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Thursday, May 26, 2016

Crack Cocaine: The Balloon Effect

crack cocaine
If you have been staying current with the news, you are aware that the United States is in the midst of an opioid epidemic. To take it one step further, you are likely aware that the Northeast and the Midwest have been affected especially hard. Even though many of the states who are struggling to get a handle on the situation are small, and have small populations relative to others, they can be seen as microcosm of the problem that America faces.

The state of Vermont is a perfect example, as is evident by the fact that Governor Peter Shumlin devoted his 2014 State-of-the-State Address to the heroin epidemic. After which, Vermont addiction treatment centers, law enforcement, and media outlets have fixed their eye on heroin—Vice reports. While placing heroin in the spotlight was, is the right move—but it is important that we see the forest for the trees.

When you think of prestidigitation, or sleight of hand, magic tricks probably come to mind. When everyone is looking in one direction, something important is happening in the other. It would seem that some have taken advantage of the focus on heroin to increase the sale of another insidious illegal narcotic. Last summer the state of Vermont saw a dramatic rise in “crack” cocaine use, according to the article.

Unlike heroin use, which can be tracked by calls to poison control centers and emergency department visits related to overdose, crack cocaine isn’t normally associated with overdoses. This means that incidents involving the drug often times come to light in the wake of crime. At the end of 2015, in an attempt to possess crack, three Vermonters poured gasoline over a young couple and burned them alive, the article reports. On top of that, a New Yorker was shot several times in Burlington, Vermont—the man was carrying crack and officials believe that he was a crack dealer.

“There’s a phenomenon called the ‘balloon effect’ where a focus on one drug can actually allow another drug market to blossom,” said Gina Tron to Vermont Public Radio, she wrote the Vice article. "It’s a characteristic of drug enforcement across the world. The demand for drugs doesn’t go away with enforcement, instead the illegal market just mutate and shifts. Dealers find ways around obstacles, and sometimes that manifest in the form of selling a different drug.”

It stands to reason that what officials in Vermont are seeing with crack, is indicative of what is happening in other parts of the country. In the wake of the opioid epidemic, nobody has their eye on the other narcotics that have the power to ruin lives. Drug dealers also carry a wide variety of drugs at any given time.

“More often than not, [crack is] distributed by the same people that distribute heroin,” said John Merrigan of Vermont State Police’s Narcotics Investigation Unit. “You can buy heroin and crack together.”

Tuesday, May 24, 2016

Opioid Prescriptions Are Declining

Over the past few years doctors across the country have been under immense pressure to help end the prescription opioid crisis that they [doctors] had a huge role in creating. For far more than a decade, physicians practicing in primary care facilities engaged in the overprescribing of prescription opioids, like OxyContin which is also prescribed under the generic name oxycodone. OxyContin, in particular, was advertised and marketed to doctors as being less addictive than other opioid narcotics—such as morphine.

Today, as many pain specialists knew years ago, there is not a doctor in the country who believes that there is such a thing as a non addictive opioid. Some opioid analgesics may be less potent, but everything from mild codeine to powerful fentanyl can be habit forming—lead to addiction—potentially resulting with a fatal overdose.

Both lawmakers and addiction health experts have been calling on doctors to only use opioids as a last resort with regard to pain management. Years of relying on opioids for any level of patient discomfort brought us to the brink; everyday in the United States 44 people die of a prescription opioid related overdose. Such a number is wholly unacceptable.

Fortunately, there has been a push to limit both pill dosages and the amount of refills a patient can have before needing to have their pain reassessed. Around the country pain management centers are now monitored; practices found to be overprescribing or failing to prevent “doctor shopping” with the use of prescription drug monitoring programs (PDMPs) are being shut down. To put it plainly, it is far more difficult for people to acquire prescription opioids.

We’re pleased to report that for the first time since OxyContin began to be prescribed in 1996, the amount of opioid prescriptions being written in the United States is on the decline, The New York Times reports. In 2013, 2014 and 2015 the number of opioid prescriptions fell, which experts believe to be the direct result of government efforts and it is an indicator that physicians are finally starting to do their part.

“The culture is changing,” said Dr. Bruce Psaty, a researcher at the University of Washington in Seattle who studies drug safety. “We are on the downside of a curve with opioid prescribing now.”

At Whiteside Manor, we know all too well the insidious nature of opioid addiction. From legal Vicodin (hydrocodone) to heroin, opioids are highly addictive and extremely dangerous. Breaking the cycle of opioid dependence is a challenge to say the least, but it is possible. We have helped a significant number of people in the depths of despair recover from their addiction to painkillers.

Thursday, May 19, 2016

Stigma Free Mental Illness

mental health
May is Mental Health Month 2016 (MHM), a time to raise awareness about mental illnesses which affect approximately 1 in 5 Americans (43.8 million), according to the National Alliance on Mental Illness (NAMI). We have made a number of progressive steps since the beginning of the new millennia, but even in the 21st Century there is still much stigma surrounding mental health disorders, such as addiction, bipolar disorder and depression.

Stigma doesn’t just hurt those living with mental illness, it has a negative impact on society as well. When society shames people about something they have no power over, it keeps them from talking about what they are going through and making the decision to seek help for fear of societal reprisals. When people suffering from mental illness are left untreated, it takes a heavy toll on society in the way of emergency hospitalizations and incarceration—the bills for which are often times assumed by taxpayers.

So if helping people living with mental illness helps the nation, then everyone has an obligation to do their part. Even if you do not suffer from a mental illness, there is an extremely high likelihood that you have someone close to you that does have mental health disorder. NAMI is calling on everyone to end the stigma of mental illness with hope, and you can start by taking the pledge to be #StigmaFree.

If you have a social media account, Facebook or Twitter for example, take some time to post mental health related information in order to raise awareness and break the shackles of stigma that hold people living with mental illness down. Remember to include #StigmaFree and/or #MentalHealthMonth in order to maximize the reach of your posts.

Perhaps you are thinking, “What’s the point?” or “What kind of impact will this have?” You might be surprised to learn how far a little compassion can go, especially when you consider the numbers below courtesy of NAMI:
  • 20.2 million of adults in the U.S experience a substance use disorder.
  • 1 in 25 adults in the U.S. (10 million) experience a serious mental illness each year.
  • 18.1 percent of adults in the U.S. experience an anxiety disorder, such as PTSD or OCD.
  • 16.9 million adults had a major depressive episode in the past year.
  • 2.6 percent of adults in the U.S. have bipolar disorder.
  • 1.1 percent of adults in the U.S. live with schizophrenia.
Only 41 percent adults in the U.S. received treatment for a mental illness in the past year.

Tuesday, May 17, 2016

Opioid Painkiller Access Around The World

If you were asked the question: “What was the leading cause of the American opioid epidemic?" it is likely that you would say that prescription opioid painkillers were the culprit, and you would not be wrong. Every day in the United States, over 40 people die from an overdose on prescription opioids, a staggering number that has lawmakers and health experts scrambling to find solutions. While the American population accounts for five percent of people living on the planet, we use three-quarters of the world’s prescription painkiller supply.

As we continue to face an opioid scourge of epidemic proportions, the majority of other countries struggle to provide pain medications to their citizens experiencing severe pain, The New York Times reports. The reasons for this may not be what you think. It is not due to drug shortages, but rather reluctance among doctors to prescribe opioid narcotics, even to patients living with terminal cancer or AIDS. Often times, in both poor and middle-income countries, opioid analgesics are restricted and/or inaccessible.

Health officials around the world report that a significant number of people are dying in severe pain, according to the article. It has become a human rights issue; and the reasons for this occurrence are varied depending on which country one lives in. A number of physicians in Russia, India and Mexico fear that they will be prosecuted or face other legal problems for ordering prescription opioid painkillers, the article reports. Under Moroccan law, opioids are considered to be poison, a limited number of doctors have permission to prescribe such drugs.

People suffering from pain struggle to access analgesics for a number of reasons, including:
  • Costs
  • Lack of Medical Training
  • Stiff Regulations
  • War on Illicit Drug Use
  • A Stoic Acceptance of Pain Without Complaint
“We shouldn’t forget that these are medicines that are really essential in our health care systems,” said Diederik Lohman, associate director of the health and human rights division at Human Rights Watch. “While clearly there are issues with some prescribing practices, there’s also clearly a risk to vilifying these medicines.”

Friday, May 13, 2016

Asian American Alcohol Abuse

alcohol abuse
The 2010 United States Census reported that there were a total of 17,320,856 Asian Americans—making up 5.6 percent of the total American population. A review of studies suggests that Asian Americans born in the United States were more likely to engage in problematic drinking, compared to those born in Asia, NBC News reports. In fact, heavy drinking has been steadily rising over the years among the demographic, possibly being the result of U.S.-born Asian Americans adopting the values and beliefs of the more individualistic world views of Americans. The research was published in Alcohol Research Current Reviews.

While there is limited research on drinking patterns of Asian Americans and such studies have a tendency of pooling all Asian Americans together, the review of studies indicated that the prevalence of alcohol abuse among young adult Asian Americans (18 to 25) rose from .74 percent in 1991 to 3.89 percent in 2002, according to the article. Large studies on Asian Americans are somewhat unreliable because of homogenous aggregation, which usually miss a number of important factors, including:
  • Variations Among Asian Sub-Groups
  • Ethnic Identity
  • Generational Status
“The population tends to be overlooked given the model minority stereotype,” said lead author Derek Iwamoto of the University of Maryland, College Park. “A lot of times larger national studies aggregate Asian Americans all together, meaning that they aggregate first, second, and third generations … it really pulls the averages down for Asian Americans.”

Iwamoto points out those genetic factors could have a hand in alcohol abuse among Asian Americans, the article reports. The demographic can be impacted by two genetic factors, most commonly present in Asians. Subgroups from East Asia often times experience negative reactions of alcohol intolerance. It is factor that is seen in Native Americans as well.

“Some Asian Americans may not engage in that high-risk drinking, but if they are allergic to alcohol … they might become drunk or intoxicated after drinking three beers versus someone who does not have that genetic makeup,” Iwamoto notes.

While alcohol abuse is on the rise among the Asian American demographic, it is worth pointing out that they have historically reported lower rates of alcohol misuse, compared to other demographics in the United States.