph A. Califano, Jr., called for a fundamental shift in the nation’s attitude about substance abuse and addiction with publication of his book, HIGH SOCIETY: How Substance Abuse Ravages America and What To Do About It. For more information visit http://www.casacolumbia.org/.
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source: http://www.casacolumbia.org

States Unleash New Ignition Lock Laws

2009-01-05T09:15:00.000-05:00

Starting this month, drivers convicted of driving while intoxicated in at least six new states will face a hi-tech hurdle to repeat offenses: ignition interlocks. After a high profile national campaign, Mothers Against Drunk Driving and other organizations convinced several state legislatures to pass laws mandating the dashboard installation of small ignition interlock device activated by a breathalyzer.

“It’s amazingly inconvenient, “ David Malham of the Illinois MADD group told Associated Press. “But the flip side of the inconvenience is death.”

Will high technology really help keep drunk drivers off the streets and highways? Malham, quoted in the Chicago Tribune, insisted that “it’s not about changing human nature, it’s about science interfering and preventing reckless behavior.” Maltham also said he is looking forward to technology that will be able to sniff a car’s interior, scan the eyes of drivers, and test sweat on the steering wheel before allowing the driver to turn the key.

In addition to Illinois, states that passed laws requiring the use of ignition locks for drunken driving convictions of varying degrees include Nebraska, Colorado, Washington, and Alaska. Other states with similar but unevenly enforced laws on the books include South Carolina, Arizona, New Mexico, and Louisiana.

Illinois is attempting to work around the program’s most obvious flaws—the convicted drinker could drive someone else’s car, or get someone else to blow into the breath-monitoring device—by instituting heavy penalties for non-compliance if the driver is caught cheating.

Lined up in opposition to ignition lock legislation, thus far, is the American Beverage Institute, a lobby group for restaurant owners. In the AP article, the Institute’s Sarah Longwell objected to the fact that states might decide to apply the laws to people other than repeat offenders—to anyone who, on any given night, blows a 0.08 or a 0.10, the common denominators of alcohol intoxication in most states.

Sounding a bit more like the National Rifle Association (NRA) than perhaps it intended, the Beverage Institute offered a dire vision of a slippery slope: “We foresee a country in which you’re no longer able to have a glass of wine, drink a beer at a ball game or enjoy a champagne toast at a wedding. There will be a de facto zero tolerance policy imposed on people by their cars.”

My modest prediction: A tangle of state lawsuits and questions over civil liberties, the more so since many of the laws are first-pass efforts and subject to interpretation.

source: Addiction Inbox

Marijuana Law Comes With Challenges

2008-12-18T07:19:00.000-05:00

BOSTON — Last month, voters approved a statewide measure decriminalizing the possession of small amounts of marijuana. Now, wary authorities say, comes the hard part. They are scrambling to set up a new system of civil penalties before Jan. 2, when the change becomes law. From then on, anyone caught with an ounce or less of marijuana will owe a $100 civil fine instead of ending up with an arrest record and possibly facing jail time.

It sounds simple, but David Capeless, president of the Massachusetts District Attorneys Association, said the new policy presented a thicket of questions and complications.

One of the most basic, Mr. Capeless said, is who will collect the fines and enforce other provisions of the law. For example, violators under 18 will be required to attend a drug awareness class within a year, but it is unclear who will make sure that they do so. The fine increases to $1,000 for those who skip the class.

A complicating factor, said Mr. Capeless, the district attorney in Berkshire County, is that state law bans the police from demanding identification for civil infractions.

“Not only do you not have to identify yourself,” he said, “but it would appear from a strict reading that people can get a citation, walk away, never pay a fine and have no repercussion.”

Wayne Sampson, executive director of the Massachusetts Chiefs of Police Association, says he anticipates that many violators will lie about their identities.

“You can tell us that you’re Mickey Mouse of One Disneyland Way,” Mr. Sampson said, “and we have to assume that’s true.”

The authorities, he said, will also have to be sure that the substance they hand out citations for is marijuana, which will involve sending it to the State Police crime laboratory.

“You’re going to appeal it and go to the clerk’s hearing,” Mr. Sampson said, “and if we don’t have an analysis from the drug lab, the clerk is going to throw the case out.”

Mr. Sampson predicted that the law would result in de facto legalization of marijuana because it would prove too difficult to enforce.

“I would argue that the proponents knew these complications right from the beginning,” he said.

About 65 percent of state voters supported the decriminalization measure, which was promoted by a group that spent more than $1.5 million on the effort.

The group, the Committee for Sensible Marijuana Policy, said that in addition to ensuring that people caught with marijuana no longer have a criminal record, the change would save about $29.5 million a year that it estimates law enforcement currently spends to enforce existing drug laws.

A spokesman for the Marijuana Policy Project in Washington, which supports the drug’s legalization and created the Committee for Sensible Marijuana Policy to get the ballot question passed here, said that judging from the experience of other states with civil penalties for marijuana possession, Massachusetts officials were exaggerating the challenges.

“I can’t help but think that the real difficulty in implementing it,” said the spokesman, Dan Bernath, “is they don’t want to do it.”

Eleven states have decriminalized first-time possession of marijuana, though in most it is technically a misdemeanor instead of a civil offense.

In Nebraska, where possession of an ounce or less of marijuana is punishable by a $300 civil fine, the process has worked smoothly for three decades, said Michael Behm, executive director of the Nebraska Crime Commission.

In New York, possession of an ounce or less of marijuana is a noncriminal violation but is still processed through the criminal system, said Robert M. Carney, the district attorney in Schenectady County.

“They are brought down to the police station so their identity is established,” Mr. Carney said of violators, “but they are not fingerprinted because it’s not an arrest.”

In Massachusetts, the Executive Office of Public Safety is working with state and local law enforcement and court officials to determine how to apply the changes. Mr. Capeless said education officials were also in on the discussions because it was unclear whether public schools and universities could forbid marijuana possession under the new law.

A spokesman for the public safety office said its legal counsel was considering “a lot of questions” as the deadline drew near. But the spokesman, Terrel Harris, would not elaborate.

“We are just trying to make sure we have all the answers,” Mr. Harris said.

Mr. Capeless said that in particular the department needed to address a clause in the new law that said neither the state nor its “political subdivisions or their respective agencies” could impose “any form of penalty, sanction or disqualification” on anyone found with an ounce or less of marijuana.

“It appears to say that you get a $100 fine and they can’t do anything else to you,” he said. “Can a police officer caught with marijuana several times get to keep his job and not be disciplined in any fashion? Can public high schools punish kids for smoking cigarettes but not for having pot?”

Mr. Bernath agreed that the law was “not completely clear” on how to handle such situations, but predicted that they would be rare.

“I think the resistance has to do with dealing with something new,” he said. “We’re pretty confident that once this gets going and the newness of it wears off, a lot of the apprehension will go away.”
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source: New York Times

Florida Drug Rehab Center Now Offering Extended Stay Programs

2008-12-08T08:01:00.000-05:00

Ambrosia Treatment Center, a holistic-based drug rehabilitation center located in Port St Lucie Florida, now offers extended stay addiction treatment programs specifically tailored to the needs of the patient.

When it comes to health problems, a quick and neat solution is preferred nowadays. We have pills and syrups to ease every possible symptom. Surgery procedures that can be performed the same day and leave minimal scarring. However, when it comes to drug and alcohol addiction there is no such thing as a 'quick and neat solution.' Recent scientific studies have shown that the longer the treatment, the better the recovery and the more permanent the sobriety.

Therefore, drug rehab centers nationwide have begun lengthening their programs and making recommendations to possible patients for longer treatment stays that are still cost effective. Ambrosia Treatment Center, a world-class holistic drug rehab facility located in Port St. Lucie Florida, has begun offering both 60-90 day programs and 6-12 month programs, in addition to their shorter programs, in order to provide specialized treatment for all of their clientele.

According to the National Institute on Drug Abuse, over forty to sixty percent of people 'will relapse after drug treatment.' Addiction experts are now proving that longer treatment where client's specific needs are taken into account will alleviate the massive weight of addicts relapsing and cycling between 30-day hospitalizations for years and years. Dr. David Lewis, director of Visions Rehabilitation Center in Malibu, says that 30-day treatment programs were originally established for the Air Force and were only scheduled in that manner for bureaucratic reasons--'men and women didn't need to be reassigned if they were away from duty for more than 30 days. Other treatment centers followed suit.'

However, there was at the time no direct scientific evidence that showed that 30 days was adequate time for treatment. Today, we know that there are no 'magic numbers' when it comes to drug and alcohol abuse treatment and those 30 days is not nearly enough. The Ambrosia Treatment Center, as a holistic-based drug rehab facility, follows this pattern by treating the 'whole' person in order to resolve the underlying issues that may be causing the addiction in the first place. Often times, treating the 'whole' person requires more than simply 30-days.

However, many people find that an extended stay beyond 30-days is too much for addiction treatment. People argue that they have jobs, school, families--the normal day-in-day out routine that needs attention. What they want from rehabilitation is a quick fix. Yet, as stated before, there is no quick fix for drug and alcohol addiction and abuse. Studies have shown that addiction is best analogized to a chronic disease, such as heart disease--addiction requires critical attention and perseverance in terms of treatment in order to remain healthy. The Ambrosia Treatment Center family provides strong and capable staff, each of which carry over 20 years experience treating substance abuse and addiction treatment clients from all walks of life. Their attention to detail enables them to provide each client with an individualized regiment of treatment and not necessarily 'cookie cutter' their therapy.

At the end of the day, this is what sets The Ambrosia Treatment Center different from other rehabilitation clinics--they care. They want to see your loved ones get well. They never give up on an addicted person. And, at the end of the day, they believe that you never fail unless you just quit trying.

For additional information on the AMBROSIA TREATMENT CENTER and drug abuse treatment please call 1-866-616-0069 or visit www.ambrosiatreatmentcenter.com.
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source: topix.net

Drug And Alcohol Abuse Double Risk Of ICU Admission

2008-12-05T09:32:00.001-05:00

While the personal health and safety risks of drug and alcohol abuse are well-documented, a new study by researchers at LDS Hospital and Brigham Young University suggests substance dependence increases medical costs by way of the intensive care unit.

Analysis of intensive care unit admissions at LDS Hospital in Salt Lake City shows drug and alcohol abuse make a patient twice as likely to be admitted to intensive care, according to the new study, published in the December issue of Intensive Care Medicine.

"Since these patients are admitted to an intensive care unit, which is geared to treat patients with a much higher acuity, medical costs are higher than for those admitted to a general ward in the hospital," reported Mary Suchyta, M.D., lead author and a physician at Intermountain Medical Center and LDS Hospital.

The researchers reviewed records for 742 patients admitted to LDS Hospital's intensive care unit over a one-year period. Nineteen percent of those patients had a history of drug and alcohol dependence prior to becoming critically ill. That's twice the rate of the population served by LDS Hospital.

"It appears that that patients with drug or alcohol dependence are at higher risk for intensive care unit admission compared to the general population, which would increase overall medical costs," said Ramona Hopkins, a psychology professor at BYU and researcher at Intermountain Medical Center and LDS Hospital.

Patients with drug or alcohol dependence were on average six years younger than the rest of ICU patients.

"What's alarming is that substance dependence meant that these individuals were critically ill and admitted to the ICU at a much younger age than the general population," Hopkins said. "If these individuals do not completely recover and return to work, that represents large potential societal costs."

The new study earned praise from the editors of Intensive Care Medicine, who noted that there are significant gaps in this type of knowledge in most ICU settings and while this article did not answer many of the questions posed by these gaps, it should stimulate further research and collaboration.

Both Drs. Suchyta and Hopkins agree that the detection of substance dependence earlier would allow doctors to address those issues and this may improve recovery.

"Dr. Hopkins and myself have thought for many years that patients with drug and alcohol dependence were over represented in the ICU populations that we have studied over the last 10-15 years and this study suggests that we were correct," noted Dr. Suchyta.

BYU undergrad Callie Beck is also a co-author on the new study. It's her second time publishing an academic paper alongside Hopkins. In 2006 she co-authored a study on brain imaging, a field she would like to pursue in graduate school. Beck is applying to nine graduate schools, including UCLA, Vanderbilt and the University of Maryland.

"Callie is an amazing student," Hopkins said. "She was involved in many aspects of the research, including data analysis and writing. That level of experience will make her stand out as she applies to graduate school."
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source: MediLexicon

Not Such A Happy Christmas For Addiction Sufferers

2008-12-03T12:46:00.000-05:00

It may be the season to be merry for most people but according to experts at the Priory Group, the UK's leading independent provider of addiction treatment services, Christmas is often the most difficult time of year for people suffering from an addiction.

The euphoria and excitement surrounding Christmas reinforces feelings of low self-esteem and low self-worth which are common in addicts. This makes it even harder to manage their addictions during the festive period.

An estimated two million people in the UK are believed to suffer from an addiction of some sort. The three most common addictions are also the ones that are the most difficult to cope with at Christmas:

- Alcohol
- Food
- Shopping

Dr Philip Hopley, consultant psychiatrist at The Priory Roehampton explains: "It can become very difficult for people to deal with the stress and anxiety caused by the financial and consumer pressures of the festive season, and by difficult family and relationship situations that often arise at this time of year. For an addict this is intensified by trying to avoid temptation at a time when the rest of the population appears to be having a fantastic time.

"During December alcohol consumption in the UK increases by 41%. Christmas puts a significant strain on people and this often leads to people using more alcohol in a bid to relax or avoid facing issues.

"There are a number of reasons why some people end up drinking too much at a consistent level, including the need for confidence in social situations, such as the office Christmas party. the financial strain caused by overspending; the pressure to be upbeat and act as the 'perfect host'; spending extended periods with relatives; and

"One of the most difficult times of the year for those recovering from alcoholism is the Christmas holidays because so many people appear to be having a good time whilst drinking. The New Year can seem like a very bleak place for alcoholics facing a long road ahead. Dr Hopley continued: "Christmas is often seen as a good excuse to indulge in overeating and excess, but to people with eating disorders it can spell despair.

"People with conditions such as bulimia and anorexia nervosa can become extremely distressed to the point of feeling suicidal because of the pressure to eat at Christmas.

"Bulimic behaviour often peaks over the holiday period and some sufferers resort to self-harm, which can become destructive addictive behaviour."

Christmas is also a very challenging time for those suffering from a shopping addiction, or Oniomania as it is clinically known, according to Priory addictions specialist Dr Hopley: "Shopping addiction or impulse buying is when someone gets a 'high' from spending money on goods and spends excessively on items that they want rather than need. At Christmas the shops are full of glitzy displays designed specifically to encourage people to buy.

"One of the main implications of shopping addiction is debt. People who are addicted to shopping may spend even when they have no money to spend with, which can soon lead to debt problems. Debts can often spiral out of control and can soon become unmanageable. Other consequences are denial and desperate acts to cover up the addiction leading to the breakdown of close relationships."

Dr Hopley concluded: "While the vast majority of people enjoy a wonderful time at Christmas there are those for whom it is a desperate time. Admitting to a having a problem and consequently seeking treatment can be the first and most important step towards being able to enjoy the festive season in the future."

Binge drinking linked to increased stroke risk

2008-12-02T09:34:00.000-05:00

Binge drinking linked to increased stroke risk. It’s well-known that binge drinking is not good for your health and a new study shows it may have an even more pronounced effect on your brain than you thought. In fact, the researchers say that making binge drinking a habit could increase your risk of a stroke.

Binge drinking often occurs at parties or in social settings where people take in large amounts of alcohol at one time. In this study, researchers defined it as consuming six or more alcoholic drinks for men or four or more drinks for women in one session. They looked at almost 16, 000 Finnish men and women age 25 to 64 years. They participated in a risk factor survey and were followed up for 10 years afterward.

In that time there were 249 participants who had a first stroke. The researchers found that while average alcohol consumption did not seem to be associated with the strokes, sessions of binge drinking showed a clear link with the occurrences. The binge drinkers were 1.85 times as likely of having a stroke compared to the non-binge drinkers and 1.99 times as likely when adjusting for the risk of ischemic (clotting) stroke alone.

The researchers concluded that heavy sessions of alcohol consumption might be an independent risk factor for stroke.

The Heart and Stroke Foundation does not recommend that you drink alcohol for the purpose of reducing your risk of heart disease and stroke. For those healthy adults who drink alcohol, consumption should not exceed 2 drinks* a day with a weekly limit of 14 drinks for men and 9 drinks for women. Binge drinking should be avoided.

(A standard drink is 341 ml of 5% beer, 142 ml of 12% wine, and 43 ml of 40% spirits.) *
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source: On the Pulse News

Huesik: Korean for binge drinking

2008-11-26T08:01:00.000-05:00

A classic South Korean working day usually ends up in Huesiks, binge drinking sessions cast as social events. But behind the drunken smiles lurks an alarming variety of health problems that stem from heavy drinking.

Night falls on Seoul as workers leave their offices. It is time for Huesiks, boozy meals shared by coworkers at least twice a week. Taking part in them is highly recommended as those who do not can find themselves quickly ostracized from the group.

This means drinking a lot; and quickly. Part of the aim is to find summon courage to lose one’s inhibition and criticize the boss. We follow one group as they treated a client in a Japanese restaurant. They are going to talk business. But, above all, they will raise toast after toast. That's already four in less than ten minutes.

Soju is Korean people’s favorite drink. It is made of rice, potatoes or barley, is very cheap and usually contains about 25% of alcohol. So, a few hours and several bars later, these employees aren’t exactly in professional shape anymore.

Having left the bar, these heavy drinkers drunkenly wait on subway platforms or stumble out onto Seoul’s streets. One businessman we come across has drunk one bottle of whisky every day for the last 20 years. Despite a recent recovery from stomach cancer, he remains a heavy drinker.

In Korea, warnings against heavy drinking are still very rare. Advertising is legal. Yet, for the local authorities, the cost of alcohol abuse is mounting. One in 10 korean adults suffers from various health problems stemming from heavy drinking. And it is not about to change as average alcohol consumption rose again in September.
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source: France 24

Heroin treatment also works on cocaine: study

2008-11-24T08:45:00.001-05:00

Methadone, a drug used for many years to treat heroin addiction, appears to work well in cocaine addiction, too, a new Canadian study suggests.

Psychologist Francesco Leri of the University of Guelph has been making rats addicted to cocaine, and then treating them with methadone.

Most of the rats responded well, he says. They lost their powerful urge for cocaine, and in addition, their brains "re-set" themselves into the same pattern that existed before they first used cocaine.

"It can be done tomorrow with humans, and should be done tomorrow," he said.

That's because methadone -- unlike a new drug -- already exists as a tested drug, with clear prescription rules and clinical staff trained in giving it out.

"There is an entire system that is already in place for the employment of methadone," that could be used for cocaine addicts.

Mr. Leri said the U.S. National Institute for Drug Abuse is looking into the use of methadone -- or a similar drug such as buprenorphine -- in a clinical setting.

The idea came up because in real life, people mix drugs.

There's no such thing as a "pure heroin addict," he said. "The norm is people who are addicted to opiates, so heroin or prescription opiates, and they co-abuse cocaine at the same time."

Researchers have wondered what happens to their cocaine problem when they start taking methadone for the heroin addiction.

But it's hard to tease apart the two addictions in humans. In his Guelph lab, Mr. Leri worked on rats with a cocaine addiction, but no exposure to heroin.

The cocaine-addicted rats in his lab didn't get a cocaine high on methadone, he said. Instead, "the methadone may be able to curb the desire that they have for that drug (cocaine)."

In addition, methadone actually reversed changes in the rats' brains that are caused by cocaine, and are known to play a key role in addictive behaviour.

"What's interesting is that, among the rats given cocaine and then methadone, these regions of the brain looked similar to how they appeared in the rats that were never exposed to cocaine.

"We feel we may have the hope of re-setting the brains of some individuals to a type of normality," he said. "I think it should be tried and I guarantee you there will be some individuals -- not everybody -- who will do better on methadone, who will be stabilized on methadone."

The study means a person who is motivated to stop taking cocaine may benefit from methadone as one tool to help, the psychologist says.

"You cannot give methadone left and right and hope that it is going to work. You need to work with individuals who in addiction to social support, in addition to cognitive therapy, will need something to curb their desire" for cocaine.

His study is published in European Neuropsychopharmacology, a research journal.
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source: The Ottawa Citizen

Task force could help stem underage college drinking

2008-11-21T07:35:00.000-05:00

Colleges and universities should take lead on setting and enforcing rules on their campuses.

Stopping underage drinking on college campuses should be a top concern of parents and academia. In recent years, there have been tragic alcohol-related deaths, and something should be done to address this issue.

Yet, we agree with state Sen. Shirley Turner, D-Mercer, the solution is unlikely to be found in legislation that imposes a uniform fix for the state's many campuses. As Turner said, the universities and colleges should be allowed to set and enforce their own rules. If the problem spills off campus, there already are laws to handle underage drinkers.

Some academic leaders have proposed lowering the drinking age from 21 to 18, when people are considered adult in other areas of society, such as the health-care, criminal justice and military systems. The Amethyst Initiative, a group of 134 college presidents and chancellors, favor making it legal for their 18- to 20-year-old students to drink. Most now do so illegally and colleges have proved inadequate to stop this behavior.

Under federal law, states can set the legal drinking age for their residents, but would lose 10 percent of their federal highway funds. The federal penalty recognizes that young people too often are involved in drinking-and-driving accidents.

On the other hand, many European countries have a much lower drinking age than the United States but balance that with much tougher drunken driving laws. Generally, there are not higher rates of alcohol-related incidents among European youths than here.

It is an issue worthy of more study, as Turner has proposed. She and Senate President Dick Codey, D-Essex, support creating a task force to look into the issue. But lowering the drinking age probably won't be acceptable to many New Jerseyans, especially those who have lost a loved one in an alcohol-related incident. But that doesn't mean the whole issue should not be reviewed. Students, parents, educators and lawmakers need to have this conversation to figure out how to get students and others to act more responsibly.
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source: Courier Post Online

Vodka makers may have to pay for addicts' treatment

2008-11-18T11:44:00.000-05:00

Amid criticism from alcohol producers, a bill was introduced in the lower house of the Russian parliament (Duma) according to which
producers of vodka and other alcoholic beverages will have to pay for the treatment of chronic alcoholics.

Lawmaker Viktor Zvagelsky of the ruling United Russia party has introduced the bill which will bound the producers of alcoholic beverages to bear the 'moral and financial responsibility' and pay for the treatment of chronic alcoholics, according to a report.

Zvagelsky proposes to set a mandatory mechanism for compensation of damage to health of citizens caused by consuming alcoholic drinks

Earlier last month, Russian interior minister Rashid Nurgaliyev had recommended to restore the Soviet-era system of forced treatment of alcohol abusers.

According to the lawmaker, the alcohol producers will have to pay approximately four roubles for per litre of vodka produced by them into a self-regulated fund to finance the network of clinics and sanatoria involved in the treatment of alcoholics.
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source: Times of India

Avoiding alcohol's temptations in 'overwhelming' war zone

2008-11-12T08:10:00.000-05:00

Once each week, in a fluorescent-lit room in a stout building near the heart of Kandahar Air Field, a multinational mix of troops and civilians gather to take on a battle that can't be fought with conventional weapons.

Sitting around a table, or on overstuffed furniture, they talk about bad days, frustrating bosses and how it is that a fellow soldier can become a drunk on a dry base in a mostly dry country.

Called Sober in the Sand, the group is this base's own chapter of Alcoholics Anonymous. For many who spend much of the year living abroad in Afghanistan, their weekly meetings have become a lifeline to staying sober far from the supports of home.

Jennifer, a 31-year-old from Winnipeg, has been sober for 10 years. Still, when she arrived to work at the base five months ago as a civilian, she was anxious about the strain that living in a war zone might cause.

"It's not like I'm shaking for a drink all the time," she said.

But she added that the base, which serves as a temporary home for more than 10,000 people from dozens of countries and is the frequent target of insurgent rocket attacks, can be "overwhelming" at times.

"It's a really crazy place."

That craziness was tempered, though, when she walked into her first AA meeting.

Instantly, she felt she belonged.

"There's a base level of understanding between alcoholics. They know you, you know them. It's almost like family."

The group operates like most conventional AA groups, meeting once a week and setting up links between new recovering alcoholics and those with more sober years under their belts. But there are unconventional elements that come with operating in a war zone.

"Here we worry about our fellow alcoholics going out and not coming back alive, which is a little harder to deal with," said Ed, a 47-year-old mechanic from Midland, Ont.

Typically, the group has about five regular members, but has swelled to more than 15 at different times.

Often, the group will gather for special meetings if soldiers are coming through who are normally stationed off base at one of the smaller outposts.

"If they need a meeting, well, darn it all, somebody should be there," said Ed, adding that those who come to the AA group for support but have to leave to work off base are usually given literature, including copies of The Big Book, a step-by-step guide to getting sober that explains the Alcoholics Anonymous tradition.

"My book I was carrying around for 14 years went out to a forward operating base with them," Ed said. "If you have no meetings out there and guys at least have something to read, at least you have some comfort."

John, a 31-year-old U.S. Army soldier from the Bronx, said it took some work to find the AA meetings when he arrived on base.

At times the program has nearly faded away, largely because of the transience of people at the base. But it has always been revived.

"People are not only coming here to talk about problems with alcohol," he said. "We come here for peace of mind. I've actually had the opportunity to help people."

For that reason, no matter how many troops and contractors move on and off the base, the group will always exist, said Chuck, a 55-year-old civilian from Minnesota who with 26 years of sobriety, is the unofficial dean of Sober in the Sand.

"AA is a program of principles. If everybody shipped out, the next recovered alcoholic coming through Kandahar would initiate it again.

"This meeting will always be here after we've gone. The AA will keep reconstituting itself, just like the Taliban."
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source: Globe and Mail

Kicking Depression: Recognize underlying disorders, tackle them, too

2008-11-09T08:25:00.002-05:00

By Christine Stapleton

Palm Beach Post Staff Writer

Oh that we could have just one mental illness afflict us at a time.

Many of us diagnosed with one mental illness have another lurking - often undiagnosed or untreated. Doctors call it "co-morbidity." Others call it "dual-diagnosis." I call it "unfair."

Two weeks ago I started sliding. Hours of feeling OK, then hours of feeling down. The OK hours slowly shrunk to OK minutes. The down hours became a day, then another and another. On the second down day the switch between my brain and stomach flicked off.

Three days later, I had already lost 5 pounds. A trainer at the gym told me I was getting too thin. A couple of my girlfriends invited me to dinner. Another threatened an intervention. I ate a sweet potato and a little cup of chicken soup.

My therapist calls this anorexia. I call it lack of appetite. It's not like I'm a waif you could blow over with a hair dryer. I just don't want to eat, and I weigh myself twice a day and track the numbers in my weight journal. Did I mention I don't eat wheat and very little refined sugar? What's the big deal? Apparently that's called an "eating disorder." It's just one of a few other "disorders" I deal with, like hypomania - a type of bipolar.

My brain plays dominoes with these disorders. A bout of mania knocks over the depression domino, which knocks over the anorexia domino, which knocks over the exercise-drug-alcohol addiction domino, which goes on and on.

It took decades for me to figure this out. It took even longer to realize that the chain-reaction that effortlessly topples the dominoes does not work in reverse. They won't automatically pop up if I manage to right just one.

Each disorder has its own treatment. Successfully treating one will not necessarily cure the other. A bipolar drug addict who gets clean is still going to have eye-popping mood swings, bursts of energy and paralyzing depression if the bipolar is not treated, too.

A food addict who smokes and gets treatment for her eating disorder but keeps smoking is still addicted to nicotine. Same with the alcoholic who cuts herself. She is not necessarily going to stop cutting just because she gets sober.

Like I said, it's not fair. It is even worse because many doctors don't understand this. They treat one illness but fail to diagnose the companion disorder(s). Then we blame the antidepressants or therapy for not working and we quit. Life becomes hell, all over again.

My solution: Surrender. Recognize the other disorders and treat them, too. I don't think of it as being a loser. I just joined the winning side.
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source: Palm Beach Post

Alcoholics Have Problems Recognizing Danger

2008-11-07T10:40:00.000-05:00

Alcoholics have trouble recognizing and avoiding dangerous situations because the area of their brain that is used to appreciate those kinds of concerns is functioning at a reduce level, stunting their ability to perceive danger. This may help explain why they do not react to the concerns of their friends and family members about their drinking.

Previous studies have shown that alcoholics have problems recognizing facial expressions and many other studies have shown cognitive deficits in alcoholics. A new study indicates that alcoholics may also have emotional processing deficits also.

Researchers studied 11 alcoholics and 11 healthy males and used fMRI brain imaging to track their brain-blood oxygenation level dependent (BOLD) responses while they were given facial-emotion decoding tasks.

Sensation Seekers

The subjects were ask to determine the intensity of happy, sad, anger, disgust and fear displayed via facial expressions. The results showed that alcoholics were most deficient at recognizing negative emotional expressions.

These deficits showed up on the fMRI images in the affective division of the anterior cingulate cortex -- part of the prefrontal brain area.

"The cingulate is involved in many higher order executive functions such as focused attention, conflict resolution and decision making," said Jasmin B. Salloum, research scientist at the National Institute on Alcohol Abuse and Alcoholism, in a news release. "Alcoholic patients are known to be sensation seekers and are less likely to shy away from signals that suggest danger."

Findings Have a Silver Lining

"Both sensation seeking and avoidance of danger are characteristic of subjects with axes II personality disorders, which many of our subjects had," Salloum said. "The findings in this study may shed some light on some of the problematic and psychopathological behaviors that are manifest in this patient group. It remains to be determined if the dysfunction of the anterior cingulate precedes alcoholism or is a result of long term drinking."

The study did have a silver lining, according to Andreas Heinz, director and chair of the department of psychiatry at Charite – University Medical Center Berlin.

"Now we can begin to understand why patients have problems avoiding dangerous situations and, particularly, why they may not react to the concerns of their friends and relatives: the brain area that should help them appreciate these concerns is functioning at a reduced level," said Heinz.

But Happy Faces Work

"Furthermore, we observed a normal or even increased brain response to happy faces. Our group recently made a similar observation, in that patients with strong brain responses to pleasant pictures have a reduced relapse risk," Heinz said. "So, relatives and friends may want to support alcoholic patients with positive messages that strengthen their self-esteem while being particularly careful, and even repetitive, in pointing out the dangers of alcohol and alcohol-associated environments. Otherwise, the patients may miss the message."

The study was published in the September 2007 issue of Alcoholism: Clinical & Experimental Research.
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source: about.com

Somewhat Better Outcomes With Longer-Term Treatment For Opioid-Addicted Youth

2008-11-05T09:38:00.001-05:00

New research published in the November 5 issue of JAMA reveals that long-term therapy rather than short-term therapy for opioid-addicted adolescents yields better results. Those who received continuing treatment with the combination medication buprenorphine-naloxone were less likely to test positive for opioids and reported lower rates of opioid use compared to adolescents who participated in a short-term detoxification program with the same medication.

Adolescents tend to abuse opioids in the form of heroin or prescription pain-relief medications. Recent research suggests that more and more young people are abusing these types of drugs, and therefore treatment needs are rising as well. "The usual treatment for opioid-addicted youth is short-term detoxification and individual or group therapy in residential or outpatient settings over weeks or months. Clinicians report that relapse is high, yet many programs remain strongly committed to this approach and, except for treating withdrawal, do not use agonist medication [drugs that mimic the effect of opioids by altering the receptor]," write George Woody, M.D. (University of Pennsylvania, Philadelphia) and colleagues.

To compare outcomes of opioid-addicted adolescents who receive either short-term detoxification or long-term treatment using buprenorphine-naloxone, Dr. Woody and colleagues conducted a study with 152 patients, 15 to 21 years of age. The long-term treatment medication consists of an oral medication that relieves symptoms of opiate withdrawal (buprenorphine) and a drug that prevents or reverses the effects of injected opioids (naloxone). Patients who were randomized to receive the 12-week buprenorphine-naloxone treatment received up to 24 mg. per day for 9 weeks and smaller amounts through the twelfth week. The remaining participants (the detox group) received up to 14 mg. per day, with doses tapering off through day 14. Individual and group counseling was offered to all participants.

Wood and colleagues found that at weeks 4 and 8, the detox group had a higher percentage of opioid-positive urine test results. Specifically, after 4 weeks, 61% of participants in the detox group had opioid-positive urine test results compared to 26% of participants in the 12-week buprenorphine-naloxone group. The figures after 8 weeks were 54% positive in the detox group and 23% positive in the 12-week buprenorphine-naloxone group. By the twelfth week, the buprenorphine-naloxone group had been tapered off of their treatment and 43% tested positive for opioids compared to 51% of detox group patients.

About 21% of detox group patients and 70% of buprenorphine-naloxone patients remained in treatment by week 12. Patients in the 12-week buprenorphine-naloxone group reported, during weeks 1 through 12, less use of opioids, cocaine and marijuana, as well as less injecting and less need for additional addiction treatment. Both groups measured high levels of opioid use at follow-up.

The authors clarify that, "Taken together, these data show that stopping buprenorphine-naloxone had comparably negative effects in both groups, with effects occurring earlier and with somewhat greater severity in patients in the detox group."

"Because much opioid addiction treatment has shifted from inpatient to outpatient where buprenorphine-naloxone can be administered, having it available in primary care, family practice, and adolescent programs has the potential to expand the treatment options currently available to opioid-addicted youth and significantly improve outcomes," conclude Woody and colleagues." Other effective medications, or longer and more intensive psychosocial treatments, may have similarly positive results. Studies are needed to explore these possibilities and to assess the efficacy and safety of longer-term treatment with buprenorphine for young individuals with opioid dependence."

David A. Fiellin, M.D. (Yale University School of Medicine, New Haven, Conn.) writes in an accompanying editorial that more evidence is necessary in order to claim any treatment is effective for opioid-addicted individuals.

He concludes that: "The results of this trial should prompt clinicians to use caution when tapering buprenorphine-naloxone in adolescent patients who receive this medication. Supportive counseling; close monitoring for relapse; and, in some cases, naltrexone should be offered following buprenorphine tapers. From a research perspective, additional efforts are needed to provide a stronger evidence base from which to make recommendations for adolescents who use opioids. There is limited research on prevention of opioid experimentation and effective strategies to identify experimentation and intercede to disrupt the transition from opioid use to abuse and dependence."
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source: MediLexicon News

Women and drug addiction

2008-11-02T07:13:00.001-05:00

The most shocking thing about the modern drug user? That she could be someone like you.

Andrea Mackenzie 57, a divorced mother of three from Newquay, was first prescribed valium for back pain as a trainee teacher in 1969. She became addicted and continued to take it for almost 40 years.

When I think of the person I was before I took diazepam, or Valium as it was called back then, I don't get angry, I get upset. I was at college in London, training to teach dance and drama and I loved putting on shows. Most students around me looked forward to the holidays, but I looked forward to the start of each term.

I went to my GP because of muscle ache in my back. He prescribed some pills and in those days you didn't ask questions, you just took them. It helped with the pain and seemed to relax me. When I went for a repeat prescription no questions were asked. For year upon year the box was just ticked. They really were handed out like sweets.

Diazepam is probably one of the most addictive drugs there is and that doctor was prescribing me an illness. It gives you a numb feeling, blanks out your emotions so everything becomes sort of dull. If you've suffered a terrible bereavement it can calm you down, but if you take it all through life you sleepwalk; nothing touches you.

My overriding feeling was always, 'I can't be bothered.' I qualified as a teacher but didn't work as one because I met my husband, an engineer, young and started a family. I took those tablets three times a day, as prescribed, and my life revolved around them. I had to have 'my tablets' with me all the time just to feel safe and, if I forgot them, I'd start hysterically panicking and we'd have to go back.

It's funny – even though I built up a tolerance, I didn't ever up the dosage or abuse them because they were on prescription. My body was craving them so I had all sorts of symptoms and went through life feeling unwell with so many non-specific things. I'd feel strange and dizzy, I'd shake, sound would be magnified, lights were too bright. I basically thought I was a hypochondriac. My family used to laugh about it.

We had three children; I loved them, I lived for them, but I was removed from them. The best way to describe it is the way you feel when you have a hangover and you've kids to look after. I didn't crawl around on the floor playing dress-up or jump on a trampoline with them. I didn't participate at children's parties. They weren't neglected, though, and I don't feel guilty because it wasn't my fault. Thank goodness they're all happy, healthy adults. We've never sat down and talked about my addiction – though of course they must know.

No one ever really suggested I should stop taking Valium. After my mother died of a heart attack right in front of me, I became hysterical and the doctor just put me on a higher dose. It comforted me – but stopped me grieving. When my marriage broke down, I really wasn't that bothered. People would talk about the 'trauma of divorce', the 'stress of moving home'; I didn't feel it.

As the years passed, people became more aware of the dangers of diazepam. I read about it, realised what was happening to me – and by the time my last daughter went to university I knew it was time to come off it. It took me three years. By then I had a fantastic, supportive GP who helped me do it so, so gradually. It made me really ill – my speech was slurred, I was permanently exhausted. At one point I had to be tested for Parkinson's.

I've been totally clear for two and a half years now and I'm a different person – the person I would have been. I don't smoke or drink alcohol or caffeine and I exercise daily on my Air Walker. I'm motivated, full of energy. I spent last week with friends at Center Parcs. My daughter joined me for a day and we rode around on our bikes – something I'd never have done when she was younger.

The real difference, though, is emotional. I feel so much more. I'm affected by things. When my own children were born, yes, I was happy – but somehow nothing seemed to stick. When my first grandson was born seven months ago it was absolutely amazing. I couldn't believe how excited I was. I've so many activities planned for him. It's like my second chance.
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source: http://www.telegraph.co.uk

Third of routine drinkers get potentially fatal liver damage

2008-10-27T08:21:00.000-04:00

One third of routine drinkers sustain enough liver damage to put themselves at risk of an early death, researchers have found.

A study at University College London found an unexpectedly high level of liver abnormalities among "normal working people" who consume more alcohol than average but would not regard themselves as alcoholics.

Professor Rajiv Jalan, head of the liver failure group at University College London hospitals and one of the authors of the study, said: "These are people working in offices who we routinely encounter.

"They are representative of working people in our society and they are at risk."

The study looked at results from more than 1,000 men and women, mostly aged 36 to 55, who used home testing kits to measure liver damage.

The kits measure specific enzymes in the blood, high levels of which indicate liver abnormalities.

More than 70 per cent of those involved in the study said they regularly drank more than the government's recommended limit of 14 units of alcohol a week for women and 21 units for men, and 41 per cent of them said they drank every day.

The results showed at least 30 per cent of the people tested had liver abnormalities.

The worrying findings will be published this week in the medical journal Hepatology and come as the government considers the introduction of national screening to counter rising levels of liver disease.

Up to two million people in Britain have chronic liver disease and many are unaware of their illness.

Deaths from the disease have increased by eight times in men aged 35 to 44 and by seven times in women over the past 30 years.

Doctors warn that symptoms of liver disease are not felt until too late and by that time patients have up to a 50 per cent chance of dying early.

A Medical Research Council study found that intelligent people can be at greater risk of alcohol problems as they seek to cope with stressful jobs.
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source: http://www.telegraph.co.uk

Struggling With Alcohol? Better Quit Smoking, Too

2008-10-25T11:35:00.001-04:00

Overcoming alcoholism is tough enough. That's one reason many alcoholics who smoke continue to light up even while they're in recovery from alcohol dependency.

But new research suggests that tackling both addictions simultaneously may offer the best chance of success.

Recovering alcoholics often admit they're using nicotine as a drug, said Dr. Michael M. Miller, president of the American Society of Addiction Medicine.

"They can tell you, 'I don't want to quit [smoking], because it changes the way I feel. I use it to deal with stress,' " added Miller, who's also director of NewStart, a chemical dependency rehabilitation program at Meriter Hospital in Madison, Wis.

A study of alcoholics in treatment for their alcohol problems used brain scans to examine how performance on cognitive tests changes with abstinence from alcohol. Twenty-five alcoholics stopped drinking for six to nine months, but the 12 who smoked continued to smoke.

"We found that the smoking alcoholics over six to nine months of abstinence did not recover certain types of brain function as the non-smoking alcoholics did," said study author Dieter J. Meyerhoff, a professor of radiology at the University of California, San Francisco. Decision-making skills, thinking speed, 3-D visualization and short-term memory were affected, calling into question the prospects of long-term sobriety, he noted.

And while smoking and non-smoking alcoholics improved on several other cognitive tests, such as learning and remembering words, smokers' brain function, in general, took longer to recover.

The findings were published in the journal Alcoholism: Clinical and Experimental Research.

Studies indicate that 60 percent to 75 percent of people in alcohol-treatment programs smoke cigarettes, and 40 percent to 50 percent are "heavy" smokers, consuming more than a pack a day.

Yet treatment for tobacco dependence is not routinely included in alcohol treatment programs, Boston University researchers reported recently in the journal Alcohol Research & Health, published by the U.S. National Institute on Alcohol Abuse and Alcoholism.

"I would say that over half of chemical dependency treatment agencies now talk about nicotine, encourage patients to stop [smoking] and provide them assistance to stop, such as with nicotine-replacement therapy or prescriptions for Zyban or Champix," Miller said. "So that's a tremendous advance."

Oftentimes, though, smoking is excused. "What you don't see," Miller said, "is building nicotine into the treatment plan and considering tobacco use to be a relapse of addiction."

The concern had been that addressing both dependencies concurrently would pose "too great a difficulty for the patient" and impede recovery from alcoholism, the Boston researchers noted. But studies now suggest that quitting smoking does not derail alcohol treatment -- and may even improve the likelihood of longer-term sobriety, they said.

In fact, Miller said studies show that people in recovery for other addictions who delay smoking cessation can later relapse to their chemical dependency because of the stress of quitting smoking six to 18 months later.

"So stopping everything at once -- getting all the psychological stress out of the way at once -- is the best way to go, and also getting all the physical withdrawal syndromes out of the way at once is the best way to go," he concluded.

Meyerhoff agreed that tackling smoking as part of an alcohol treatment program is a smart tactic.

"The alcoholics have shown that they are willing to change one behavior, namely excessive drinking," he said. "If they are in that mindset, it is a great opportunity for treatment specialists to also convince them of the negative effects of continued chronic smoking."
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source: U.S.News & World Report

Survey: Alcohol abuse remains problem at UConn

2008-10-24T10:47:00.000-04:00

STORRS, Conn. --One of every four University of Connecticut students say they have blacked out from heavy drinking during Spring Weekend festivities, according to a new survey.

The review, conducted by UConn's Center for Survey Research and Analysis, also says two of every five students surveyed say they got "severely drunk" during the annual party.

Some UConn officials said they were shocked by the findings, especially since the university has stepped up enforcement and offers many alcohol-free recreation events. However, national experts and some students say they were less surprised.

The survey mirrors national trends, said Brandon Busteed, founder and chief executive officer of Outside the Classroom, a company that works with colleges to fight high-risk drinking.

"That is a very frightening statistic, but I don't think it's too far out from national statistics, which is kind of depressing," Busteed said of the 25 percent blackout figure.

The university's Department of Wellness and Alcohol and Other Drug Prevention Services commissioned the survey to gauge what students want out of Spring Weekend, and how UConn can make it safer and more memorable for them.

The festivities, which occur just before final exams, draw up to 20,000 students and their guests each spring.

Unsanctioned off-campus parties at nearby apartment complexes frequently generate dozens of arrests, assaults and ambulance trips for inebriated and injured party guests.

UConn Spring Weekend events gained national attention in 1998, when a party in an off-campus parking lot led to rioting. This year, the student newspaper's editor said she was sexually accosted at one of the parties and wrote about it on the paper's front page.

A committee examining Spring Weekend has been holding informal hearings for the past two weeks to get suggestions from police, doctors, student, apartment complex owners, Mansfield town employees and others.

The survey results come from an online questionnaire sent in March to all of the approximately 15,000 UConn undergraduates ages 18 or older on the Storrs campus.

The survey did not include the most recent Spring Weekend in April, since it was distributed about a month earlier.

A total of 2,571 students responded, with 1,709 answering the question about whether they had blacked out due to substance use during a Spring Weekend.

The survey defined "blacking out" as being conscious, but having no recollection due to substance use. It distinguished blacking out from "passing out," which was described as being unresponsive due to substance use.

Twelve percent of students reported passing out at a Spring Weekend.

"I agree that it's a shocking number," said Julie Elkins, assistant to the vice president for student affairs at UConn. "In some ways, it reminds me of folks who usually drink responsibly, and then New Year's Eve hits and they make choices they normally don't. I think Spring Weekend is their New Year's Eve."

Given the level of drinking, Student Body President Ryan McHardy said, the number of blackouts reported was right on the mark.

"Am I surprised? No, and it's unfortunate. That's the behavior I've seen in Spring Weekend," McHardy said.

"There's an expectation that's going to happen," McHardy said. "That, to me, seems to be the No. 1 issue that needs to be addressed."
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source: http://www.boston.com

Gene mutation in worms could further understanding of alcoholism in humans

2008-10-23T07:32:00.001-04:00

Scientists at the University of Liverpool have found that a genetic mutation in worms could further understanding of alcoholism in humans.

The work follows a study carried out by Oregon Health and Science University, which suggested a link between a gene mutation in mice and tolerance to alcohol. Researchers at Liverpool have investigated this in worms, looking specifically at the role the gene plays in communication between cells in the nervous system.

This gene specifies the ways in which amino acids arrange themselves into a protein called UNC-18 - or Munc18-1 in humans, an essential component of the nervous system. Researchers found that a naturally occurring change in this gene can result in a change in the nature of one of the amino acids, which then alters communication between cells in the nervous system. As a result of these changes the nervous system becomes less sensitive to the effects of alcohol, allowing the body to consume more.

Professor Bob Burgoyne, Head of the University's School of Biomedical Sciences, explains: "Alcohol consumption can affect the nervous system in a number of ways. Low concentrations of alcohol can make the body more alert, but high concentrations can also reduce its activity, resulting in motor dysfunction and a lack of coordination. Some people, however, are more susceptible to these effects than others, but it has never been fully understood why this is.

"We used the nematode worm as a model to look at the role genes play in alcohol tolerance because all of the worm's genome has been characterised and we can therefore identify its genes easily. The gene we looked at corresponds to a gene in humans that performs the same function in the nervous system. Mutations in genes can occur naturally without any known cause and will persist if they are not particularly harmful."

Dr Jeff Barclay, co-author of the research, added: "We investigated alterations in amino acids in two genetically identical worms. One carried a mutation that was exactly the same as the genetic change our American colleagues found in mice and the other carried a different change within the same gene. Both these mutations altered the way communicate occurs between cells in the nervous system. The mutations reduce the negative behavioural effects of alcohol and so more can be consumed before the body starts to react badly to it.

"Now that we have shown the link between the gene and alcohol tolerance in worms, it is possible to search the human gene to see if there are any spontaneous changes that could help identify individuals with a predisposition to alcoholism."

The research is published in Molecular Biology of the Cell.
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source: http://www.news-medical.net

Cocaine usage continues to rise, report finds

2008-10-21T17:23:00.001-04:00

One in 20 Irish people and almost one in 10 young people has taken cocaine, a major all-Ireland study of the use of the drug has established.

Men are twice as likely to use cocaine as women and regular and even daily use of the drug is increasing, according to the drug prevalence study carried out for the National Advisory Committee on Drugs (NACD).

North Dublin, where almost 16 per cent of young people reported use of the drug, emerges as the country’s cocaine blackspot, but prevalence rates are rising steeply throughout the country.

Use of the drug by 15-34-year-olds has risen five-fold in the north-eastern counties over the past five years, and more than three-fold in the midlands and the west.

The vast majority of cocaine users start taking their drug in their early twenties and the most popular means of obtaining it is from friends and family, the study finds.

One in four people said they knew someone who took cocaine, compared to 14 per cent in the last all-Ireland survey carried out in 2002/03.

The study reveals that cocaine users are taking the drug more often, with one-in-four users snorting the drug once a week and 7 per cent reporting daily use. No-one reported daily use in the earlier survey.

Overall lifetime use now stands at 5.3 per cent, up from 3 per cent in the last survey. Some 1.7 per cent of respondents reported using the drug in the previous year, up from 1.1 per cent, and 0.5 per cent said they had taken cocaine in the previous month, up from 0.3 per cent.

“While these figures are of concern, we should not lose sight of the fact that they are reasonably low and that any perception that ‘everyone is at it’ is far from the true situation,” commented Minister of State with responsibility for drugs strategy, John Curran.

The survey also shows that cocaine use varies greatly between different regions, with the highest rates recorded in the more densely populated areas in the east of the country, roughly from Louth to Cork. “The challenge is to ensure that the lower rates are kept at such levels while the problem is tackled comprehensively in the areas of higher use.

Mr Curran said the risks attached to cocaine use were often ignored or underestimated by users. “Cocaine use is linked to heart conditions, strokes and to various other physical complaints that vary depending on the route of administration of the drug. Frequent (or long-term) use of cocaine can also have a powerful effect on the user’s mental health, through depression, anxiety, agitation, compulsive behaviour and paranoia.”

He defended the efforts being made to tackle drug misuse, pointing out that the over €61 million was allocated to the area in last week’s Estimates. The Government is spending over €200 million on measures aimed directly at problem drug use, he said.

Almost 7,000 people were surveyed north and south for the study, which was carried out between October 2006 and May 2007.
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source: © 2008 irishtimes.com

12-stepping Alcoholics into the 21st century

2008-10-20T06:22:00.000-04:00

After 73 years, program continues to help addicts and loved ones

God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.

Editor’s note: Anonymity is the spiritual foundation of all of the traditions of Alcoholics Anonymous, according to the organization’s literature. For that reason, we have chosen to identify by first name only the AA members quoted in this story.

On May 16, 2004, Bob awoke at 2 a.m. in the driver’s seat of his car with a bottle of vodka in his lap. He was in the parking lot of a convenience store, but he had no idea where the store was.

“I had developed a tendency to get angry and drink and drive and be gone for a couple of days,” Bob says. “This was one of those crazy excursions. I could have been in Arkansas or Minnesota. I figured it would seem stupid to stagger into the store and ask where I was, so I drove around until I figured it out.”

He shakes his head. “Great logic.”

Luckily, he was in Conyers.

“When I got home, my heart was pounding, I was sweating and the room was spinning, like a thousand times before. But I’d scared myself so much that the fear of continuing to live like that overcame my fear and reluctance of turning my life and will over to God.”

Bob was willing to admit that he was powerless over alcohol and prayed to God to take the burden from him.

“It sounds stupid, but I felt the presence of something in the room,” he says. “I could feel it, and then it felt like an elephant had been sitting on my chest, and it got up and walked away. Something big and good had happened.”

Bob hasn’t had a drink since, and attributes his abstinence to the five Alcoholics Anonymous (AA) meetings he attends every week.

“Every time I go, I’m reminded that I’m an alcoholic and I have a problem,” he says. “But it can be overcome, and I am overcoming.”

It’s been 73 years since AA began, and the 12-step concept it fathered is more popular than ever. Twelve-step programs now treat millions around the world for everything from drug addiction, gambling and overeating to clutter, sexual compulsion and workaholism.

“Twelve-step programs are very helpful for a lot of people, especially when it comes to substance abuse issues,” says Dr. Tommie Richardson, a staff member of the Ridgeview Institute. “They are the most successful modality we know of right now. The fact that they’ve been around so long and continue to thrive tells you that.”

“It’s a brilliant program,” says Tere Tyner Canzoneri, a minister and pastoral counselor at The Emmanuel Center for Pastoral Counseling in Atlanta. “There’s not a person on the planet who couldn’t benefit from working the steps.” Robby Carroll, a minister at Shallowford Presbyterian Church and a marriage and family therapist, regularly refers clients to 12-step programs because “they’re the only programs that understand the challenge of addiction.”

Addiction has resisted the best efforts of science, medicine, psychiatry, social workers and social pressure before and since the providential meeting in 1935 of Bill Wilson, a New York stockbroker, and Dr. Bob Smith, an Akron, Ohio, surgeon.

Both were alcoholics, but Wilson used spiritual principles and the insight that alcoholism was a disease to get sober. After he persuaded Smith to follow suit, they began working with other alcoholics and started the first AA group that same year.

Favorable publicity and the publication in 1939 of Wilson’s book “Alcoholics Anonymous” anchored the program’s status and popularity.

Today AA is the largest of the 12-step programs (followed by Narcotics Anonymous and Al-Anon) with an estimated worldwide membership of 2 million. Experts, citing the difficulty of estimating anonymous fellowships, believe the numbers are much higher.

There are more than 400 groups and 1,100 AA meetings a week in the Atlanta area alone. Dr. Steven Lee, medical director of Summit Ridge Hospital and director of Addiction Services in Gwinnett County, estimates addictions affect 15 to 20 percent of the population in Gwinnett alone.

“We’re just touching the tip of the iceberg that needs treatment,” he says.

The 12 steps are a rigorous program of spirituality, self-examination and self-renewal that Smith, affectionately remembered as “Dr. Bob” by 12-steppers, summarized as “Trust God, clean house and help others.”

Trusting God doesn’t come easily, however. Many participants either don’t believe in God or blame Him for their difficulties, which is why the steps refer to “a Power greater than ourselves” and “God as we understood him.” Mention of religion during meetings is forbidden, and rigorously enforced.

Nevertheless, therapists say that some find spirituality of any stripe objectionable and don’t return. Nor do 12-step programs always work with those in the early stages of addiction.

“I see folks who have gotten into treatment after a DUI or who think it’s an aberration,” says Bob Fredrick, a clinical social worker and therapist in Atlanta. “They say ‘I just don’t connect there’ or ‘I’m not as bad as them.’ There’s a lot of denial with addiction.”

Lee says there is an organization for physicians that relies on conventional therapy and medication rather than meetings. “I disagree,” he says, “but they’re not the core of the recovery community. It’s hard for them to admit they’re powerless.”

There are other recovery groups, says Scott Maddox, an addiction counselor and executive director of Alpha Recovery in Atlanta and Brunswick, “but all the evidence shows that the 12-step approach is the most successful.”

And while individual therapy gets to core issues faster, he says, 12-step programs are superior because, “You have people who have common problems and experience with solutions to those problems. They provide a support network for ongoing recovery that therapy doesn’t provide.”

“They’re one of the few places that folks really feel understood,” AA member Frederick says. “Folks ready to deal with addictions find kindred spirits who understand that they’re dealing with a disease, and it’s not a willpower or moral issue.”

Bob says he thinks the steps are pure genius.

“When they started to take hold,” he says, “I realized it wasn’t about stopping drinking, it was really about living sober.”

The program, he says, offers a systematic formula for living life.

“It’s a toolbox,” he says, “to get me through life. Before, I had one tool, and that was a bottle opener.”

Al-Anon Helps Spouse Deal With Disease

Peggy knows how long she’s been in Al-Anon by calculating how long her husband’s been sober: 25 years.

“I’ve been in 27 years,” she says. “In the beginning I didn’t really want it, but I needed it. Then I realized I really wanted it, that it was good for me. I knew what was going on. He couldn’t con me anymore. I went to a lot of AA and Al-Anon meetings, so I was very aware of the disease.

“The alcoholic is drinking, and we’re hugging the alcoholic. We’re perfectionists, sensitive, fun and caring. It’s almost the same disease, except we’re not allergic to alcohol.”

She attends two or three Al-Anon meetings a week, and accompanies her husband to AA meetings a couple of times a month.

“It’s a miracle,” she says. “I’ve learned so much, but I don’t know it all, so I keep going. I think it’s for all people, not just those with alcohol problems. It just makes for a better life.”

‘Your Part Is The Only Thing You Have Control Over’

Karen, a single mother with a 9 1/2-year-old daughter, is a recovering alcoholic who’s been sober and attending AA meetings for 22 years. Two years ago, she began going to Al-Anon as well.

“I was dating a crack addict,” she said. “It was the most insane thing I could do. I knew I loved alcoholics; that’s the gist of it. They’re fabulous people, exciting. In Al-Anon, you learn to focus on yourself because your part is the only thing you have control over.”

Karen’s daughter attends a weekly meeting of Alateen (for children and teens affected by alcoholism in a family member) and “loves it. She’s never known me to drink, but she gets a lot of help with what she’s going through with her father.”

Karen says the meetings “taught me to apply spirituality in a way I didn’t learn in church. I have freedom to do anything I want to do, to be anything I want to be… .”

THE 12 STEPS OF ALCOHOLICS ANONYMOUS

1. We admitted we were powerless over alcohol —- that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Note: Other 12-step groups have adapted AA’s steps, sometimes changing the wording to accommodate the needs of their constituents. Al-Anon, for example, changed one word, replacing “alcoholics” in Step 12 with “others.”
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source: Atlanta Journal-Constitution

Alcohol admissions triple at central London hospital

2008-10-17T08:27:00.001-04:00

Adult alcohol-related admissions to an inner London hospital have tripled in the last four years, according to new research.

Trends in admissions were studied at the emergency departments and in medical admissions at two inner London hospitals – University College Hospital and the Whittington Hospital from 2004-8.

The total number of adult in-patient admissions at the two hospitals rose from 998 in 2004-05, to 2,690 in 2007-08. Adult attendances linked to alcohol in the emergency departments rose too - from 2,560 in 2004-05 to 3,434 in 2007-08.

Dr Andrew Smith, lead researcher, and colleagues found the figures for University College Hospital demonstrated a clear trend. This was not the case with the Whittington data.

University College Hospital is located in an area with a high concentration of pubs and nightclubs whilst the Whittington is not, which might be the reason for the increase in alcohol-related attendances at this hospital, they suggested.

Separately, they examined trends in teenage alcohol-related presentations. No increase in hospital admissions was observed, although the number of A&E attendances for under-18s rose from 98 in 2004/05 to 165 to 2007/08.

‘This increase coincides approximately with the change in the licensing laws. While under-18s might not generally be expected to be drinking in licensed premises, the law changes also affected off-licenses which may be of relevance,’ said Dr Smith.

The Licensing Act 2003 came into effect in November 2005. This change appears to have been paralleled by an increase in the presentation of alcohol-related illnesses in these two hospitals, conclude the authors.

‘A three-fold increase in the total number of adult admissions is noted at one hospital which if repeated at other centres, would have significant ramifications on NHS resources if this trend continues,’ they added.

The data were presented at the Royal College of Psychiatrists’ Faculty of General and Community Psychiatry Annual Meeting in Manchester today.

It follows last week’s calls for strong public policy measures to counter the alcohol problem in society. Dr Nick Sheron and colleagues said changes to price and availability of alcohol would work better than clinical treatments or Government initiatives to cut alcohol-related harm.

Writing in Gut, they say evidence from the WHO, the Academy of Medical Sciences and the EU, show that the best way of reducing consumption and alcohol-related harm is to tackle price.
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source: On Medica

A tough-on-crime approach to justice that actually works

2008-10-15T09:52:00.002-04:00

Instead of jailing repeat petty criminals, we should send them to mandatory addiction treatment

In a season of tough talk on crime, I propose a challenge to our political leaders. In Canada, one group of criminals commits a disproportionate number of crimes that we could easily reduce with more coercive sentencing. However, our usual form of coercion -- imprisonment -- doesn't work for them. They need a different kind of sentence. But to make that happen -- and to significantly reduce the number of crimes they commit -- would require will and wisdom that our legislators can't seem to muster.

The legal system refers to these men -- they are almost all men -- as chronic offenders. What everyone knows, but the justice system doesn't acknowledge, is that they are also drug addicts, hooked on heroin or crack cocaine. They steal not for gain but to support their addiction, to pay for their next fix.

This has nothing to do with getting high. For an addict, the point is to avoid the effects of withdrawal, which in the case of heroin can include cramps and muscle spasms, fever, cold sweats and goose bumps (hence the phase "cold turkey"), insomnia, vomiting, diarrhea and a condition called "itchy blood," which can cause compulsive scratching so severe that it leads to open sores. For addicts, drug use is not a lifestyle choice that's easy to change.

Many have been addicted for their entire adult lives, and as a result have spent half their lives behind bars, serving dozens of sentences for minor crimes. These are the "revolving door" criminals -- arrested, tried, sentenced to a few weeks or months, then dumped back out on the street, only to be arrested, tried and convicted again a few weeks later.

Canada has hundreds of criminals like that, mainly in the larger cities. Vancouver alone recently identified 379. According to a report by the Vancouver Police Department, the vast majority were addicted to drugs or alcohol. Many also suffer from a mental disorder, generally untreated. Between 2001 and 2006, Vancouver's few hundred chronic offenders, as a group, were responsible for 26,755 police contacts -- more than 5,000 contacts per year, 14 a day. The costs are staggering. Arrests, prosecutions and incarcerations end up costing some $20,000 per criminal per month -- per month! There has to be a better way.

Punishment alone is not it, though, for a couple of reasons. For one, the idea of punishing criminals is based at least partly on the concept of specific deterrence. You steal, we lock you up. Applied most strongly to property crimes -- which is what these offenders mainly commit -- specific deterrence assumes that the criminal is a rational actor who will consider: Is it worth it? And in fact, specific deterrence often works; many offenders really do stop committing crimes after fairly short jail sentences.

But not addicts.

The problem is the presumption of a rational actor. That is exactly what we do not have with drug addicts, who do not -- usually cannot -- stop to consider the likely punishment for a crime they are about to commit. They see only the escape from the more immediate and dire punishments of drug deprivation. By comparison, the threat of being caught and thrown in jail is nothing.

As well, because chronic offenders tend to commit minor crimes and draw short sentences -- say, 30 to 90 days for theft -- their lives shift constantly between jail and the streets.

We could use longer sentences to "warehouse" chronic offenders -- the American "three strikes and you're out" approach. But long-term imprisonment would be a very high-cost way to deal with what is really a public health issue.

And there's the crux of the problem.

The criminal justice system is not designed to treat addicts. While prisons do provide some drug treatment, it is almost always short-term and underfunded.

Clearly, Canadians need more protection from chronic offenders than we are now getting.

With chronic offenders, we have an issue of both criminal law and public health. Addicted offenders must be required to undergo serious, long-term drug treatment.

Since 1996, Alberta law has required minors with an apparent alcohol or drug addiction to participate, with or without their consent, in an assessment and treatment program. Saskatchewan and Manitoba have similar legislation and even allow parents of drug-addicted children to ask a court to require treatment, whether or not the child is in trouble with the law.

Although the research is scant, mandatory treatment does appear to have about the same success rate as voluntary treatment. A 1970s American study looked at the effectiveness of methadone maintenance treatment for those who entered the program under high, moderate or no coercion and found no significant difference in outcomes for the three groups.

Given the costs of incarceration -- not counting the costs to future victims -- paying for mandatory drug treatment for them hardly seems an issue, even if it only works some of the time. As for whether mandatory treatment is somehow inhumane, how humane is it to sentence these addicts to punishments we know don't work and then dump them back on the street no better than before?

Politics aside, Canadians deserve evidence-based criminal justice policies that actually reduce crime. Our challenge is to make the tough choices that move beyond "tough on crime" rhetoric and produce real change.
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source: James C. Morton and The Ottawa Citizen

The Big Question: Why is opium production rising in Afghanistan, and can it be stopped?

2008-10-14T07:09:00.002-04:00

Why are we asking this now?

Nato and the US are ramping up the war on drugs in Afghanistan. American ground forces are set to help guard poppy eradication teams for the first time later this year, while Nato's defence ministers agreed to let their 50,000-strong force target heroin laboratories and smuggling networks.

Until now, going after drug lords and their labs was down to a small and secretive band of Afghan commandos, known as Taskforce 333, and their mentors from Britain's Special Boat Service. Eradicating poppy fields was the job of specially trained, but poorly resourced, police left to protect themselves from angry farmers. All that is set to change.

How big is the problem?

Afghanistan is by far and away the world's leading producer of opium. Opium is made from poppies, and it is used to make heroin. Heroin from Afghanistan is smuggled through Pakistan, Russia, iran and Turkey until it ends up on Europe's streets.

In 2008, in Afghanistan, 157,000 hectares (610 square miles) were given over to growing poppies and they produced 7,700 tonnes of opium. Production has soared to such an extent in recent years that supply is outstripping demand. Global demand is only about 4,000 tonnes of opium per year, which has meant the price of opium has dropped. In Helmand alone, where most of Britain's 8,000 troops are based, 103,000 hectares were devoted to poppy crops. If the province was a country, it would be the world's biggest opium producer.

In 2007, the UN calculated that Afghan opium farmers made about $1bn from their poppy harvests. The total export value was $4bn – or 53 per cent of Afghanistan's GDP.

Is it getting better or worse?

There was a 19 per cent drop in cultivation from 2007 to 2008, but bumper yields meant opium production only fell by 6 per cent. Crucially, the drop was down to farmers deciding not to plant poppies, and that was largely a result of a successful pre-planting campaign, led by strong provincial governors, in parts of the country that are relatively safe.

Only 3.5 per cent of the country's poppy fields were eradicated in 2008. High wheat prices and low opium prices are also a factor in persuading some farmers to switch to licit crops.

In Helmand, one of the most volatile parts of Afghanistan, production rose by 1 per cent as farmers invested opium profits in reclaiming tracts of desert with expensive irrigation schemes. Opium production was actually at its lowest in 2001. The Taliban launched a highly effective counter-narcotics campaign during their last year in power. They used a policy of summary execution to scare farmers into not planting opium. Many analysts attribute their loss of popular support in the south, which contributed to their defeat by US-led forces in late 2001, to this policy.

How are the drugs linked to the insurgency?

The Taliban control huge swaths of Afghanistan's countryside, where most of the poppies are grown. They tax the farmers 10 per cent of the farm gate value of their crops. Antonio Maria Costa, head of the UN Office on Drugs and Crime, said the Taliban made about £50m from opium in 2007.

They also extort protection money from the drugs smugglers, for guarding convoys and laboratories where opium is processed into heroin. The UN and Nato believe the insurgents get roughly 60 per cent of their annual income from drugs. The Taliban and the drug smugglers also share a vested interest in undermining President Hamid Karzai's government, and fighting the international forces, which have both vowed to try and wipe out the opium trade.

What about corruption?

The vast sums of drugs money sloshing around Afghanistan's economy mean it is all too easy for the opium barons to buy off corrupt officials.

Most policemen earn about £80 a month. A heroin mule can earn £100 a day carrying drugs out of Afghanistan. Most Afghans suspect the corruption reaches the highest levels of government. President Karzai is reported to have called eradication teams to halt operations at the last minute for no apparent reason.

When an Afghan counter-narcotics chief found nine tonnes of opium in a former Helmand governor's compound, he was told not burn it by Kabul – but he claims he ignored the order.

President Karzai's brother, Ahmed Wali Karzai, is widely rumoured to be involved in the drugs trade – an allegation he denies. The New York Times claimed US investigators found evidence that he had ordered a local security official to release an "enormous cache of heroin" discovered in a tractor trailer in 2004. Privately, Western security officials admit they suspect that a number of government ministers are drug dealers.

Where does that leave the international community?

Right across Afghanistan, the government is corrupt and Afghans are fed up. The police organise kidnappings. Justice is for sale. Violence is spreading and people don't feel safe. The progress promised in 2001 hasn't been delivered.

Education is a rare success. There are now more than six million children at school, including two million girls, compared with less than a million under the Taliban.

But the roads which link the country's main cities aren't safe. Taliban roadblocks are increasingly normal. UN convoys are getting hijacked.

A report published by 100 charities at the end of July warned violence has hit record highs, fighting is spreading into parts of the country once thought safe, and there have been an unprecedented number of civilian casualties this year.

General David McKiernan, the US commander of almost all the international forces in Afghanistan, insited to journalists at a press conference on Sunday that Nato isn't losing. The fact he had to say it suggest public perception is otherwise. He also said that everywhere he goes, everyone he speaks to is "uniformly positive" about the future. Those people must be cherry-picked.

Crime in the capital, Kabul, is rising. The Taliban broke 400 insurgents out of Kandahar jail this summer, and they attacked the provincial capital in Helmand last weekend. People are frustrated at the international community's failures and scared that the Taliban are coming back.

What does that mean for the future?

President Karzai has touted peace talks with the Taliban through Saudi intermediaries. The international community maintains it will support the Afghan government in any negotiations, but privately diplomats admit that if they opened talks tomorrow they would not start from a "perceived position of strength".

General David Petraeus is about to take command at CentCom, which includes Afghanistan, and he is expected to focus on churning out more Afghan soldiers and engaging tribes against the insurgents.

Meanwhile, in Pakistan, it remains to be seen whether Asif Ali Zardari will rein in his intelligence service and crack down on the Taliban safe havens in the Pakistani tribal areas, which they rely on to launch attacks in Afghanistan.

There are also elections on the horizon. The international community is determined that they must go ahead, despite the obvious security challenges, and anything the Afghan candidates do should be seen in the context of securing people who can deliver votes.

Does the war on drugs undermine the war on terror?

Yes

*Working to eradicate poppies will remove farmers' best source of income and turn them against Nato

*Using resources to fight against the entrenched poppy trade diverts them from the war with the Taliban

*Corruption in government means that battling opium turns the mechanism of the state against our forces

No

*In the end, an Afghanistan without opium production will be much less prone to the influence of the Taliban

*Money from the international drugs trade may find its way to terrorists outside of Afghanistan

*Removing the source of corruption will strengthen the country's institutions in the long term
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source: http://www.independent.co.uk

Alcohol-related arrests up at IU Southeast

2008-10-13T10:26:00.000-04:00

The Indiana University Southeast Campus Police Department is now dealing with a problem many campuses have had for years — alcohol offenses.

For the first time, IUS offers on-campus housing for students this year. With residents comes more students trying to test the limits.

Less than two months since the residence halls opened, campus police have already made nine alcohol-related arrests. Several others have been cited or given referrals. By comparison, IUS reported only two on-campus alcohol violations and six referrals from 2004 until 2006. The 2007 crime reports will be released next month.

“This is something we’ve never really had to deal with before,” said Dennis Simon, campus chief of police. “We’ve had very few arrests in the past.”

In fact, the police department is in the process of changing its crime reporting system so that an arrest log will be available in the campus police office. In the past, there were so few arrests they never had to worry about that.

So far, two arrests were made and three citation issued for minor consumption. There have been four operating while intoxicated arrests, two disorderly conduct arrests and one possession of marijuana arrest.

Simon believes the number of alcohol violations will continue to drop as students realize campus police and school administrators will not tolerate alcohol on campus.

“Problems have decreased significantly after the first two weeks,” he said. “We indicated to people that you can’t get away with breaking the rules.”

Most of the problems have involved non-students visiting students on campus, Simon said. Six out of nine people arrested were not students.

The university prohibits alcohol, tobacco and weapons on campus. The only exception is when alcohol is allowed at certain events approved by the chancellor.

Simon met with Floyd County Prosecutor Keith Henderson earlier this year, and both agreed to let the school handle minor offenses like alcohol consumption. In those situations, campus police will issue referrals and Student Affairs decides the discipline. The range of penalties include probation and suspension or even removal from campus housing for repeat offenders.

“We want students to have a good college experience,” Simon said.

Simon also thanked the Community Advisors, students who are selected to monitor residence halls, saying they had been “vigilant.”
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source: News and Tribune

Don’t wait for cops to detect alcohol abuse

2008-10-11T07:46:00.001-04:00

Rightful outrage over dangerous drunken drivers has fueled new demands for tougher laws and penalties.

And who can argue?

But with Wisconsin on top of most lists for binge drinking or drunken driving, you know there are many more folks out there who are risks but have yet to become a statistic or headline.

So let’s not overlook another, better way to get at the nub of the problem.

A pilot prevention program, if broadened as many respected medical associations say it should be, would screen many more people for problem drinking or drug use before it’s too late. It would intervene with information and, where needed, treatment, before these problem drinkers end up in highway carnage or handcuffs.

It would start at the doctor's office.

One of my doctors requires me to complete an annual survey that asks, among other things, about alcohol or drug consumption. The trouble is, most doctors don't have time to talk about it. They can barely deal with your high blood pressure or arthritis or other painful ailment as it is.

Waukesha's Family Practice Center is one of 20 clinics participating in the promising prevention effort through the Wisconsin Initiative to Promote Healthy Lifestyles, financed with a $12 million, five-year federal grant. (See www.wiphl.comfor information.)

Betzaida Silva-Rydz is the specially trained health educator at the Waukesha clinic. She describes a woman who came to the clinic for medical issues and, like others, completed four screening questions - like when was the last time she had four drinks in one sitting.

After she was provided information, without judgment, the woman recognized that both she and her husband had a problem in ways they hadn't considered, affecting their health, their family, their finances.

Through a few more sessions, the couple saw their way to changes that put more effort into family and less into social drinking.

It's the kind of story repeated last week at a meeting of health care professionals where early screening and intervention were hailed by the likes of Milwaukee Commissioner of Health Bevan Baker and Milwaukee County District Attorney John Chisholm.

Baker, quoting his wife, said it's not just taking the bull by the horns - which can leave you gored - it's removing the horns.

The National Institute on Alcohol Abuse and Alcoholism says one in four Wisconsinites is a problem drinker or drug user, but only 10% to 20% of them get help. The state estimates the consequences cost $5 billion a year in health care, social services and criminal justice. One brief screening and intervention saves $1,000, a state study reports.

The National Commission on Prevention Priorities, which tries to identify the biggest bang for the buck in public health spending, has an eye-opening ranking of how to best make us healthier:

First, men older than 40 and women older than 50 should take a daily aspirin for cardiovascular health. Second, children should be immunized. Third, help people quit smoking.

And fourth? Have routine alcohol screening and intervention. It's ahead of cholesterol screening, blood pressure screening. even cancer screenings.

It's that important. So more clinics should get involved. More insurance plans should cover it. And more people desperate to do something about drunken drivers should demand it.
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source: Milwaukee Journal Sentinel

Doctors can't treat your drinking problem

2008-10-07T04:41:00.001-04:00

The rise in alcohol abuse should be a matter for social policy not the GP's surgery

‘Your GP is the first place to turn if you are concerned about your drinking.’ This was the concluding advice of a recent eight-page Guardian supplement devoted to ‘Britain’s harmful relationship with alcohol’. Once regarded as a manifestation of moral turpitude, excessive drinking is now defined as a medical condition. GPs have taken the place of evangelical ministers at the head of the modern temperance crusade. The fact that these same doctors come second only to publicans in terms of death from alcohol-induced cirrhosis of the liver has not diminished medical authority in this area.

The rise of GPs in dealing with alcohol problems is based on claims for the effectiveness of ‘brief interventions’. This means doctors giving patients a quick, but empathetic, lecture on the adverse health consequences of alcohol before advising them to stop. But close scrutiny of these studies reveals that their high success rates are achieved at a cost. They exclude patients who are alcohol dependent (including only those deemed to have ‘hazardous’ levels of drinking). They follow up for a short period (usually less than 12 months). And they define success in terms of a reduction in total consumption or episodes of binge drinking (rather than achieving abstinence).

If doctors suggest to patients drinking over the odds that they should consider cutting back, they do, for a while, before resuming their old habits. A desperate resort to old-fashioned medical paternalism? – yes. A solution to ‘Britain's harmful relationship with alcohol’? – no.

Prominent doctors and medical organisations instinctively recognise the ineffectiveness of medical intervention – and indeed of medical treatment. They have campaigned for prohibitionist measures to deal with excessive drinking. No newspaper or television feature on alcohol is now complete without a leading liver specialist, psychiatrist or GP demanding more regulations on the sale of alcohol. They call for banning advertising, raising prices and for tougher policing of licensing laws. But if doctors cannot treat alcoholism in their surgeries, why should anybody accept their proposals in the sphere of social policy? After all, they have no expertise there whatsoever.

The notion that doctors can treat the nation’s alcohol problem is a delusion that is convenient for the medical profession and for politicians eager to respond to the latest moral panic. But it marks an evasion of the real issues. Self-destructive patterns of alcohol consumption express personal and social demoralisation. This is not susceptible to medical – or political – quick-fixes.
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source: The Times

Stress of Ike recovery also strains recovery of addicts

2008-10-06T06:46:00.001-04:00

Houstonians are still confronting the lingering effects of Hurricane Ike: damaged homes, piles of debris, lost work and ends that won't meet. But for recovering alcoholics and addicts, coping with post-Ike realities may also mean reaching out to sobriety buddies instead of the bottle or drugs.

Stress is the greatest threat to people fighting addictions, Houston experts say, and Ike's toll could trigger relapses.

"What underlies addiction and substance abuse is fear, anxiety and stress. People drink and use because it medicates their anxiety," said Dr. Scott Basinger, a neuroscientist and associate dean at Baylor College of Medicine. "Don't get too hungry, too angry, too lonely or too tired, because being hungry, angry, lonely or tired are well-known risk factors for relapse."

The risk is heightened during a disaster, when loss of power, phone service and transportation cuts contact with counselors. Afterward, assessments of the damage, joblessness and other factors could create a perfect storm for recovering addicts to slip.

"A lot of times, these things have a delayed effect," said Joy Schmitz, a psychologist at the University of Texas Health Science Center at Houston who studies behavior and substance abuse. "It could be a challenging time for patients who are trying to maintain abstinence, especially if they recently quit."

Many people did reach out for help in Ike's aftermath.

Calls flooded area treatment centers, and some support groups held meetings by candlelight just hours after Ike passed. The Sunday after the storm, for instance, people showed up for substance abuse meetings at Memorial Hermann's Prevention and Recovery Center.

"I think people seek out the fellowship, they seek out each other to have someone to lean on, to talk to and to support," said center CEO Matt Feehery. "People who have a solid recovery network will do just fine. Isolation is an enemy if you've lost something — property, power, a loved one."

Heather, who agreed to speak on the condition that her last name not be used, admitted that Ike tested her newfound sobriety. She had voluntarily gone to treatment, she said, to overcome alcohol and cocaine abuse.

But on the evening that Ike made landfall, she found herself with an unopened beer in her hand at a hurricane party. She reached in her pocket to feel for her silver coin — a recovery reminder handed out at Alcoholics Anonymous meetings.

"I surprised myself by not drinking," the former bartender said.

"I thought underneath those stressful situations I would relapse, but I didn't," said Heather, who resumed treatment at a Houston center after the storm.

Because of the chance of relapse under stressful post-storm conditions, the Texas Department of State Health Services has required state-funded substance abuse treatment services to track clients impacted by hurricanes Katrina, Rita, Gustav and Ike.

"This information can help service providers offer better screening, assessment and referral services as they will have an idea of what environmental factors, such as being a disaster survivor, may have contributed to the change in behavior," agency spokeswoman Emily Palmer wrote in an e-mail.

Substance abuse counselors are concerned that Ike will continue to spin off stress, leading people deeper into addictions.

"They go through something like this, and they start to self-medicate, and the problem starts to escalate," said Dr. Jason Powers, chief medical officer at The Right Step, a Houston treatment center.
_____
source: http://www.chron.com

Understanding Addictions

2008-09-22T11:34:00.001-04:00

CAMDEN (Sep 22): “Understanding Addictions” will be the subject of a free evening program open to anyone in the Midcoast area and presented by the First Congregational Church, Camden, from 7 p.m. to 9 p.m. on Thursday, September 25.

“’Understanding Addictions” is intended both for people who may be suffering from an addiction and for individuals who would like to be more helpful to a family member or a friend who is struggling with addiction,” said program leader, Mary Ellen Ostherr who works as a substance abuse therapist for Mid-Coast Mental Health and also has a private practice. She has worked in the field helping individuals and families with substance abuse and recovery for 15 years.

“Part of the program will be about how to understand the signs of addiction and what you can do about it as a friend or family member. The program will also cover how to recognize enabling behaviors and what to do to help stop those behaviors that can contribute to someone’s addiction,” she said. “An important part of the program will cover how we can reach out and help others.”

Denial—how to recognize it and how to deal with it as a friend or family member will also be covered, Ostherr said.

Maine currently leads the nation in per capita addiction to opiates and the state is number two in alcohol addiction. Factors that make the problem worse for the people of Maine, she said, include the long winters, the ready availability of drugs and alcohol, and the high risk nature of some jobs in Maine.

It is easy to get hurt and take prescription drugs as part of the rehabilitation, she said. Good people can find that weeks later they may develop an addiction. Another factor is the Internet. There are now websites that make it all too easy to get prescription medications. Some of these websites have doctors standing by who will write the prescription.

“Understanding Addictions” is offered through the “Live and Learn” series of free seminars and workshops presented for residents of the Midcoast area by the First Congregational Church, Camden.

“Understanding Addictions” will be held in the Mayflower Room of the church at 55 Elm Street in Camden. Participants should park in the Church parking lot behind the Church and enter through the door on the parking lot side. The Church is handicapped accessible.
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source: http://waldo.villagesoup.com/

Younger drinkers risk ruining their lives

2008-09-21T07:44:00.001-04:00

As a college president, I have many reasons to be concerned about the consumption of alcohol by my students. Perhaps the most clear-cut reasons are legal. Students who consume alcohol under the age of 21 are breaking state law. Furthermore, even those who are of legal drinking age might cause civil liability to accrue to the college if they drink to excess and cause harm to themselves or others.

However, the most important issues surrounding excessive and underage student drinking are, for me and my fellow presidents, not legal. Of much greater concern are the potential adverse consequences to the students themselves. Nationally almost 2,000 college students between the ages of 18 and 24 die each year from unintentional injuries in which alcohol was a factor. Additional hundreds of thousands of students are injured; many of them seriously. These deaths and injuries are avoidable.

Every empirical study I have seen in 25 years of studying the issue in Canada and the United States confirms that there is a direct relationship between the legal drinking age and the incidence of alcohol-related death and injury. For that reason, I would not support any reduction in the legal drinking age. This was one of the alternatives posited by the Amethyst Initiative as a way of combating underage and binge drinking. It is unfortunate that the drinking age has attracted the most attention, especially since it seems doubtful that lowering the drinking age would lead to any appreciable amelioration of the most serious consequences.

In the first place, patterns of high-risk drinking behavior are already typically well-established before students arrive at college. Findings from the Harvard School of Public Health College Alcohol Study, published in the Journal of American College Health (Volume 50, No.5, 223-236), state that in 2001, 43.6 percent of underage college students were classified as binge drinkers, meaning consumption of at least five drinks in a row for men or four drinks in a row for women during the two weeks before completion of the study questionnaire. The vast majority of these began drinking in high school and, increasingly, underage drinking and binge drinking are regularly occurring as low as the eighth grade or earlier.

The National Institute on Alcohol Abuse has found that the reported first use of alcohol went from age 17 1/2 in 1965 to 14 in 2003. Research further shows that the earlier students begin consuming alcohol, the more likely they will engage in behavior harmful to themselves and others.

Clearly this problem is as wide-ranging as the adverse consequences it brings about. Unsafe sexual practices, sexual abuse, health problems, drunk driving, property damage, vandalism, assault and alcohol dependence can all be added to the list.

And then there is the often less visible but very real matter of academic consequences. In the 1980s I reviewed thousands of files from students applying to Canadian law schools. Hundreds of those revealed a similar pattern: poor grades in the freshman year, a modest GPA increase in the sophomore year and then substantial improvement in the junior and senior years. Usually no explanation would be given for this other than a vague reference to "problems of adjustment."

Requests for a more detailed explanation typically yielded a rueful account of how the first year and a half of college were spent in a beery fog before reality intervened. Sadly too late for those whose grades, averaged over four years, were uncompetitive for law school or graduate school and who had to lower their expectations as a result. What a waste of human capital, individually sad but cumulatively tragic.

How do we as a society deal with this? Senate President Richard Codey has asked New Jersey's colleges to provide details of their alcohol policies. It is a fair request and one to which we should be glad to respond given the extensive policy frameworks, policing regimens, educational programs and health intervention measures we have developed. More importantly, it holds out the opportunity to frame the discussion properly.

Why are so many — but by no means all — college students acculturated to abusing alcohol? It can't just be about "adjustment" and new-found freedom since many of our students are sophisticated and experienced in ways that previous generations were not. We also need to go further and ask why alcohol abuse has been matched by a similar abuse of prescription pain relievers, tranquilizers, stimulants and sedatives. And why are these drugs so accessible?

I and my fellow presidents look forward to making progress in answering these questions.
___________
Dr. Peter P. Mercer is president of Ramapo College of New Jersey.
______
source: My Central Jersey, http://www.mycentraljersey.com

Drug addicts shun mobile needle exchange

2008-09-19T07:19:00.001-04:00

Far fewer needles handed out and returned since fixed-site exchange was closed

Victoria's mobile needle exchange is handing out far fewer needles to addicts than its fixed-site predecessor, statistics released yesterday show.

The experiences of Peter, who has used both services, might explain why.

Before the Cormorant Street needle exchange closed on May 31, Peter picked up a supply of clean needles every day.

"I had my routine of going down there," the 32-year-old cocaine and heroin addict, who declined to give his last name, said last night as he sat on the grass outside the Our Place shelter on Pandora Avenue. "Now I have to chase the mobile exchange all over the streets in a 10-block radius and I miss them sometimes and I end up going without clean needles."

Needle exchanges are promoted as a service that reduces the spread of disease among addicts by providing them with clean syringes to inject their drugs. But critics have also suggested that exchanges encourage illicit drug use.

A report released yesterday shows the number of needles supplied by the mobile exchange is down 23 per cent, from about 35,000 a month at the fixed site to 27,000 in August from the mobile unit.

Needles returned amount to just 40 per cent of those going out, a sharp drop from the 70 per cent return rate at the Cormorant Street exchange.

The figures were released by the Vancouver Island Health Authority and AIDS Vancouver Island in a summary of the first three months of the mobile service.

The Cormorant Street needle exchange closed after neighbours complained about illegal drug activity. The mobile service is supposed to be a stop-gap measure until a new permanent site can be located.

A decrease in needles coming back could indicate a number of things, said Katrina Jensen, executive director for AIDS Vancouver Island. "There are a number of factors, one is that they're disposing of them in other ways, like putting them in the garbage," said Jensen. Another possibility is that clients are keeping them and haven't used them yet, she said.

"Some clients may be taking extra syringes to keep them going for several months, and that's why we're not seeing those ones come back. It could also be that clients are using their own syringes and refusing ours."

There haven't been reports of a spike in the number of syringes discarded on the streets, said Jensen.

Aside from the syringes, clients aren't taking part in counselling services to the extent they did at the permanent site. There is no privacy and those working on the mobile service don't have the time, said Jensen.

"Due to the public nature of the mobile service a lot of clients aren't comfortable engaging in long conversations with workers. They just want to get their stuff and be gone."

Concern is mounting over how the mobile service will fare when cooler weather sends illicit drug users indoors, Jensen said.

Victoria Coun. Charlayne Thornton-Joe is concerned by the decrease in the number of needles exchanged by the mobile service.

"It concerns me that a major city does not have a fixed site," Thornton-Joe said. "It's a loss. I've always been an advocate for a fixed site which offers support and services."

Thornton-Joe has discussed the issue at meetings with the Downtown Service Providers and the clean and safe committee of the Downtown Victoria Business Association.

Thornton-Joe would like to see statistics from other local groups who hand out or take back needles. Some groups take in needles, but don't give them out, she explained.

The councillor would also like to see statistics on addicts' increased use of crack pipes, instead of needles.

"I'm hearing from street nurses that people are re-using needles and health issues are going to increase because of that," said Thornton-Joe.

Back on the grass outside Our Place, Peter pulled up his pant leg to show an abscess on his leg that became infected two weeks ago after he injected drugs with a dirty needle. The abscess required surgery at Royal Jubilee Hospital. But because he only runs into the mobile exchange service about every three days, Peter said he continues to put his health at risk.

"An hour ago, I had to use a dirty needle to suck dope out of a spoon and transfer it into another dirty needle and put it in my arm," he said.

Then by chance, five minutes before speaking to the Times Colonist, Peter ran into the mobile needle exchange and took a handful of syringes.

"Here's a lost soul looking for one right now," he said, handing a syringe to a young girl who sat down beside him. "If I don't give her one, she'll find one in the sewers."
__________
source: © Times Colonist (Victoria) 2008

Drinkers fall into 'nine groups'

2008-09-18T07:06:00.001-04:00

The government believes it has identified nine types of heavy drinker as it launches a new alcohol campaign.

Research by the Department of Health in England with focus groups found heavy drinkers often fell into one of a number of categories.

These ranged from de-stress and depressed drinkers to people who boozed because of boredom or to bond.

Experts said helping people to understand the reasons for their drinking habits was "very useful".

The nine types of heavy drinker

The research showed that those drinking heavily - defined as consuming 35 units a week for women, 50 for men, which is twice the recommended limit - did so for a variety of reasons.

For example, de-stress drinkers were defined as people in pressured jobs who used alcohol to relax.

Whereas it said bonding drinkers could be anyone in society who had hectic social lives and lost track of their drinking.

The research was done to inform a new drive by ministers to crack down on heavy drinkers.

A pilot is being run in the north west of England over the coming months to specifically target heavy drinkers.

Over 900,000 households will receive leaflets through the post highlighting the link between drinking and conditions such as cancer and liver disease.

The campaign is focusing on adults aged over 35 who fall into the nine drinking categories.

Risk

Along with the information about disease risk, people will be given details about where they can go to get help.

This will include a website where they can calculate their own individual risk from drinking and get access to a self-help manual. A telephone helpline will also be set up.

The government hopes the tailored approach will help 4,000 people in the region to reduce their drinking within a year.

If it is successful, officials hope to roll it out to other parts of England.

Public health minister Dawn Primarolo admitted these heavy drinkers were a "tough one to crack".

But she added: "This is a totally fresh approach to helping people understand the effects of their drinking habits and help them make changes for the better."

Alcohol Concern chief executive Don Shenker said: "This type of marketing is very useful.

"In order to get people to examine their drinking they need to become aware of why they are doing it and what motivates them."

The Nine Types of Drinker

Name Characteristics Key motivations

Depressed drinker | Life in a state of crisis eg recently bereaved, divorced or in financial crisis | Alcohol is a comforter and a form of self-medication used to help them cope

De-stress drinker | Pressurised job or stressful home life leads to feelings of being out of control and burdened with responsibility | Alcohol is used to relax, unwind and calm down and to gain a sense of control when switching between work and personal life. Partners often support or reinforce behaviour by preparing drinks for them

Re-bonding drinker | Relevant to those with a very busy social calendar | Alcohol is the ‘shared connector' that unifies and gets them on the same level. They often forget the time and the amount they are consuming

Conformist drinker | Traditional guys who believe that going to the pub every night is ‘what men do' | Justify it as ‘me time'. The pub is their second home and they feel a strong sense of belonging and acceptance within this environment

Community drinker | Drink in fairly large social friendship groups | The sense of community forged through the pub-group. Drinking provides a sense of safety and security and gives their lives meaning. It also acts a social network

Boredom drinker | Typically single mums or recent divorcees with restricted social life | Drinking is company, making up for an absence of people. Drinking marks the end of the day, perhaps following the completion of chores

Macho drinker | Often feeling under-valued, disempowered and frustrated in important areas of their life | Have actively cultivated a strong ‘alpha male' that revolves around their drinking ‘prowess'. Drinking is driven by a constant need to assert their masculinity and status to themselves and others

Hedonistic drinker | Single, divorced and/or with grown up children | Drinking excessively is a way of visibly expressing their independence, freedom and ‘youthfulness' to themselves. Alcohol used to release inhibitions

Border dependents | Men who effectively live in the pub which, for them, is very much a home from home | A combination of motives, including boredom, the need to conform, and a general sense of malaise in their lives
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source: BBC News

Study finds mom's beliefs may impact their kids' alcohol use

2008-09-17T09:23:00.001-04:00

Mothers, take note. If you really want to curb your teens' chances of using alcohol, help them develop a self-view that doesn't include drinking. According to a new Iowa State University study, the power of positive thinking by moms may limit their children's alcohol use. But beware. The opposite is also true.

"When mothers overestimated their teens' future use of alcohol, the teens developed the self-view that they were likely to drink alcohol in the future, which ultimately led them to drink more," said Stephanie Madon, an ISU associate professor of psychology and lead author of the study.

Madon collaborated on the study with ISU graduate students Ashley Buller, Kyle Scherr and Jennifer Willard; Max Guyll, an assistant professor of psychology; and Richard Spoth, director of the Partnerships in Prevention Science Institute at Iowa State. They analyzed data obtained from a series of interviews with nearly 800 Iowa mothers and their children over three to five years.

Their paper, "The Mediation of Mothers' Self-Fulfilling Effects on Their Children's Alcohol Use: Self-Verification, Informational Conformity, and Modeling Processes," was recently published in the Journal of Personality and Social Psychology, a professional journal of the American Psychological Association.

Previous research found self-fulfilling prophecy

The team's previous research had found a link between a mother's belief about her child's likelihood of using alcohol and her child's actual use in junior high school and high school.

"We previously found that mothers' beliefs about their teen's future use of alcohol were about 50 percent correct and 50 percent incorrect, and that the incorrect portion of mothers' beliefs created a self-fulfilling prophecy -- teens behaved like their mothers had incorrectly expected them to," Madon said.

Their latest study builds upon those results.

"What we were trying to do in this paper was understand the mechanisms involved in the self-fulfilling prophecy process," Madon said. "We know that mothers have self-fulfilling effects on their kids' alcohol use through the past work that we've done. What we wanted to do here was understand 'How is that happening? What are the mechanisms that are creating that?'

"We derived our hypothesis from three large, well-known theories in the social/psychological literature -- self-verification theory, research on conformity and social learning theory as it pertains to modeling processes," she said.

According to Madon, self-verification theory proposes that people are motivated to confirm what they already believe to be true about themselves. The study found strong evidence that a mother's beliefs regarding her child's likelihood of using alcohol altered her child's self-view in either a positive or negative direction. The child then validated that new self-view by acting consistently with it later on.

"What people believe ultimately has an impact on what actually occurs," Madon said. "But it's not just because they believe it. It's not magic. When we believe something -- even if we're wrong -- when we believe it's true, we act as though it is. And sometimes when you act as though something's true, your behaviors will cause the belief to become true.

"So I think the moral here is to help children develop positive and pro-social self-concepts about themselves, because children are likely to make choices that match how they view themselves," she said.

Kids model their friends' drinking behavior

The study also found some evidence that modeling -- a tendency for people to learn by watching others -- may alter a child's alcohol use. Madon says they had a little bit of support for modeling as it related to friends' alcohol use.

"We hypothesized that mothers may influence who their children are friends with and that children may learn how to behave by watching what their friends do," she said.

But there was no evidence that children conformed their own belief to their mothers' on how acceptable it was for adolescents, in general, to use alcohol.

"How acceptable children thought it was for adolescents to drink alcohol was explained by their own self-views, not by their mothers' beliefs about them. And that's not surprising given that what you think about yourself is going to be strongly tied to what you think is acceptable behavior," Madon said.

She says that it's still a good idea for mothers to instill in their children the belief that adolescent alcohol use is unacceptable, since the study did show a direct effect of teens' perceptions regarding the acceptability of alcohol use on their own drinking.

"The more acceptable teens believed adolescent alcohol use was, the more alcohol they tended to drink themselves," Madon said.
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source: Iowa State University

Feeling thirsty or dying for drink?

2008-09-16T06:37:00.001-04:00

It is Northern Ireland's drug of choice, but our relationship with alcohol can be problematic.

BBC presenter William Crawley has taken a look at the unique drink culture in the television documentary Dying For A Drink.

Made by Doubleband Films, director and producer Brian Henry Martin outlines the challenge set to the presenter.

As an experienced documentary filmmaker for Doubleband Films, I have made films over the past few years on many big and powerful subjects, everything from the Normandy landings on D-Day to the Heysel stadium disaster.

But no subject has daunted me more than what I faced in Dying for a Drink, this society's strange and obsessive relationship with alcohol.

Firstly, the question was where to begin?

From the outside, alcohol is this society's drug of choice, it lubricates every part of our lives. And then secondly, where to stop with such a huge subject?

Ultimately, the answer for our documentary Dying For A Drink lay in the approach.

We wanted to take the issue of this society's relationship with alcohol out of the daily news, out of the tabloid headlines and take a more measured approach. But is our drinking already out of control?

The use and abuse of alcohol is a rapidly growing problem in Northern Ireland.

We have doubled the amount of alcohol we drink in 20 years, the number of alcohol related deaths has also doubled in the same period and we have cut the price of alcohol, so that it is now cheaper in some cases than water.

In this timely, authored documentary, William Crawley sets out on a personal journey to explore our curious and frequently unhealthy relationship with alcohol and to consider the impact that it has on us all - as individuals and as a society.

William meets people from all sides of the alcohol debate, who talk frankly about how alcohol has affected their lives.

These are ordinary people with extraordinary attitudes towards drink; people like young teenage pioneers taking the pledge never to drink alcohol for the rest of their lives; people like the chronic alcoholics of a wet hostel whose drastic drinking habits reveal a lifetime's addiction and people like the sophisticated drinkers at a social wine tasting who drink alcohol not for the affect but for the taste.

Along with leading medical experts in Northern Ireland like Dr Neil McDougall, Consultant Hepatologist at the Royal Victoria Hospital, Dr Cathal Cassidy from the Royal College of Psychiatrists and Professor Mahen Varma, Consultant Cardiologist, at the Erne Hospital, these range of people with very different experiences and opinions provide the film with a revealing perspective on our relationship with alcohol.

It was important for me as a filmmaker, to set William a personal challenge over the course of the film.

His challenge was to abstain from alcohol for one month; five completely dry weeks.

We wanted to see what happens when someone in our society completely removes alcohol from their lives. The challenge proved to be more difficult and life changing than William first thought.

For the month long booze free challenge William recorded his own tee-total video diary at home with both surprising and compelling results.

And at the end of the abstaining challenge - and the film - William has the choice to drink alcohol again or not.

On the final day of filming, when William was poured a pint of the finest Hilden Brewery beer, we genuinely did not know what decision he was going to make.

For me, the biggest revelation from this journey to the bottom of the bottle - was this society's all or nothing attitude towards alcohol.

We are one of the largest consumers of alcohol in Europe with an ever increasing binge drinking problem, but also with a record number of teetotallers, people young and old completely abstaining from alcohol.

It would appear that the middle ground, which some of us may have witnessed abroad, responsible, enjoyable, healthier drinking (maybe even with food around the family table!) has passed most of us in Northern Ireland by.

Dying For a Drink is a documentary that will touch the lives of practically all viewers, as it is about the role that alcohol has in all our lives.

We want this film not to be the end of the discussion, but to be the starting point for a debate about our relationship with alcohol.
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source: BBC News

New Drug Arrests Alcohol Addiction in Rats

2008-09-14T07:21:00.001-04:00

A compound with fewer side effects offers hope that alcoholism could one day be cured by a pill.

More than 15 million Americans drink too much, according to the National Institute on Alcohol Abuse and Alcoholism. New research on rats may help them curb that addiction.

At present, there are three approved drugs for battling alcoholism, none of which work very well. Among them: naltrexone, which is effective for some alcoholics (as well as opiate addicts) because it blocks a pain pathway in the brain associated with the pleasures of drinking.

In an effort to boost its effectiveness, neuroscientist Selena Bartlett of the Ernest Gallo Clinic & Research Center at the University of California, San Francisco, and her colleagues chemically manipulated naltrexone so that it cut off a related pleasure pathway in the brain. Their findings, published in the journal Biological Psychiatry: rats (trained to crave alcohol) given the new compound, dubbed SoRI-9409, consumed half as much hooch. In addition, there were fewer side effects. Researchers say that unlike naltrexone, this drug did not diminish the animals' desire for water and other nonalcoholic beverages, such as sugar water. "It is much more selective in its effect on drinking," Bartlett says.

Rats given the drug for 28 days refrained from heavy drinking for another four weeks after they were taken off the drug. "That is currently the biggest challenge in alcoholism treatment," which relies primarily on rehabilitation centers, Bartlett notes. When people return home, they typically also return to drinking. "Drinking stays down without the drug in place. It's done something to permanently change and reduce the drinking."

Efficacy trials in humans are already ongoing for another drug known as varenicline, which, in addition to curbing smoking, also cuts drinking. But SoRI-9409 might prove more specifically focused on alcoholism as well as free of some of the side effects reported by those who use varenicline to stop their craving for nicotine.

"We've got a pipeline of different medications targeting different aspects of the disease," Bartlett says. "It's an exciting time for people that suffer from this disease as there are more treatments coming through. Once upon a time, this wasn't really considered possible."
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source: Scientific American

How to Decrease Your Chance of Becoming Addicted to Narcotic Painkillers

2008-09-12T07:00:00.002-04:00

It's the patient's responsibility to find a doctor who knows how to screen for addiction.

The chance of becoming addicted to narcotic painkillers is around 1 in 500 when patients are properly screened before their doctors hand over a prescription, according to a 2008 meta-analysis that examined 2,500 chronic pain patients. With less careful screening, the risk can rise to 1 in 30.

The tricky part for pain patients, says David Fishbain, MD, a professor of psychiatry at the University of Miami, is finding a doctor who knows how to do the screening.

The patient's responsibility

Pain patients are often bounced from family doctors to specialists and back, with no one taking the time to monitor their ongoing use of the medication, or to “qualify” them for what the medical profession calls chronic opioid analgesic therapy (COAT)—the taking of narcotic painkillers for a long period of time.

That means it falls to patients to find health-care practitioners who are experienced in working with chronic pain patients, so that the physicians are comfortable deciding both when to prescribe narcotics and how their use can be safely monitored.

The top warning signs of addiction risk are, not surprisingly, a history of illicit drug use or alcohol abuse in the patient or his family. But smoking is also on Dr. Fishbain’s radar, because “any addiction is a potential risk factor for another addiction.” And there's a long list of factors that may be less predictive but still relevant, including depression and anxiety disorders, which means that doctors need to consider the patient's entire history and not just how he or she answers a few targeted questions.

More work for the doctor

Once a patient is on COAT, physicians have to watch for behavior that may presage or signal addiction, which includes the use of multiple doctors and pharmacies for prescriptions, as well as calling in early for refills. Doctors often ask patients to sign narcotics contracts; they also may issue only short-term prescriptions, and some docs even require urine tests.

So having a patient on narcotics is a lot of work for a careful doctor, and that, Dr. Fishbain says, explains why family doctors, also known as general practitioners (GPs), can feel caught in the middle.

“GPs are in the unfortunate position of having patients who have been put on COAT by specialists," he says. "But the specialists don’t have the time to [screen and monitor]; they want to do more invasive procedures [such as back surgery], so they send the patients back to the GPs. The GPs then have the patients but don’t know what to do.”

This all adds up to a lot of narcotic prescriptions being prescribed by poorly informed doctors, says Dr. Fishbain.

How to find the right care

“You should try to find a physician who has experience in pain management and who has experience in chronic opioid analgesic therapy," recommends Dr. Fishbain. "They need to be up on the literature and aware of the screening.”

In other words, the educated patient has to do his own screening to find the educated doctor. Referrals—to a pain clinic, for example—are reassuring, but there’s no substitute for asking questions up front and starting out with a GP who knows how to prescribe for chronic pain.
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source: health.com

Novel Compound Shows Promise for Treatment of Alcoholism

2008-09-11T14:29:00.001-04:00

BIRMINGHAM, Ala., Sept 11, 2008 /PRNewswire-USNewswire via COMTEX/ -- - Southern Research Institute and Gallo Research Center today announced that peer-reviewed results from a study testing Naltrexone-derived pyridomorphinan (SoRI-9409) will be published in the December 2008 issue of the journal Biological Psychiatry. The publication is available online today at the journal's website, and suggests that a new compound that causes selective and long-lasting reduction in ethanol consumption might be a promising candidate as a novel treatment for alcoholism.

The article, "A Novel Delta Opioid Receptor Antagonist, SoRI-9409, Produces a Selective and Long-Lasting Decrease in Ethanol Consumption in Heavy-Drinking Rats" by Selena Bartlett, BPharm PhD, Director of Preclinical Development Group at the Gallo Research Center at University of California San Francisco, et al presents the effects of SoRI-9409 on ethanol consumption. These are promising developments for the treatment of alcoholism. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates 15.1 million people are alcohol-abusing or alcohol-dependent individuals. There are currently only three FDA-approved options for the treatment of alcoholism.

The compound, SoRI-9409, was first designed and synthesized in Southern Research's Drug Discovery research division by Dr. Subramaniam (Sam) Ananthan under U.S. Government Grant DA008883. "Southern Research has been particularly interested in ligands that interact with opioid delta receptor subtype since such ligands hold promise as therapeutic agents for treatment of drug addictions and other disorders," said Dr. Ananthan, senior scientist and manager of Computational Chemistry and CNS Discovery Chemistry at Southern Research Institute. "The present findings by Dr. Bartlett and her group on the effect of SoRI-9409 on its ability to reduce alcohol intake not only provides us with a new drug lead, but also serves as the impetus for further research aimed at discovery of new therapeutic compounds for treating alcoholism and related disorders."

The Preclinical Development Group that Dr. Bartlett leads at the UCSF-affiliated Gallo Center was established to develop new treatments and bridge the gap between research and clinical treatment. The purpose of the study was to find improved compounds for the treatment of alcoholism. "The study results demonstrate that this compound causes selective and long-lasting reductions of ethanol consumption and suggests the compound might be a promising candidate as a novel treatment for alcoholism. This study indicates that compounds with a higher affinity for delta opioid receptors and reduced affinity for mu opioid receptors might be better treatment candidates than Naltrexone, the current FDA approved treatment for alcoholism", said Dr. Bartlett.

"The study on SoRI-9409 and alcohol cessation has yielded vital data that will help fuel novel treatments for a devastating and very difficult-to-treat illness," said Dr. Bartlett. "To date, we have considered and evaluated other compounds, and theories, but the information yielded from this study, along with previous research on this particular compound, has proven to be the most promising to date. We are looking forward to collaborating with our partner, Southern Research, to enter the next phase of research." The research was also supported by the State of California for Medical Research on Alcohol and Substance Abuse and Department of Defense.
Southern Research operates a successful drug discovery research program resulting in six FDA approved drugs with six additional drug candidates in late-stage preclinical and early clinical development.

"Much of our success stems from having a highly successful medicinal chemistry group, and seeking out collaborators who are driven to help us develop new lead compounds and bring those drugs to market," said David Harris, director of Business Development for the Drug Discovery Division at Southern Research. "We're happy to be working with Gallo on this promising new drug to treat alcohol addiction. It is another example of Southern Research's commitment to finding therapies for some of our society's most challenging diseases."

First author on the paper is Carsten Nielsen, PhD, a postdoctoral scientist working with Bartlett. Co-authors are Jeffrey A. Simms, Haley B. Pierson, Rui Li at the Gallo Clinic and Research Center and Surendra K. Saini and Subramaniam (Sam) Ananthan at Southern Research Institute.
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source: http://www.marketwatch.com

Painkiller Abuse Can Predispose Adolescents to Lifelong Addiction

2008-09-11T08:01:00.001-04:00

Adolescent mice exposed to the painkiller Oxycontin can sustain lifelong and permanent changes in their reward system – changes that increase the drug’s euphoric properties and make such adolescents more vulnerable to the drug’s effects later in adulthood.

No child aspires to a lifetime of addiction. But their brains might. In new research to appear online in the journal Neuropsychopharmacology this week, Rockefeller University researchers reveal that adolescent brains exposed to the painkiller Oxycontin can sustain lifelong and permanent changes in their reward system – changes that increase the drug’s euphoric properties and make such adolescents more vulnerable to the drug’s effects later in adulthood.

The research, led by Mary Jeanne Kreek, head of the Laboratory of the Biology of Addictive Diseases, is the first to directly compare levels of the chemical dopamine in adolescent and adult mice in response to increasing doses of the painkiller. Kreek, first author Yong Zhang, a research associate in the lab, and their colleagues found that adolescent mice self-administered Oxycontin less frequently than adults, suggesting that adolescents were more sensitive to its rewarding effects. These adolescent mice, when re-exposed to a low dose of the drug as adults, also had significantly higher dopamine levels in the brain’s reward center compared to adult mice newly exposed to the drug.

“Together, these results suggest that adolescents who abuse prescription pain killers may be tuning their brain to a lifelong battle with opiate addiction if they re-exposed themselves to the drug as adults,” says Kreek. ”The neurobiological changes seem to sensitize the brain to the drug’s powerfully rewarding properties.”

During adolescence, the brain undergoes marked changes. For example, the brain's reward pathway increases production of dopamine receptors until mid-adolescence and then either production declines or numbers of receptors decline. By abusing Oxycontin during this developmental period, adolescents may inadvertently trick the brain to keep more of those receptors than it really needs. If these receptors stick around and the adolescent is re-exposed to the drug as an adult, the rush of euphoria may be more addictive than the feeling experienced by adults who had never before tried the drug.

In contrast to illicit drug use among adolescents, the problem of nonmedical use of painkillers such as Oxycontin and Vicodin has escalated in recent years, with the onset of abuse occurring most frequently in adolescents and young adults. Recent studies by the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration have shown that 11 percent of persons 12 years old or older have used a prescription opiate illicitly. “Despite the early use of these drugs in young people, little is known about how they differentially affect adolescent brains undergoing developmental change,” says Kreek. “These findings gives us a new perspective from which to develop better strategies for prevention and therapy.”

This research was supported by the National Institute on Drug Abuse.
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source: http://www.innovations-report.com

Curbing Binge Drinking Takes Group Effort

2008-09-09T07:09:00.001-04:00

Every state has a minimum drinking age of 21, and the vast majority of college students are younger than that. Yet drinking, and in particular drinking to get drunk, remains a major health and social problem on campuses. Car crashes and other accidental injuries, sexual assaults, fights, community violence, academic failure and deaths from an overdose of alcohol are among the consequences.

College students spend about $5.5 billion a year on alcohol, more than they spend on books, soft drinks and other beverages combined. Alcohol is a factor in the deaths of about 1,700 college students each year.

The consequences can be particularly severe when people binge drink, a drinking pattern adopted by 44 percent of college students, national surveys have shown. Binge drinking is defined as consuming five or more drinks for men or four or more for women in a row, usually within two hours.

“Most alcohol-related harms experienced by college students occur among drinkers captured by the five/four measure of consumption,” Henry Wechsler of the Harvard School of Public Health and Toben F. Nelson of the University of Minnesota wrote in July in The Journal of Studies on Alcohol and Drugs.

A petition circulating among college presidents seeks to lower the drinking age to 18 on the theory that it would reduce the number of students who binge drink beyond the boundaries of college campuses. But opponents say there is no hard evidence for this belief and a better plan would be to change the drinking culture on campus.

About half of college binge drinkers arrive on campus having engaged in similar behavior in high school; an equal number acquire this behavior in college, Elissa R. Weitzman of Harvard and colleagues reported.

Every year, tens of thousands of college students wind up in emergency rooms suffering from the life-threatening effects of alcohol intoxication. And every year, about a dozen students, including some of the best and brightest and most athletically talented, die from acute alcohol poisoning. In one study of students who suffered alcohol-related injuries, 21 percent reported consuming eight or more drinks in a row.

Although Greek houses, which have the highest rates of binge drinking, are infamous for a free-flowing alcohol culture, studies have found that student athletes and sports fans are also among the heaviest drinkers, often gathering to drink to oblivion after an athletic event.

A Community Approach

A concerted effort has been made in the last decade to define the factors that prompt binge drinking on campuses and devise effective methods to combat it. What has become most obvious to researchers is that colleges cannot achieve this on their own.

“Basically, having programs to reduce binge drinking on college campuses in the absence of broad-based community interventions to do likewise may be a bit like rearranging deck chairs on the Titanic,” said Dr. Timothy S. Naimi of the Centers for Disease Control and Prevention.

The Harvard School of Public Health College Alcohol Study, which began in 1993, has identified several environmental and community factors that encourage binge drinking. Dr. Wechsler, who directed the study, said in an interview that high-volume alcohol sales, for example, and promotions in bars around campuses encourage drinking to excess.

“Some sell alcohol in large containers, fishbowls and pitchers,” he said. “There are special promotions: women’s nights where the women can drink free; 25-cent beers; two drinks for the price of one; and gut-busters, where people can drink all they want for one price until they have to go to the bathroom. Sites with these kinds of promotions have more binge drinking.

“Price is an issue,” he added. “It can be cheaper to get drunk on the weekend than to go to a movie.”

Although it is a college’s duty to educate students about the effects of alcohol and the risks of drinking too much, “education by itself doesn’t work,” Dr. Wechsler said. “You must attack the supply side as well as the demand side.”

More than half the alcohol outlets surrounding colleges that participated in the Harvard study offered promotions with price discounts, and nearly three-fourths that served alcohol on the premises had price discounts on weekends.

The study found that the sites of heaviest drinking by college students were off-campus bars and parties held off-campus and at fraternity and sorority houses.

Strong Policies Work

Among the factors associated with lower levels of drinking were strong state and local drunken-driving policies aimed at youths and young adults, as well as state alcohol-control policies like keg registration and laws restricting happy hours, open containers in public, beer sold in pitchers and billboards and other types of alcohol advertising.

“College sports events should not be sponsored by alcohol purveyors,” Dr. Wechsler said.

Community measures that helped to curtail binge drinking during the eight-year course of the study included a limit on alcohol outlets near campus, mandatory training for beverage servers, a crackdown on unlicensed alcohol sales and greater monitoring of alcohol outlets to curtail under-age drinking and excessive consumption by legal drinkers.

Campus practices that resulted in small but significant reductions in binge drinking included greater supervision of fraternities and sororities and more stringent accreditation requirements for Greek houses, policies to notify parents when students have trouble with alcohol, an increase in substance-free residence halls and more alcohol-free activities like movies and dances, especially on weekend nights.

But, Dr. Wechsler said, “college presidents can’t do it alone. They need help from legislative and community leaders. Alcohol is sold and consumed in the community. Residents need to get together to get it under control.”

What Parents Can Do

Dr. Wechsler urged that parents “put pressure on schools.” They should ask officials at the schools their children attend, or plan to attend, what they are doing to control drinking — especially binge drinking. When visiting schools, parents should check out the quality of life in the dorms. If they detect problems suggestive of heavy drinking, like excessive noise or vomit in the bathrooms, “they should demand that these issues be addressed,” he said.

Of course, he added, “parents should talk to their kids about drinking. Parents shouldn’t think that if it’s a beer and not a drug it’s of no consequence. Beer kills more people than drugs.”

Parents might also make it clear to students that they are expected to perform admirably outside the classroom as well as within it. Studies have shown that there is less drinking by students concerned about their grades, but also by those involved in volunteer work and other activities on and off campus.
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source: New York Times

Start discussing ways to educate about alcohol

2008-09-08T07:57:00.001-04:00

This summer, I signed the Amethyst Initiative, a statement from university presidents that invites public discussion on how Americans deal with alcohol. It proposes that America has developed a culture of dangerous binge drinking, particularly on college campuses. The signatories call on elected officials and the public to weigh all the consequences of current alcohol policies and invite new ideas on how best to prepare young adults to make responsible decisions about alcohol use.

More than 120 college and university presidents have signed in support of initiating this discussion. Some support the current 21-year-old drinking age; others may want to change it. But they are united in their concern about the effects of binge drinking.

Binge drinking is a cultural pattern that differs from past approaches to alcohol. Let me offer my own story: I did not drink until I was in college at a time when the drinking age in Massachusetts was 18. I was introduced to the graciousness of a sherry hour. Wine or beer was served as part of a semester-end get-together at a professor's house. After church, parishioners would invite students to their homes to discuss the sermon over spaghetti and Chianti. Drinking was part of a larger culture of sociability and community.

That's not true today. The Centers for Disease Control and Prevention cites a report saying that 70 percent of binge-drinking incidents occur among adults over 24. People ages 14-24 are 15.5 percent of the population but account for 30 percent of binge-drinking episodes.

I applaud the efforts of organizations such as MADD in raising awareness that drinking and driving do not mix. But while the current 21-year-old drinking age may have helped discourage drinking and driving, it has not stemmed the incidence of young people who drink. We have taken drinking, particularly for traditional college-age students, and driven it underground. While fewer people between 18 and 21 are dying from alcohol-related accidents, more students are binge drinking and getting drunk before attending an event. More are victims of alcohol poisoning and alcohol-related date rape. More drink to get drunk.

Unlike when I went to college, there is no similar opportunity today to educate students about drinking because it is against the law for faculty, staff and off-campus adults to serve alcohol to students under 21. Responsible drinking is a learned behavior. We know that the overwhelming majority of college-age students drink, but we cannot model what responsible drinking is like.

Over the years, colleges have seen an increase in students coming to us with binge-drinking habits that began in high school. At Butler, we offer alcohol-education programs from the first day students arrive on campus. We remind students of the law and the dangers of drinking to excess. We issue citations for alcohol violations.

Butler has had success in reining in binge drinking, but all universities deal with this issue. It is not enough to preach abstinence, sanction offenders and pick up the pieces after a student has been a victim of alcohol abuse. There must be education about alcohol from childhood through adulthood. That's what the Amethyst discussion is all about.
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source: Indy Star

Fear of alcohol addiction 'pandemic'

2008-09-06T07:45:00.001-04:00

Every dollar spent on alcohol and drug treatment could save taxpayers at least $5, say experts.

They warn of a "pandemic waiting to happen" if the country's addiction problems are not addressed.

A paper released by the National Committee for Addiction Treatment (NCAT) yesterday revealed what one member called "horrifying" statistics, detailing devastation wrought by alcohol and drug addicts.

It also cited a 2005 United Kingdom study, which found that money spent on standard treatment therapies for alcohol problems saved about five times that amount in expenditure on health, social and criminal justice services.

National Addiction Centre director Doug Sellman said the difference was even more marked for drug addicts, where $8 could be saved for every dollar spent.

The statistics included:

89 per cent of serious offences are committed under the influence of alcohol and drugs.

Between 75 per cent and 90 per cent of weekend crime is alcohol-related.

Up to 50 per cent of men who physically abuse their partners have substance-abuse problems.

Alcohol plays a role in 30 per cent of fatal car crashes.

70 per cent of Emergency Department admissions are caused by alcohol abuse.

This happened in an environment where only 22,000 of New Zealanders with addictions accessed treatment services in any given year, leaving an estimated 138,000 unaided, NCAT co-chair Christine Kalin said.

Treatment costs ranged from $80 for an intervention for a low-level problem to more than $8000 for months of residential treatment.

Kalin, who released the paper at the Cutting Edge Addiction Treatment Conference in Christchurch, said staff in the sector were sick of turning away people who needed help.

"Anecdotally, I know that there are services that have waiting lists. Rather than building prisons, having health budgets overspent, having police resources stretched, let's put some of that money into services at the front end rather than the ambulance at the bottom of the cliff.

"At a very minimum, we need to have the capacity to treat the 160,000 who we know need special help, and help now," she said.

Alcohol Healthwatch director Rebecca Williams said the problem was probably worse than it appeared because people who could not access services were likely to be incorrectly recorded.

"This is a sort of pandemic waiting to happen ... I think services, if they were actually presented with all of the cases that needed help and support, they would simply not be able to cope."

Experts warned that turning people away often meant the window of opportunity to help them was missed.

Kalin said investment in the sector could take the form of community-based treatment options, aimed at specific high-risk groups such as schools and prisons.

Only one third of alcohol or drug addicts were thought to receive treatment while incarcerated, she said.

Associate Minister of Health Damien O'Connor, who addressed the conference yesterday, said the Government had increased its spending from $65 million in 2001 to $94m last year.

National health spokesman Tony Ryall said the party also recognised it was an issue, particularly for families of drug-affected young people, and would address it in its health policy.
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source: Stuff NZ, http://www.stuff.co.nz/

Five Ways Parents Can Help Middle School Kids Delay Their First Drink

2008-09-05T08:46:00.002-04:00

The first few weeks of middle school are a frenzy of friends, parties, and school events. It's also time for parents to start talking with their kids about the dangers of drinking alcohol, according to The Science Inside Alcohol Project of the American Association for the Advancement of Science (AAAS).

Twenty percent of 14 year-olds say they've been drunk at least once, according to the Surgeon General, and recent news points out dangers of alcohol use by the young:

-- The Partnership for A Drug-Free America released a study in August, 2008 of 6,500 teens in which 73% said school stress caused them to drink and take drugs.

-- A Columbia University study, also released in August found that "problem parents," those who let their kids stay out past 10:00 PM on school nights in particular, are putting them in situations where they are at risk for drinking and drug use.

-- About 100 university leaders called for a national discussion of lowering the drinking age back to 18, saying it's not clear that 21 works.
The middle school years are crucial in the battle to prevent early alcohol use. Young adolescents' bodies and friendships are changing. They start pulling away from parents; yet seek out other adults for guidance. It's the most vulnerable time, specialists say, but also one of the last times they still can be influenced by adults.

No one sets out to be a disengaged parent. But it's hard to be vigilant and talk to your kids about complicated topics when you are constantly on the go. "As parents better understand the physiological effects of alcohol on the body and the fact that their children might be starting younger, it can motivate them to have this sometimes awkward conversation," says Shirley Malcom, head of the Education & Resources Directorate at AAAS. "That's where the science can help."
Members of AAAS' The Science Inside Alcohol Project are writing a book for middle school parents and developing an interactive Web-based science and health curriculum explaining how alcohol affects adolescents' brains and bodies. Based on extensive research, the AAAS team suggests five steps parents can take to talk with their kids about alcohol.

1. Find Teachable Moments - We live in a culture of celebrity. If a celebrity your child admires admits to a drinking problem, or an instance of alcohol abuse occurs in your community, talk about it. Ask your middle school student if she knows anyone who drinks alcohol and whether it is at parties or has been brought into her school. Answer questions. Have this conversation often.

2. Talk to Your Kids When Everything is Fine - Middle school students are volatile, hormonal beings. They are sweet and wonderful one moment, and blow up the next. Pick a time when things are quiet and they're a captive audience such as in the backseat of your car. Don't take no for an answer.

3. Engage Your Kids in the Science of Alcohol - Adolescents are incredibly self-involved. Alcohol can cause memory loss, impair sports performance, incite embarrassing behavior and affect how they feel and look. Make them aware of these facts. If there is a history of alcoholism in your family explain about genetic predispositions towards alcohol abuse.

4. Be Vigilant - There's no alternative to monitoring your kids. Have an early curfew. Know where they are at all times. Even if you are not home on a weeknight, make sure you can reach your kids by phone. Get to know their new friends and their parents. Find out what their rules and level of engagement are.

5. Learn to Trust Your Child - Now's the time when all the work you've put into creating a value system for your child begins to pay off. Set limits and enforce rules, but remember to give your child room to make his or her decisions, within your comfort zone. Praise them when they do well. It's worth a thousand words.
The Science Inside Alcohol Project of AAAS is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
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source: http://www.marketwatch.com

CADCA Survey Finds Alcohol Top Problem Facing Communities

2008-08-16T08:24:00.001-04:00

According to CADCA´s 2007 Annual Survey of Coalitions, 68 percent of community anti-drug coalitions across the country ranked alcohol as the number one problem facing their community. The Annual Survey of Coalitions (formerly known as the National Coalition Registry) is the only nationwide survey that targets community-based drug and alcohol abuse prevention organizations.

In the 2007 Survey, marijuana came in at a close second, with 60 percent of community groups ranking it as among the top five major problems in their areas. Other substances cited among the top five concerns include tobacco, methamphetamine and prescription drugs. Coalitions also consider binge drinking as one of the issues that they struggle with in their communities, confirming what several other nationwide studies have shown.

“It’s no surprise that our members are seeing big problems with youth alcohol use in their communities. The findings from our Annual Survey of Coalitions reflect those of other major national surveys that show alcohol use as the number one abused substance, followed by cigarette smoking and marijuana use,” noted General Arthur T. Dean, CADCA Chairman and CEO.

CADCA’s Web-based survey is conducted annually to identify the major issues facing community coalitions and to understand how coalitions work in their communities. Participants are asked a wide range of questions, such as the substance abuse issues facing their communities, the activities they use to address those issues and the organizations and agencies that help them in their efforts. The survey also asks for descriptive information, such as geographic target area, budget size and coalition membership, offering a picture of what typical community coalitions look like. In 2007, 700 coalitions participated in the survey.

When asked what major partners help them tackle their community’s problem, 88 percent said law enforcement was one of their strongest allies, 86 percent said parents and 81 percent cited the faith community.

According to the 2007 findings, community coalitions use a wide range of strategies to address their community’s problems. Some of the most widely-used strategies include education and information dissemination; media outreach, advertisements and public service announcements; special events and community forums; community mobilization and neighborhood improvement activities; and training to community groups.

In addition to the 2007 findings, CADCA is also launching a new feature in its Annual Survey of Coalitions that will allow people who have completed the survey to obtain state and national survey reports. For example, survey participants are now able to:

• Download a copy of their previous survey responses from 2007, 2006 and 2005.

• Obtain a report on a particular topic in the survey – such as, the sectors typically represented on coalitions, the activities coalitions are engaged in and the type of federal prevention funding coalitions receive.

• Network with other coalitions in their state by searching the Survey Report database for other coalitions in their state who are dealing with the same issues or working in the same areas.

CADCA members receive the same information but also get national level reports, expanding their networking potential.

To access the Annual Survey Reports, visit: http://cadca.org/annualsurvey and login with the information used to participate in the 2007 Survey. Forgot your login? Send an email to registry@cadca.org or membership@cadca.org or call 800-54-CADCA, ext. 240 or 257.
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source: Community Anti-Drug Coalitions of America, http://www.cadca.org/

Restoring a People -- Program Battles Native Substance Abuse

2008-08-15T07:19:00.001-04:00

The counselors of an intensive outpatient treatment center run here by the Navajo Nation, Pastor Cecil Lewis Jr. and Robinson Tom have started a fight against the tribe’s alcoholism and drug abuse because these problems hasten the breakdown of Indian families.

According to them, people addicted to alcohol and drugs lose self-confidence, giving up the will to live or do anything. Unable to raise their families due to addiction, they put their children under care of grandparents, uncles or aunts who are already struggling to survive on food stamps and scanty incomes.

Children who grew up watching the miseries of substance abuse often follow in their parents’ footsteps. In the end, the idea of a traditional mother and father or the concept of supportive, safe and nurturing family evaporates into thin air.

Even though tribes have made great strides in past years, the counselors argue that no less than 10 percent of Navajos could be diagnosed as alcoholics, and there isn’t a single house in the Navajo Nation that isn’t affected by alcohol or drug abuse. Use of methamphetamines among young people is also an issue. The predicament is mirrored throughout Indian reservations and communities across the country.

Pastor Lewis and Counselor Tom understand the situation very well because they have been there themselves. “I was an alcoholic,” said Pastor Lewis, a counselor for the Faith-based Initiative Project at the treatment center in this tiny town mostly populated by Navajos, about 130 miles northwest of Albuquerque. “I thought getting drunk would be a way to alleviate and resolve my problems. But they just became worse.” He said just like any other person in trouble, he tried many ways to live life and failed, until he finally found God in 1984 and turned his life around. “I run into the people everyday who remind me of my past,” said Robinson Tom, who has been sober for the last 15 years, “Not only do alcoholism and substance abuse destroy a person, but they decimate families, relationships and beliefs.”

Tom had his first drink when he was 9 years old—it was given to him by an adult relative—and he tried to kill himself in 10th grade. His suicidal urge was repeated three more times. Tom stopped drinking after he seriously injured himself by falling from a tall tree while drunk. In his sickbed, he felt that being an alcoholic wasn’t the way his creator wanted him to live.

To tackle the substance abuse problem, Crownpoint Department of Behavioral Health Services, serving the Eastern Navajo region since 1970’s, offers treatment services ranging from traditional Navajo methods to Alcoholics Anonymous classes. Since 2001, the center has administered a faith-based initiative project, to promote access to spiritual healing services for the Navajos suffering from substance abuse.

In Navajo, the center is called “Dine’ Bee lina’ Na’ Hisoolnaal” Center. According to Tom, the native phrase means “restoring the life of a person so he can live the way he was supposed to live.” Most of the center’s clients are those who ran into trouble with the law because of their addiction and were ordered to take up to six weeks of counseling programs.

Pastor Lewis, who is also leading about 20 to 35 congregations at Dear Spring Mission in the area, puts emphasis on spiritual healing through the words of God. During counseling, he uses the Bible as a tool, which he believes to possess the power of changing a person. “Deep inside our hearts is an inner man,” said Pastor Lewis. “There’s spirit which was always hungry for God. When you find the god, you’ll look beyond our natural instincts or ways of life and can change the miserable life.” Counselor Tom relies on treatments rooted in Navajo traditions. For example, he likes to take his clients to a sweat lodge at the center for purification ceremonies.

Dozens of alcoholics and drug abusers in shorts sit in the pitch darkness of a tent made of sticks and wool blankets. In the middle of the dirt floor, a pit has been dug and filled with rocks heated by fire.

Cedar logs are thrown on the rocks, giving off a fragrance, and then lavender, sage and sweet grass. A bucket of water is then thrown on the rocks, filling the tent with a heavy steam. There, the abusers and addicts purify their spirit corrupted with alcohol and drugs. Women clients use a separate sweat lodge.

Tom sees the sweat lodge as a way to share culture and help his fellow Navajo clients find a more spiritual path that leads them to a right way. However, the treatment alone can’t tackle the substance abuse problems. “In order to attack the substance abuse effectively, there must be a way to fight poverty, because it leads to alcoholism and drug abuse,” said Pastor Lewis. “Just think how the Navajo Nation would be improved if there was a majority of people working and earning.”
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source: New America Media, http://news.newamericamedia.org

New Test Effective in Detecting Heavy Drinkers

2008-08-14T08:43:00.001-04:00

The sooner alcohol problems are addressed the better the outcome and the less long-term damage is done from excessive drinking. Physicians and healthcare providers now have a new chemical-based test that is more accurate in detecting heavy drinking in their patients. The test can detect heavy drinking episodes in the past four to six weeks.

Physicians and healthcare providers have a new tool which is twice as likely to detect heavy drinking in patients compared to the usual liver enzyme test. The Early Detection of Alcohol Consumption test has been found effective in detecting patients who drink in excess.

The test is used to determine if a patient has engaged in heavy drinking in the previous four to six weeks. Heavy drinking is defined as more than five drinks a day for men and four drinks a day for women.

How The EDAC Test Works

The Early Detection of Alcohol Consumption test is actually an algorithm of 20 blood chemistry levels. Those measurements are compared to a database of more than 1,700 heavy and light drinkers.

Scientists have found that the Early Detection of Alcohol Consumption test is twice as accurate as a liver enzyme test that has been used for years to detect heavy drinking. In one study, 88% of the heavy drinkers and 92% of the light drinkers were correctly identified using the test.

The test is even more effective with patients over 40 years of age.

Early Detection Important
Research has shown that the sooner alcohol problems are addressed the better the outcomes and the less long-term damage. At the 2008 meeting of the American Association for Clinical Chemistry, physicians were encouraged to use the test to increase early intervention with heavy drinkers.

"Physicians can use the test as part of an early intervention," James Harasymiw, director of Alcohol Detection Services, said in an AACC news release. "When patients are confronted with test results, they may be more likely to change their behavior."

"Physicians can show patients the test results to help convince them that their drinking is causing serious damage to their organs and other biologic systems," Harasymiw said.

More Accurate Than Screening Tests?
There are many short alcohol screening tests that are available to screen for alcohol problems in the healthcare setting, but the results of those tests depend upon the patient answering the questions openly and honestly.

Someone trying to cover up or minimize their drinking habits could easily do so with the short-answer screening tests. But the Early Detection of Alcohol Consumption test measures actual blood chemistry levels, making it more difficult for heavy drinkers to hide their consumption.
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source: Harasymiw, James W., et al. "Identification of Heavy Drinkers By Using the Early Detection of Alcohol Consumption Score." Alcoholism: Clinical and Experimental Research Volume 25 Issue 2, Pages 228 - 235.

More drug use, less treatment in E. Ky.

2008-08-13T08:02:00.001-04:00

A higher proportion of people in Appalachia abuse prescription painkillers than in the rest of the nation, and the problem is even greater in coal-mining areas such as Eastern Kentucky, according to a federal study.

Compounding the problem, relatively few facilities in Appalachia offer short and long-term residential treatment — the kind of service needed by many people addicted to OxyContin and other painkillers.

“There's truly an access-to-health-care disparity for these coal-producing counties that we need to address,” said David Mathews, director of adult services with Kentucky River Community Care, which provides services including substance-abuse and mental-health treatment in eight Eastern Kentucky counties.

The findings are included in a new study of access to substance-abuse and mental-health treatment in Appalachia that was underwritten by the Appalachian Regional Commission— a federal-state partnership that works to create opportunities for self-sustaining economic development and a better life for Appalachian residents.

The study underlines the cyclical relationships between poverty, depression and drug abuse in parts of Appalachia, and the resulting need for more treatment facilities.

Anne Pope, federal co-chair of the agency, and Gov. Steve Beshear announced the results at a news conference Tuesday in London.

Pope said Beshear had pushed ARC to tackle the issue of substance abuse, and also cited the efforts of Louise Howell, executive director of Kentucky River Community Care.

Pope said trying to reduce substance abuse fits with ARC's mission to boost economic development because substance abuse is a barrier to improving the economy.

“Communities cannot grow if there is a major substance-abuse problem,” Pope said.

Distress, depression

Researchers found that, generally, access to substance-abuse and mental health care in Appalachia compared favorably with access in the rest of the country.

However, there were differences within the sprawling region — which includes all of West Virginia and parts of 12 other states from New York to Mississippi.

The central part of the region, including Eastern Kentucky, faces some significant challenges, the study found.

For instance, more residents of Appalachia reported problems with serious psychological distress and major depression, and the rate of such problems was higher in Central Appalachia. The study was based on analysis of information from surveys, hospitals and treatment facilities.

There is a link between the economy and mental-health problems such as depression, treatment providers said. Most of the counties considered economically distressed by the ARC are in Eastern Kentucky.

“When they're not able to provide for their families, the stress and depression are going to increase,” Kathy Tremaine, director of Cumberland River Comprehensive Care, said of people having financial problems.

The study found that, as the main reason for being admitted to treatment, abuse of drugs such as prescription painkillers was higher in Appalachia — especially in coal-mining areas — than elsewhere.

Such abuse is rising across the country, but it's going up faster in Appalachia, particularly in those mining areas, researchers found.

And despite concerns about prescription drug abuse, alcohol was the main reason for people being admitted to treatment in Appalachia, as in the nation. The study found a much higher percentage of people in Appalachia being admitted primarily for alcohol abuse – 45 percent in 2004, compared with 22 percent in the nation.

Less cocaine, meth

There was good news in the study. Among other things, it found relatively lower marijuana and cocaine use in Appalachia and lower treatment admission rates for heroin. It also found that, although there might be “hot spots” of methamphetamine abuse, use of the drug was lower overall in Appalachia than in the United States.

People in the region have recognized the problems and responded with a variety of programs such as school-based prevention activities to try to prevent drug abuse, though there is a need for more.

Researchers also found that proportionately more facilities in Appalachia offered intensive outpatient care, mental-health assessment and substance-abuse family counseling; that nearly all facilities offered some form of substance-abuse treatment; and facilities offered more free and reduced-cost treatment and accepted more forms of payment.

However, fewer facilities there offered outpatient detoxification, and there were fewer places where people could stay for short- or long-term substance-abuse treatment.

Mathews, with Kentucky River Community Care, said that it's clear there is a need for more treatment for substance-abuse and mental-health problems.

Surveys found that in the same Eastern Kentucky counties where people reported relatively high rates of painkiller abuse and drug dependence, a higher percentage of people said they had needed drug treatment in the last year but had not gotten it.

People told researchers about a variety of barriers to substance-abuse and mental-health treatment, including lack of transportation, lack of money and fear of being stigmatized.

Money is a key issue for treatment providers as well.

The state cut funding for community mental-health centers 3 percent in the current budget, and funding hadn't gone up to match costs even before, Tremaine said.

“We've gone underfunded for the last 10 years,” she said.

Tremaine said that means the centers provide services without getting reimbursed. Cumberland River doesn't turn away people needing treatment, but the question is how long that can continue, she said.

Waiting for treatment

A shortage of money for residential substance-abuse treatment services — especially to hire trained people to provide treatment — means there is a waiting list to get into such facilities in Eastern Kentucky.

The danger is that people might not come back when a spot finally opens up.

“If we don't get people in when they're motivated, we've lost them,” Mathews said.

Beshear said a state initiative to build 10 substance-abuse treatment centers in Kentucky, called Recovery Kentucky, will help address the shortage of residential care in the state. Five are already open.
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source: Lexington Herald Leader, http://www.kentucky.com

Alcohol battle pays dividends, UVa study finds

2008-08-12T06:47:00.001-04:00

Some University of Virginia students’ perceptions of their peers’ drinking habits are changing, a new study suggests.

Data from an estimated 15,000 surveys done from 2001 to 2006 has led to a marketing campaign researchers said is correcting misconceptions about what many people believe is more or less a collegiate pastime.

James Turner, executive director of Student Health at UVa, said Monday that the study is based on surveys of undergraduate students.

The study’s findings included showing that over the six-year period students reported driving under the influence fewer times in 2001 than they did in 2006.

While Turner said some students assume the opposite.

“It’s these misconceptions of the norms that tend to drive behavior,” Turner said.

Schools across the country have used similar approaches — known as “social norming” — to curb alcohol abuse, promote recycling and combat prescription drug abuse, among other things.

During the study, the UVa surveys asked students to pair their alcohol consumption with a list of consequences they may have experienced after drinking too much.

The list included missing class, having unprotected sex and getting in trouble with police.

After comparing 2006 numbers with those from 2001, the study found that roughly 2,000 fewer students were injured by alcohol-related events and that 550 fewer engaged in unprotected sex.

The study also found the number of students who reported experiencing no alcohol-related consequences was down by 2,500. And that females tended to respond positively to the university’s social norming marketing 30 percent more often than males, Turner said.

Poster campaign

Turner said the university has reinforced those findings by promoting them campus-wide on posters and on the Internet.

It’s also led to the distribution of more than 30,000 cards that help students gauge their alcohol intake.

Linda Hancock is director of the Wellness Resource Center at Virginia Commonwealth University, where since 2002 freshmen have been surveyed about their perceptions of safe sex and responsible alcohol use prior to their first day of classes.

After the initial surveys, Hancock said, students are inundated with posters around campus that debunk misconceptions about the state of VCU students’ health habits. Officials also print “stall journals” with VCU survey data and place them in bathrooms around the university.

Hancock said people are often skeptical after hearing VCU students live healthy lifestyles. Among students, that perception can come from repeatedly seeing unhealthy living among the same people again and again and thinking it’s normal, Hancock said.

“The majority who don’t get hammered don’t get seen,” she said.

Hancock said VCU’s surveys report 25 percent of the students don’t drink and that upwards of 70 percent are not drinking in a range she describes as “high risk,” or having a blood-alcohol level above .08, the legal limit in Virginia.

The UVa study also reported that 25 percent of its students report being alcohol-free, Turner said.

H. Wesley Perkins, a sociology professor at Hobart and William Smith Colleges in upstate New York, said that while plenty of schools have tried implementing social norms programs, many don’t stick with them long enough to see substantial results.

Some schools put up posters during Alcohol Awareness Week and then “go home for the year,” he said.

Social norms

Perkins helped pioneer work on social norms in the mid-1980s and helped with the UVa study. He said the five-year data collection period produced figures he believes other schools would find if they stuck longterm with norming programs.

At Hobart and William Smith — population less than 2,000 — Perkins said a four-year study in the late 1990s showed “high-risk drinking” was cut by 40 percent over the life of the study.

Around the country he’s also found that “scare tactics” and cracking down on policy enforcement often lead to a backlash from students.

At Florida State University, health officials try to correct misconceptions among their student body — roughly 35,000 undergraduates this fall — with mandatory classes for those found committing an alcohol violation on or off campus.

Those classes also try to find out if a student has underlying problems, such as prescription-medication abuse, said Lesley Sacher, director of FSU’s Thagard Student Health Center.

Sober data

Outside of a student getting in trouble, the college has also used public service announcements, billboards and advertisements on buses to put sober data out.

“When you’re dealing with a complex social issue, there’s really no magic bullet,” Sacher said of the university’s multiple approaches.

Lynn Reyes, a drug and alcohol counselor at the University of Arizona, said she finds mandatory classes for students who get into trouble with alcohol to be effective.

“My preference is to talk to students one on one about norms,” Reyes said.
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source: Charlottesville Daily Progress, http://www.dailyprogress.com/

Saving Brains - Fetal Alcohol Syndrome Discovery In Sheep Could Help Humans Soon

2008-08-11T07:45:00.001-04:00

In a study on fetal alcohol syndrome, researchers were able to prevent the damage that alcohol causes to cells in a key area of the fetal brain by blocking acid sensitive potassium channels and preventing the acidic environment that alcohol produces. The cerebellum, the portion of the brain that is responsible for balance and muscle coordination, is particularly vulnerable to injury from alcohol during development.

The researchers also found that although alcohol lowers the amount of oxygen in the blood of the mother, it is not the lack of oxygen that damages the fetal cerebellum, but the drop in pH.

Fetal alcohol syndrome is a condition in which maternal drinking during pregnancy injures the brain of the developing fetus. Alcohol is the most common cause of injury to the fetal brain. Children born with fetal alcohol syndrome may have cognitive impairments and difficulty regulating their behavior. They often have difficulty in school and exhibit behavioral problems, such as impulsiveness, later in life.

The syndrome is estimated to occur in approximately one in every 1,000 births in Western countries. Milder forms of the condition, known as fetal alcohol spectrum disorders, occur more frequently.

The study with sheep, published in the August issue of the American Journal of Physiology, demonstrated that the damage can be prevented by blocking acid sensitive potassium channels, known as TASK channels, that lead into the Purkinje cells. The study, "Acid Sensitive Channel Inhibition Prevents Fetal Alcohol Spectrum Disorders Cerebellar Purkinje Cell Loss," was carried out by Jayanth Ramadoss, Emilie R. Lunde, Nengtai Ouyang, Wei-Jung A. Chen and Timothy A. Cudd. The research was done at Texas A&M University.

Maternal drinking lowers the blood pH of both the mother and the fetus, making the blood more acidic. The researchers hypothesized that this acidity damages the Purkinje cells of the fetal cerebellum. Using 56 pregnant sheep, they induced the change in pH in some sheep using alcohol, while in others they manipulated the extracellular pH. This approach allowed them to test their hypothesis that it was the fall in pH that created the damage, not the alcohol, per se.

Alcohol produced a 45% reduction in Purkinje cells of the fetal cerebellum, while the pH changes alone produced a 24% decrease. A drop in the number of Purkinje cells in the cerebellum is a measure of damage.

However, when the researchers used a drug, doxapram, to block the TASK channels leading into the Purkinje cells, they prevented the change in pH in the fetal cerebellar cells and prevented any reduction in the number of these cells.

"This study demonstrates that direct pharmacological blockade of TASK 1 and TASK 3 channels protects the most sensitive target of fetal alcohol exposure, cerebellar Purkinje cells," the authors concluded.

This study complements work by other researchers who have found success with supplements such as choline, a precursor for the neurotransmitter acetylcholine. These supplements may work on the same mechanism that Dr. Cudd's lab has been researching.

Funding: The research was funded by the National Institutes of Health (NIH) Pediatrics Initiatives and the NIH National Institute on Alcohol Abuse and Alcoholism.
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source: http://www.scientificblogging.com

My father gave me my first hit of heroin

2008-08-09T07:29:00.001-04:00

Crime was part of my life from my earliest memory. Not just the seedy, dark kind, but the day-to-day-to-pay-the-bills crime. This included theft, fraud, robbery and drug-dealing. Mum had left us when I was three. Dad did whatever he could to keep us going. Crime was how we survived, and as I grew older it became a father and son business.

Dad was first released from prison in 1982. We were living in a smart flat in Kensington and he'd gone straight back to dealing drugs to bring in money - getting a job wasn't even on his radar. Part of our income came from a 2kg block of Peruvian cocaine he was holding for a mate. Dad woke me up on my 16th birthday with a massive line of coke neatly presented on an antique mirror. I loved it. It never felt as if he was being irresponsible. It was normal to me.

A few weeks later, I was watching him dealing with two new customers. They were buying heroin. I'd been snorting a lot of coke and had overdone it. The hash was no longer balancing the buzz of the coke. I wanted something stronger. Dad clearly thought smack was something special - he told me it calmed the erratic, euphoric hit of cocaine. I became convinced this was what I needed for my amphetamine-frayed nerves. I'd asked him for heroin plenty of times, but he'd always flatly refused. When it started to look as if I was going to ruin this transaction with the new customers, he took me into the kitchen.

"Look, kid, I don't know what you're up to, but we need their business - I have to pay the rent." He took out a six-inch square of silver foil from the cupboard. "You can have some of this, but only a little, then piss off to your room and let me seal the deal."

My heart beat faster. This was the rite of passage I'd been waiting for, and another step deeper into Dad's world. I knew what to do - I'd seen him do it plenty of times. The narcotic rush that ran through my body was physical and emotional. I instantly understood why Dad loved it so much. It made everything easier, happier and safer. In that moment I felt a deeper connection to my father. It sounds shocking but, for me, it was no different from your average father and son sharing their first quiet pint down the local pub.

This initiation into the world of class As happened at a time when I was terrified of what the future held. Dad had been locked up for the previous three years, and had missed my transition from boy to teenager. We had a lot of catching up to do.

My smack habit developed quickly, partly from the little Dad gave me to calm me down and partly from the stuff I nicked off him to keep me stoned. I once angrily asked him why he gave it to me and he told me he wanted to keep me off the streets. At least this way he could "keep an eye on me". It was a twisted paternal protectiveness that led to our relationship breaking down completely, and ended with him back in prison and me locked up for the first time in my life.

My father was essentially lazy; crime was a means to getting us to a better place. Long-term, he wanted me to go to college; get some qualifications and a "proper" job. He was well-intentioned, but hopelessly deluded by the painkilling drugs he loved so much.

A while back I heard that the dysfunction our parents hand down to us gives us something to work with, something to motivate us out of the gutter; that's if we're lucky enough to survive our early years. Giving me heroin was a mistake my father grew to regret deeply - I knew this because he told me, many times. It accelerated me to a place to which I was already heading. And, looking back, the quicker I got there the better. My destination was prison, for dealing and taking drugs.

At 21, I was released on bail to go into rehab and I was able to do what my father never managed through all his years in prison, reading books and meditating: I got clean from drugs and alcohol, and I've stayed clean ever since.

That day in the kitchen had a dark beauty to it. Taking drugs was part of the way my father and I connected. I'm thankful I was able to get a little closer to him during that time. Heroin took my father's life, through a deliberate overdose 16 years ago. Bizarrely, it gave me mine. I still love and miss him deeply.
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source: The Guardian, http://www.guardian.co.uk

America's Hard-Drinking Cities

2008-08-08T08:15:00.001-04:00

Austin, Texas, is famous for its parties. People flock from around the world to attend events like the annual South by Southwest film and music festival. And when they get there, chances are they make like the locals and throw back a few cold ones--because Austin may be the hardest-drinking city in America.

Austin ranks high for its drinking habits across the board. According to the Centers for Disease Control and Prevention's (CDC's) 2007 Behavioral Risk Factor Surveillance System Survey, 61.5% of adult residents say they have had at least one drink of alcohol within the past 30 days, and a staggering 20.6% of respondents confess to binge drinking, or having five or more drinks on one occasion.

Some residents attribute those numbers to the city's sizable population of college students. Austin is home to several schools, including the University of Texas at Austin, one of the largest universities in the country.

"I imagine that's probably why the city's on [the list]," says Hunter Darby, manager of Austin's Dog & Duck Pub. "Sixth Street in Austin is like a tiny version of Bourbon Street. It caters a lot to a younger crowd who are right at age 21. They'll just go from bar to bar to bar. ... There are a ton of bars per human being in this town."

Collegiate excess has repercussions far beyond hangovers and missed classes, and should be of concern to members of the surrounding community. "Binge drinking hurts not only the drinker but also others near him," says Henry Wechsler, Ph.D., a lecturer at the Harvard school of Public Health, where he was also the director of the College Alcohol Study, and author of Dying to Drink: Confronting Binge Drinking on College Campuses.

"The binge drinker disturbs the peace, through noise, vandalism and sometimes violence. Like secondhand smoke, binge drinking pollutes the environment."

"The [social] cost of alcohol is in the billions of dollars. Roughly half the total is related to what's called alcohol addiction," says Paul Gruenewald, scientific director of the Prevention Research Center at the University of California, Berkeley, which is funded by the National Institute on Alcohol Abuse and Alcoholism.

"The other half is related to other harms that happen to people when drinking; primarily drunk driving, drunk driving crashes, pedestrian injuries, violent assaults, and various criminal behaviors and various injuries," Gruenewald said.

"It's not a pretty picture. It's quite ugly from the public health point of view. It's a much bigger problem than crime related to illegal drugs," he added.
By The Numbers: America's Hard-Drinking Cities

Coming in second on the list is Milwaukee. This city, known as "the nation's watering hole," has a long reputation as a city built on beer. It was once the nation's top beer-producing city, home to four of the world's largest breweries: Schlitz, Pabst, Miller and Blatz. Legendary sitcom characters Laverne and Shirley fixed bottle caps on one of the city's assembly lines. Even the town's baseball team--the Brewers--reflects its boozy past.

Rounding out the top five hardest-drinking cities are San Francisco; Providence, R.I.; and Chicago.

To determine the cities with the highest alcohol consumption, we started by making a list of the 40 largest metropolitan statistical areas in the U.S.--geographic entities defined by the U.S. Office of Management and Budget for use by federal agencies in collecting, tabulating and publishing statistics.

We then examined data from the CDC's 2007 Behavioral Risk Factor Surveillance System Survey (BRFSS), a nationwide system that collects information on health risk behaviors, preventive health practices and health care access.

In this survey, the CDC develops a core questionnaire and provides it to state governments, which then perform telephone surveys asking more than 350,000 American adults about their health.

Due to state-by-state variations in the handling of the survey, the BRFSS isn't a perfect way to measure drinking habits. But since its data come directly from citizens, it does provide a good idea of regional variations.

The survey doesn't report results for every city in the nation, so two of our 40 candidate cities were eliminated from the list due to missing data. And because the CDC coordinates the surveys but does not individually manage them, there tend to be differences in sample size and margin of error from city to city. So we removed another five cities from our list because they exhibited unusually large margins of error.

The remaining 33 cities were then ranked based on their residents' responses to three different questions on the BRFSS: whether they had at least one drink of alcohol within the past 30 days; whether men had more than two drinks per day or women one drink per day; and whether they had five or more drinks on one occasion. In each case, higher-ranking cities reported larger percentages of their population answering in the affirmative.

To determine the 15 hardest-drinking cities, we added up the rankings from each category, counting the "five or more drinks on one occasion" question twice, since it most directly addresses the question of problem drinking. We then sorted that sum into our final ranks.

Of course, just because a city ranks high on the list doesn't make it a den of debauchery. A top-drinking town could be populated by health-conscious adults who sip a glass of wine a day in order to keep their hearts healthy. And just downing a few cold ones doesn't make a person irresponsible.
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source: Forbes

Aging sobers most drinkers, but not alcoholics

2008-08-07T12:05:00.001-04:00

As Americans aged over the last two generations, they drank less alcohol. And the younger generation of adults drank less heavily than the ones before it, according to the first analysis of alcohol-consumption trends over adult life spans.

By the time they reached their 80s, more than 40 percent of men and 60 percent of women said they didn't drink at all, according to a study in the August issue of The American Journal of Medicine.

Over time, beer drinkers generally shifted to wine, the study found, and the younger generation drank less hard liquor than the older ones did. At the same time, more and more adults aged into moderate drinkers by federal dietary standards. They define moderate drinking as two drinks per day for men and one per day for women.

"They've understood that a little alcohol is OK but a lot is not good," said Curtis Ellison, a co-author of the report and a professor of medicine and public health at Boston University School of Medicine.

At the same time, rates of problem drinking remained unchanged, Ellison's team found. Nearly 13 percent of men and 4 percent of women reported problems across the study span.

"It seems they just can't get over their problems with alcohol," Ellison said.

Researchers relied on estimates of alcohol consumption reported every two to four years from 1948 through 2003 for a famous and massive study of lifetime health called the Framingham Heart Study. The alcohol analysis involved 8,600 of its participants, born from 1900 through 1959.

The participants' experiences with alcohol reflect trends for most of the last century.

Women consistently drank less than men, the study found. Heavy drinking dropped with age for men but fell less markedly for women.

By their mid-70s, men were drinking half the beer they'd drunk in their mid-30s, and the decline among women was similar.
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source: McClatchy Washington Bureau

No easy answer to problem of alcohol

2008-08-06T09:07:00.001-04:00

Alcohol and drug abuse is a major issue in Jackson County.

That was the consensus of panelists who discussed the topic Monday night during a town hall meeting sponsored by Together For Jackson County Kids. The meeting "Impact of Alcohol and Other Drugs on Jackson County Community: How Can We Change It?" was held at the Black River Falls Middle School.

About 10 residents attended the meeting, which featured presentations from Nick Lee, a drug and alcohol counselor with West Central Wisconsin Behavioral Health; Terry Greendeer, the Alcohol and Other Drug Program Director with Ho-Chunk Nation; Sheriff Duane Waldera; youth member Ben Hodge from Together for Jackson County Kids and Michelle Schoolcraft, social worker with the county's Department of Health and Human Services.

Brockway Police Chief Christian Eversum could not attend the meeting, but sent a letter saying his research on police calls in 2007 shows 25 percent involved some use of alcohol, tobacco or drugs.

"We clearly have a serious issue in Jackson County and it is going to take the hard work of everybody in this community to make positive change," Eversum's letter said.

Waldera echoed Eversum's comments but said the alcohol and drug connection with county calls is much higher.

"We do have a problem," Waldera said. "We need to somehow come up with a program to intervene. Citations can and do have an impact, but it needs to be more than just paying a fine and moving on. The majority of cases that sit in jail are alcohol-related and alcohol can be just about linked to every case when we've had to intervene."

Greendeer, who has worked with the Ho-Chunk alcohol and drug program for 21 years, said alcohol affects everybody regardless of race, social or cultural beliefs.

"One of the biggest things that I see with the Native American person is that one of the biggest things taken from them is their spirit," Greendeer said. "They aren't able to define what their values and beliefs are once alcohol has taken over their whole life."

Both Greendeer and Lee said preventing youth from abusing alcohol has to start with the parents, who need to understand the law and need to be involved.

"If there is normal, responsible drinking at home and it hasn't become abusive and when it doesn't become that way, there's probably a good chance a teen isn't going to acquire that attitude and engage in abuse of alcohol," Lee said.

Greendeer said her office conducts alcohol awareness activities every April, but the biggest challenge is getting participation from adults.

"Parents do not want to be involved," she said. "It hasn't changed. You're talking about a problem that exists and has been in existence for years and years and generations, but it's always hidden in the closet and is devastating to everybody. I don't know what to do. They don't want to admit there is even a problem."

Greendeer said sometimes a parent will refer a child for in-patient treatment and the child is gone for 45 days, but comes back to the same home environment that contributed to the addiction problem in the first place.

"The family doesn't get the treatment that the child should have had," Greendeer said. "They want their child to live a sober lifestyle but yet the parent hasn't gone the extra mile to be supportive of their child while they are in treatment."

In-patient facility

Judge Thomas Lister, who attended the meeting, asked Greendeer if the Ho-Chunk Nation would be willing to work with the community to provide an in-patient treatment facility in Jackson County. She said the nation is working on providing one for its own members, but would have an interest in a community center as well.

Lister said a facility closer to home would allow members to get the family support they need. He also said the facility would give the courts more options for defendants who need treatment rather than putting them in jail for a cost between $40 to $80 a day, depending on their medical needs.

"Give me an inpatient facility where I can put them rather than in jail," Lister said. "Give me that $40 to $50 a day to a residential treatment center where they can get some meaningful intervention. Maybe we can pull together some philanthropists and local organizations and try for one."

Lister said the court is limited when dealing with alcoholism as a disease. Simply putting alcoholics in jail may be punishment for the crime, but upon release the person has not been rehabilitated.

Waldera said continuing to arrest repeat offenders for bail violations - many of them for consuming alcohol - ties up two to three hours of a deputy's time for each arrest.

"It tends to be a revolving door sometimes," Waldera said. "Our deputies get frustrated. If there is a way to intervene, identify the problem and get them adequate help, it will be a cost-saving to the county. We can fill the beds in the jail; that's not the issue. But we need to keep repeat offenders out of the jail and have them be productive citizens in society."

Schoolcraft said Together for Jackson County Kids remains committed to continuing discussion and dialogue on the alcohol and drug abuse issue and additional town hall meetings are possible.

"We need to find a common ground that all of us can live with to help our children grow up and be successful adults," she said.
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source: Jackson County Chronicle, http://www.jacksoncountychronicle.com/

Guns and Poppies

2008-08-05T08:24:00.001-04:00

In the morass that is Afghanistan, not just the Taliban are flourishing. So too is opium production, which increasingly finances the group’s activities. There is no easy way to end this narcotics threat, a symptom of wider instability. Even a wise and coordinated plan of attack would take years to bear real results. But the United States and the rest of the international community are failing to develop one. They must work harder, smarter and more cooperatively to rescue this narco-state.

The scope of the problem is mind-numbing. Opium production mushroomed in 2006 and 2007, and Afghanistan now supplies 93 percent of the world’s heroin, with the bulk going to users in Europe and Russia. According to official figures, the narcotics trade rakes in about $4 billion a year, which is about half of Afghanistan’s gross domestic product. It strengthens the extremist forces that American and NATO troops are fighting and dying to defeat; it undermines the Afghan state they are trying to build; and it poisons drug users across Europe, where many people do not see Afghanistan as their problem and leaders are shamefully ignoring the connection.

Last week, the United Nations reported an alarming new development: Afghan drug lords are recruiting foreign chemists, mostly from Turkey, Pakistan and Iran, to help turn raw opium into highly refined heroin. Doing so adds value and lethality to the product they export.

American, European, Afghan and United Nations officials have sabotaged their mission by continuing to bicker over why poppy cultivation has skyrocketed, what to do about it and who should act. In a particularly damning indictment in The Times Magazine, Thomas Schweich, a former State Department official, blamed corrupt Afghan officials, internal policy divisions and the reluctance of American and NATO military to take on counternarcotics roles, as much as the Taliban.

Mr. Schweich should have pointed a finger at President Bush for the fundamental failure in Afghanistan. Mr. Bush put too few resources into the country after 9/11, then left the aftermath to NATO and various warlords while America shifted focus to the disastrous war of choice in Iraq. The results: a Taliban and Al Qaeda resurgence coupled with historic poppy crops.

It is very good news that 20 of Afghanistan’s 34 provinces may soon be free of poppy cultivation, but that means production is overwhelmingly concentrated in the south, largely in Helmand Province, where the Taliban are strongest and the government is weakest.

Mr. Schweich’s main recommendation — to aggressively eradicate poppy crops by aerial spraying — is politically untenable and of questionable value. Other things can be done, or done better, including building a criminal justice system that can prosecute major drug traffickers and having American and NATO forces play a more robust role in interdiction. The Afghan and American governments have broken ground on a new airport and agricultural center in Helmand — an encouraging attempt to help farmers shift from poppies to food crops.

Allegations that President Hamid Karzai protects officials and warlords in the trade are troubling. Washington and its allies must press him to address this problem. They also should seize assets and ban visas for major traffickers who have homes outside Afghanistan.

Longer term, the answer lies in a consistent, integrated and well-financed plan to establish security throughout Afghanistan, put kingpins in jail, develop a market economy and a functioning government in Kabul, and rapidly expand incentives for smaller farmers to stop growing poppies. It is all one more daunting Bush administration legacy that will be left for the next president to fix.
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source: The New York Times

When one drink just isn't enough

2008-08-04T10:02:00.001-04:00

One drink leads to another, and another . . .

This weekend alcoholics from around the South Island will be in Ashburton for an Alcoholics Anonymous assembly. They come from all walks of life, but they share a common desire to stay sober. Reporter Michelle Nelson tells the story of two women affected by alcoholism. Rita is a recovering alcoholic, and Jane talks of the impact her alcoholic father had on her childhood.

My name is Rita, I’m an alcoholic.
Many of you know me, few of you know about my alcohol and drug addiction.

I live among you, work with you, stand alongside you in the queue outside parent-teacher interview rooms, chat with you in the corner dairy and deal with you in a professional capacity.

That’s the odd thing about alcoholics – you just can’t pick us. There are those in our ranks whose drunken behaviour ends in the mayhem and violence that attracts media attention, but the majority of us are living right alongside you. These days, with the support of AA, I am a recovering alcoholic.
For me, only another addict can understand the despair of addiction.

One of the first AA slogans I took on board was “don’t pick up the first one and you can’t get drunk.” It took a while, but therein lies the essence of my “problem.” Cliché; it’s not what we drink – it’s how we drink.

Have you ever told yourself you won’t drink tonight? This week? Until your birthday? Until someone else’s birthday?

Or that you deserve a drink because you had a bad day? Because you had a good day? Because a bird flew overhead?

I made a lot of promises to myself and to those who cared about me. I am a mother, a wife, a daughter, a sister and a friend – and I am an alcoholic, I have a disease and my addiction to alcohol is symptom of that disease.

Nobody in their right mind would choose to be an addict. But there is something wrong in my mind; when I pick up a drink I don’t stop until I’m pissed.
There are scientific theories to explain my disease ranging from a genetic predisposition to drink like a fish to my upbringing in a family of boozers – both of which open a stupid chicken or the egg debate, and at the end of the day it doesn’t matter.

The fact is I am an alcoholic. And these days I’m okay with that. In fact I really wonder why I was so scared of being sober.

You see, I never could live life on its own terms. I was an insecure kid and alcohol was a magic potion for confidence - and fear of being exposed kept me drinking.

And that’s one of the things that bond us alcoholics. Underneath the social trappings we all battle common demons and insecurity and fear are a common thread.

By the luck of the gods I found myself in Queen Mary rehab some years ago now.

There I heard a dear old lady speak of stabbing her husband. I ate with a man who tried to cut his girlfriend’s throat.

The stories of the multi-millionaire, who owned a helicopter, the doctor who never prescribed anything he hadn’t tried himself, the accountant, the teacher, the truck driver, the transvestite sex worker, the priest, the gang member and the nurse have much in common.

Alcoholism, or any other addiction for that matter, plays no favourites. It takes no account of race, colour or creed, whether you are rich or poor, or educated and powerful. If it’s going to get you it will. The question is – what can be done about it?

AA is the only thing that worked for me. I tried counselling and saw psychiatrists, walked out the door and got pissed. Today I am sober and that’s what matters.

An eight-year-old child and her little sister sit in a car parked outside a pub. They have been there for a long time.

They are arguing about who will go in to drag their father out of the pub. Both children are frightened of drinking men – and with good reason.
Eventually Jane goes. She is fobbed off with a packet of chips and her father’s promise not to be long.

Hours later he staggers from the bar and gets behind the wheel. The girls know better than to argue.

“He would sit me on his knee so I could steer the car, then I learned to drive and soon I was driving a drunk home, I was only eight or nine years old.”
Soon Jane’s father began taking her on ‘trips’ – which were in fact pub crawls, on which she was frequently abused.

“His hands would be up my dress and he’d say your mother’s doing the same thing to your brother.

“I was disgusted, I loved my mother and I thought what he was saying was true.”

Jane was fed many lies as her father set about isolating her by maligning her mother’s character.

“He told me my mother was having an affair with the headmaster, I thought that was true too.”

Jane doesn’t remember a childhood. Her story is more about her survival in a warzone awash with alcohol.

“I know now that my mother had to beg for money to feed us, but there were always flagons. I never felt like a little girl, I was always worried about what would happen next. I was always trying to keep mum safe, keep my sister safe, keep myself safe.”

When Jane was in her teens her parents separated and her mother learned of the sexual abuse.
“She had a nervous breakdown, it was terrible.”

Again Jane picked up the pieces, setting a pattern she would carry into adulthood.

“All my life I’ve been trying to save people.”

But while Jane was trying to save others she was bent on a path of personal self-destruction. Not surprisingly she left school with few qualifications; she began binge drinking, developed eating disorders and formed a succession of unsuccessful relationships with men.

Two years ago Jane ended a violent relationship and was diagnosed with traumatic stress disorder; she thinks it is responsible for the panic attacks she has long suffered.

“It’s always been there, all my life that I can remember I just never had a name for it.”

Emotionally and physically battered and determined to turn her life around, she made contact with an abused women’s support group then Al-anon, a support group for family members whose lives have been blighted by alcoholism.

“There was no where else to go. Being raised by an alcoholic almost destroyed my life.

“I’m learning to put my needs ahead of others, I can’t save them but I can save myself.”
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source: Ashburton Guardian, http://www.ashburtonguardian.co.nz/

Aspen is now Colorado’s outlet for a controversial new addiction treatment

2008-08-03T07:27:00.001-04:00

What if there was a magic pill that alcoholics and addicts could take to stop their cravings?

Steve Ayers, an Aspen doctor, and Annie Brown, an Aspen nurse with a clinical specialty, don't claim to have a magic pill.

But they do claim to have something almost as useful: a drug cocktail that can relieve cravings, reduce sleeplessness, restore normal brain function, and help patients feel better so that they can fully engage in recovery.

Since November, the two have been providing a controversial treatment called Prometa to alcoholics, cocaine addicts and a few methamphetamines addicts in the Aspen area.

Brown and Ayers, who also is chief of staff at Aspen Valley Hospital, an emergency room physician, and the Pitkin County coroner, are convinced the program does what it claims, and they are backed by several studies. But nationwide, some critics have argued that the treatment, needs more study and/or approval from the Food and Drug Administration (FDA).

A combination of three drugs (flumazenil, hydroxyzine, and gabapentin), nutritional therapy, and psycho-social counseling, the Prometa treatment program was developed by a Spanish doctor in the 1990s. Since Terren Peizer bought the protocols and began marketing it, approximately 3,000 patients have been treated in the United States, according to Brown.

Treatment begins with a three-day infusion of flumazenil, given intravenously for three- to five-minute intervals while the patient's cardiac state is monitored.
The flumazenil infusion is followed by dosages of hyroxyzine, gabapenin and nutritional supplements over a 39-day period.

The drugs help change the anatomy and chemistry of the brain to return addicts to a pre-addiction state in which they do not have a physiological dependence on the drug, said Ayers. In short, it allegedly reduces cravings.

“You can remodel [brain tissue] quickly with the right influence. That's how you learn a new skill, like throwing a Frisbee. Your brain tissue is actually forming new cells,” explained Ayers.

The partners, who are the only people licensed to administer the protocol in Colorado or Wyoming, say the program has been even more successful than they'd hoped. While not all their clients have achieved sobriety without relapse, all patients claim their cravings have been reduced, they say.

“I've been working 25 years with addiction — this is the most robust intervention, the best tool I've had,” Brown said.

Their clients, in e-mails forwarded by Brown, are equally glowing.

“What Prometa did for me I cannot put into words,” wrote one recovering alcoholic.
Another patient, who earned a college scholarship after kicking his cocaine addiction, cautioned that Prometa is not a magic pill, but is “the wind in the sails of those that are ready.”

A third testified to its effect on his psyche: “Before Prometa I had cravings all the time. All I could think about was drinking. After Prometa the cravings have decreased … if I am at lunch and I see someone drinking, I think about ordering a drink and then I don't.

Critics

Not everyone in the medical community has given wholehearted support for the treatment. Prometa has had several public-relations challenges, perhaps chief among them the fact that Terren Peizer, who owns and markets the treatment program through his company Hythiam, is former junk bond salesman.

Given the cost of the treatment, Peizer — who visited Aspen last summer as an Aspen Institute panelist for a bioethical dilemmas seminar — stands to become a very wealthy man. Aspen treatments, for example, cost $12,000 to $18,000, a portion of which is returned to Peizer as a “licensing fee.”

Also, Peizer has not sought approval from the FDA for the treatment protocol. Technically, he does not have to, as the drugs have individually received FDA approval for other uses.

Opponents have also argued the protocol hasn’t been thoroughly and independently studied. An October 2007, Hythiam-funded study, led by Dr. Harold C. Urschel and published in the Mayo Clinic Proceedings medical journal, was criticized for not having a control group or placebo. The television show 60 Minutes later reported that Dr. Urschel's clinic sold the Prometa treatment during the trial, suggesting that doing so was a conflict-of-interest.

Several other “double-blind” studies have since been held with control groups and placebos, and have found that Prometa reduces cravings. But none have yet been peer-reviewed in a medical journal, note critics.

But Ayers and Brown say that not all the criticisms are valid.

Ayers countered that many medical protocols have never been studied. For example, he said, every alcoholic who is admitted to an emergency room in America gets a shot of thiamine, the dosage of which has never been studied.

“There's a million things in medicine that are considered standard of care and scientifically founded that are not double-blind studied,” he said.

Having said that, he did acknowledge that Prometa should be “if people are going to pay that much for it.”

On the topic of FDA approval, he argued that the FDA doesn't approve protocols, only drugs. Many drugs are now prescribed for a use other than their approved use, he said.

Brown countered concerns about cost by noting that Hythiam has said its first priority this year is to convince managed care programs to pay for Prometa. Acknowledging that some never will (many insurance companies don't cover drug and alcohol treatment), she also pointed out the high cost of addiction, a number that can easily top the cost of Prometa, given time.

Brown also noted that $1,500 of the fee goes toward therapy in the person’s hometown.

Future

Prometa is revolutionary, say Brown and Ayers, because it claims to reduce cravings. But for years, treatment centers have used drugs to help manage addiction.
Perhaps the most famous is Antabuse, which makes the alcoholic very ill if he or she drinks. Vivitrol, a short-term immunization that blocks alcohol's ability to work on the brain, has also been used with some success.

But Ayers argues that Prometa, and the drug protocols that will likely follow it in the next few years, are the future of addition medicine. Within two years, he predicted, all addictions will likely be treated medically — and the medical community will laugh about the fact that it ever considered addiction to be simply a behavioral problem.
“The addiction medical community is all over this concept of treating [addiction] medically and finding different ways to treat it,” he said.

He even predicted that doctors might be able to provide immunizations to protect children with a family history of addiction, some day. Immunized people would be able to snort cocaine, but it would have no effect on their brain.

“All these things are going to create ethical dilemmas in medicine,” he said. “How do you immunize someone? How do you take away their ability to experience cocaine?”
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kredding@aspentimes.com
The Aspen Times

NIDA Study Sheds Light on why Addiction is a Chronic Disease

2008-08-02T07:33:00.002-04:00

Drug addiction dramatically shifts a person's attention, priorities, and behaviors towards a focus almost entirely on seeking out and taking drugs. Now, an animal study funded by the National Institute on Drug Abuse, part of the National Institutes of Health, has identified some of the specific long-term adaptations in the brain's reward system that may contribute to this shift. These long-lasting brain changes may underlie the maladaptive learning that contributes to addiction and to the propensity for relapse, even after years of abstinence from the drug. The study was published in Neuron on July 30, 2008.

Investigators from the University of California, San Francisco (UCSF) using an animal model of addiction, were able to distinguish brain changes in rats trained to self-administer cocaine, versus those animals that were trained to self-administer natural rewards such as food, or sucrose for several weeks. The investigators also were able to look at how much the "expectation" of receiving the drug influenced those brain changes by comparing rats trained to self-administer the drug versus animals who received the same amount of cocaine, but received it passively, i.e. they could not control their own drug taking by self-administration.

It has been hypothesized that persistent drug seeking alters the brain's natural reward and motivational system. The current study focuses on how drug seeking alters the communication between brain cells in this critical circuitry. In the normal processes of learning and memory formation there is a well documented strengthening of communication between brain cells, this process is known as "long-term potentiation" (LTP). The new study reports that LTP was similar in the rats that had learned to self administer cocaine, food or sucrose, but with a critical distinction. The increase in LTP due to cocaine persisted for up to three months of abstinence, but the increase in response to natural rewards dissipated after only three weeks. Importantly, the nature of the cocaine experience had a strong effect on the outcome, since rats exposed to cocaine when they did not expect it (passive infusions) displayed no LTP, neither transient nor long lasting. Finally, the study showed that LTP in rats that self-administered cocaine persisted after they were trained to stop drug self-administration behaviors. This indicates that, once established, it is very difficult to reverse the "memory trace" associated with drug reward.

"This research provides a better characterization of the variables, at the cellular, circuit, and behavioral level that contribute to the persistent nature of addictive disorders," said Dr. Elias A. Zerhouni, NIH director.

"The researchers were able to illuminate why drug related memories are so stable," said NIDA Director Dr. Nora Volkow. "Their persistence is highly refractory to new learning, which makes our jobs that much tougher, and reminds us that treatment must recognize and address the high propensity for relapse almost anywhere down the road."

"These results indicate that the LTP induced by self administered cocaine is more persistent than that produced by natural rewards, such as food; and that the LTP is not just a result of exposure to cocaine, but also is linked to the drug's effects and the animal's learning to obtain the drug," said Dr. Billy Chen, postdoctoral fellow at UCSF's Ernest Gallo Clinic and Research Center and lead author of the study. "These are important distinctions that will help us better understand how addiction develops, and why drugs can overshadow other natural rewards and become the mainstay of an addicted person's life."

In 2006, six million Americans age 12 and older had abused cocaine in any form. There are currently no medications for cocaine addiction, therefore standard treatments typically rely on behavioral interventions. However, relapse after treatment for cocaine addiction is common.
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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 ensure the rapid dissemination of research information to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and further information on NIDA research can be found on the NIDA web site at http://www.drugabuse.gov.

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, visit www.nih.gov
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source: NIDA

Binge drinking 'out of control'

2008-07-31T07:28:00.001-04:00

Binge drinking is "spiraling out of control" in Grey-Bruce, with a third of residents who drink alcohol reporting engaging in it during the past year, a figure 12 per cent higher than both the provincial and national averages.

The percentage of local drinkers over the age of 12 binge drinking nearly doubled to 34 per cent in 2007 from 18 per cent in 2001, according to the Canadian Community Health Survey, which monitors a range of health indicators including alcohol and tobacco use.

"For the most part, most places in Canada have not doubled. These numbers are just really high," said Matthew Myatt, associate epidemiologist for the Grey Bruce Health Unit.

"I wouldn't say we expected to see the jump in the numbers because this is really high, 12 per cent (higher than the average) is huge."

The provincial average for binge drinking by those who drink alcohol was 21.2 per cent in 2007, the national average was 21.8 per cent. Binge drinking is considered to be having five or more drinks on one occasion at least once per month in the past 12 months.

"Alcohol abuse through binge drinking is spiraling out of control in Grey Bruce," the health unit said in a news release. "Alcohol is the most popular drug in Grey Bruce and its abuse is on the rise."

Research has proven that adverse health effects due to drinking begin at the "binge drinking" level of consumption, Myatt added.

According to Dr. Geoffrey Fong, a psychologist at the University of Waterloo, binge drinking is heavily affected by social context and peer pressure.

"If you start drinking at a young age it becomes a problem that quickly becomes a social epidemic because it's highly visible and spreads throughout a social group," said Fong, an expert in global health issues and the effects of alcohol on social behaviour.

"What initially may seem like a small increase in drinking will blossom fairly quickly because of social effects."

The local co-ordinator of the FOCUS Community Program says the goal of program is to prevent problems, including injuries and chronic diseases, associated with drinking and drug use.

"If adults that drink alcohol can begin to assess the amount and their patterns of drinking, we hope there will be a change in the culture of drinking in Grey Bruce and also a reduction in the burden of disease," Marie Barclay, a public health nurse, said in a news release.
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source: Owen Sound Sun Times

Unanswered cries for help

2008-07-30T09:49:00.001-04:00

Instances are growing in which certain prescription drugs do a lot more than kill the pain — they kill the user.

In articles published this month, Las Vegas Sun reporters Marshall Allen and Alex Richards reported that this tragic trend is national and particularly acute in Nevada.

Their research revealed that 258 people in Clark County died last year — as opposed to 57 in 1997 — from conditions related to overdoses of prescription drugs.

They also documented that Nevadans consume about twice the national average of several prescription painkillers — a statistic that is probably more than coincidental to the rising numbers of fatal overdoses.

To add perspective, Allen and Richards did some comparisons of last year’s in-state deaths. There were more from prescription drug overdoses than from auto accidents. And from firearms. And from overdoses of cocaine, heroin and methamphetamine combined.

On Monday Allen reported that the number of Nevadans who are addicted to prescription drugs has reached crisis proportions. The result is that the state’s inpatient and outpatient substance abuse treatment programs, already overwhelmed by tens of thousands of people addicted to alcohol and street drugs, are increasingly not meeting the need.

Thousands of Nevadans who are succumbing to addiction and want help are being told to wait, when waiting can be perilous to their health.

Inpatient treatment programs are considered best for addicts, but in Clark County there is a total of 375 beds for this service.

Addicts who have money or who have good health insurance have little problem getting treated in Nevada, but the numbers of addicts without these attributes are legion.

Rising fatalities are not the only cost. Addiction often leads to domestic violence and other crimes that take a human toll and overcrowd our courts, jails and prisons. It fills emergency rooms and beds at our public hospitals. It leads to traffic accidents, unemployment and homelessness. These consequences add up to a much greater public cost than an expanded treatment system.

The lack of adequate assistance for addicted Nevadans who lack the means to help themselves is a grave problem that should be addressed by the 2009 Legislature.
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source: Las Vegas Sun

History shows illegal drugs are not a recent problem

2008-07-29T08:54:00.001-04:00

Illicit substances have been in demand here for at least 350 years; no legal measures have ever made a difference.

EVERY TIME gardaí make a big drug seizure - and there have been plenty of them recently - they must have mixed feelings. On the one hand, there is another victory in the "war on drugs". Good police work seems to be getting results. On the other hand, though, everyone - especially gardaí - knows that however many battles are won, the war was lost a long time ago. The reality is that the amount of seizures is largely a function of the amount of drugs being imported; that when one gang is broken, there will always be another hungrier, more vicious one ready to step into the breach; and that for all the millions spent here and the trillions spent worldwide, illegal drugs are cheaper and more ubiquitous than they have ever been.

The real issue is, of course, demand. If people want mind-altering substances, there will be big money in supplying them. We lose sight of this reality because we have a distorted narrative in our heads. The story we assume to be true is that, while Irish people always drank alcohol and took enthusiastically to tobacco, illegal drugs are essentially a recent phenomenon. They came in during and after the 1960s, along with all the other moral and social laxities of that decade. They are an outside influence, a downside to the modernity that we adopted. They cling, therefore, to the surface of Irish culture and can, with enough persistence, be scraped off.

It is weird that we should think this, because there are few western European societies in which the consumption of illegal, mind-altering substances was so open, and so socially acceptable for so long. I doubt that there are many readers who haven't drunk, or been present when others drank, the primary Irish illegal drug of the 19th and 20th centuries. It is called poteen. How odd that we forget about it, and forget, too, that 400 years of law enforcement failed to stop people making and drinking it.

Poteen became prominent in Irish society after 1661, when excise duty on Irish whiskey was re-introduced. As duty went up and the price of "parliament whiskey" rose, the native Irish responded by making their own alcohol. Originally, this was generally decent malt whiskey. But as time went on, poteen developed in a way that we are familiar with from cocaine or heroin. With a thriving, unregulated trade in which price was the key factor, poteen makers turned to whatever was available - molasses, sugar, treacle, potatoes, rhubarb. The more unscrupulous of them added bite to an adulterated product with meths or paint stripper.

The stuff became dangerous, unreliable and of often poor quality. The authorities came down heavy, sending armed soldiers against the distillers. Illegal distillers were shot, imprisoned, transported. None of it made a blind bit of difference.

Neither did the threats of the IRA in the early 1920s or the creation of a native government. The "war on poteen", as we might call it, continued in the 1930s, during which there were 500 stills detected every year by the Garda. But it was social change - emigration, relative prosperity, urbanisation - and cheaper official whiskey, that eventually killed the poteen trade. It was not law enforcement.

Poteen, it might be objected, is unusual, because it represented a displacement of an existing demand. How, then, could one explain the huge demand for another mind-altering substance: ether?

In his classic historical essay, Ether Drinking in Ulster, KH Connell disclosed the extraordinary story of the widespread and open consumption of this hallucinogenic industrial solvent, especially in the North. In the 1890s, it was estimated that 50,000 people in counties Derry and Tyrone were "etheromaniacs". The burning, unstable liquid, which turns to gas at body temperature, was not pleasant to drink (it made the uninitiated violently ill) but its effects seem to have been rather like those of LSD: "You always heard music and you'd be cocking your ears at it . . . Others would see men climbing up the walls and going through the roof . . ." Again, like today's illegal drugs, ether was widely consumed even though it harmed people's health, led to deaths by accidental overdoses, and encouraged some addicts to steal in order to supply their habit. And again, law enforcement was relatively ineffective. Ether-drinking died out largely because of social change and the availability of alternative intoxicants.

The point of this brief history lesson is simply this: there has been a demand for illegal and unapproved mind-altering substances for at least the last 350 years in Ireland. That demand has been channelled into different substances - poteen, ether, hash, LSD, heroin, cocaine, ecstasy - but there is no great evidence that it is actually higher now, as a proportion of the population, than it was a century ago.

Law enforcement (even when it was much harsher than it is now) and church sanction (even when the churches were far more powerful than they are now) had little success in combating this trade, so long as the demand made it a lucrative one. Why do we imagine that things are any different now?
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source: © 2008 The Irish Times

Titan Pharmaceuticals Announces Positive Results from Phase III Clinical Trial of Probuphine for the Treatment of Opioid Addiction

2008-07-28T07:19:00.002-04:00

Titan Pharmaceuticals, Inc. (AMEX:TTP) today announced positive, statistically significant results from its randomized, double-blind, placebo controlled, multi-center Phase III clinical trial of Probuphine®. Probuphine is Titan’s novel, subcutaneous implant formulation designed using its ProNeura technology to deliver six months of buprenorphine. Buprenorphine is currently marketed as a sublingual formulation for the treatment of opioid addiction.

Probuphine showed a clinically and statistically significant difference over placebo in illicit opioid use over 16 weeks as measured by urine testing performed three times per week (p=0.0361) – this was the primary endpoint acceptable to the U.S. Food and Drug Administration (FDA). Additionally, Probuphine achieved statistical significance in the Phase III trial’s key secondary endpoint, the difference in illicit opioid use from weeks 17-24 (p=0.0004). Moreover, Probuphine treatment showed a statistically significant difference in illicit opioid use versus placebo over the full six-month (weeks 1-24) period (p=0.0117).

“We are extremely pleased by these positive results and the potential of Probuphine to be an important advance in the treatment of opioid addiction,” said Marc Rubin, M.D., President and CEO of Titan. “Even as buprenorphine, with estimated sales of half a billion dollars in worldwide sales, is fast becoming the gold standard for opioid addiction treatment, there are growing concerns about compliance with and abuse of the currently available treatment options and a critical need for safe, effective treatment options. These data show that our proprietary subcutaneous implant can safely deliver Probuphine over six months. We look forward to completing this development program and forging strategic alliances to commercialize Probuphine worldwide.”

Additional secondary efficacy analyses, including the mean percentage of urines negative for illicit opioids over treatment weeks 1-16, 17-24, and the complete six-month period also statistically favored Probuphine over placebo. Another important indicator of treatment effectiveness, patient retention, was approximately 66 percent for Probuphine compared to 31 percent for placebo. Probuphine was also well tolerated throughout the six-month trial.

“These data are very promising and I believe that the success of Probuphine should have a very significant impact on our ability to effectively treat opioid addiction,” said Walter Ling, M.D., Professor of Psychiatry and Director of the Integrated Substance Abuse Programs at the David Geffen School of Medicine at UCLA, and a principal investigator in this trial. “As a clinician, I am concerned by the growing problem of opioid addiction, especially prescription opioid abuse, and the challenge of effectively treating our patients with a safe, abuse-resistant and diversion-resistant treatment. These data could translate into a dramatic change in our treatment possibilities.”

Worldwide, it is estimated that there are 6 million opioid addicts. Approximately one-half of this potential patient population is addicted to illicit opioids, such as heroin, and the other half to prescription drugs, such as oxycontin, methadone, and codeine. Until recently, the only approved medication assisted therapies for opioid addiction had been available at only a limited number of authorized facilities in the U.S. As of 2000, U.S. physicians can be certified to prescribe less restricted opioid addiction medications in an office setting, which has greatly expanded patient access to opioid addiction pharmaceutical therapies. Despite these advances, this remains a highly underserved market with only about 750,000 people globally receiving medicinal treatment for opioid addiction.
More details here...
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source: Business Wire

Two Takes: Drugs Are Too Dangerous Not to Regulate—We Should Legalize Them

2008-07-26T07:20:00.002-04:00

The nation's drug problems should be controlled through regulation and taxation

Peter Moskos of John Jay College of Criminal Justice wrote Cop in the Hood: My Year Policing Baltimore's Eastern District.

Drugs are bad. So let's legalize them.

It's not as crazy as it sounds. Legalization does not mean giving up. It means regulation and control. By contrast, criminalization means prohibition. But we can't regulate what we prohibit, and drugs are too dangerous to remain unregulated.

Let's not debate which drugs are good and which are bad. While it's heartless to keep marijuana from terminally ill cancer patients, some drugs—crack, heroin, crystal meth—are undoubtedly bad. But prohibition is the issue, and, as with alcohol, it doesn't work. Between 1920 and 1933, we banned drinking. Despite, or more likely because of, the increased risk, drinking became cool. That's what happens when you delegate drug education to moralists. And crime increased, most notoriously with gangland killings. That's what happens when you delegate drug distribution to crooks. Prohibition of alcohol ended in failure, but for other drugs it continues.

Law enforcement can't reduce supply or demand. As a Baltimore police officer, I arrested drug dealers. Others took their place. I locked them up, too. Thanks to the drug war, we imprison more people than any other country. And America still leads the world in illegal drug use. We can't arrest and jail our way to a drug-free America. People want to get high. We could lock up everybody and still have a drug problem. Prisons have drug problems.

Illegal production remains high. Since 1981, the price of cocaine has dropped nearly 80 percent. Despite the ongoing presence of U.S. and other troops, Afghanistan has been exporting record levels of opium, from which heroin is made. Poor farmers may not want to sell to criminals, but they need to feed their families, and there is no legal market for illegal drugs. Al Qaeda in Afghanistan, the FARC in Colombia, and drug gangs in Mexico all rely on drug prohibition. A legal drug trade would do more to undermine these terrorists than military action would. If we taxed drugs, profits would go to governments, which fight terrorists.

Illegal drug dealers sell to anyone. Legal ones are licensed and help keep drugs such as beer, cigarettes, and pharmaceuticals away from minors. Illegal dealers settle disputes with guns. Legal ones solve theirs in court. Illegal dealers fear police. Legal ones fear the IRS.

Less use. Regulation can reduce drug use. In two generations, we've halved the number of cigarette smokers not through prohibition but through education, regulated selling, and taxes. And we don't jail nicotine addicts. Drug addiction won't go away, but tax revenue can help pay for treatment.

The Netherlands provides a helpful example. Drug addiction there is considered a health problem. Dutch policy aims to save lives and reduce use. It succeeds: Three times as many heroin addicts overdose in Baltimore as in all of the Netherlands. Sixteen percent of Ameri-cans try cocaine in their lifetime. In the Netherlands, the figure is less than 2 percent. The Dutch have lower rates of addiction, overdose deaths, homicides, and incarceration. Clearly, they're doing something right. Why not learn from success? The Netherlands decriminalized marijuana in 1976. Any adult can walk into a legally licensed, heavily regulated "coffee shop" and buy or consume top-quality weed without fear of arrest. Under this system, people in the Netherlands are half as likely as Americans to have ever smoked marijuana.

It's unlikely that repealing federal drug laws would result in a massive increase in drug use. People take or don't take drugs for many reasons, but apparently legality isn't high on the list. In America, drug legalization could happen slowly and, unlike federal prohibition, not be forced on any state or city. City and state governments could decide policy based on their needs.

The war on drugs is not about saving lives or stopping crime. It's about yesteryear's ideologues and future profits from prison jobs, asset forfeiture, court overtime pay, and federal largess.

We have a choice: Legalize drugs, or embark on a second century of failed prohibition. Government regulation may not sound as sexy or as macho as a "war on drugs," but it works better.
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source: U.S News And World Report

Illegal Painkiller Overdoses Kill More Than 1,000 Americans

2008-07-25T07:04:00.001-04:00

More than 1,000 Americans died in 6 cities between 2005 and 2007 from overdosing on nonpharmaceutical fentanyl (NPF), in the biggest ever epidemic of overdoses involving illegally produced versions of the painkiller. Health officials predict there will be further outbreaks of NPF overdose because the illegal narcotic is easier and cheaper to produce than heroin.

The figures are being reported today by the US Centers for Disease Control and Prevention (CDC), in the 25th July issue of the Morbidity and Mortality Weekly Report (MMWR).

Illicitly manufactured nonpharmaceutical fentanyl (NPF) is 30 to 50 times more potent than heroin. It is a synthetic opioid and classed by the US authorities as a narcotic.

The findings of a CDC and Drug Enforcement Agency (DEA) investigation showed that between 4th April 2005 and 28th March 2007, a total of 1,013 deaths occurred in six US jurisdictions; the largest NPF epidemic to date. This is nearly 10 times higher than an epidemic in the 1980s when 110 people died of fatal overdoses of different fentanyl analogs, said the report.

The largest number of deaths were in metropolitan Chicago (349), Philadelphia (269), and Detroit (230). The other areas were St. Louis, Missouri, and the states of Delaware and New Jersey.

Emergency medical staff said some of the victims were found with the needle still stuck in their arms. The drug was so powerful that they died before completing the injection, said Dr Stephen Jones, a co- author of the report who is now retired from the CDC, reported Reuters.

The authorities decided to carry out the investigation after receiving a number of reports of overdoses linked to NPF. For instance in April 2006 increases in overdoses among illegal drug users were reported in Camden, New Jersey, which triggered similar reports in other jurisdictions, including Chicago and Detroit, which had been discovered earlier but falsely attributed to heroin overdose until urine samples of some of the dead showed traces of fentanyl.

Thus in May 2006 the CDC started ad-hoc case-finding surveillance in six state and local jurisdictions. This was later taken over by the DEA. This is how the 1,013 NPF related deaths were identified. After this the DEA started regulating access to N-phenethyl-4-piperidone, which is used to make illegal analogs of fentanyl.

The CDC report said the pattern of NPF overdoses points to illegal distribution networks, citing as an example that the NPF found in Chicago and Detroit most likely came from a clandestine production site in Mexico. However, they can't explain why they did not find any NPF-related deaths in other areas of high heroin use, such as in New York City.

As well as the deaths discovered through the CDC/DEA surveillance system, over the same period there were reports of other NPF-related deaths from suburban and rural areas of Illinois, Michigan, and Pennsylvania and in Kentucky, Maine, Maryland, Massachusetts, New Hampshire, Ohio, and Virginia.

The CDC suggested that although the number of NPF-related deaths spotted by the CDC/DEA surveillance system fell substantially in 2007, they predict further epidemics of NPF overdoses are likely because the drug is easier and cheaper to produce than heroin.

Deaths related to heroin and other illicit drugs are well documented in the US. From 1999 to 2005, the figure went up by 87.5 per cent, from 4.0 to 7.5 per 100,000 of the population (age-adjustied deaths from unintentional drug poisoning, mostly linked to pharmaceutical and/or nonpharmaceutical drugs).

The CDC said their report had four limitations: first the figures could be under-reported because for example only participating centers in six jurisdictions were included in the surveillance; second, there is no standard toxicology definition of cause of death for fatal drug overdoses; third, some of the deaths could be misclassified as NPF when they were really pharmaceutical fentanyl-related deaths (ie legal use); and finally, in addition to fentanyl, other substances may have contributed to the overdoses, including alcohol.

Nevertheless, the CDC said the figures are sufficient to warrant improvements in a number of areas relating to drug overdoses. These include improvements in identifying and reporting drug overdose, so law enforcers and public health officials can act more quickly (eg to seize drugs and provide outreach support).

The agency also said there was a need to develop or expand:

* National standards for toxicologic testing and classifying cause of death in drug overdose and poisoning.

* Professional standards for referring overdose surivivors for addiction treatment and education, such as those that exist for suicide survivors.

* Public health programs to help drug users get treatment, be educated about risks of overdose, and learn ways to avoid and deal with overdose.

Jones said in a telephone interview reported by Reuters that the report highlights "an extraordinary episode of fatal drug overdoses".

"But it's got to be recognized as part of the bigger problem of the increasing numbers of drug overdose deaths in the United States," he added.
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source: MediLexicon

Drug report shows shifting trends in use and abuse in Texas

2008-07-24T12:44:00.002-04:00

Heroin users are younger, and a growing proportion of crack cocaine users are Anglo or Hispanic, according to a recent report on drug abuse trends in Texas.

The shifting demographics highlight why treatment, prevention and education programs must be flexible to respond to new addiction patterns, the report’s author said.

"The type of person using a drug 10 years ago is often not the same person using it today," said Dr. Jane Maxwell of the University of Texas Addiction Research Institute. "It is always evolving. You have to target new groups."

The report, Substance Abuse Trends in Texas, relied on data from multiple agencies, law enforcement and drug-treatment centers.

Among the more important trends noted is a new generation of younger, Hispanic heroin users.

Of those admitted to treatment centers funded by the Department of State Health Services, the average age of a heroin user has fallen from 37 in 1996 to 34 in 2007. Meanwhile, the proportion that is Hispanics has more than doubled, from 23 percent in 1996 to 55 percent in 2007.

"What we’re seeing is more people starting heroin when they are younger," Maxwell said. "One day they’ll use a needle. We need more effective treatment to target a younger population."

Dealers marketing the drug more to youths plays a major role in the increase, experts say.

In Dallas, for example, the "cheese heroin" epidemic involved dealers cutting heroin with Tylenol PM and selling it for as little as $3 a dose. Of 174 cases in which heroin users were age 19 and under in Dallas in 2007, 52 percent were male, 92 percent were Hispanic, and 96 percent inhaled their heroin, according to the report.

Tarrant County treatment centers saw a much smaller increase in young heroin users.

"We have seen more cases but still not anything like they saw in Dallas," said Stevie Hansen, chief of addiction services for Mental Health Mental Retardation of Tarrant County. "We’re ready for this epidemic to spread this way, but it just really hasn’t happened here. That’s a good thing."

Changing demographics

Statewide, the face of crack cocaine is also changing. It was originally a drug thought to primarily affect African-American communities, but the proportion of African-American addicts in treatment centers has dropped from 75 percent in 1993 to 46 percent in 2007.

The proportion of Anglos in treatment for crack cocaine increased from 20 percent in 1993 to 35 percent in 2007, while the numbers for Hispanics increased from 5 percent to 18 percent.

In Tarrant County, the majority of males treated for crack addiction are still African-American, but white women have surpassed African-American women, according to Fort Worth’s Recovery Resource Council, which screens potential patients.

"That’s how drugs evolve," said Suzanne Lofton, clinical director for the council. "They start in one community, one ethnicity or one age group. Word spreads, and the drug spreads into others."

Other trends noticed in Tarrant County treatment centers are more adults hooked on pain medications and fewer on methamphetamine. More patients seem to have longtime addictions, said Daryl Dulany, a licensed clinical social worker for Volunteers of America.

"I don’t know if it’s because they’re waiting longer to get treatment," Dulany said. "But I do know that the line to get in is longer."

Texas trends

Trends in drug and alcohol use among Texans, according to Substance Abuse Trends in Texas: June 2008, conducted by the Gulf Coast Addiction Technology Transfer Center and University of Texas Addiction Research Institute:

Cocaine/crack In 2007, 13 percent of high-school students reported having used cocaine/crack, compared with 12 percent in 2005. Between 1987 and 2007, the proportion of people using powder cocaine admitted for treatment increased from 23 percent to 48 percent for Hispanics, while it dropped for Anglos (from 48 percent to 33 percent) and African-Americans (from 28 percent to 18 percent).

The number of deaths statewide in which cocaine was mentioned increased from 223 in 1992 to 795 in 2006.

Heroin was the drug of choice for 10 percent of users admitted to state treatment centers. The majority of addicts inject the drug, but the proportion inhaling it has increased from 4 percent in 1996 to 20 percent in 2007.

Those in treatment were younger and more likely to be Hispanic. "This increase in inhalers and decrease in age at admission is evidence of the emergence of younger heroin users," the report found.

Cheese heroin — a mixture of heroin and Tylenol PM — continues to be a problem in Dallas County, the report stated. However, an analysis of overdose deaths there found only one death that involved cheese heroin alone.

The other deaths also involved drugs like cocaine, Xanax or hydrocodone, "which shows that this is not a population of novice users but a growing problem among very young, experienced heroin users."

Prescription drugs Abuse of alprazolam — the anti-anxiety drug in Xanax — and muscle relaxers appears to be growing.

The number of calls to poison-control centers involving alprazolam has grown, and the drug was mentioned on 216 death certificates in 2006, the report found.

Misuse and abuse of the muscle relaxer carisoprodol have also grown. Poison centers reported 83 calls in 1998 and 510 in 2007.

In 2006, carisoprodol was mentioned on 146 death certificates, up from 51 in 2003.

Methamphetamine
There are some signs that the rate of methamphetamine abuse is slowing. Deaths involving amphetamines or methamphetamines dropped from 2005 to 2006 (the most recent year available), and authorities busted fewer meth labs in 2007 than in 2006.

The Drug Enforcement Agency in Dallas reported that the availability of meth is stable but the price is rising because of tighter border security and increasing difficulty in obtaining the needed chemicals in Mexico.

However, less of the Mexican product could lead to more local labs, Maxwell said.

Alcohol
Alcohol continues to be the drug of choice for Texans. In 2007, 78 percent of high-school students reported having drunk alcohol.

Almost 50 percent had drunk in the past month, and 29 had drunk five or more drinks in a row in the last month.

Binge drinking has increased among girls and decreased among boys. In 2005, 26 percent of girls and 33 percent of boys reported binge drinking. In 2007, 28 percent of girls and 30 percent of boys reported doing it.

A 2005 Texas college survey found that 84 percent of students had drunk alcohol in their lifetime and almost 30 percent reported binge drinking.

Marijuana
Reported marijuana use among Texas high school students was down. Thirty-eight percent of students admitted to having smoked it in 2007, a decrease of 4 percent since 2005.

Marijuana was the primary problem for 23 percent of those admitted to treatment programs in 2007, with the average age being 23. Of those admitted, 42 percent were Hispanic, 30 percent were Anglo, and 27 percent were African-American.
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source: Star-Telegram, http://www.star-telegram.com

One-in-four adults drinks excessively as doctors warn of 'tsunami of alcohol-related harm'

2008-07-23T07:35:00.001-04:00

A quarter of UK adults are damaging their health through excessive drinking, it was revealed yesterday.

Some ten million regularly flout advice on how much to drink, egged on by a licensing industry ignoring its own voluntary code on social responsibility.

There is also clear evidence that cheaper booze is to blame for a massive rise in alcohol consumption, as drink prices have halved in 30 years, relative to earnings.

A blizzard of new figures included:

* The harm caused by excess drinking is costing the UK £25billion a year in healthcare, crime and lost productivity.
* Aound 800,000 hospital admissions a year are due to alcohol-related conditions, 70 per cent more than in 2002-2003.
* Heavy drinking is killing 15,000 people a year - including a quarter of all deaths among young men aged 16 to 24.

Ministers were accused of 'dithering' as they hinted they may bring in laws to replace the failed voluntary code and outlaw aggressive discounting, but said they
would wait for more evidence before making any decision.

Professor Ian Gilmore of the Royal College of Physicians warned: 'The Government are understandably anxious about being seen as a nanny state, but unless they take action their own figures suggest we are moving towards a tsunami of health-related harm.'

Alcohol industry leaders hit back, questioning the findings and accusing the Government of failing to enforce existing laws.

The Home Office commissioned consultants KPMG to assess the voluntary code, which was agreed three years ago and is supposed to stop drinks companies, pubs and bars cashing in on binge drinking.

In particular it is meant to stop the trade glamorising heavy drinking, marketing products to youngsters or encouraging rapid boozing through cutprice promotions in bars.

Another code is meant to ensure drinks containers are clearly labelled with the units of alcohol they contain.

The codes were at the heart of the Government's strategy as it brought in 24-hour drinking.

But researchers uncovered a catalogue of blatant abuses, describing scantily-clad women selling shots of spirits to drunken men in clubs by flirting with them, club DJs urging punters to drink more so they can 'get laid' and bar staff selling alcopops to young customers too drunk to count their change.

In 726 visits they saw only three cases where staff refused to serve a drunken customer. The worst excesses were in 'vertical drinking' venues - the large town centre pubs with no seats where young customers are crammed in.

Researchers also voiced concern over cheap supermarket alcohol.

KPMG concludes that the voluntary code has failed totally. It blames 'overriding commercial interests' to sell more alcohol, and the lack of enforcement. A separate study at Sheffield University highlighted close links between alcohol prices and consumption levels, while Department of Health figures detailed the level of harm.

The British Beer and Pub Association called for 'a renewed focus on individual responsibility and accountability, not just pointing the finger at business'.

A spokesman said: 'The Government should address the underlying culture. Legislation is a sledgehammer that will not crack the nut.'

The lost labelling

The drinks industry first agreed to include alcohol unit information on all bottles and cans ten years ago.

Labels should display the number of units inside and remind drinkers of the Government's 'safe' guidelines.

These are three to four units a day for men and two to three for women.

But a decade later, independent monitoring say they found that only just over half of all packaging - 57 per cent - contains such labelling.

Just 3 per cent carried all the information ministers want, including a warning to pregnant women to avoid alcohol.

The Department of Health admitted: 'There is now real doubt as to whether the agreement can be implemented to the extent that was originally expected'.

The 24-hour impact

The introduction of round-the-clock drinking almost three years ago was one of Labour's most controversial moves.

The Licensing Act swept away longstanding laws on closing times, letting thousands of pubs and clubs stay open into the early hours.

Police and hospitals have since complained of dramatic increases in their workload late into the night.

In the worst-affected areas, alcohol-related cases in hospital have more than doubled.

Public Health minister Dawn Primarolo played down the impact of the changes yesterday, insisting the upward trends in alcohol consumption and harm were already well established and there is no evidence they have become worse.

But hopes of creating a 'Mediterranean-style' cafe culture appear to have come to nothing.
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source: Mail Online

Success of drug program is celebrated

2008-07-22T16:02:00.001-04:00

Inmates hear encouraging words about beating addiction

At 19, Jacoby Smith was sentenced to 55 years because of his cocaine addiction.

He robbed people making late-night bank deposits so he could feed his habit.

"I had a weapon sometimes," Smith, 41, said. "My intentions were never anything more than to [get] money to support my habit."

He finished his prison term in 2006 and now supports four generations of family, from grandmother to grandkids, by working at the Wilmington docks while on probation.

And he thanks the Key Program, a substance abuse program at Young Correctional Institution that celebrated its 20th anniversary Monday.

"I'm proud. I'm proud now of who I am," said Smith, who's been clean for seven years.

Without drug treatment, recidivism rates can top 70 percent, according to the Delaware Department of Correction. While state officials couldn't immediately provide numbers for the Key Program, a similar program in New Jersey boasts of cutting male recidivism by a third and female recidivism by half, said William Palatucci, senior vice president of Community Education Centers, which sponsors the Key Program.

Smith knew he would be at Monday's celebration. He needed to show the success that's possible for those in the program.

"It was heartfelt, just to be in the atmosphere [of Key] and rekindle a lot of experiences that happened here," he said.

The program relies on group and individual therapy to break self-destructive cycles. Participants gradually take on more responsibilities during the program's roughly 18-month regimen. Toward the end of his term, Smith counseled younger inmates.

The prisoners in Key are separated from the general population. They referred to each other as family during the celebration, and a group of them put on a play about life for family members on the outside.

For Smith, it was the one-on-one therapy with a counselor that changed him. He said the one-hour sessions were never enough time to talk. He wrote a lot of essays about self-destructive tendencies and would talk them over regularly.

One realization he had was that using his ability to rile people up and get their attention could be put to better use than getting friends together to cause trouble.

With his long purple T-shirt standing out in the ocean of white prison garb, Smith spoke to the crowd of about 200 inmates currently in the program. He told them of his life of crime and drugs. He gave them encouraging words and drew a standing ovation.

"I was overwhelmed," Smith said. "To receive that response when I'm not being an active participant, that was rewarding."

One of the program's strengths is that it teaches the inmates responsibility, said Smith and Dohn Price, an inmate currently in the program. Their problems are their own and they can't blame circumstances or other people for crimes they commit.

"It's good to come to prison and do more than just jail time and work on yourself," said Price, who is serving a 16-month term.

It's also a tough program, he said. Inmates work seven days a week on their problems, regardless of bad days. That system also keeps out the unmotivated, Price said.

"The process is made to weed out those that aren't ready," he said.
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source: Delaware Online, http://www.delawareonline.com

Binge drinking strategy on rocks

2008-07-21T07:08:00.001-04:00

Labor risks falling off the wagon of its national binge drinking strategy after missing by three months its own deadline for tabling options to tackle alcohol abuse.

In May, a meeting of federal and state ministers with responsibility for drug strategy pledged to fast-track an interim report on binge drinking in recognition of the "urgency'' of the issue.

The document was to go before the Council of Australian Governments in July.
Last week, the ministers met again, with the July 3 COAG event behind them but no report at hand.
A spokeswoman for Parliamentary Secretary Jan McLucas, representing the federal Government on drug strategy, attributed the delay to "extensive'' consultations with the alcohol industry and health groups.

"These consultations, and the work required to gather the necessary information, means that the Ministerial Council on Drug Strategy will now make an interim report to COAG in October,'' Ms McLucas said.

Five months ago, Kevin Rudd unveiled his own $53.5 million plan to combat the binge drinking ``epidemic'', promising a hard-hitting TV campaign as well as grant and pilot project funding.

But he needs the states on board if he is to achieve consistency in local laws restricting parents' ability to supply alcohol to their children and ensuring pubs, clubs and restaurants serve alcohol responsibly.

The report was to cover both those issues, together with the tougher areas of possible controls on alcohol advertising and lower-alcohol products for young people, as well as health warnings on alcohol.

Paul Dillon, director of Drug and Alcohol Research and Training Australia, applauded the report's ambitious agenda and said he could only speculate on the reasons why it had been delayed.

The backlash from related policies - such as the Government's multi-billion-dollar alcopops tax, which it had tied to its binge drinking agenda - may have contributed to the delay.

The alcohol industry had already made inroads in portraying the Rudd Government as wowserish, which could force a more softly-softly approach from Canberra, Mr Dillon said.

"As soon as people think the Government is going to limit what they drink, how they drink, and the cost of what they drink, you run into problems,'' he said.

A spokesman for Health Minister Nicola Roxon denied she was stepping back in any way from the campaign to curb excessive drinking.

"The Government is working very hard and will have more to say on binge drinking,'' she said.
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source: The Australian

Europe's approach to drugs is more enlightened ... it's tougher

2008-07-19T07:21:00.001-04:00

In 2006, Governor-General Michaëlle Jean was hosting Queen Silvia of Sweden during the Swedish royal family's visit to Canada when the topic of illegal drug use came up. The GG told the Queen that Canada is taking an enlightened approach. Instead of punishing users, she said, society needs to be understanding of drug use and assist in reducing harm until the addict is ready to quit.

Alas, the Queen was not impressed. She briskly informed the GG that Sweden takes a hard-line approach, that users are given a choice between treatment and jail, and that Sweden's addiction rates are much lower than Canada's. After that, they changed the subject.

Advocates of harm-reduction measures, such as needle exchanges, methadone programs and Vancouver's supervised-injection site, often point to Europe's more enlightened approach to drugs as proof of how far behind we are in Canada. But parts of Europe are having second thoughts. Socially progressive Sweden had a brief but disastrous fling with prescription heroin back in the 1960s. After that, it embraced the hard-line approach. Today its policy is to make drugs very difficult to get, but treatment very easy - and sometimes compulsory. "The vision is that of a society free from narcotic drugs," says Maria Larsson, the Minister for Public Health.

As a consequence of grassroots support for this policy, drug use in Sweden is a third of the European average. "The lessons of Sweden's drug control history should be learned by others," said Antonio Maria Costa, who heads the UN's Office on Drugs and Crime.

Scotland took a different tack. Drug use is widely tolerated, as you know if you saw Trainspotting. Rehabilitation programs are scarce, but the national methadone program has become a vast and ineffective money-pit. Scotland has more than 50,000 heroin addicts. Drug deaths have soared, drug-related crime is high, and tens of thousands of children are growing up with addicted parents. "Methadone has quite literally become the opiate of the masses," warned Neil McKeganey, one of Scotland's foremost drug policy experts.

Two months ago, the Scottish government announced a change in direction. From now on its primary focus will be on "recovery," not just harm reduction. "Harm reduction ideas have failed in Scotland," says Prof. McKeganey. "They have failed to protect injectors from hepatitis C, failed to reduce the scale of the drug problem, failed to reduce many of the harms inflicted on others."

The Netherlands is famous for its permissive drug culture, but even it is not as permissive as it used to be. Although you can still toke up in marijuana coffee shops, pot remains illegal. A parliamentary proposal to allow regulated, large-scale marijuana production was voted down, and the government moved vigorously against the psychedelic drug ecstasy. Switzerland (which runs supervised-injection sites but also has thousands of treatment beds) voted against decriminalizing marijuana. The UK made marijuana possession semi-legal a few years ago, but experienced an explosion of pot use among minors, as well as a sharp rise in harmful effects attributed to more potent strains of weed. It has now reversed course and reclassified marijuana as a harmful drug.

Like Canada, Australia is experimenting with a supervised-injection site, in Sydney. The passionate debate over whether it reduces harm is virtually identical to the one in Canada.

I asked Scotland's Neil McKeganey if he had witnessed the drug scene in Vancouver, a city that is famous for its harm-reduction approach. He had. "I was utterly shocked," he said. "I could hardly believe that in a culturally developed, sophisticated city there could be a drug problem of such magnitude." In his view, too much emphasis on harm reduction invariably undermines prevention efforts. "To provide a setting where someone can inject street drugs is doomed. The next step is saying, maybe we should be providing them with drugs as well."

The provision of "clean" drugs is, in fact, what many advocates of Insite want next. "Many individuals who promote harm reduction believe there's fundamentally nothing wrong with drug use, except the fact that it's illegal," says Prof. McKeganey.

Every nation is different, and drug policies that work in one place may not work in another. But to him, Vancouver is a clear case study in what not to do. "It's a harbinger of what other cities could experience if they do not develop effective prevention methods."
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source: The Globe and Mail, http://www.theglobeandmail.com

Alcohol + loud music = more alcohol

2008-07-18T15:11:00.001-04:00

Trying to limit your alcohol intake is tougher when you're drinking in a bar with loud music, according to a new study.

Researchers have already shown that listening to fast music can speed up the rate of drinking. But now they say loud music has the same effect. Both fast and loud music can heighten arousal, causing people to drink faster and order more drinks, say the authors of the study, published online today in the journal Alcoholism: Clinical & Experimental Research. And there's another reason why people drink more when the band is blasting: They can't converse.

"...loud music may have had a negative effect on social interaction in the bar, so that patrons drank more because they talked less."

The authors of the study suggest that bar owners tone it down a little so that people won't overindulge. Since we know that won't happen, you may have to monitor yourself. If your ears are ringing, slow down before the room starts spinning.
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source: Los Angeles Times Blogs, http://latimesblogs.latimes.com

Detox centre set for next year

2008-07-17T08:04:00.001-04:00

Mattress detox will take the place of police cells or emergency rooms once a new Addictions Treatment Centre opens next year in downtown Regina.

The project is the result of the Regina & Area Drug Strategy Report, which identified the need for a stronger treatment continuum, said Dave Hedlund, executive director of mental health and addictions services for the Regina Qu'Appelle Health Region.

"One part of which was the capacity to deal with people who are drunk or high at the time in a way that was more therapeutic as opposed to only using police cells or emergency rooms," Hedlund said. "That kind of service -- a place to sleep, to get cleaned up and to have a conversation hopefully in the morning about how you could start to think about turning your life around -- they usually refer to that as brief detox or mattress detox."

The new centre will replace the Detox Centre at 2839 Victoria Ave., and integrate services offered by Regina Recovery Homes and the region to help people recover from alcohol and drug addictions. Many individuals who will use the brief detox beds may need observation but not hospitalization, said Foster Monson, executive director of the Detox Centre.

Aside from the one- to three-day program that will have space for up to 20 clients on a 24/7 basis, a comprehensive 10- to 14-day program called Social Detoxification Services will have 25 single rooms.

"Once they're in the brief detox, it gives the staff and especially the client an opportunity to evaluate their situation to the extent that they would move to the social detox, which is a longer period of detoxification," said Monson. He added that one individual went through detox 44 times before he became sober.

The centre's services will include an addictions assessment, physician visits and optional AA meetings. Hedlund said the direct pathway from one level of treatment to the next in the same building will help ensure an addict's success.

Work will begin this fall to renovate the building at 1640 Victoria Ave., where Future Print is currently located. The treatment centre is slated to open at the end of 2009 and will employ 23 full-time addictions workers. The purchase of the building and renovation cost is pegged at $5.8 million and funded by the provincial and federal governments and the RQHR.

The Ministry of Health has provided $5.1 million in capital funding and $1.25 million towards the centre's $1.8-million operating costs, said Joceline Schriemer, legislative secretary for addictions.

"It's a step in the right direction," Schriemer said. "We're maintaining a relationship with Recovery Homes and that's very important ... Enhancing the drug and alcohol services in this province is a top priority for our government."

The health region distributed information sheets to area residents in June and visited 30 nearby agencies to explain the project. Since planning is in the early stages, the region will hold public consultation meetings in September to provide residents with an opportunity to get more information about the centre.

Leila Francis, executive director of the Core Community Association, doesn't dispute the need for addiction services but wonders why the region didn't arrange public consultations before the building was purchased. She questions whether the centre will generate extra traffic, create parking issues and raise security issues.

"The community here doesn't have a lot of resources within its boundaries yet we house the major feeding programs in the city, so is it going to generate any additional clientele?" Francis asked. "We want to ensure that there is minimal fallout to the community with this centre because all the (addictions) services will be concentrated there."

Glen Perchie, executive director of the region's EMS and emergency services, said the brief detox beds will reduce the pressure on emergency departments.

"A lot of times, people with addictions problems and those coming in intoxicated have a chronic underlying problem and we're not so good at that," he said. "This is an opportunity to bypass the emergency department in many cases and take them directly to a place that's actually focused on their care and get them the appropriate help. It's the fast track to the right place."
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source: © The Leader-Post (Regina) 2008, http://www.canada.com/reginaleaderpost

Children often innocent victims of adult addiction, drug abuse

2008-07-16T11:05:00.002-04:00

For one 12-year-old girl, addiction is a drawing of a green monster with red eyes that has a steel band around her mom, dad and older sister. It carries a bag of alcohol, nicotine and inhalants.

For another child, addiction is a sketch of his mom and dad in a beer can, with the words “please stop” etched above in crayon.

And for a handful of kids, it’s an image of a broken heart, sometimes drawn with parent’s names on each side, or the names of a brother or sister, aunt or uncle.

Whatever the image, the picture is the same for kids who were asked to describe the disease: drug and alcohol addiction hurts families, especially children.

“It’s now a huge issue. Almost one out of three, one out of four kids are living in a family with alcohol or drug abuse,” said Jerry Moe, vice president and national director of children’s programs at The Betty Ford Center in California. “They’re the No. 1 at-risk group.”

Moe, speaking Monday at Indiana University of Pennsylvania to kick-off the 20th year of the Mid-Atlantic Addiction Research Training Institute Summer School, said that, though the issue is prevalent now, this is the time to stop the multi-generational disease and push back the first age a child may use a substance. Children in families with addiction are at a higher risk of getting the disease than those without any family history, he said.

“If one takes a coin that says at-risk and turns it over, it says at-promise. Some kids have the most incredible strength and promise. They just need safe people to guide them,” he said.

Ten years ago, the average age for a child to have his or her first drink was 15 years old, he said, but today the average age is 12 years old.

“Younger kids start regardless of any other risk and are more likely than ever to get harmfully involved,” he said.

Part of the reason for such prevalent effects on children has been a change in the family form over the last 35 to 40 years, said Robert Ackerman, director of MARTI.

“I don’t think children today are different than when I was a child. If you let a child do what they want, they’ll do what they want,” he said. “What has changed dramatically is adult behavior. Children in many cases are trying to survive changes in adult behavior in our culture.”

Child abuse, neglect, abandonment and divorce are some of the many interrelated problems that affect families suffering from addiction.

“We hear the African saying ‘It takes a village to raise a child.’ Well it takes that same village to stop the parents,” he said.

Pictures drawn by kids in the programs at the Betty Ford Center illustrate the feelings of guilt, shame, hopelessness, anger and sadness that children in families with addiction experience.

One girl drew a picture of her dad passed out on a couch the entire time she was with him for the weekend while she sat alone on a chair crying. Another drew an image of his mom with a bottle on a bed while he was on the phone with his grandpa, asking for help.

Conflict, Moe said, is what hurts families the most, but children are also hurt by what doesn’t happen in the family place, especially when they know something is wrong.

“They may not be able to name it specifically. They may not be able to name addiction. But they know something is wrong because they love their parents more than anything else,” he said. “… Kids know a lot. We don’t give them enough credit for how much they know and some feel they’re going crazy because no one validates.”

But the situation is not hopeless as treatment and research organizations are shifting their focus to advocate and work for all children, not just those from addicted families, Ackerman said.

Another step is for people to become conscious of the effects on children. It is important, he said, for adults to admit that kids are affected by their behavior, whether they realize it or not.

For Moe, anyone that can get involved in the life of a child can help. Forming relationships and letting a child know someone safe is there for them can help tremendously, he said.

“What are their strengths? Build them. Skills? Give them some new ones. Supports? Be one,” he said. “Help kids find the beauty and goodness inside.”

In his arsenal of games and techniques at the Betty Ford Center, his most potent weapon is love.

“It’s our most basic human need that from the time we’re conceived to when we take our last breath. We need to love and be loved,” he said.
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source: http://www.indianagazette.com

The Failure of the Office of National Drug Control Policy

2008-07-15T06:31:00.002-04:00

As an insider in the nation's war against drugs, I spent almost fifteen years in the executive office of the President. Eleven of these years were in the Office of National Drug Control Policy where I served four of the nation's so-called drug czars preparing the federal drug control budget, writing many of the national drug control strategies, and conducting performance measurement and analysis of the efficacy of those strategies. I left government in 2000, but continue to be highly involved in shaping drug policies and measuring performance in drug policy both nationally and internationally.

In the latest 2008 National Drug Control Strategy, the Office of National Drug Control Policy (ONDCP) -- the federal executive office agency charged with shaping this nation's national drug control strategy -- claims that America has reached a turning point in the war on drugs. In reality, we have little reason to believe a significant change has occurred. ONDCP based its claim on declining use for youth -- a trend that long precedes this administration's tenure -- but ignores the lack of progress with regard to adult drug use, rates of drug addiction, the inaccessibility of substance abuse treatment, and new emerging drugs of demand such as pharmaceutical drugs and methamphetamine. If America is to be successful in the fight against drugs, the first priority for the next administration -- Republican or Democrat -- must be to reinventing ONDCP as an effective policy office capable of leading the nation's struggle with drugs.

In the 1980's, the United States essentially focused on supply reduction, largely in response to a cocaine epidemic, and with the belief that source and transit zone interdiction was the most effective means of reducing drug use in the United States. By the 1990's we had learned that interdiction was a relatively ineffective way of reducing drug use -- and expensive besides. So we focused our efforts on demand reduction. Now, at the beginning of the new millennium we have...inexplicably...come to believe again that source and transit zone interdiction is an effective way to reduce drug use in America. There is no evidence to support this belief. And it is all the more surprising that we have refocused our efforts in this way at a time when many of the major drugs of abuse -- including marijuana, methamphetamine, and controlled pharmaceuticals, are produced domestically.

The central task of ONDCP -- and what must now become the central political debate -- is determining how best to combine and fund the five essential ingredients of drug control policy: prevention, treatment, domestic law enforcement, international or source country programs, and interdiction.

Though Congress created ONDCP to formulate research-driven and performance-based policy, assess and modify policy through performance measures, and give a precise accounting of the federal drug control budget, ONDCP fails at all of those tasks. In the 90's ONDCP created a performance measurement system for evaluating the effects of its policies on drug use, drug availability, and the negative consequences of drug use; however, this decade, no such performance measurement system has been utilized. As a consequence, policy is now flying blind resulting in lost opportunities for more success.

Simply put: the cornerstone of all evidence-based policy driven by reliable performance data. Currently, ONDCP has failed to establish baseline measures link to the ingredients of an effective drug policy. This is inhibiting our nation's ability to better assess future action. The first step of any administration must be to reassert ONDCP as the flagship substance abuse organization by instituting a performance measurement system to allow Congress, the American people, and ONDCP itself access to crucial data. To stay ahead of emerging drug trends, ONDCP must once again make knowledge development, data systems and research a priority. Leading drug use indicators must steer drug control policy rather than outdated trends.

Second, ONDCP's budgetary role must be fixed. A review of the Federal drug control budget for this decade shows the following: the Administration's drug control budget since FY02 has emphasized supply reduction programs over demand reduction programs; resources for supply reduction (interdiction of drugs, source country programs, and law enforcement), grew by almost 57% from the FY 02 baseline level to the FY 09 request now before Congress; and by comparison, demand reduction resources (prevention and treatment, including resources for research for agencies like the National Institute on Drug Abuse) grew by only 2.7 percent--prevention is actually cut 25 percent.

This budget trend runs counter to what research would otherwise suggest: that efforts to reduce demand are best addressed through treatment and prevention rather than supply reduction.ONDCP must fully exercise its budgetary authority. Working with the Office of Management and Budget to formulate and distribute an accurate drug control budget to implement its policy priorities is the only way to ensure that research findings are reflected in the drug control budget.

Finally, a new administration must retool and reemphasize ONDCP as an effective policy leadership organization. Right now, ONDCP administers many programs that could be better managed by other federal agencies responsible for drug program administration. ONDCP rediscover its roots by again becoming a leader in policy formulation to develop a drug policy that is evidence-based and includes performance measurement to hold it accountable for results. An outdated organizational structure reflecting the 1980's cocaine war must be abandoned in favor of one that addresses today's multifaceted drug threat, recognizing that drug use occurs in drug markets where the most common drugs are more often domestically produced. Programs which distract from ONDCP's policy-setting mission must be jettisoned to agencies more suited to those particular tasks (e.g. Drug Free Communities to SAMHSA). ONDCP must focus exclusively on policy and budget.

The new administration will face a unique opportunity to reshape American drug policy. ONDCP must develop a strategy that is research- and performance-based. It must present a federal drug control budget that emphasizes effective programs that support an evidence-based, comprehensive drug control policy. It is now up to the next president, be he or she Democrat or Republican, to enable ONDCP to meet the nation's needs to reduce drug use and its damaging consequences.
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Author: John Carnevale
source: Huffington Post, http://www.huffingtonpost.com

Methamphetamine use stable but causing more problems

2008-07-14T06:39:00.002-04:00

New research suggests methamphetamine use has stabilised over the past three years, but frequent users are experiencing more health and legal problems.

Massey’s Centre for Social and Health Outcomes Research and Evaluation (SHORE) has released the 2007 Illicit Drug Monitoring System (IDMS), which offers a snapshot of trends in drug use and drug related harm in New Zealand.

Lead researcher Dr Chris Wilkins says frequent users of methamphetamine were more likely to have needed an ambulance, accident and emergency department, drug and alcohol worker, counsellor or GP in relation to their drug use in 2007 compared to the previous two years.

“Overall levels of methamphetamine use appear to be fairly stable but this research indicates there is a growing population of heavy users experiencing health and legal problems.” Dr Wilkins says.

Frequent methamphetamine users were also more likely to have committed violent or property crime last year compared to the 2005 findings.

“Users are under increasing financial pressure, however only minorities of frequent users reported paying for their drug use with money from property crime and even smaller minorities committed violent crime.”

There has been some decline in the availability of crystal methamphetamine (ice), the research shows.

“This is likely to reflect the impact of some very large seizures of crystal methamphetamine made by police and customs in 2006 and 2007,” Dr Wilkins says.

Frequent drug users, interviewed as part of the ongoing research, stated that more people they knew were using ecstasy last year compared to 2006.

“The situation with ecstasy is somewhat confused by the previous ready availability of BZP party pills [now outlawed], which are sometimes fraudulently sold by drug dealers as ecstasy. Increasing use of ecstasy may also reflect the declining reputation of methamphetamine which is increasingly associated with serious psychological problems and addiction.”

The full report can be found at: http://www.shore.ac.nz/projects/idms_study.htm
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source: Massey University, http://www.massey.ac.nz

Mixed progress for bupe

2008-07-12T11:02:00.002-04:00

As city includes hard-core addicts, more drop out

Baltimore has doubled the number of people using the medication buprenorphine to shake off heroin addiction but has struggled to keep them in treatment.

As the Baltimore Buprenorphine Initiative has accepted more hard-core drug addicts dealing with complications such as mental illness, more drop out. At the start of the initiative in October 2006, officials had picked mostly highly motivated participants.

The retention rate dropped to 52 percent for the year that ended June 30 compared with 65 percent in fiscal year 2007. That is prompting city health officials to question which patients do best on buprenorphine, sold as Suboxone and widely known as "bupe."

"Who is the right candidate for bupe?" asked Dr. Joshua M. Sharfstein, Baltimore's health commissioner. "It's just really hard to tell." He said officials will examine that issue closely.

The initiative, which cost about $2 million last year, is "continuing to gain momentum," he said. "More clinics are participating. More patients are being treated. More doctors are interested in seeing patients."

The novel program introduces addicts to Suboxone in city-backed clinics that stabilize patients before transferring them into the care of private doctors who have become qualified to prescribe the drug.

The city has streamlined its process of securing health insurance for the mostly low-income participants and added clinics and doctors to expand access.

But the 771 patients who entered the program over the past year are taking longer than the first year's 388 patients to make the transfer because they still abuse drugs other than heroin, such as cocaine.

Some studies have shown that methadone is better for longtime heroin addicts while Suboxone is best for people who are newly addicted or who are hooked on pain pills like OxyContin. Sharfstein hopes that pairing public and private resources will render buprenorphine an effective new weapon to battle heroin addiction.

In 2006, more than 10,000 city residents were admitted to facilities for heroin addiction treatment. Each year more 200 die from overdoses of heroin and other narcotics.

Valarie Clark abused heroin for nearly 20 years. After enrolling in the city initiative nearly two years ago, she has experienced her longest stretch without using heroin.

But her struggles demonstrate the challenge of getting even the best patients - Clark was held up as model before the City Council last summer - to stick with treatment.

Last month, after a dispute in her recovery house, Clark moved out and stopped taking Suboxone, without consulting her doctor or therapist at Total Health Care, the city's largest participating clinic.

She fell into a depression that left her with a choice: heroin or bupe.

"I would have used," said Clark, 52.

But she chose the bupe, starting again with the pills left over from her earlier prescription. "The depression went away and I'm continuing my therapy," she said. "I'm back in the [recovery] house."

A recent report showed that fewer addicts stuck with Suboxone treatment after 90 days than in the first year. The city's goal was to retain 67 percent at least that long. In the period from October 2006 to June 2007, the initiative succeeded in keeping 65 percent that long. But that dropped to just over half in the 12 months ending June 30.

"The retention rate has fallen," Sharfstein said.

One major reason is that the initiative has broadened its reach to take in people who are new to treatment, who suffer from other psychological problems or addictions and who engage in high-risk activities like prostitution.

It also took longer for patients to get off all drugs so they could be transferred out of city-backed clinics into the care of private doctors. Many patients stop using heroin but continue to abuse cocaine, leaving them ineligible to transfer. The city had wanted to transfer patients to the medical system after 90 days. In the first year, it took an average of 155 days. For the year that ended June 30, it took 163 days.

In addition, the initiative's pace of training doctors has lagged. Sharfstein had wanted 100 doctors to receive the federal waiver required to prescribe the pills. So far, 82 have received the clearance after completing an eight-hour training course.

The initiative also made a special effort to recruit more psychiatrists to deal with patients suffering both addiction and other mental illnesses.

"I would characterize this as good progress," Sharfstein said in an e-mail. "While we have not had 100 new waivered doctors yet, I am confident we will get there."

Suboxone's expense remains an issue. Methadone for heroin addiction costs about $8,000 per person over two years, the city reported last year. Suboxone treatment costs nearly twice that and has gotten more expensive.

Wendy Merrick, who directs addiction care at Total Health Care in West Baltimore, said the price per bottle of 30 pills has increased from $107.15 to $111.70.

To help cut costs, the Baltimore Substance Abuse Systems Inc., which manages most of the budgets for nearly all of the participating addiction treatment centers in Baltimore, has started buying in bulk, said Marla Oros, a consultant with BSAS.

The city's first report on its initiative in July 2007 made little mention of efforts to prevent misuse and illegal sales of buprenorphine. In December, The Sun published a three-part series that showed that abuse of Suboxone was on the rise across the nation as its availability increased. The drug was rolled out in 2003 after the federal government allowed doctors to prescribe it from their offices, unlike methadone, which is dispensed from highly regulated clinics.

The latest report devotes an entire section to efforts that the city has taken to minimize misuse of the drug: counting pills, testing urine and monitoring patients when they first start taking the pills. But the report states that "there is no evidence of a significant public health threat from buprenorphine diversion in Baltimore at this time."

A survey of 30 Baltimore physicians conducted by a consultant with the drug's manufacturer, Reckitt Benckiser Pharmaceuticals Inc., found that 67 percent were "aware of buying and selling of Suboxone, a percentage higher than the national average," the report states.

Clark, who was profiled in the series and has returned to treatment at Total Health Care, said she has seen the street demand for Suboxone increase.

"I was just at Lexington Market getting lunch and, wow, it's amazing," said Clark, who first tried Suboxone on the street. "It's almost like people are asking for Suboxone more than other things. The bupes. They ask for bupes."
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doug.donovan@baltsun.com

Copyright © 2008, The Baltimore Sun

Wellstone son launches push on mental health bill

2008-07-10T06:10:00.001-04:00

The son of the late Minnesota Sen. Paul Wellstone made a big push Wednesday for mental health insurance long championed by his father, leading a call-in effort urging Congress to take up the legislation before its August recess.

David Wellstone wants Congress to approve legislation that would mandate equal health insurance coverage for mental and physical illnesses when policies cover both, known as mental health parity. The bill is co-sponsored by Rep. Patrick Kennedy of Rhode Island.

The Senate and House have already passed different versions of the bill, but negotiators have reached a compromise. Now, the sticking point is finding a way to pay for it.

The Congressional Budget Office has estimated the House bill would cost the federal government around $3.9 billion over 10 years -- $820 million in increased Medicaid costs, and $3.1 billion in lost tax revenue. That latter figure assumes that employees would receive more of their compensation in nontaxable employer-paid premiums, and less in taxable wages.

"Now that the House and Senate have agreed on a compromise bill, we are so close," David Wellstone wrote to supporters. He said in a telephone interview that he expected thousands of people would call in to push for passage -- and he was hopeful for a vote next week.

Under the compromise, House backers agreed to drop a requirement that said that if a plan provides mental health benefits, it must cover mental illnesses and addiction disorders listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, which is used by mental health professionals. The Senate bill did not have that requirement.

But the Senate negotiators made concessions, too, including agreeing to some of the House language requiring parity for out-of-network coverage.

The House bill was sponsored by Kennedy, who has battled depression, alcoholism and drug abuse, and Rep. Jim Ramstad, R-Minn., a recovering alcoholic who is Kennedy's Alcoholics Anonymous sponsor.

"This is literally a life-or-death issue for millions of Americans suffering from mental illness and addiction," Ramstad said, "and I'm grateful we are so close to enacting legislation for which we've fought so long and hard." Ramstad is retiring at the end of the term.

The House bill was named for Paul Wellstone, a Minnesota Democrat who died in a plane crash in 2002. In 1996, he and Sen. Pete Domenici, R-N.M., won passage of a law banning plans that offer mental health coverage from setting lower annual and lifetime spending limits for mental treatments than for physical ailments. The new legislation would build on that by adding things like co-payments, deductibles and treatment limitations, a longtime goal of Wellstone's.

The Senate bill was sponsored by Kennedy's father, Massachusetts Democrat Edward Kennedy, Domenici, and Mike Enzi, R-Wyo.
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source: Associated Press

Drinking to destruction

2008-07-08T06:37:00.002-04:00

With a difficult exam behind or a weekend ahead, a college student goes drinking. After the youth ties one—or make that several—on, he or she is noticeably drunk, but friends simply put the inebriated to bed to "sleep it off." Instead of passing out, the student passes away—and becomes another troubling statistic of alcohol poisoning. Drinking games play a deadly role, which explains the flat reception for a video game called "Beer Pong."

Rising toll
An Associated Press analysis of federal records found that 157 college-age people, 18 to 23, drank themselves to death from 1999 through 2005, the most recent year for which figures are available. The number of alcohol-poisoning deaths per year nearly doubled over that span, from 18 in 1999 to a peak of 35 in 2005, though the total went up and down from year to year and dipped as low as 14 in 2001.

Point of oblivion
A separate AP analysis of hundreds of news articles about alcohol-poisoning deaths in the past decade found that victims drank themselves well past the point of oblivion — with an average blood-alcohol level of 0.40 percent, or five times the legal limit for driving.

Fighting bingeing
Schools and communities have responded in a variety of ways, including programs to teach incoming freshmen the dangers of extreme drinking; designating professors to help students avoid overdoing it; and passing laws to discourage binge drinking.

This week, a Las Vegas-based company changed the name of an upcoming video game to "Pong Toss," instead of "Beer Pong" — the name of a popular college drinking game. Connecticut's Atty. Gen. Richard Blumenthal had said Monday that a video-game-rating board's decision to approve "Beer Pong" for children as young as 13 showed the organization needed to take the issue of teen drinking more seriously.

Spike on weekends
The federal data showed deaths spiking on weekends — when young people are more likely to go out with the goal of getting drunk — and in December, when college students wrap up finals. Most of the dead were young men.

College students on average drink only a little more than adults in a typical week or month, said Scott Walters, an assistant professor of behavioral sciences at the University of Texas School of Public Health. College students "tend to save the drinks up and drink them all at once."

Fears for Freshmen
Freshmen were found to be at greatest risk, with 11 of 18 freshmen deaths occurring during the first semester.

Walters said one reason is that freshmen are on their own for the first time and trying new things. Also, there is a mentality that "if you're under 21 and someone's got alcohol, you've got to drink it, because you never know when somebody's going to have it again."

One practice—drinking 21 shots on a 21st birthday—has proven especially lethal. Of the college-age deaths reviewed, 11 people, including eight college students, died celebrating their 21st birthdays.
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source: Chicago Tribune

State of Drinking: Alcohol woven into small-town economy

2008-07-07T07:34:00.001-04:00

The bar at Coppershot, a jumping downtown nightspot, gleams.

Owner Scott Hanadel has plenty of help keeping the bar's copper surface polished: the elbows of all those drinkers.

The popular bar frequently is packed, especially when there's live entertainment -- no small feat in a town with so much competition for a drinker's dollar.

Including restaurant bars and those inside other gathering spots such as the local VFW post, New London has one bar for roughly every 420 residents. That ranks among the higher numbers nationwide but is not unusual by Wisconsin standards. A 1990 study by the National Institute on Alcohol Abuse and Alcoholism found that Wisconsin was home to seven of the country's top 10 metropolitan areas with the most bars per capita.

Hanadel has no doubt what would happen if the town ever ran dry.

"It would die," he said. "There would be no reason to come downtown unless you wanted to catch a movie. This town would be a ghost town."

In Wisconsin, where drinking is inextricable from the fabric of life, alcohol informs not only the culture but also the economy. Nowhere is that more evident than in the state's small towns.

Notwithstanding the well-documented human and financial toll of alcohol abuse, which can be overwhelming, officials say the production and sale of alcohol infuses Wisconsin's economy by providing livelihoods, generating revenue and breathing life into city centers that otherwise would wither.

Such dichotomy makes for a complicated and sometimes rancorous debate.

Liquid assets

Wisconsin's drinking establishments rang up $598 million in sales in 2002, the last year for which full figures are available, according to the 2002 Economic Census. There were 14,038 people employed in alcohol-serving capacities, census data show.

Currently, Wisconsin has 10,571 drinking establishments that operate with beer-liquor licenses, according to Jessica Iverson, spokeswoman for the Wisconsin Department of Revenue. That includes standalone bars, restaurants, recreational venues such as bowling alleys and hotel lounges.

Another 1,760 operate with beer-only licenses. The vast majority of those are restaurants, Iverson said.

A 2007 survey conducted by the Washington, D.C.-based Beer Institute reports that the brewing industry was responsible for more than 30,000 jobs in Wisconsin in 2006. The industry had a $3.35 billion impact on the state when based on brewers, wholesalers and retailers, the survey reports.

Wisconsin ranks near the top for per capita alcohol consumption. In 2005, Wisconsin ranked fifth, averaging 2.92 gallons of booze sold per person.

Terry Harvath, president of the Outagamie County Tavern League, said downtowns in many small towns likely would fizzle after dark without alcohol.

"When people do go out for entertainment, I think drinking and dancing goes with it," Harvath said. "When you can cover all aspects of somebody going out -- if you can serve food, the beer and the liquor, and wine at the same time -- you're cornering the market."
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source: http://www.wausaudailyherald.com