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Tuesday, October 18, 2016

Drug Abuse Arrests in 2015

Addiction is a mental illness. A condition with a set of criteria delineated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). While there is no cure for the disease, one which take tens of thousands of American lives every year, with treatment and continued maintenance people can and do recover.

The United States has been waging a “war on drugs” since the 1970’s. Millions of people’s lives have been devastated by the enactment of draconian drug sentencing laws. Legislation which does little, if anything, to address the problem of addiction. It would be nice to think that people who serve time for drug related offenses, will come through on the other side reformed and dead set on not repeating the same mistakes. Unfortunately, that is far from the case. The vast majority of people who go to prison or jail for drug use related offenses, end up being incarcerated in the future for a similar offense.

It is little secret that the U.S. has been in the grips of an opioid use epidemic. Between prescription opioids and heroin, there are over 2 million Americans who meet the criteria for an opioid use disorder. Naturally, our prisons and jails are already overpopulated with nonviolent drug offenders. There simply is not room, nor would it do any good to try to imprison the millions of opioid addicts. That does not mean that law enforcement agencies will not try, despite the call from many lawmakers to offer treatment over jail.

The President, politicians on both sides of the aisle and addiction experts all agree that we can no longer delude ourselves into thinking that the war on drugs is a fight that can be won. They understand that treatment is the best weapon against addiction. You might think that the more enlightened stance on addiction would result in fewer arrests for nonviolent drug offenses, yet that is far from the case. In fact, many states still lock up people every day for drug crimes.

The Federal Bureau of Investigation (FBI) recently released a report that showed there were nearly 1.5 million arrests for drug abuse in 2015, Newsweek reports. The majority of the arrests were for simple possession of drugs, primarily marijuana. Below is a breakdown of the arrests:
  • Marijuana (38.6 percent or 574,641 people)
  • Heroin / Cocaine (19.9 percent or 296,252 people). 
  • Possession of Other Dangerous Non-Narcotics (20.2 percent)
  • Synthetic Drugs (5.1 percent)

Tuesday, October 4, 2016

Experimental Drug Could Help Alcoholics

There are a couple of medications available that have shown promise with regard to reducing alcohol cravings and the symptoms of alcohol withdrawal, Vivitrol (naltrexone) and Acamprosate. While these medications are commonly prescribed in addiction treatment settings, the majority of alcoholics never see the inside of such facilities. Since those types of drugs are considered to be under-utilized, a significant number of people with alcohol use disorder who could benefit from such medications rarely are offered the drugs by their primary care physician.

Acamprosate, with some individuals, has been found to mitigate the symptoms that typically accompany post-acute alcohol withdrawal, such as insomnia, anxiety and restlessness. All three of those symptoms have lead people to consider, or worse actually, relapse. Which is why public health officials are encouraging doctors to utilize alcohol use disorder medications, as it may give certain patients a better chance at prolonged recovery, NPR reports.

“They’re very safe medications, and they’ve shown efficacy,” said George Koob, Director of the National Institute of Alcohol Abuse and Alcoholism. 

Alcoholism plagues millions of people around the globe every year. It practically goes without saying that “booze” is pervasive, people are exposed to practically everywhere. Being one of the reasons that relapse rates are so high, external triggers are everywhere. It is unfortunate that there isn’t a plethora of medication options available for the treatment of alcohol use disorder. But, fortunately researchers continue to work on new drugs that could help people abstain from drinking.

New research suggests that an experimental drug, ABT-436, could be a promising aid for people with alcohol use disorder who experience high levels of stress, according to Live Science. On average, participants in the study who were given ABT-436 were able to abstain for 51 days, compared to 42 days in the placebo group. The findings were published in the journal Neuropsychopharmacology.

“Our findings suggest that potential future studies with drugs targeting vasopressin blockade should focus on populations of people with [alcohol use disorder] who also report high levels of stress,” study co-author Megan Ryan, a clinical project manager at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Wednesday, September 21, 2016

Opioid Epidemic Week - Raising Awareness

September is an important month for people in both addiction medicine and recovery. There is a plethora of events taking place with regard to addiction and mental health as a whole, including National Recovery Month and Suicide Prevention Awareness Month. As we mentioned at the end of August, National Recovery Month is about increasing awareness and celebrating successes of those in recovery.

Suicide Prevention Awareness Month is equally important because most of the suicides that occur every year are related to mental illness. On top of that, a significant number of people living with a mental health disorder, such as depression, use drugs and alcohol to cope with their symptoms. A coping mechanism that can lead to addiction. While mind altering substances can provide temporary relief, in the long run they actually exacerbate one’s mental illness. Without assistance in the form of treatment and continued therapy, people will often resort to choices that they cannot undue, i.e. suicide.

Encouraging people to seek help for any form of mental illness is of the utmost importance, and breaking the stigma that often accompanies mental health is just one facet. The other is making sure that assistance is widely available, especially in rural America—regions often hit the hardest by the American opioid epidemic. Treatment is the best weapon against mental health disorders, a tool that has proven to save lives—time and time again.

The Substance Abuse and Mental Health Services Administration (SAMHSA) released their 2015 National Survey on Drug Use and Health. The findings were troubling to say the least. It turns out that one-third of American adults were prescribed opioid painkillers last year, despite the government's efforts to encourage a change in prescribing practices among primary care physicians.

On Monday, the White House administration announced the launch of Prescription Opioid and Heroin Epidemic Awareness Week. The President is calling on Congress for $1.1 billion to fund a several initiatives vital to fighting the opioid epidemic.

“During Prescription Opioid and Heroin Epidemic Awareness Week, we pause to remember all those we have lost to opioid use disorder, we stand with the courageous individuals in recovery, and we recognize the importance of raising awareness of this epidemic.” --Proclamation by President Obama, September 16, 2016

Federal agencies announced several plans, such as:
  • Expanding substance use disorder treatment in the TRICARE system to include coverage of intensive outpatient programs and treatment of opioid use disorders with medication-assisted treatment.

  • Establishing enhanced measures in conjunction with the Chinese government to combat the supply of fentanyl and its analogues coming to the United States.

  • Supporting distance learning and telemedicine programs that expand access to healthcare, substance use disorder treatment, and educational opportunities in rural communities.

Tuesday, September 6, 2016

Impulse Control In Alcoholics

A common thread that everyone with a history of addiction shares is having a lack of impulse control. For the average person, having a couple drinks and going to bed is no hassle at all. But for the alcoholic, having one drink begets another and they will typically not stop drinking until there is no more alcohol to be had. Simply put, there is no 'off switch' for people with alcohol use disorder.

While it is well understood that substance use disorder is a mental illness in the field of addiction medicine, a significant number of people still believe that addiction occurs in people who have a lack of willpower or a moral failing. It is a mindset that throws fuel on the fire that is the stigma of addiction. The reality of addiction is quite different than most people think, since addiction is a mental health disorder. Understanding the nature of substance use disorder begins and ends in the human brain.

In fact, when it comes to impulse control in alcoholics, new research suggests that it may be due to a lack of a certain enzyme in the brain, according to International Business Times. Years of research by the University of Linköping indicates that an enzyme known as PRDM2, or the lack thereof, could be responsible for diminished impulse control in alcoholics. The findings were published in the journal Molecular Psychiatry.

"PRDM2 controls the expression of several genes that are necessary for effective signaling between nerve cells," said lead author Markus Heilig. "When too little enzyme is produced, no effective signals are sent from the cells that are supposed to stop the impulse."

Down the road research on PRDM2 could lead to the development of drugs that could increase impulse control, potentially preventing relapse, the article reports. In the meantime, Heilig points out that addiction is a biological problem, one that should not carry stigma.

"We see how a single molecular manipulation gives rise to important characteristics of an addictive illness," adds Heilig. "Over the long term, we want to contribute to developing effective medicines, but over the short term the important thing, perhaps, is to do away with the stigmatization of alcoholism."

Wednesday, August 31, 2016

Oxygen Could Help Opioid Withdrawal

opioid withdrawal
For the millions of Americans currently living with an opioid use disorder, the thought of withdrawal is frightening. It is one of the major reasons that prescription painkiller and heroin addiction can persist for years, and in some cases even decades. Opioid addicts are fully aware that the drugs they use carry a huge potential for overdose, yet in some cases the risk out outweighs being subject to the pain of withdrawal.

Aside from opioid addicts who suffer from legitimate chronic pain which often leads to continue use, a significant number of people who are dependent on such drugs will relapse shortly after withdrawal begins. Unlike ‘kicking’ other addictive drugs, opioid withdrawal is synonymous with up to two (2) weeks of severe restlessness and discomfort, along with nausea and body aches. Without the assistance of a medical detoxification facility, most addicts will resume use in less than three (3) days after cessation.

However, even with the aid of certain drugs and medical supervision, withdrawal is still not a walk in the park. Finding ways to mitigate the severity of withdrawal could help opioid addicts see the detox period through and begin the journey of recovery before they throw in the towel. New research suggests that the use of pure oxygen in a hyperbaric chamber could ease the pain of opioid withdrawal, according to a Washington State University press release. The findings were published in the journal Brain Research.

The preliminary tests involved mice that were addicted to morphine. Before being withdrawn from the drug the mice were given pure oxygen at 3.5 times atmospheric pressure in a chamber, the article reports. The mice exhibited much less severe withdrawal symptoms and appeared to be calmer, compared to the mice that did not get the same treatment. Currently the use of hyperbaric oxygen treatment is not approved by the U.S. Food and Drug Administration (FDA), but hopefully it will be in the future—considering the opioid addiction epidemic the country faces.

"Our research and work that we hope to do in the future should stimulate some clinical researchers to come up with clinical evidence to convince the FDA that this should be an approved indication," said Ray Quock, a pharmacologist and Washington State University psychology professor.