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Supervised Injection Facilities Can Benefit People Using Intravenous Drugs

Supervised Injection Facilities Can Benefit People Using Intravenous Drugs

People who inject drugs in a facility where staff members provide clean needles and guard against overdoses say they have reduced their use of public spaces for drug use, a new study finds.

Using supervised injection facilities also has given them a greater ability to use hygienic injecting practices and provides better protection from fatal overdoses, they told authors of the study.

More than 100 supervised injection facilities operate legally in 166 cities throughout the world, Reuters reports.

There are no such facilities that are legally sanctioned in the United States. The study involved one staff member and 22 participants from one community-based organization that has successfully operated an underground facility since September 2014.

Lead author Peter Davidson of the University of California, San Diego told Reuters no one has ever overdosed in a supervised injection facility, where staff members are equipped with the opioid overdose antidote naloxone. The findings were published in the International Journal of Drug Policy.

Original linkOriginal author: Ezra
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Senate Report: Medicaid Contributing to Opioid Crisis

Senate Report: Medicaid Contributing to Opioid Crisis

Medicaid is contributing to the nation’s opioid crisis by establishing incentives that make it profitable to abuse and sell opioids, a report by Republicans on the Senate Homeland Security and Governmental Affairs Committee concludes.

The report notes that at least 1,072 people have been convicted or charged nationwide since 2010 for improperly using Medicaid to obtain prescription opioids, some of which were then resold on the nation’s streets. “The number of criminal defendants increased 18 percent in the four years after Medicaid expanded, 2014-2017, compared to the four years prior to Medicaid expansion,” the report states.

The committee’s top Democrat, Claire McCaskill of Missouri, said Medicaid expansion is not to blame for the opioid epidemic, USA Today reports.

“This idea that Medicaid expansion is fueling the rise in opioid deaths is total hogwash,” McCaskill said. “It is not supported by the facts. And I am concerned that this committee is using taxpayer dollars to push out this misinformation to advance a political agenda.”

Original linkOriginal author: Ezra
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Move to Lower Legal Blood Alcohol Levels to Reduce Drunk Driving Deaths

Move to Lower Legal Blood Alcohol Levels to Reduce Drunk Driving Deaths

A new report calls for lowering legal blood alcohol levels to reduce drunk driving deaths.

The National Academies of Sciences, Engineering, and Medicine report recommends lowering legal blood alcohol levels for drivers from 0.08 to 0.05 percent blood alcohol concentration (BAC), according to HealthDay.

The report also calls for increasing alcohol taxes significantly, strengthening policies to prevent illegal alcohol sales to people under 21 and to already-intoxicated adults, enacting all-offender ignition interlock laws, and providing effective treatment for offenders when needed.

“Strong evidence from the U.S. and other countries, such as Canada, shows that individuals convicted of alcohol-impaired driving who have ignition interlocks installed on their vehicles are less likely than others to be rearrested for alcohol-related driving or to crash while the device is installed,” the report states. “Therefore, all states should enact laws to require ignition interlocks — breath alcohol analyzers connected to the ignition system of a vehicle — for all offenders with a BAC above the limit set by state law.”

Original linkOriginal author: Ezra
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Opioid Overdoses Fuel Rise in Accidental Deaths

Opioid Overdoses Fuel Rise in Accidental Deaths

Opioid overdoses are fueling a sharp increase in accidental deaths in the United States, according to a new report by the National Safety Council (NSC).

The group found accidental deaths became the third-leading cause of fatalities in 2016 for the first time in more than a century, NPR reports.

Accidents accounted for 161,374 deaths that year, up 10 percent from 2015. Common causes of accidental deaths include motor vehicle crashes, falls, drowning, choking and poisoning—a category that includes accidental overdoses.

In a statement, NSC said, “The unprecedented spike [in accidental deaths] has been fueled by the opioid crisis. Unintentional opioid overdose deaths totaled 37,814 from drugs including prescription opioid pain relievers, heroin, and illicitly-made fentanyl.”

Original linkOriginal author: Ezra
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Getting to Zero Alcohol-Impaired Driving Fatalities Through a Comprehensive Approach

Getting to Zero Alcohol-Impaired Driving Fatalities Through a Comprehensive Approach

Alcohol-impaired driving remains the deadliest and costliest danger on U.S. roads today.

Every day in the United States, 29 people die in an alcohol-impaired driving crash—one death every 49 minutes. After decades of progress, alcohol-impaired driving fatality rates plateaued and have increased for the past two years—making it a persistent public health and safety problem.

Each alcohol-impaired driving crash represents a failure of the system.

A coordinated, systematic, multi-level approach spanning multiple sectors is needed to accelerate change.

With support from the National Highway Traffic Safety Administration, the National Academies of Sciences, Engineering, and Medicine convened a committee to help identify promising strategies to reduce deaths caused by alcohol-impaired driving in the United States.

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NCADD and Facing Addiction Have Merged

NCADD and Facing Addiction Have Merged

Today, Facing Addiction and the National Council on Alcoholism and Drug Dependence (NCADD) are proud to announce a definitive agreement to merge our organizations – creating a national leader in the effort to turn the tide on the addiction epidemic.

Inspired by decades of advocacy, led largely by NCADD in partnership with many NCADD Affiliates from around the country, Facing Addiction formed an unparalleled, coalition that launched on October 4, 2015, with a historic concert and rally on the National Mall in Washington, DC. On that day, an unprecedented group of entertainers, politicians, advocates, and “everyday Americans” came together to tell the country that we must unify our voices to turn the tide against addiction.

Since that historic event, Facing Addiction has quickly become a leading voice in the effort to turn the tide against addiction in our country. They have now forged a coalition of some 750 Action Network partners reaching more than 35 million people connected to this cause.

Facing Addiction was selected to be the exclusive co-sponsor to launch the United States Surgeon General’s historic report, titled Facing Addiction in America, which was unveiled at a major event at Paramount Studios in Los Angeles on November 17, 2016.

Today, Facing Addiction and the National Council on Alcoholism and Drug Dependence (NCADD) are proud to announce a definitive agreement to merge our organizations – creating a national leader in the effort to turn the tide on the addiction epidemic.

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Increase in Opioid Overdoses Leads to Rise in Organ Donations

Increase in Opioid Overdoses Leads to Rise in Organ Donations

The increase in fatal opioid overdoses has led to a rise in organ donations, according to CNN.

The United Network for Organ sharing, which manages the nation’s organ transplant network, says early data indicates a record number of deceased organ donors in 2017, for the fifth year in a row. There were more than 10,000 deceased organ donors last year—a 3 percent increase from 2016. More than 1,300 of those donors died from drug overdoses.

“About 40 percent of the increase (in the past five years) tracks back to the drug intoxication issue,” said Dr. David Klassen, the network’s Chief Medical Officer. In the past five years, the number of donors who died of drug overdoses increased 144 percent, while the number of deceased organ donors overall rose 24 percent.

Klassen said people who died of overdoses are usually good candidates for organ donation. “They tend to be younger and tend not to have the burdens of diseases associated with aging,” he said. He added that while the drugs may cause people to stop breathing or their hearts to stop, they don’t necessarily harm the organs.

Original linkOriginal author: Ezra
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Study Looks at Role of Medication-Assisted Treatment Started in the ER

Study Looks at Role of Medication-Assisted Treatment Started in the ER

A new study will assess whether starting medication-assisted treatment in the emergency room within hours of an opioid overdose will prevent people from relapsing after they recover.

Researchers at Virginia Tech, Carilion Clinic and Inova Fairfax Hospital received a $1 million grant to conduct the study, The Roanoke Times reports.

Participants treated for opioid overdoses in the emergency room will be asked if they want to participate in the study. If they consent, they will receive an injection of Sublocade, an extended-release form of buprenorphine, a drug that reduces opioid cravings.

Sublocade was approved by the Food and Drug Administration in November. It is the first ever buprenorphine injection for the treatment of moderate-to-severe opioid use disorder in adult patients.

Original linkOriginal author: Ezra
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Federal Officials Suspend Database of Programs to Treat Addiction and Mental Illness

Federal Officials Suspend Database of Programs to Treat Addiction and Mental Illness

Health officials have suspended a database of programs that help prevent and treat addiction and mental illness, The Washington Post reports.

The National Registry of Evidence-based Programs and Practices, run by the Substance Abuse and Mental Health Services Administration, was suspended in September. No new postings have been added since then.

The database includes hundreds of programs that have been evaluated by an independent contractor and found scientifically valid.

Addiction and mental health specialists say they rely on the database to find appropriate and effective treatments, the article notes. Officials would not say why the database was suspended. They confirmed the contract for running the database will be taken over by a new entity, which they said is working closely with other parts of the agency to “institute an even more scientifically rigorous approach to better inform the identification and implementation of evidence-based programs and practices.”

Original linkOriginal author: Ezra
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APA Releases New Practice Guideline on AUD Pharmacotherapy

APA Releases New Practice Guideline on AUD Pharmacotherapy

The American Psychiatric Association (APA) recently released a new practice guideline for the pharmacological treatment of alcohol use disorder (AUD). Despite the high prevalence of AUD and its significant public health consequences, patients with this disorder remain undertreated.

The guideline aims to increase physician and public knowledge on the effectiveness and risks of the five medications that may be used for the treatment of AUD: acamprosate, disulfiram, gabapentin, naltrexone, and topiramate.

Of these five, naltrexone and acamprosate have the best available evidence related to their benefits, and both have minimal side effects. As such, they should be considered the preferred pharmacological options for patients with moderate to severe AUD who want to reduce drinking or achieve abstinence. However, acamprosate should be avoided in patients with significant renal impairment, and naltrexone should be avoided in patients with acute hepatitis or liver failure, or in patients currently taking opioids or who may be expected to take opioids.Disulfiram, gabapentin and topiramate are also options for treatment of AUD but should typically be considered after trying naltrexone and acamprosate, unless the patient has a strong preference for one of these medications. Disulfiram is a special case as it does cause a series of adverse reactions if alcohol is consumed within 12 to 24 hours of taking the medication; the reactions include elevated heart rate, flushed skin, headache, nausea, and vomiting. Therefore, disulfiram is suggested only to patients who wish to achieve abstinence from drinking. Patients taking topiramate are at an increased risk of cognitive dysfunction, dizziness, and loss of appetite, whereas patients taking gabapentin may experience fatigue, insomnia, and headache.

While the guideline focuses specifically on evidence-based pharmacological treatments for AUD, it also includes recommendations and suggestions related to psychiatric evaluation of patients with AUD and developing a person-centered treatment plan. Evidence-based psychotherapeutic treatments for alcohol use disorder also play a major role in treatment and peer support groups such as Alcoholics Anonymous, and other 12-step programs can be helpful for many patients. However, specific recommendations related to these treatments are outside the scope of this guideline.

The full guideline, executive summary, and related materials are available here.

 

Original linkOriginal author: Ezra
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Need for Multiple Naloxone Doses on the Rise

Need for Multiple Naloxone Doses on the Rise

The percentage of people treated for a drug overdose who need more than one dose of the opioid overdose antidote naloxone is on the rise, a new study suggests.

Researchers from the Centers for Disease Control and Prevention (CDC) analyzed data from the National Emergency Medical Services Information System, and found the percentage of patients receiving multiple naloxone doses among emergency medical service (EMS) responders increased from 14.5 percent in 2012 to 18.2 percent in 2015, which represents a 26 percent increase in four years.

“We found there were 31,000 cases in which two or more naloxone doses were needed in 2015 in a prehospital setting,” said lead author Mark Faul, PhD, Senior Health Scientist at the CDC. “Of those, 4,000 cases required three doses, 1,600 required four doses, 615 required five doses and 200 cases required six or more doses.” He noted that not all people requiring multiple naloxone doses were successfully revived.

The study was published in Prehospital Emergency Care.

Dr. Faul discussed the results at the recent annual meeting of the American Public Health Association.

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Association Found Between Non-Cigarette Tobacco Product Use and Future Cigarette Smoking Among Teens

Association Found Between Non-Cigarette Tobacco Product Use and Future Cigarette Smoking Among Teens

According to the National Institute on Drug Abuse (NIDA), some teens who use e-cigarettes and other non-cigarette tobacco products report smoking cigarettes one year later, based on recent research funded by institutes within the National Institutes of Health and the Food and Drug Administration.

The research is based on data from the participants of the nationally representative Population Assessment of Tobacco and Health (PATH) study.

The researchers studied cigarette-smoking initiation among more than 10,000 participants in the PATH study. When first interviewed at ages 12-17, roughly half of the group reported that they had used e-cigs, hookah, snuff, or other non-cigarette tobacco products, but never cigarettes; the rest said they had always been completely tobacco-free.

When re-interviewed one year later, 4.6 percent of the group reported that they had now smoked a cigarette. Adjusted for other smoking risk factors, those who initially reported having used a non-cigarette tobacco product were twice as likely to have smoked cigarettes during the past 30 days, and those who had used more than one type of product were nearly four times as likely.

Original linkOriginal author: Ezra
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Sessions Allows More Aggressive Enforcement of Federal Laws Against Marijuana

Sessions Allows More Aggressive Enforcement of Federal Laws Against Marijuana

Attorney General Jeff Sessions has rescinded a policy that discouraged prosecutors from enforcing federal laws against marijuana in states that have decriminalized the drug, The New York Times reports.

In a statement, Sessions said that his memo to United States attorneys directs them “to use previously established prosecutorial principles that provide them all the necessary tools to disrupt criminal organizations, tackle the growing drug crisis, and thwart violent crime across our country.”

While marijuana remains illegal under federal law, the drug has been at least partly legalized—including for medicinal use—in 29 states and the District of Columbia. California began allowing the sale of recreational marijuana on January 1.

Sessions’ move is likely to increase the confusion about whether it is legal to buy, sell or possess marijuana in states where federal and state law conflict, the article notes.

Original linkOriginal author: Ezra
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Recreational Marijuana Sales Begin in California

Recreational Marijuana Sales Begin in California

Recreational marijuana sales began on January 1 in California.

California, the nation’s most populous state, is the sixth state to allow sales of recreational marijuana.

Adults 21 and older can possess as much as one ounce of marijuana, and grow up to six plants at home.

The marijuana industry in California is forecast to reach $7 billion in a few years, the article notes. The entire U.S. legal marijuana market was worth $6.6 billion in 2016, according to New Frontier Data, which tracks the industry.

Marijuana remains illegal under federal law. It is unlawful to take the drug across state lines, mail it or bring it on a plane.

Original linkOriginal author: Ezra
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What’s Behind the Addiction Crisis in Rural America?

What’s Behind the Addiction Crisis in Rural America?

People in rural America are dying from drug overdoses at a faster rate than Americans who live in other parts of the country, and opioid poisonings in rural counties are increasing at more than three times the rate of increase in urban counties. Why are rural Americans being hit so hard by the opioid crisis?

While many factors contribute to substance misuse and addiction in rural regions of states such as Kentucky, Maine, and West Virginia, several are linked to the recent social and economic decline of rural communities. The dawn of the 21st century brought dramatic and rapid transformations in American rural life. The Great Recession took a significant toll on rural areas where employment dropped and has not yet returned to pre-recession levels. And rural job growth has lagged well behind urban job growth since 2011. Further, economic globalization and the relocation of production jobs overseas caused a shift away from stable and reasonably compensated employment in production to poorly compensated service jobs.

As one might expect, poverty in rural areas is rising. Between 2000 and 2005–2009, the number of non-metro communities with poverty rates exceeding 30 percent increased nearly 50 percent, from 1,125 to 1,666. More than 300 rural counties (15.2 percent of all rural counties) qualify as persistently poor, compared with just 50 urban counties (4.3 percent of all urban counties).

This socioeconomic decline in rural communities has increased the risk of addiction, particularly opioid addiction, among those who live there. For example, the limited available work in rural areas is often physical and sometimes dangerous. As a result, chronic pain and injuries are more common than in urban areas. The cost of taking time off from work to heal is so great that many of the rural poor have come to rely on opioid pain medications just to keep functioning.

The high rate of opioid prescriptions in rural counties has increased the availability of opioids, putting more people at risk for addiction. Those at risk are not just the recipients of the original prescriptions. Diversion is common due to the widespread need for money and the close social and family connections that characterize rural communities. When everyone knows everyone, it’s easy to find someone who is willing to sell their medication.

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Social Media is Bringing Our Teens Down

Social Media is Bringing Our Teens Down

According to data released by the Centers for Disease Control and Prevention, there was a 33% increase in the number of teens experiencing depression, a 23% rise in teen suicide attempts, and a 31% surge in the number of teens who died by suicide in the five years between 2010 to 2015.

The National Suicide Prevention Lifeline Foundation says suicide is now the second leading cause of death for young people between the ages of 10 to 24.

What has gone wrong in the lives of our teens and why at such an alarming rate?

Despite the critical nature of this question, there are no clear answers. There is, however, a great deal of speculation, and many say our kids’ use of social media contributes this high suicide rate.

In a paper published in Clinical Psychological Science, researcher Jean Twenge and her colleagues found significant increases in depression, suicide attempts, and suicide in teens from every background in late 2012. At the same time, smartphone ownership crossed the 50% threshold. By 2015, just three years later the number of teens with access to smartphones grew to a whopping 73%.

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FDA Launches Campaign to Counter Tobacco Promotion

FDA Launches Campaign to Counter Tobacco Promotion

With smokers experiencing a number of triggers to use at popular retail locations, the federal government has decided to fight back on the same playing field.

The Food and Drug Administration (FDA) announced that its “Every Try Counts” campaign will display at convenience stores and gas stations a number of messages encouraging smokers to quit.

The two-year campaign, which will launch in 35 U.S. markets in January, will try to capitalize on research showing that smokers who have previously tried to quit are more likely to try again. One of the campaign's print advertisements reads, “You Didn't Fail at Quitting. You Just Haven't Finished the Process.”

The FDA and the National Cancer Institute have partnered to establish an Every Try Counts website that offers consumers tips on quitting and words of encouragement, as well as a mobile app to track triggers and information on access to coaching assistance.

Original linkOriginal author: Ezra
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Cigarette smoking is increasing among Americans with drug problems

Cigarette smoking is increasing among Americans with drug problems

Odds of smoking among Americans with a substance use disorder are more than five times greater than the overall population ---science daily

While cigarette smoking has declined in the U.S. for the past several decades, since 2002 the prevalence of smoking has increased significantly among people with an illicit substance use disorder, according to a new study by researchers at Columbia University's Mailman School of Public Health and the City University of New York.

Until now, little was known about whether the decline in smoking was also occurring among individuals with illicit substance use disorders. The findings are published online in the journal Addiction.

The data show that smoking rates increased among those with substance use disorders, including hallucinogens, inhalants, tranquilizers, cocaine, heroin, pain relievers, simulants, and sedatives, while cigarette smoking decreased among individuals with cannabis use disorders, as well as among those without any substance use disorders.

Source: Columbia University's Mailman School of Public Health. (2017, December 19).

Original linkOriginal author: Ezra
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South Carolina Partners with Law Enforcement on Naloxone Program

South Carolina Partners with Law Enforcement on Naloxone Program

State prevention leaders joined forces with local police departments to create an effective naloxone training, distribution, and monitoring program.

On June 3, 2015, then Governor Nikki Haley signed the South Carolina Overdose Prevention Act into law, increasing medical professionals' access to the anti-overdose drug naloxone and authorizing first responders, including firefighters and police officers, to carry and administer it.1,2 The need to expand the safe use of this life-saving medication was urgent. In 2015, 468 people in South Carolina had died from opioid-related overdoses, up from 453 deaths the previous year.3

Police involvement in administering naloxone was critical, as police officers were frequently first on the scene of many overdoses. "Many of our counties are very rural. It takes anywhere from six to eight minutes for an ambulance to respond to a 911 call, whereas law enforcement typically responds in four minutes or less," says Michelle Nienhius, Prevention Manager for the South Carolina Department of Alcohol and Other Drug Abuse Services (DAODAS). "When someone overdoses on heroin or other opioid drugs, minutes can mean the difference between life and death."

But the new state law presented challenges to local law enforcement. "Many of them thought that it was not their place, that administering naloxone was for [emergency medical services] to provide," says Nienhius.

To prepare law enforcement for their new role, DAODAS worked with the state Department of Health and Environmental Control's Bureau of Emergency Medical Services to create a pilot overdose prevention/naloxone training and monitoring program. "We were fortunate to have a forward-thinking partner who had experience training EMTs to use naloxone," Nienhius says. With additional input from the state’s Fifth Circuit Solicitor’s Office, and naloxone products donated by two pharmaceutical companies, the team created the Law Enforcement Officer Naloxone (LEON) program—a comprehensive training and online reporting system.

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National Drug and Alcohol Facts Week® (NDAFW) is coming January 22-28, 2018

National Drug and Alcohol Facts Week® (NDAFW) is coming January 22-28, 2018

NDAFW is a national health observance linking teens to science based facts to SHATTER THE MYTHS® about drugs!

National Drug and Alcohol Facts Week® links students with scientists and other experts to counteract the myths about drugs and alcohol that teens get from the internet, social media, TV, movies, music, or from friends.

It was launched in 2010 by scientists at the National Institute on Drug Abuse (NIDA) to stimulate educational events in communities so teens can learn what science has taught us about drug use and addiction.

The National Institute on Alcohol Abuse and Alcoholism became a partner starting in 2016, and alcohol has been added as a topic area for the week.

NIDA and NIAAA are part of the National Institutes of Health.

Original linkOriginal author: Ezra
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