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Wednesday, July 27, 2016

DXM Case Study Shows Promise

While both safe and effective, over-the-counter (OTC) cough medicines can be abused and be dangerous. It is likely that you have some knowledge of the trend, mainly among teenagers, of abusing cough syrups in order to get high. Many cough medicines contain minute amounts of alcohol, but the desired ingredient sought after by teen abusers is known as dextromethorphan (DXM).

The common cough medicine ingredient suppresses one’s cough and works as expectorant. In normal doses it does as advertised, but when it is used in un-recommended ways the cough suppressant can cause intoxication. According to the National Institute on Drug Abuse (NIDA), DXM can cause:
  • Euphoria
  • Dissociative Effects
  • Hallucinations
In recent years there have been attempts made to curb DXM abuse. Most commonly by way of limiting how much of DXM containing products can be purchased at one time, or setting age restrictions. Since 2010, DXM abuse has been on the decline which led to a case study on the causes of the decrease in use, DSN reports. “Dextromethorphan: a case study on addressing abuse of a safe and effective drug,” was published in the journal Substance Abuse Treatment, Prevention.

DXM abuse is at an all-time low with approximately 3 percent of U.S. teens using it in unintended ways, the article reports. The case study, conducted by the Consumer Healthcare Products Association (CHPA), took an in depth look at CHPA’s efforts to:
  • Raise parental awareness of the behavior.
  • Increase teen perception of risk and social disapproval.
  • Limit teen access to the products.
“While we cannot point to one specific effort and say, ‘This is the action that drove down abuse,’ CHPA and our member companies have been disciplined in executing a program that is grounded in research and utilizes tools to ensure our strategies and specific messages were effective,” CHPA Senior Vice President, Policy, and General Counsel & Secretary David Spangler said. “We hope that this case study demonstrates how targeted and less disruptive interventions can be effective when trying to reach teens on niche issues such as dextromethorphan abuse and that the learnings we gained will be beneficial for other groups who are working to positively influence teen behavior.”

Thursday, July 21, 2016

HIV: Needle Exchange Necessity

The spread of infectious disease was once a rare occurrence in rural America, new cases of hepatitis C and HIV were quite uncommon. Sadly, that is no longer the case—being another byproduct of the prescription opioid and heroin epidemic tearing through the American heartland. Last year, we wrote about an outbreak of HIV occurring in Indiana which was believed to be linked to the intravenous use of Opana—a powerful opioid that was once lauded as being harder to tamper with. Clearly, tampering with Opana to be used via snorting or injection is not that difficult.

That being said, when we wrote about the Indiana HIV outbreak, now nearly a year and a half ago, there were only 24 confirmed cases linked to Opana. Between November 2014 and November 2015 in Scott County, Indiana alone, there were 181 new cases of HIV linked to IV Opana use, HealthDay reports. Such a staggering number should be a clear sign that needle exchanges are a must in rural parts of the country. The report was published in the New England Journal of Medicine.

"It was the largest outbreak that has occurred in the U.S. since the introduction of HIV treatment," said lead author Dr. Philip Peters, a medical officer with the Division of HIV/AIDS Prevention at the U.S. Centers for Disease Control and Prevention(CDC). "And it occurred in a poor and rural community. We have not seen HIV outbreaks in these types of communities before."

A number of lawmakers across the country are still resistant to offering clean syringe services, despite rampant needle sharing and the spread of infectious disease. While some have come around in the wake of the recent HIV and hep C outbreaks in rural regions, it is still difficult to come across clean needles.

In fact, a report conducted by the Centers for Disease Control and Prevention (CDC) found that rural opioid users are more likely than urban addicts to tamper with prescription opioids to be injected, according to the article. The finding underscores just how important syringe service programs are just for stemming the spread of disease. People with opioid use disorders seeking clean needles are in unique position. Addiction recovery counselors are typically onsite at needle exchanges, which means they can discuss recovery options with people seeking syringes.

Tuesday, July 19, 2016

Banning 22 Synthetic Drugs

synthetic drugs
As you might imagine, the story of synthetic drug use continues. In case you have not been following the surge of synthetic drug use in the United States, which is often linked to both serious side effects and fatal outcomes, we will take a moment to get you up to speed.

The class of drugs is usually used to describe chemicals, many of which are currently legal, that are sprayed on benign materials to be either smoked or ingested. Such chemicals are found on ‘bath salts’ or plant matter which is referred to as synthetic cannabis. The chemicals produce a host of intoxicating effects, stimulant or hallucinogenic in nature, that can cause users to act in odd/dangerous ways.

With that in mind, you may be wondering how many of these chemicals are not banned? The simple answer is that the compounds are produced in clandestine laboratories, particularly in China. There are several formulations which are constantly altered by chemists to skirt any attempts at government bans. The persistent effort to alter such formulas has led to a significant lack of oversight and testing, meaning that synthetic drug users serve as lab rats. Such people have no way of predicting the outcome of synthetic drug use.

Throughout the country, it is probably fair to say that synthetic marijuana is the most popular of these types of drugs—the most popular being known as “K2” or “Spice.” While in some areas, synthetic marijuana use incidents are isolated, in other places it is somewhat rampant. Officials in Florida and New York have seen a dramatic rise in synthetic drug use, causing lawmakers to scurry to get control of the situation.

In New York there were 130 suspected overdoses on synthetic drugs last week, CNN reports. New York Sen. Chuck Schumer likened the surge of synthetic drug use as being reminiscent to "a scene from 'The Walking Dead.' But it was no TV set, it was real life." Sen. Schumer has introduced a bill that would ban 22 synthetic drugs.

“New York’s most recent K2 binge that left our ER’s bulging and streets strewn with stupefied users with zombie-like symptoms are a sign of what’s to come if Congress doesn’t act quickly,” said Schumer in a news release. “We need a federal hammer to nail these toxic concoctions of synthetic drugs before things get worse. This federal legislation will ban 22 synthetic drugs, including powerful forms of fentanyl, crippling the unlawful chemists cooking up these drugs and the cartels that push them to our local stores and streets. Banning these drugs quickly will help the feds step up their game of whack-a-mole so that we can help stem the tide of synthetic drug use here in New York City and across the country.”

Friday, July 15, 2016

Fetal Cannabis Exposure

The use of any mind altering substance while pregnant is tantamount to playing with fire. Drug and alcohol use can dramatically affect the course of your child's life, causing a long list of problems with their brain. The disclaimers are there, especially with alcohol. Yet, every day babies are born exhibiting signs that the fetus was exposed to either drugs or alcohol.

In recent years there has been a lot of buzz about neonatal abstinence syndrome (NAS), a condition that can occur when a fetus is exposed to opioid narcotics, such as prescription painkillers or heroin. Babies exhibiting signs of NAS require intensive care which can last for weeks. This is needed so that the baby can safely withdraw from the opioid narcotics with as much ease as possible. Sadly, there is not much research available regarding the long term effect of fetal opioid exposure.

More and more states have become marijuana friendly in recent years, which means that the number of people using the drug is likely to go up in the coming years. It also stands to reason that many expecting women will expose their child-to-be to marijuana.

Lack of research on marijuana until recently has left a lot of questions unanswered regarding the effects of marijuana across the board. However, new research suggests that fetal exposure to cannabis can result in abnormal brain structure, MNT reports. The consequences could mean long-term mental health problems. The findings were published in the journal Biological Psychiatry.

"This study is important because cannabis use during pregnancy is relatively common and we know very little about the potential consequences of cannabis exposure during pregnancy and brain development later in life," says lead researcher Dr. Hanan El Marroun, of Erasmus University Medical Center in the Netherlands. "Understanding what happens in the brain may give us insights in how children develop after being exposed to cannabis."

Thursday, July 14, 2016

Doctors' Role in the Opioid Epidemic

prescription opioids
The United States continues to face an unprecedented epidemic with regard to drug use, specifically involving prescription opioid and heroin. So it would stand to reason that solutions require an unprecedented approach. Lawmakers on both sides of the aisle have come around to the reality that we can no longer wage war on drug dealing and addiction, but rather provide those battling with substance use disorder the resources necessary to recover. Addiction treatment services are more effective than prison cells.

For the first time in our Nation’s history, we have a director of the White House Office of National Drug Control Policy (ONDCP), commonly referred to as the “drug czar,” that knows firsthand the nature of addiction. ONDCP head Michael Botticelli, battled with addiction and found recovery, and now he works to implement effective measures against the scourge of opioid use taking 70 lives a day. Botticelli recently spoke with USA TODAY, where he pointed out that doctors and drug companies played a huge role in creating the issue we find ourselves in.

“The root cause of our opiate epidemic has been the over-prescribing of prescription pain medications,” Botticelli told the USA TODAY Editorial Board. “Physicians get little to no training related to addiction in general, but particularly around opiate prescriptions.”

As the epidemic continues, it is widely accepted that both pharmaceutical companies and primary care physicians are largely responsible for the dire situation we face. If lawmakers are going to move away from draconian drug laws, physicians need to adopt new ways of addressing patient pain and utilize the resources available to reduce addiction rates. Identifying at-risk patients or those who meet the criteria for opioid use disorder.

Informing such patients about the risks of continued use and what options are available for recovery is one of the best weapons against a type of addiction that affects millions of Americans. Please take a moment to watch a short interview below:

If you are having trouble watching the video, please click here.