Congratulations to NCADD-San Diego for being Facing Addiction with NCADD's "Affiliate of the Month" for March 2018!

ncadd-sd-aotm-march-18

NCADD national said: "We are grateful for your affiliation with us and proud of the excellent services you provide to your community.  We are highlighting you on our Facebook Page, Affiliate of the Month<https://www.facebook.com/notes/national-council-on-alcoholism-and-drug-dependence-ncadd-national-office/ncadd-sd-san-diego-ca-affiliate-of-the-month-march-2018/1744890972237190/>, and on the NCADD website, Affiliate of the Month<https://www.ncadd.org/blogs/affiliate-of-the-month/ncadd-sd-san-diego-ca-affiliate-of-the-month-march-2018>, to share your good work with the public and to demonstrate our pride and appreciation of your agency's work."

We are completely humbled by the honor.

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As More U.S. States Legalize Marijuana, Mexico’s Drug Cartels Turn to Heroin

As More U.S. States Legalize Marijuana, Mexico’s Drug Cartels Turn to Heroin

Mexican drug cartels are turning to heroin as more U.S. states legalize marijuana, according to USA Today.

Small farmers who used to plant marijuana to be smuggled in the United States are switching to opium poppies, which brings them a better price. The opium gum is harvested and processed into heroin.

According to U.S. Customs and Border Protection, marijuana seizures have fallen by more than half since 2012, while seizures of heroin and methamphetamine have soared.Heroin seizures by the U.S. Border Patrol rose from 430 pounds in 2012 to 953 pounds in 2017.

Marijuana seizures dropped from 2,299,864 pounds in 2012 to 861,231 pounds in 2017. Meth seizures rose from 3,715 pounds in 2012 to 10,328 pounds in 2017.

 

Original linkOriginal author: Ezra
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Legislative Hearings on Opioid Crisis to Focus on Law Enforcement, Public Health

Legislative Hearings on Opioid Crisis to Focus on Law Enforcement, Public Health

House Republicans will hold a series of hearings on addressing the opioid crisis, with a focus on law enforcement, public health and insurance coverage, according to The Wall Street Journal.

The first hearing, by the House Energy and Commerce Committee, will be held on February 28.

The bills to be considered are likely to require additional funding from Congress, the article notes. One bill under consideration would make it easier for certain derivatives of synthetic drugs to be categorized as controlled substances. Another bill would ensure that doctors can get details of a patient’s past substance use if consent is given.

Under one piece of legislation, in-home hospice providers would be permitted to destroy remaining opioids after a patient dies. Another proposed bill would increase use of prescription drug monitoring programs, and would make it easier for states to share data on opioid use and overdose deaths.

Original linkOriginal author: Ezra
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It’s Not the Rehab—It’s the Relationships!

It’s Not the Rehab—It’s the Relationships!

Individuals in active addiction sometimes say, “I don’t need another rehab, I could teach those groups.” Outpatient counselors sometimes say, “So-and-so isn’t doing well: S/he needs to go to rehab.”

The first position discounts the value of addiction rehabilitation by equating it with the content of psychoeducational groups. The second elevates its value to that of a panacea for faltering recoveries. Rehabs—and, for that matter, outpatient addiction treatment programs that incorporate similar elements—are neither of these.

Research has consistently shown that psychoeducation provides little or no benefit to those seeking addiction recovery. But interpersonal connection, such as an alliance with an empathic therapist, provides even more benefit than the actual method of treatment employed by the therapist. The wisdom of spirituality as well as the findings of science indicate that the way of recovery is not alone.

Essential tasks for those seeking addiction recovery are to make sufficient lifestyle changes that they no longer obtain and consume addictive substances in response to environmental cues and to cultivate resilience and self-acceptance by engaging in open, honest, mutually-respectful interpersonal relationships.

Many individuals with addiction require considerable structure and support to address these tasks. Residential rehabilitation centers and other addiction treatment programs often provide that—and empathic, pragmatic staff frequently make the essential tasks hard to avoid—but clients who simply attend these programs rather than engage in them are less likely to do well.

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Can Vivitrol Help People Leaving Jail Stay Off Opioids?

Can Vivitrol Help People Leaving Jail Stay Off Opioids?

Many people who are arrested and brought to jail on Rikers Island in New York City use opioids, and are forced to detox while in jail.

Researchers at New York University (NYU) are studying whether providing the opioid-addiction medicine extended-release naltrexone (Vivitrol) to these individuals when they leave jail reduces their risk of relapse and overdose.

“When we launched the study, many people used methadone to detox in jail, but didn’t continue it for maintenance,” said Joshua D. Lee MD, MSc, Associate Professor of Population Health and Medicine/General Internal Medicine and Clinical Innovation at the NYU School of Medicine. “That means they are leaving jail with no maintenance medication, which puts them at great risk of relapse and overdose, as well as HIV and hepatitis C from injection drug use.”

Vivitrol is a monthly injection that blocks the effects of opioids, including pain relief or the feelings of well-being that can lead to opioid misuse. It has no potential for abuse.

“Many people leaving jail think they can stay opiate-free on their own, but the chance of successful recovery without medication-assisted treatment is low,” Dr. Lee said. “If they receive naltrexone, they can either continue using it once they are out of jail, or at least it gives them a month to make arrangements for methadone or buprenorphine.”

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Many Teens Say Peers’ Vaping Led Them to Try E-Cigarettes

Many Teens Say Peers’ Vaping Led Them to Try E-Cigarettes

Almost 40 percent of teens who use e-cigarettes say seeing their peers use the devices led them to try vaping themselves, a new government report finds.

Teens who try e-cigarettes are often tempted by the flavors of vaping liquids, and some believe e-cigarettes are safer than traditional cigarettes, HealthDay reports.

E-cigarettes are the most commonly used form of tobacco among middle school and high school students, according to the report by the Centers for Disease Control and Prevention.

In 2016, a report by the U.S. Surgeon General called for reducing e-cigarette use among young people. The report said young people are more vulnerable than adults to the negative consequences of nicotine exposure. “These effects include addiction, priming for use of other addictive substances, reduced impulse control, deficits in attention and cognition, and mood disorders,” the report stated.

Original linkOriginal author: Ezra
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FDA Announces Voluntary Destruction and Recall of Kratom Products

FDA Announces Voluntary Destruction and Recall of Kratom Products

The Food and Drug Administration (FDA) this week announced it is overseeing the voluntary destruction and recall of kratom products.

Earlier this month, the FDA warned kratom is an opioid and has been linked with 44 deaths. Kratom, an unregulated botanical substance, is used by some people to relieve pain, anxiety and depression, as well as symptoms of opioid withdrawal.

The company that makes kratom-containing products under the brand names Botany Bay, Enhance Your Life and Divinity promised to recall and destroy the products, HealthDay reports.

The company, Divinity Products Distribution, agreed to stop selling all products containing kratom.

In a statement, the FDA said, “Based on the scientific evidence of the serious risks associated with the use of kratom, in the interest of public health, the FDA encourages all companies currently involved in the sale of products containing kratom intended for human consumption to take similar steps to take their products off the market and submit any necessary evidence, as appropriate, to the FDA to evaluate them based on the applicable regulatory pathway.”

Original linkOriginal author: Ezra
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What Causes Spouses to Resemble One Another In Their Risk for Alcohol Use Disorder?

What Causes Spouses to Resemble One Another In Their Risk for Alcohol Use Disorder?

A population-based registry study, found that the increase in risk for a first onset of alcohol use disorder in a married individual after the onset of alcohol use disorder onset in his or her spouse was large and rapid.

When an individual was married in either order to serial partners with vs. without alcohol use disorder, the risk for alcohol use disorder was substantially increased when the partner had an alcohol use disorder registration and decreased when the partner did not have an alcohol use disorder registration.

What does this mean? A married individual’s risk for alcohol use disorder is likely directly and causally affected by the presence of alcohol use disorder in his or her spouse.

Although spouses strongly resemble one another in their risk for alcohol use disorder (AUD), the causes of this association remain unclear.

The study seems to conclude that the increase in risk for AUD registration in a married individual following a first AUD registration in the spouse is large and rapid.

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Are Fetal Alcohol Spectrum Disorders Common In the United States?

Are Fetal Alcohol Spectrum Disorders Common In the United States?

A recent cross-sectional study of over 13,000 first-grade children in four regions of the United States was designed to estimate the prevalence of fetal alcohol spectrum disorders, including fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder.

Fetal alcohol spectrum disorders are costly, life-long disabilities.

Older data suggested the prevalence of the disorder in the United States was 10 per 1000 children; however, there are few current estimates based on larger, diverse US population samples.

Out of a total of 6,639 children who were selected for participation, a total of 222 cases of fetal alcohol spectrum disorders were identified.

The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 per 1,000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 per 1,000 children.

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Separating Side Effects Could Hold Key for Safer Opioids

Separating Side Effects Could Hold Key for Safer Opioids

NIH-funded scientists may have revealed brain functions in pre-clinical research that widen the safety margin for opioid pain relief without overdose

Opioid pain relievers can be extremely effective in relieving pain, but can carry a high risk of addiction and ultimately overdose when breathing is suppressed and stops. Scientists have discovered a way to separate these two effects -- pain relief and breathing -- opening a window of opportunity to make effective pain medications without the risk of respiratory failure. The research, published today in Cell, was funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Opioid medications suppress pain by binding to specific receptors (proteins) in the brain; these same receptors also produce respiratory suppression. However, the way these receptors act to regulate pain and breathing may be fundamentally different. Studies using mouse genetic models suggest that avoiding one particular signaling pathway led to more favorable responses to morphine (pain relief without respiration effects). The investigators then explored if they could make drugs that would turn on the pathways associated with pain relief and avoid the pathways associated with respiratory suppression.

"We are pleased to have uncovered a potential new mechanism to create safer alternatives to opioid medications, ones that would be far less likely to cause the side effects that lead to overdose deaths associated with the misuse of opioids," said NIDA Director Nora D. Volkow, M.D. "We are excited that basic research on how opioid drugs work in the brain has led to this novel approach, and that we continue to make critical progress in this area."

How the pathways split following receptor activation is referred to as biased signaling. The study showed that as the degree of bias (divergence) increased, so too did the ability of an opioid to reduce pain in mice without affecting breathing. Similarly, compounds that favor the breathing pathway produced more respiratory side effects at lower doses. Ultimately, opioids with a larger divergence (bias factor) had a larger margin of safety, or therapeutic window, opening up an opportunity for medication intervention.

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Connect People With Support Services to Fight Opioid Epidemic: Surgeon General

Connect People With Support Services to Fight Opioid Epidemic: Surgeon General

Connecting people with support services such as food and housing is a key step in curbing the opioid epidemic, Surgeon General Jerome Adams said recently.

“We’ve got to be more innovative in terms of helping folks understand that providing all these services will increase their chances of success and ultimately lower cost,” Adams said at an event sponsored by Faces and Voices of Recovery and Indivior. “That’s what I want Congress to know, that’s what I want policymakers to know — we’re not throwing good money after bad; we’re actually getting a return on investment by wrapping people with the support services they need to be successful in recovery.”

Adams said his brother self-medicated to cope with untreated mental health issues, The Hill reports.

“He ended up committing criminal activity to support his habit and is now in state prison a few miles away from here in Maryland because of his addiction, still not getting treatment,” Adams said, a story he called “far too common.”

 

Original linkOriginal author: Ezra
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OxyContin Maker Announces It Will No Longer Market Drug to Doctors

OxyContin Maker Announces It Will No Longer Market Drug to Doctors

Purdue Pharma, the maker of OxyContin, said it will no longer market the drug to doctors.

The announcement comes in response to lawsuits that blame the company for helping to trigger the opioid crisis, CBS News reports.

The company said it has eliminated more than half its sales staff, and will no longer send sales representatives to doctors’ offices to talk about opioid medications.

OxyContin is the world’s top-selling opioid painkiller. Purdue, along with pharmaceutical distributors and other companies that make opioids, are defending themselves against hundreds of state and local lawsuits that aim to hold the drug industry accountable for the opioid epidemic, the article notes. The lawsuits are seeking money and changes to how the industry operates.

Original linkOriginal author: Ezra
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The Great Opioid Lie

opiod-lie

More than 500,000 people have died from prescription drug overdoses just since the year 2000 – while the industry making these opioids earned an estimated $200 billion from the sales of these pills. Beyond this staggering human toll, prescription opioid misuse costs our economy nearly $80 billion per year. Today, more than three-quarters of those suffering from heroin addiction used prescription opioids prior to heroin.

How we got to this point is complicated. But one thing is clear: the crisis began with big pharma’s great Opioid Lie.

Learn More

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Treating Depression May Help Patients Stop Long-Term Prescription Opioid Use

Treating Depression May Help Patients Stop Long-Term Prescription Opioid Use

Patients with long-term opioid prescriptions and depression who take antidepressants are more likely to stop using opioids, a new study concludes.

“Depression can worsen pain and is common in patients who remain long-term prescription opioid users,” lead researcher Jeffrey Scherrer, PhD, of Saint Louis University said in a news release. “Our study should encourage clinicians to determine if their non-cancer pain patients are suffering from depression and aggressively treat patients’ depression to reduce opioid use.”

He added, “Effective depression treatment may break the mutually reinforcing opioid-depression relationship and increase the likelihood of successful opioid cessation.”

The findings will be published in British Journal of Psychiatry.

Original linkOriginal author: Ezra
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Long-Term Marijuana Use Is Associated With Health Problems Later in Life

Long-Term Marijuana Use Is Associated With Health Problems Later in Life

Attitudes and policies regarding recreational marijuana use are becoming increasingly permissive.

To effectively address the implications of these developments, researchers and policy makers need to understand how much and how long people use marijuana during the lifespan, and the degree to which different use patterns are associated with long-term issues such as health status.

This study found that:

Marijuana users exhibited six different patterns of marijuana use from ages 18 to 50.Longer-term marijuana use (extending from age 18 into the late 20s or beyond) was associated with increased risk of self-reported health problems at age 50.

To this end, Yvonne Terry-McElrath of the University of Michigan and her colleagues applied the statistical technique of latent class analysis to identify distinct patterns of marijuana use from age 18 to 50 among nearly 10,000 participants in the Monitoring the Future (MTF) study. The participants had reported their past-year marijuana use when they were high school seniors in 1976–1983, at 2-year intervals through age 30, and then at 5-year intervals until they reached age 50.

The researchers emphasize that their results do not necessarily indicate that marijuana caused the users’ health problems. “Our findings do not confirm causality,” Ms. Terry-McElrath says. “We can say that, among these participants, those who reported longer use patterns also reported higher levels of negative health outcomes, even after we controlled for numerous demographic and behavioral characteristics.” She notes that other research has also linked cannabis use to poor health.

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“Deaths of Despair” Caused by Opioids, Alcohol and Suicides: Report

“Deaths of Despair” Caused by Opioids, Alcohol and Suicides: Report

The incresing rate of deaths due to opioids, alcohol and suicides are part of a public health crisis described as “deaths of despair” in a new report published recently.

Life expectancy in the United States has decreased for the second year in a row because of these factors, researchers wrote in BMJ.

The drop was particularly steep among middle-age white Americans and people living in rural areas, USA Today reports.

“Why white Americans are dying at higher rates from drugs, alcohol, and suicides is unclear, complex, and not explained by opioids alone,” the researchers wrote. They note that possibilities include the collapse of industries and the local economies they supported, the erosion of social cohesion and greater social isolation, economic hardship, and distress among white workers over losing the security their parents once enjoyed.

Original linkOriginal author: Ezra
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State and Local Law Enforcement Officials Protest Cut to Drug Prevention Program

State and Local Law Enforcement Officials Protest Cut to Drug Prevention Program

State and local law enforcement officials came to Capitol Hill last week to protest a Trump Administration proposal to move oversight of a drug prevention program from the Office of National Drug Control Policy (ONDCP) to the Justice Department.

The High Intensity Drug Trafficking Areas Program sends millions of federal dollars to 28 task forces across the country.

The task forces, composed of state, local and federal law enforcement officers, use the funds to combat drug trafficking in their communities, The New York Times reports.

Under a draft budget plan from the Office of Management and Budget, the $275 million program would be run by federal law enforcement officers.

“In the middle of this huge epidemic, is now the time to start rearranging the deck chairs?” said Chauncey Parker, the director of the program task force in New York City. “ONDCP are the experts and the professionals on this issue, and they’re the best ones from a holistic standpoint to be able to take a look at all of this.”

Original linkOriginal author: Ezra
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FDA Calls Kratom an Opioid

FDA Calls Kratom an Opioid

The Food and Drug Administration (FDA) is warning that the supplement known as “kratom” is an opioid and has been linked with 44 deaths, The Washington Post reports.

Kratom, an unregulated botanical substance, is used by some people to relieve pain, anxiety and depression, as well as symptoms of opioid withdrawal.

The FDA recently conducted a scientific analysis that provided even stronger evidence of kratom’s opioid properties, the agency said in a statement. “We have been especially concerned about the use of kratom to treat opioid withdrawal symptoms, as there is no reliable evidence to support the use of kratom as a treatment for opioid use disorder and significant safety issues exist,” said FDA Commissioner Scott Gottlieb.

The analysis has “contributed to the FDA’s concerns about kratom’s potential for abuse, addiction, and serious health consequences; including death.”

Original linkOriginal author: Ezra
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Naloxone Administration May Lead to Complications

Naloxone Administration May Lead to Complications

There seem to be a growing number of cases of high amounts of fluid in the lungs – known as noncardiogenic pulmonary edema – following administration of the opioid overdose antidote naloxone, experts said at a recent meeting of the New York Society of Addiction Medicine annual meeting.

“The cause of naloxone-associated pulmonary edema is unclear. It may be that it is part of the natural history of opioid overdose, and we are just seeing it more often because we have the ability to save patients using an antidote. It could also be because when we wake people with naloxone, they try to take a deep breath against a closed airway, causing barotraumas – injuries caused by increased air or water pressure,” says Nicholas Nacca, MD, Assistant Professor of Emergency Medicine and Medical Toxicologist at the University of Rochester Medical Center.

There is no hard data to support that this phenomenon has increased in frequency, but it certainly seems to be the case, he said. “The dose and route of administration have changed recently. Naloxone is now available in 4-milligram intranasal doses, which is higher than what we have used in the past,” said Dr. Nacca. “Previously, naloxone was available in 2-milligram doses.” In the controlled setting of an emergency room, toxicologists recommend giving the lowest dose of naloxone possible to reverse the respiratory arrest. This is different than in the field, where first responders, police and lay persons are using preloaded intranasal drug delivery devices.

“Lives are being saved by these doses of naloxone, and at this time, complications may be a necessary evil,” he said.

Another common issue with naloxone administration is that first responders may be used to administering naloxone via intramuscular or intravenous injection.

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New Treatment Guidance Issued For Pregnant Mothers with Opioid Use Disorder

New Treatment Guidance Issued For Pregnant Mothers with Opioid Use Disorder

The Substance Abuse and Mental Health Services Administration (SAMHSA) released new Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants.

SAMHSA’s Clinical Guidance comes at a time of great need for effective opioid use disorder (OUD) treatment.

In 2016, over 20,000 pregnant women reported using heroin or misusing pain relievers in the past month. Newborn babies of mothers who used opioids while pregnant are at risk of neonatal abstinence syndrome--a group of physical and neurobehavioral signs of withdrawal.

“SAMHSA is filling an urgent need for reliable, useful, and accurate information for healthcare professionals working to treat opioid dependent mothers and their children,” said Dr. Elinore F. McCance-Katz, SAMHSA’s Assistant Secretary for Mental Health and Substance Use. “Ultimately, the steps explained in this guidance will help the mother and her infant safely receive treatment for opioid use disorder and neonatal abstinence syndrome.”

The Clinical Guidance offers standard approaches to a range of real-world scenarios faced by healthcare professionals working with mothers and infants. For each scenario, the guidance offers clinical action steps and supporting evidence. The action steps reflect the best available treatment, including medication-assisted treatment for the mother and infant and appropriate types of social supports and follow-up services.

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