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Thursday, March 16, 2017

Marijuana Use Linked to Heart Failure

As California works out what recreational marijuana use will look like throughout the state, researchers continue to probe the drug and its effects on the human body. The law which Californians voted on, Proposition 64, allows adults over the age of 21 to buy and consume marijuana products. While legalization is generally considered to be a good a thing when compared to the damage caused by prohibition, there is significant evidence that suggests that the drug is not without side-effects. Some of which, could be long term.

Most of the research available that is utilized by legalization opponents, is often linked to adolescent use of the substance. Studies have found convincing evidence that marijuana use in adolescents can lead to cognitive issues, particularly regarding memory. Developing brains are particularly susceptible to the drug's effects. What’s more, young people who use cannabis may be at a greater risk of developing a problem with not only “weed,” but other mind altering substances. Great pains should be taken by both parents and educators to deter teenage use of the drug.

When it comes to adult use, most Americans would probably agree that the substance is relatively harmless. It is a perception that likely arises from comparisons between “pot” and other drugs, e.g. cocaine and opioids. What Americans deduce from such comparisons are not so much as wrong, as they are a precarious line of thinking. And just because a substance is legal does not mean that is inherently safe. Alcohol is legal for people 21+ to imbibe, but more people die from alcohol-related health complications every year, than from any other addictive substance.

So, as California gears up to begin selling marijuana for recreational use in 2018, it is important that citizens of the state are apprised of possible health concerns that could arise from cannabis use. Research has shown that, after accounting for a number of factors, marijuana use was associated with an increased risk of stroke and heart failure, according to a press release from the American College of Cardiology. The link between the drug and heart problems came from an analysis of more than 20 million health records from young and middle-aged patients across the country. The research was presented at the American College of Cardiology's 66th Annual Scientific Session.

Researchers involved in the study had to take into account various considerations before reaching their conclusion. Factors included both demographics and lifestyle choices such as whether a patient drank alcohol or smoked cigarettes, or not. Compared to those patients who didn’t use marijuana, those who engage in use were found to be at a much greater risk of:
  • Heart Failure
  • Coronary Artery Disease
  • Stroke
  • Sudden Cardiac Death
"Like all other drugs, whether they're prescribed or not prescribed, we want to know the effects and side effects of this drug," said study lead author, Aditi Kalla, MD, Cardiology Fellow at the Einstein Medical Center in Philadelphia. "It's important for physicians to know these effects so we can better educate patients, such as those who are inquiring about the safety of cannabis or even asking for a prescription for cannabis."

As always, more research is required. The study did not have access to vital information which could further point out who is at the greatest risk. For instance, quantity and regularity of use or how the drug is consumed. Did a patient smoke cannabis or did they ingest it? Even without that information, the current findings are of the utmost importance moving forward.

Friday, March 3, 2017

Trading Opioids for Alcohol

Programs of addiction recovery are built upon abstaining from drugs, alcohol or any other mind-altering substance that can be habit-forming. It makes sense. While many have gone into Alcoholics Anonymous (AA) thinking that they can still use drugs or sought help from the program of Narcotics Anonymous thinking they can still drink alcohol, it is a line of thinking that almost always ends with one going back to their substance of choice.

If you meet the criteria for addiction of any kind, then you are susceptible to the lures of any mind-altering substance. Deluding one’s self otherwise is a dangerous course. It is not uncommon for someone to stop using one substance, only to develop an unhealthy relationship with another. If you are new to recovery and have attended a 12-Step meeting where somebody mentioned something about that occurrence, do yourself a favor and heed those words. It could save you a lot of future heartache.

While total abstinence is oft considered the best course of action for living a healthy productive life, not everyone is receptive to the program and the thought of never using anything, ever again, is often to hard a pill to swallow. Some addicts who want to be free from a certain substance, but are not willing to take the steps necessary as prescribed in the tenets of 12-Step recovery, will sometimes turn to doctors or clinics for assistance. For opioid addicts, that often involves being prescribed certain drugs to be free of painkillers and/or heroin, such as buprenorphine or methadone.

Addiction assistance by way of medication can be quite effective at keeping people from using illicit drugs. But without a program of recovery there is a good chance of either going back to one’s drug of choice or forming an unhealthy relationship with another substance. A course that can bring about new problems in one’s life. A new long-term study showed that while people undergoing methadone maintenance use fewer illegal drugs, their alcohol intake often becomes harmful, according to a University of Zurich news release. The findings were published in the journal Lancet Psychiatry.

To be sure, opioid-maintenance programs can improve the quality of one’s life. Yet, if such improvements are offset by an alcohol-related illness then the subject is moot. The researchers point out that previous studies have shown a correlation between opioid addicts dying from liver disease, according to the article. Important findings, to say the least.

"They reveal that there is still a major therapeutic need for treatment with regard to frequent alcohol consumption," said Marcus Herdener, study head and chief physician at the University Psychiatric Hospital.

Opioid addiction recovery is possible, even without the aid of drugs, like methadone. You can find your way in life free from all potentially harmful substances. Please contact Whiteside Manor to begin the life-saving journey of recovery. We can show you the “way.”

Friday, February 17, 2017

Suboxone and Prior Authorizations from Insurance

Opioid narcotics are highly effective substances used to treat varying degrees of pain in patients around the world. There is, arguably, no other form of drugs that can mitigate symptoms of pain as well as opioids, such as oxycodone (OxyContin ®) and hydrocodone (Vicodin ®). The efficacy of such drugs, and mandates on pain management in the United States, resulted in the most severe drug epidemic in the history of mankind. And America is ground-zero.

You are probably aware that in recent years there has been a major push from both health experts and lawmakers to rein in the American opioid addiction epidemic. Efforts which came in the form of legislation and prescribing guidelines, as well as the creation of prescription drug monitoring programs (PDMPs). The efforts had, in many ways, the intended effect—leading to a serious reduction in prescriptions written, the closing of pharmacies and clinics and prosecuting certain doctors. However, given that the crux of ending the epidemic is helping the millions of opioid-dependent Americans get the treatment they need—it is fair to say that much more work is needed.

Most of the people charged with tackling the opioid epidemic agree that we can no longer hold on to the misguided belief that we can arrest addiction away. Even if doctors stop prescribing opioids outright, patients will find their drugs on the street. If they cannot afford prescription opioid street prices, they will typically opt to use heroin. A cheaper and stronger alternative. Law enforcement could arrest every dealer in the country, but others will fill the void in their absence.

The point, which you have probably gathered by now, is that addiction treatment is the best weapon. Unfortunately, it has been a real struggle for some people to get the help that they need. The result being this crisis is now in uncharted water, at least in some cases. The National Institute on Drug Abuse (NIDA) has been urging more doctors to prescribe Suboxone (Buprenorphine), a drug that can greatly alleviate the pain typical of opioid withdrawal. The drug, when used within a maintenance model has been shown to reduce the risk of relapse.

The call to make Suboxone more accessible has been somewhat difficult to heed, for a number of reasons: 1) Few doctors are licensed to prescribe the drug. 2) Doctors can only prescribe the drug to a set number of patients. 3) Insurance companies have been slow to offer coverage for Suboxone or have policies that make it difficult for patients to get the drug.

Fortunately, the third issue appears to be coming to an end. Starting in March one of the top insurance providers will make it easier for patients to get Suboxone, making them one of three to change their coverage in recent months, NPR reports. Aetna will no longer require doctors to seek prior authorization from the insurance company before they prescribe Suboxone. This is a big move that should help thousands of Americans.

With addiction treatment, and the decision by a patient to seek it, time is of the utmost importance. The decision to seek help is often times fleeting. If doctors can't provide help immediately, reneging on one’s decision typically follows. The Aetna policy change should mitigate the risk of an addict changing their mind.

"If someone shows up in your office and says, 'I'm ready,' and you can make it happen right then and there ― that's great," said Dr. Josiah Rich, a professor of medicine and epidemiology at Brown University. "If you say, 'Come back tomorrow, or Thursday, or next week,' there's a good chance they're not coming back.”

Wednesday, February 1, 2017

AUD, PTSD and American Indians

If you study U.S. history in high school, you are aware of the gruesome picture painted in textbooks of how our ancestors treated American Indians. From before the “Trail of Tears,” to the present day. Now in the 21st Century, it could easily be argued that not a whole lot has changed regarding the treatment of native peoples. Attempts to exploit their land and disenfranchise a people who desire to find a place in America, continues to this day.

While it is easy to look at history and say that several efforts have been made to make reparations for the awful treatment American Indians endured and continue to be subject to, sadly, it would seem that they are hardly enough to undo the centuries of psychological trauma inflicted upon this land's first men and women. Statistically speaking, American Indians (AIs) / Alaskan Natives (ANs) peoples living in this country experience higher rates of mental illness. And that’s not all, according to an American Psychiatric Association Fact Sheet:
  • Native Americans have twice the rate of victimization than that of African Americans, and more than 2.5 times that of whites.
  • Native Americans experience serious psychological distress 1.5 times more than the general population.
  • Compared to all other ethnic groups, Native Americans use and abuse alcohol and other drugs at younger ages and at higher rates.
Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) often go hand in among any group of people. Untreated PTSD commonly results in self-medicating with drugs and alcohol, which in turn leads to AUDs, and the like. A new study sought to compare rate of PTSD and AUD among the Native peoples, to that of non-Hispanic Whites (NHWs), Newswise reports. The findings were published in the journal Alcoholism: Clinical and Experimental Research.

The researchers found that PTSD was significantly associated with AUD in both populations, according to the article. However, the link was much greater among AI/ANs. AI and AN males experienced both PTSD and AUD at three times the rate of NHW men (9.5% vs. 3.1%). The research team would like to see more studies that look at the trauma that arises from cultural loss.

Tuesday, January 17, 2017

People With Mental Illness Want to Quit Smoking

mental health disorders
Only 15 percent of American adults smoke cigarettes, quite a drop from not that long ago. Cigarettes are both addictive and a leading cause of preventable death. While adult smoking rates are at relatively low rates among the general public, the same cannot be said for people with mental health disorders. As many as 57 percent of people living with serious mental illness smoke cigarettes, according to PsychCentral. Highlighting the need for psychiatrists and caseworkers to help people with mental health disorders quit smoking.

A new study found that a large number of psychiatric patients would like to be free from cigarettes, the article reports. However, researchers found that mental health caseworkers don’t prescribe smoking cessation drugs or refer patients to outside resources that could help with quitting.

“Patients with serious mental illness die an average of 25 years younger than people who don’t have these problems, and smoking is a big factor,” said study first-author, Li-Shiun Chen, M.D., an assistant professor of psychiatry at Washington University School of Medicine and BJC Behavioral Health in St. Louis. “Smoking is a common and serious problem for our patients, and although smoking rates have been decreasing in the general population, the rates remain very high in this vulnerable population.”

The researchers surveyed 213 psychiatric patients, of which 82 percent expressed interest in smoking cessation, according to the report. However, only 13 percent were receiving treatment at the time. The lack of encouragement from providers to quit may be the result of a long held belief that mental health patients have "bigger fish to fry" than cigarettes. Yet, new research indicates that quitting smoking can help mitigate the symptoms of mental illness. And for recovering addicts who smoke, quitting can reduce their risk of relapse.

A large population of people in recovery have co-occurring mental health disorders, such as depression or bipolar disorder. If quitting smoking can reduce the recurrence of symptoms and reduce the risk of relapse, mental health care providers could do a lot of good by encouraging smoking cessation, prescribing drugs like Chantix and refer patients to outside services.

“We want the psychiatrists and caseworkers to know whether their patients have expressed a wish to stop smoking so that they can refer them to counseling or provide them with prescriptions for nicotine lozenges, patches, or other medications that may help these patients quit smoking. We think those fairly simple changes really could pay off in a big way.”

The research was published in the Community Mental Health Journal.