NCADD News Service

In Ontario, Individuals with Alcoholic Liver Disease Will Not Have to Wait Six Months for Liver Transplants

In Ontario, Individuals with Alcoholic Liver Disease Will Not Have to Wait Six Months for Liver Transplants

Ethical principles stand behind healthcare providers who withhold medical treatments that are “futile or pointless.” But withholding treatment can be controversial. For example, the family of a gravely ill patient might not agree with professionals that an unproven treatment is futile.

Even when scientific evidence in favor of a treatment accumulates, medical practitioners can be slow to embrace it. In Ontario, Canada, Debra Selkirk combined scientific reports with her powerful personal story, seeking to overturn the rule that individuals with advanced alcoholic liver disease must demonstrate six months of abstinence from alcohol to be eligible for a liver transplant.

Debra shares her account of that process below.

Mark Selkirk died on November 24, 2010 from liver failure caused by alcohol use disorder.  He was never assessed for a liver transplant because he had not been alcohol-free for 6 months, a restriction placed on alcoholic liver disease patients (ALD) around the world.

The 6-month wait remains the most controversial policy in liver transplantation. Liver transplant pioneer surgeon Dr. Thomas Starzl began writing about its injustice as early as 1988, saying “…the imposition of an arbitrary period of abstinence before going forward with transplantation would seem medically unsound or even inhumane.”

Subsequent research concluded that the post-transplant rate of return to heavy drinking is extremely low. Organ loss due to drinking is even more rare. In 2008, a comprehensive analysis of international data by a University of Pittsburgh team established the return to heavy drinking at 2.5 percent in any given year. The study concluded, “The average rates of all outcomes we examined suggest that during any given year of observation, most transplant recipients with substance use histories will neither use substances nor become nonadherent to components of the medical regimen.”

Additional studies support similar conclusions, yet most transplant centers continue to deny transplants to ALD patients until they reach the 6-month benchmark. The policy remains intact, based largely on stigma against patients with alcohol use disorder, fueled by a fear that the public will be less likely to donate their organs if they think livers are being wasted by transplanting them into individuals with alcohol use disorder.

Continue reading
  391 Hits
391 Hits

NCADD Affiliate Executive Director Featured in NY Times Op Ed

NCADD Affiliate Executive Director Featured in NY Times Op Ed

Fay Zenoff, Executive Director of NCADD’s San Francisco Affiliate, the Center for Open Recovery, was featured in an Op Ed in the November 5 New York Times.

The piece, entitled, “Let’s Open Up About Addiction,” by Laura Hilgers, talks about the new openness toward recovery, including its risks as well as its benefits.

Ms. Hilgers, who has a child in recovery, acknowledges the safety that anonymity provides but also the value of hearing from those, such as Fay, who are leading successful lives in recovery. Click here to read the article.

Original linkOriginal author: Ezra
  443 Hits
443 Hits

President’s Commission on Opioid Crisis Calls for Nationwide System of Drug Courts

President’s Commission on Opioid Crisis Calls for Nationwide System of Drug Courts

President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis released its final report, calling for expanding drug courts into all 94 federal court jurisdictions.

The commission also recommended easier access to alternatives to opioids to treat pain, The Washington Post reports.

Drug courts are specialized court programs that target criminal defendants and offenders, juvenile offenders, and parents with pending child welfare cases who have alcohol and other drug dependency problems.

The commission made more than 50 recommendations, including requiring doctors and others who prescribe opioids to demonstrate they have received training in safely providing the drugs before they can renew their licenses to handle controlled substances with the Drug Enforcement Administration.

Providers should be required to check prescription drug monitoring databases to ensure patients aren’t “doctor shopping” for prescription drugs, the commission said. In some states, use of the databases is voluntary, the article notes.

Original linkOriginal author: Ezra
  198 Hits
198 Hits

Fentanyl is Key Factor Driving Opioid Overdose Deaths: CDC

Fentanyl is Key Factor Driving Opioid Overdose Deaths: CDC

Illicitly manufactured fentanyl is a key factor driving opioid overdose deaths, according to a new report by the Centers for Disease Control and Prevention (CDC).

Fentanyl and similar drugs, such as carfentanil, are increasingly contributing to a complex illegal opioid market with significant public health implications, the CDC said.

The CDC analyzed toxicology reports from almost 5,200 fatal opioid overdoses in 10 states between July and December 2016. They found fentanyl and similar drugs were directly responsible for more than half of the opioid overdose deaths, HealthDay reports.

In most cases, fentanyl or similar drugs were mixed into heroin, often without the knowledge of the people who overdosed. In almost half of fatal overdoses involving fentanyl, the drugs were injected. Fatal overdoses also occurred when drugs were swallowed or snorted, the CDC said.

Original linkOriginal author: Ezra
  397 Hits
397 Hits

Many Teens Who Take Adderall as “Study Drug” Unaware it is Amphetamine

Many Teens Who Take Adderall as “Study Drug” Unaware it is Amphetamine

Many teens who take the attention-deficit/hyperactivity disorder drug Adderall as a “study drug” are unaware it is an amphetamine, a new study finds.

Some high school and college students take Adderall because they think it will improve their mental function and school performance, according to HealthDay.

Nonmedical (not using a drug as directed by a doctor) use of amphetamines, such as Adderall, can lead to abuse and dependency, as well as medical problems such as seizures and heart problems, the article notes.

The new study included 24,000 high school seniors. Although 8 percent reported nonmedical amphetamine use, and 7 percent reported nonmedical Adderall use in the past year, 29 percent of those who used Adderall nonmedically reported no nonmedical amphetamine use.

“Our findings suggest that many young people are unaware that Adderall is an amphetamine,” lead author Joseph Palamar of NYU said in a news release. “In addition, such conflicting reports mean that prescription stimulant misuse may be underestimated.”

Continue reading
  358 Hits
358 Hits

Giving Tuesday

Giving Tuesday

November 28 is Giving Tuesday.  That’s a great day to give to the National Council on Alcoholism and Drug Dependence (NCADD)!

Occurring this year on November 28, Giving Tuesday is held annually on the Tuesday after Thanksgiving (in the U.S.) and the widely recognized shopping events Black Friday and Cyber Monday to kick-off the holiday giving season and inspire people to collaborate in improving their local communities and to give back in meaningful ways to the charities and causes they support. 

NCADD has been “A Trusted Voice of Hope, Help and Healing for Over 70 Years!”  We urge our many supporters and friends to show your commitment to fighting the devastating consequences of alcoholism and drug dependence on individuals, families and communities across the country with a donation to NCADD. 

NCADD is the oldest addiction advocacy organization in America, with a national network of Affiliates providing an array of addiction-related services at the local level. For over 70 years, NCADD has been making consistent progress in creating public awareness of alcoholism and drug dependence as treatable and preventable diseases. 

The entire NCADD community – Board of Directors, Affiliates and staff – is active in the critical areas of public policy, prevention, advocacy, treatment, medical and scientific research, communication and education.  Working with the media and other organizations has heightened the public profile of recovery and brought into clearer focus the fact that millions of people are living lives in recovery. 

Continue reading
  605 Hits
605 Hits

Drug Overdose Death Rates in Rural Areas Exceed Those in Cities

Drug Overdose Death Rates in Rural Areas Exceed Those in Cities

A new government report finds drug overdose death rates are now higher in rural areas of the United States than in urban areas.

The Centers for Disease Control and Prevention (CDC) study found drug overdose death rates in 1999 were 6.4 per 100,000 in cities, compared with 4 per 100,000 in rural areas. By 2015, the rate was 17 per 100,000 in rural areas and 16.2 per 100,000 in cities, HealthDay reports.

“The drug overdose death rate in rural areas is higher than in urban areas,” CDC Director Brenda Fitzgerald, MD, said in a news release. “We need to understand why this is happening so that our work with states and communities can help stop illicit drug use and overdose deaths in America.”

Most overdose deaths occurred in homes, where rescue efforts may fall to relatives who have limited knowledge of or access to life-saving treatment and overdose follow-up care, the CDC noted.

Original linkOriginal author: Ezra
  496 Hits
496 Hits

FDA Encourages Use of Medication-Assisted Treatment for Opioid Addiction

FDA Encourages Use of Medication-Assisted Treatment for Opioid Addiction

The Food and Drug Administration (FDA) will encourage widespread use of medication-assisted treatment for opioid addiction, the agency’s commissioner said recently.

The FDA has approved three medication-assisted treatment drugs: buprenorphine, methadone and naltrexone.

A report issued last year by Pew Charitable Trusts concluded that medication-assisted treatment is the most effective way to deal with opioid use disorder.

FDA Commissioner Scott Gottlieb, appearing before the House Committee on Energy and Commerce, said, “Unfortunately, far too few people who are addicted to opioids are offered an adequate chance for treatment that uses medications. In part, this is because insurance coverage for treatment with medications is often inadequate.”

In his remarks, Gottlieb noted that some people may need medication-assisted treatment for years, if not for their entire lives. He said the FDA will issue guidance to drug manufacturers to promote the development of new addiction treatments, The Washington Post reports.

Original linkOriginal author: Ezra
  346 Hits
346 Hits

DEA releases 2017 National Drug Threat Assessment

DEA releases 2017 National Drug Threat Assessment

DEA Acting Administrator Robert Patterson recently announced results of the 2017 National Drug Threat Assessment (NDTA), which outlines the threats posed to the United States by domestic and international drug trafficking and the abuse of illicit drugs.

“This report underscores the scope and magnitude of the ongoing opioid crisis in the United States,” said Acting Administrator Patterson. “The information in the report represents data gathered over the past year, but of critical importance is the real time information we get every day from our partners. It has never been a more important time to use all the tools at our disposal to fight this epidemic, and we must remain steadfast in our mission to combat all dangerous drugs of abuse.”

Over the past 10 years, the drug landscape in the United States has shifted, with the opioid threat – including controlled prescription drugs (CPDs), fentanyl and other synthetic opioids, and heroin – reaching epidemic levels and impacting significant portions of the United States. While the current opioid crisis has received significant attention, other drugs of abuse remain prevalent. These include methamphetamine, cocaine, new psychoactive substances (NPS), and marijuana. In addition, drug poisoning deaths are the leading cause of injury death in the United States; they are currently at their highest ever recorded level and, every year since 2011, have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide.

2017 NDTA findings of note:

CPDs have been linked to the largest number of overdose deaths of any illicit drug class since 2001. Although abuse has lessened in some areas, CPDs are still used by more people than cocaine, heroin, MDMA, methamphetamine, and PCP combined.Heroin poses a serious public health and safety threat to the United States. Overdose deaths, already at high levels, continue to rise. The increased mixing of heroin with analogues of the highly-potent synthetic opioid fentanyl and other synthetic opioids has exacerbated this situation.Fentanyl is increasingly mixed with diluents and sold as heroin, often with no heroin present in the product. Fentanyl also continues to be made more widely available in the form of counterfeit prescription pills marketed for illicit street sales.The methamphetamine threat has remained prevalent. Inbound seizures of methamphetamine from Mexico have increased every year since 2010, but domestic production has declined.The cocaine threat continues to rebound. Cocaine availability and use have increased significantly, partially due to record increases in coca cultivation and cocaine production in Colombia, the primary source for the cocaine market in the United States.NPS, manmade products that mimic the effects of controlled substances, continue to be a challenge. The NPS most commonly abused in the United States include synthetic cannabinoids and cathinones, which are available from China and packaged into a variety of forms domestically. Traffickers continue to modify NPS’ chemical formulas to create new substances to circumvent regulations and expand their market.Marijuana production in the United States has increased and the national discussion surrounding marijuana enforcement efforts continues to evolve. User demand for concentrated forms of marijuana has continued.Mexican cartels remain the greatest criminal drug threat in the United States. The cartels are the principal wholesale drug sources for domestic gangs responsible for street-level distribution. The Sinaloa Cartel maintains the most expansive footprint in the United States while the Jalisco New Generation Cartel has increased its presence across the United States.

The National Drug Threat Assessment provides a yearly assessment of the many challenges local communities face related to drug abuse and drug trafficking. Highlights in the report include usage and trafficking trends for drugs such as prescription drugs, heroin, methamphetamine, cocaine, marijuana, and the hundreds of synthetic drugs.

Continue reading
  263 Hits
263 Hits

President’s Opioid Commission Focuses on Insurance Companies’ Role in Crisis

President’s Opioid Commission Focuses on Insurance Companies’ Role in Crisis

President Trump’s opioid commission last week focused on health insurance companies’ role in contributing to the addiction crisis.

The commission is scheduled to deliver its final report on November 1.

Some health insurance companies favor opioids over less addictive but more expensive drugs to treat pain, according to USA Today. Some insurers also cover only one type of addiction treatment, the article notes. New Jersey Governor Chris Christie, who is leading the commission, said the final report will place new demands on health insurance policies.

Although health insurers are required to treat mental health and substance use disorders the same as any other disease, a government report last year found insurers still place limits on coverage, such as stricter pre-authorization requirements.

Original linkOriginal author: Ezra
  205 Hits
205 Hits

National Prevention Week 2018

National Prevention Week 2018

National Prevention Week is an annual health observance dedicated to increasing public awareness of, and action around, mental and/or substance use disorders.

Mark your calendars!

SAMHSA’s next National Prevention Week will be from May 13 to 19, 2018. Each year around this observance, communities and organizations across the country come together to raise awareness about the importance of substance use prevention and positive mental health.

The theme for NPW 2018 is: Action Today. Healthier Tomorrow.

National Prevention Week is an annual health observance dedicated to increasing public awareness of, and action around, substance abuse and mental health issues. Purpose of National Prevention Week

Continue reading
  369 Hits
369 Hits

Smoking Marijuana and Driving

Smoking Marijuana and Driving

A new study conducted by Liberty Mutual Insurance and Students Against Destructive Decisions (SADD) found that a third of all teens surveyed think it is legal to drive under the influence of marijuana in states where it has been legalized for recreational use.In the same study, 27 percent of parents surveyed believe it to be legal as well. The study found that while 93 percent of parents think driving under the influence of alcohol is dangerous, only 76 percent feel that driving under the influence of marijuana is dangerous. The results indicate that teens are receiving mixed messages about the dangers of marijuana use and driving. This thinking puts themselves and fellow drivers at risk, particularly with 22 percent of teens admitting that driving under the influence of marijuana is common around their friends.However, marijuana use has a direct impact on your body, similar to alcohol. According to the National Institute on Drug Abuse, effects include:

altered senses (for example, seeing brighter colors)altered sense of timechanges in moodimpaired body movementdifficulty with thinking and problem-solvingimpaired memoryhallucinations (when taken in high doses)delusions (when taken in high dosespsychosis (when taken in high doses)

"Driving under the influence of marijuana significantly impairs motor coordination, judgment and reaction time," said Mike Sample, MS, CSP, Lead Driving Safety Expert and Technical Consultant at Liberty Mutual in a news release. "Parents and teens alike must appreciate the importance of not driving under the influence of marijuana to help keep everyone safe on the road."

Original linkOriginal author: Ezra
  345 Hits
345 Hits

Statement from The NIH Director on Combating the Opioid Crisis with Scientific Solutions

Statement from The NIH Director on Combating the Opioid Crisis with Scientific Solutions

Opioid misuse and addiction is an urgent and rapidly evolving public health crisis.

An estimated 2 million Americans are addicted to opioids, and approximately 25 million suffer daily from chronic pain. The urgency and scale of this crisis calls for innovative scientific solutions, from prevention to intervention and treatment. Today, the President declared America's opioid crisis a public health emergency.

The National Institutes of Health is committed to bringing the full power of the biomedical research enterprise to bear on this crisis. That effort ranges from basic science of the complex neurological pathways involved in pain and addiction, to services and implementation science to develop and test treatment models, to integrating behavioral interventions with medication-assisted therapy, to forging strategic partnerships to advance safer, non-addictive treatments for pain.

In 2016, NIH spent $483 million on pain research ranging from cell and molecular mechanisms of acute and chronic pain, to safe, effective therapy development, to large scale clinical trials. Just this week, NIH issued the Federal Pain Research Strategy to prioritize funding in support of effective solutions to chronic pain. The belief that people with pain would not become addicted to opioid medications was promoted 20 years ago in the medical community, but sadly has contributed to an over-reliance on opioid medications, and to the current addiction and overdose crisis. While there are other approved medications and non-medication strategies that can be used to treat chronic pain, their effectiveness in many chronic pain conditions is limited and the medications come with their own side effects. There is a pressing need for potent alternative treatments for chronic pain that are non-addictive.

In support of the Administration's efforts to provide concrete and rapid response to address America's opioid crisis, NIH is pursuing formal partnerships with more than 30 biopharmaceutical companies and academic research centers to develop:

Continue reading
  388 Hits
388 Hits

SAMHSA Reaffirms Efforts to Address the Public Health Emergency on the Opioid Crisis

SAMHSA Reaffirms Efforts to Address the Public Health Emergency on the Opioid Crisis

President Trump’s declaration of the opioid crisis as a public health emergency reaffirms the role of the Department of Health and Human Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) as leaders in solving one of America’s most pressing public health issues.

The President recently appointed Dr. Elinore F. McCance-Katz as the first Assistant Secretary for Mental Health and Substance Use, underscoring the urgency of the issue.

“SAMHSA looks forward to continuing its role in helping American communities fight the opioid crisis through evidence-based programs in prevention, treatment, and recovery services,” said Dr. McCance-Katz. “The announcement today by President Trump reflects our commitment to this cause and inspires us to redouble our efforts on behalf of all who have suffered the effects of opioid addiction.”

HHS is implementing five specific strategies that are guiding SAMHSA’s response. The comprehensive, evidenced-based Opioid Strategy aims to:

Improve access to treatment and recovery services to prevent the health, social, and economic consequences associated with opioid addiction and to enable individuals to achieve long-term recovery;Target the availability and distribution of these drugs, and ensure the broad provision of overdose-reversing drugs to save lives;Strengthen public health data reporting and collection to improve the timeliness and specificity of data and to inform a real-time public health response as the epidemic evolves;Support cutting-edge research that advances our understanding of pain and addiction, leads to the development of new treatments, and identifies effective public health interventions to reduce opioid-related health harms; andAdvance the practice of pain management to enable access to high-quality, evidence-based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related harms.

Over the past 15 years, communities across our nation have been devastated by increasing prescription and illicit opioid abuse, addiction, and overdose. In 2016, over 11 million Americans misused prescription opioids, nearly 1 million used heroin, and 2.1 million had an opioid use disorder due to prescription opioids or heroin. Since 2013, the introduction of illegally produced fentanyl has made the problem worse. The Trump Administration is committed to bringing everything the federal government has to bear on this health crisis.

Continue reading
  273 Hits
273 Hits

29% of College Students Think ADHD Drugs Help School Performance

29% of College Students Think ADHD Drugs Help School Performance

A survey of college students finds 29 percent mistakenly think drugs used to treat attention deficit hyperactivity disorder (ADHD) increase school performance.

An additional 38 percent are unsure of the drugs’ effects on school performance, HealthDay reports.

There is no evidence that stimulant medications such as Ritalin and Adderall are effective study aids, the article notes. The survey included almost 7,300 students, none of whom had been diagnosed with ADHD.

The belief that stimulant drugs increase school performance was especially high among students who misused the drugs. Among the 11 percent of students who said they had used stimulant medication for non-medical reasons in the past six months, almost two-thirds believed the drugs would boost their grades.

The findings appear in the journal Addictive Behaviors.

Original linkOriginal author: Ezra
  1189 Hits
1189 Hits

Hepatitis C Spreads as a Result of Opioid Epidemic

Hepatitis C Spreads as a Result of Opioid Epidemic

New cases of hepatitis C are on the rise as a result of the nation’s opioid epidemic, according to health officials.

The Centers for Disease Control and Prevention announced earlier this year that new hepatitis C cases have almost tripled nationwide in just a few years, The Washington Post reports.

The increase is largely due to intravenous drug use among young adults.

Hepatitis C can be contracted at any point during the drug injection process, including by using a drug cooker or tourniquet with another person’s blood on it, according to Shruti Mehta of the Johns Hopkins Bloomberg School of Public Health.

Treating hepatitis C can cost tens of thousands of dollars, and is limited by insurance and Medicaid, the article notes. Treatment is mostly unavailable to people who are still using illicit drugs.

Original linkOriginal author: Ezra
  500 Hits
500 Hits

Justice Department Charges Chinese Distributors Who Sold Fentanyl to Americans Online

Justice Department Charges Chinese Distributors Who Sold Fentanyl to Americans Online

The U.S. Justice Department announced charges against two Chinese nationals who sold fentanyl online to American customers, The Washington Post reports.

The men are the first Chinese-based fentanyl manufacturers and distributors to be designated as Consolidated Priority Organization Targets, which the Justice Department considers to be among the most significant drug trafficking threats in the world.

According to the Justice Department, one of the men operated websites that sold fentanyl directly to American customers.

He also ran at least two chemical plants in China capable of producing tons of fentanyl and fentanyl analogues. The other man ran at least four fentanyl labs in China. He also advertised and sold fentanyl online.

The article notes it is unclear if the men could ever be brought to the United States to face charges.

Original linkOriginal author: Ezra
  425 Hits
425 Hits

Senators: Repeal Law That Impedes DEA’s Ability to Crack Down on Opioid Distribution

Senators: Repeal Law That Impedes DEA’s Ability to Crack Down on Opioid Distribution

Two Democratic senators have introduced legislation that would repeal a law they say hampers efforts by the Drug Enforcement Administration (DEA) to fight the opioid epidemic.

According to a report by The Washington Post and 60 Minutes, the Ensuring Patient Access and Effective Drug Enforcement Act impeded the DEA’s authority to freeze suspicious shipments of opioids in order to reduce the flow of painkillers to the black market.

CNN reports Senator Claire McCaskill of Missouri and Senator Joe Manchin of West Virginia have called for the repeal of the legislation, which was signed into law by President Obama in 2016. The law passed by unanimous consent in the Senate.

“Media reports indicate that this law has significantly affected the government’s ability to crack down on opioid distributors that are failing to meet their obligations and endangering our communities,” McCaskill said in a statement. “I’ll be introducing legislation that repeals this law and continue my work investigating the role pharmaceutical distributors played in fueling this public health crisis.”

Senator Manchin called the legislation a “horrible law that should have never passed in the first place.”

Original linkOriginal author: Ezra
  376 Hits
376 Hits

Tom Marino Withdraws Nomination as Head of ONDCP

Tom Marino Withdraws Nomination as Head of ONDCP

Representative Tom Marino of Pennsylvania announced that he is withdrawing his name from consideration as head of the White House Office of National Drug Control Policy.

His decision comes in the wake of a Washington Post and 60 Minutes joint report that concluded legislation Marino sponsored hampered efforts by the Drug Enforcement Administration (DEA) to fight the opioid epidemic.

The legislation, the Ensuring Patient Access and Effective Drug Enforcement Act, was opposed by the DEA, and supported by drug companies, NPR reports.

It changed the standard for identifying dangers of opioids to local communities from “imminent” threats to “immediate” threats. This impeded the DEA’s authority to freeze suspicious shipments of opioids in order to reduce the flow of painkillers to the black market, the article notes.

Original linkOriginal author: Ezra
  307 Hits
307 Hits

Prevalence of Illicit Drug Use is Higher in Large Metro Areas

Prevalence of Illicit Drug Use is Higher in Large Metro Areas

According to the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (MMWR), although both metropolitan and nonmetropolitan areas experienced significant increases from 2003–2005 to 2012–2014 in self-reported past-month use of illicit drugs, the prevalence was highest for the large metropolitan areas compared with small metropolitan or nonmetropolitan areas throughout the study period.

The report goes on to note that past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12–17 years).

The prevalence of past-year illicit drug use disorders among persons using illicit drugs in the past year varied by metropolitan/nonmetropolitan status and changed over time. Across both metropolitan and nonmetropolitan areas, the prevalence of past-year illicit drug use disorders declined during 2003–2014.

Although both metropolitan and nonmetropolitan areas experienced significant increases from 2003–2005 to 2012–2014 in self-reported past-month use of illicit drugs, the prevalence was highest for the large metropolitan areas compared with small metropolitan or nonmetropolitan areas throughout the study period. Notably, past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12–17 years).

The prevalence of past-year illicit drug use disorders among persons using illicit drugs in the past year varied by metropolitan/nonmetropolitan status and changed over time. Across both metropolitan and nonmetropolitan areas, the prevalence of past-year illicit drug use disorders declined during 2003–2014.

Continue reading
  158 Hits
158 Hits