NCADD-SD News & Blog

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Fentanyl-Related Substances Temporarily Placed as Schedule I Drugs

Fentanyl-Related Substances Temporarily Placed as Schedule I Drugs

It is well known that deaths associated with the abuse of substances structurally related to fentanyl in the United States are on the rise and have already reached alarming levels.

While a number of factors appear to be contributing to this public health crisis, chief among the causes is the sharp increase in recent years in the availability of illicitly produced, potent substances structurally related to fentanyl. Fentanyl is approximately 100 times more potent than morphine, and the substances structurally related to fentanyl that DEA is temporarily controlling also tend to be potent substances. Typically, these substances are manufactured outside the United States by clandestine manufacturers and then smuggled into the United States.

As a result, the Administrator of the Drug Enforcement Administration has issued a temporary scheduling order to schedule fentanyl-related substances that are not currently listed in any schedule of the Controlled Substances Act (CSA) and their isomers, esters, ethers, salts and salts of isomers, esters, and ethers in schedule I.

This action is based on a finding by the Administrator that the placement of these synthetic opioids in schedule I is necessary to avoid an imminent hazard to the public safety. As a result of this order, the regulatory controls and administrative, civil, and criminal sanctions applicable to schedule I controlled substances will be imposed on persons who handle (manufacture, distribute, reverse distribute, import, export, engage in research, conduct instructional activities or chemical analysis, or possess), or propose to handle fentanyl-related substances.

This temporary scheduling order is effective February 6, 2018, until February 6, 2020.

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Study of First-Graders Shows Fetal Alcohol Spectrum Disorders Prevalent In U.S. Communities

Study of First-Graders Shows Fetal Alcohol Spectrum Disorders Prevalent In U.S. Communities

NIH-funded research examined over 6,000 children to determine prevalence of FASD ranged from 1.1 to 5 percent.

A study of more than 6,000 first-graders across four U.S. communities has found that a significant number of the children have fetal alcohol spectrum disorders (FASD), with conservative rates ranging from 1 to 5 percent in community samples. The new findings represent more accurate prevalence estimates of FASD among general U.S. communities than prior research. Previous FASD estimates were based on smaller study populations and did not reflect the overall U.S. population. The study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.

FASD is an umbrella term for a range of health effects caused by prenatal alcohol exposure. Individuals with FASD may experience growth deficiencies, facial abnormalities, and organ damage, including to the brain. The effects of prenatal alcohol exposure on the brain can result in a range of neurobiological deficits that contribute to physical, cognitive, behavioral, and social challenges throughout life.

“Prenatal alcohol exposure is a leading preventable cause of developmental disabilities worldwide,” said NIAAA Director George F. Koob, Ph.D. “Estimating the prevalence of FASD in the United States has been complex due to the challenges in identifying prenatally exposed children. The findings of this study confirm that FASD is a significant public health problem, and strategies to expand screening, diagnosis, prevention, and treatment are needed to address it.”

The study was conducted by the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence (CoFASP) consortium, which studies the prevalence of FASD among U.S. school children. Before the study began, consortium members established standardized classification criteria for FASD based on facial features, growth, and neurodevelopmental performance. Co-led by Philip May, Ph.D., of the University of North Carolina Nutrition Research Institute, Kannapolis, and Christina Chambers, Ph.D., of the University of California San Diego School of Medicine, the findings are reported online in the Journal of the American Medical Association.

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Philadelphia Encourages Development of Sites for Supervised Injection Drug Use

Philadelphia Encourages Development of Sites for Supervised Injection Drug Use

Philadelphia officials are encouraging organizations to open facilities where staff members provide clean needles and guard against overdoses.

Advocates for these facilities say they would save lives. Opponents say they sanction an illegal activity, and make it easier for people to use drugs, The Wall Street Journal reports.

The Philadelphia facilities would offer a wide range of services, including referrals to treatment and social services, wound care, medically supervised drug consumption, and access to sterile injection equipment and the opioid overdose antidote naloxone, according to a news release.

City officials said a scientific review of studies of supervised injection facilities showed they reduce deaths from drug overdose; prevent HIV, hepatitis C and other infections; and help people who use drugs get into treatment.

The review estimated that one site in Philadelphia could prevent up to 76 deaths from drug overdose each year.

Original linkOriginal author: Ezra
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What Today’s Parents Should Know About the Gateway Drug Theory

What Today’s Parents Should Know About the Gateway Drug Theory

While scanning the latest news, it’s easy to feel as if we’ve traveled back in time to the 1980s. “Just say no?” “The war on drugs?”

After nearly three decades, there’s still little evidence to suggest these outdated addiction prevention and treatment strategies work, and some evidence even shows that they are counterproductive. Yet, they continue to influence how we both talk about and treat addiction. And just last month, dialogue about the “gateway drug theory” resurfaced in the New York Times, raising the question: is this highly publicized hypothesis, which also originated in the final quarter of the 20th century, grounded in fact or fiction? We answer this question – and more – below.

WHAT IS THE GATEWAY DRUG THEORY?First popularized in the 1980s, the gateway drug theory purports that adolescent use of tobacco, alcohol or marijuana increases an individual’s risk of using and/or developing addiction to other licit and illicit substances that may be perceived as more harmful, such as opioids, cocaine and methamphetamines.

ARE TOBACCO, ALCOHOL AND MARIJUANA GATEWAY DRUGS?In a sense, yes, but the important thing to note is that every drug is a gateway drug if used during adolescence or young adulthood while brain development is still underway.Whether it’s nicotine, alcohol, marijuana or opioids, it is the age of the person initiating use – not the specific substance itself – that increases the risk of using other addictive substances and developing addiction.

WHY ARE YOUNG PEOPLE WHO SMOKE, DRINK OR USE DRUGS MORE SUSCEPTIBLE TO DEVELOPING ADDICTION?During adolescence, the human brain goes through numerous developmental changes in structure and function. While the areas of the brain associated with memory, learning, judgment, decision-making, risk-taking, reward, emotion and stress are maturing, they are uniquely vulnerable to the damage that addictive substances such as nicotine, alcohol and other drugs inflict on these critical brain functions. That damage to the brain not only makes the individual more susceptible to addiction, but it also further impairs the skills needed to make good decisions and sound judgements, heightening the risk of future substance use and addiction.

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Opioid Public Health Emergency Renewed for Another 90 Days

Opioid Public Health Emergency Renewed for Another 90 Days

The Trump Administration renewed the order declaring the opioid crisis a public health emergency on January 22, a day before the 90-day mandate was set to expire, ABC News reports.

The Department of Health and Human Services has not said whether the public health emergency will be renewed every 90 days, the article notes.

In October, President Trump declared the opioid crisis a public health emergency. The order waives regulations and gives states more flexibility in how they use federal funds to combat the crisis.

Under a public health emergency, states could temporarily shift federal grant funds from a wide range of public health issues—such as HIV, diabetes and maternal care—to fund opioid treatment programs. A public health emergency is not as sweeping as a national emergency, which would give the president even more power to waive privacy laws and Medicaid regulations, the article notes.

Original linkOriginal author: Ezra
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Fear Factor: Do Scare Tactics Keep Teens from Using Drugs

Fear Factor: Do Scare Tactics Keep Teens from Using Drugs

Thinking back to your middle school or high school health classes, you may recall photographs of lungs blackened by cigarette tar or videos of teenagers dropping out of school, fighting with friends and family, or even dying because of their errant drug and alcohol use.

Exposing children and teenagers to the most damaging consequences of these behaviors has long been a mainstay in America’s addiction prevention strategy – but that poses the question: do scare tactics work?

There is evidence to suggest that scaring people can help them adopt or avoid certain behaviors – this is especially true when the proposed negative outcome is paired with an “efficacy method” or something people can do to eradicate the fear.

It also tends to work better when it comes to:

One-time only or infrequent prevention behaviors, e.g., going to the dentist for a checkupBehaviors that detect a health problem, e.g., having a suspicious mole checked for cancer, getting a mammogram

And worse for:

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FDA Asks Makers of Anti-Diarrhea Drug to Change Packaging to Curb Abuse

FDA Asks Makers of Anti-Diarrhea Drug to Change Packaging to Curb Abuse

The Food and Drug Administration (FDA) this week asked the makers of the over-the-counter anti-diarrhea drug loperamide (Imodium A-D) to change the way they package their products, in an effort to reduce abuse.

Some people take extremely high doses of loperamide in an attempt to manage opioid withdrawal symptoms or to achieve euphoric effects of opioid use, the FDA said in a statement.

Loperamide is safe when used at recommended doses, The Washington Post reports. But when it is taken at extremely high doses, the drug can cause dangerous, irregular heartbeats.

The FDA is asking manufacturers to redesign their packages so they contain only enough medication for short-term use. The agency is also asking for “unit dose packaging,” such as blister packs that require a person to unpeel each dose separately.

Original linkOriginal author: Ezra
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Illicit Fentanyl Use Linked to Cases of Amnesia

Illicit Fentanyl Use Linked to Cases of Amnesia

More than a dozen people who used fentanyl, either alone or in combination with stimulants, have suffered severe memory loss, researchers from West Virginia University report.

These cases involved severe short-term memory loss, HealthDay reports.

Imaging scans revealed the patients had lesions on the hippocampus, a region of the brain associated with memory. The patients did not recovery quickly, and may never fully regain their short-term memory, according to lead researcher Marc Haut.

“They all have difficulty learning new information, and it’s pretty dense,” Haut said. “Every day is pretty much a new day for them, and sometimes within a day they can’t maintain information they’ve learned.” He added, “Based upon the imaging, I would be surprised if they didn’t have at least some significant memory problems permanently.”

The findings are published in the Annals of Internal Medicine

Original linkOriginal author: Ezra
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Nurse Practitioners and Physician Assistants Now Eligible to Prescribe Buprenorphine

Nurse Practitioners and Physician Assistants Now Eligible to Prescribe Buprenorphine

Nurse practitioners and physician assistants will now be eligible to prescribe and dispense the opioid addiction treatment buprenorphine from their office, Reuters reports.

The Drug Enforcement Administration said the change will make it easier for residents of underserved areas to receive treatment for opioid addiction.

The new rule is a result of the Comprehensive Addiction and Recovery Act (CARA), passed in 2016.

The law expanded access to substance use treatment services and overdose reversal medications by extending the privilege of prescribing buprenorphine in office-based settings to qualifying nurse practitioners and physician assistants. CARA requires that nurse practitioners and physician assistants complete 24 hours of training to be eligible to prescribe buprenorphine.

“This action reflects this work and the ongoing need to further expand access to the most effective treatment for opioid use disorder,” David Fiellin, Professor of Medicine, Emergency Medicine and Public Health at Yale School of Medicine, told Reuters.

Original linkOriginal author: Ezra
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Trump Plans to Slash Drug Policy Office Budget

Trump Plans to Slash Drug Policy Office Budget

The Trump Administration is planning to cut more than $340 million from the budget of the White House Office of National Drug Control Policy (ONDCP), CBS News reports.

The administration will eliminate the agency’s grant-making capabilities, according to the article. Two grant programs–the High Intensity Drug Trafficking Areas (HIDTA) and Drug-Free Communities (DFC)–would be relocated to, and managed by, the Department of Justice and Department of Health and Human Services.

According to a spokesperson from the White House Office of Management and Budget, the administration’s 2019 budget is not final.

HIDTA provides assistance to federal, state, local, and tribal law enforcement agencies operating in areas determined to be critical drug-trafficking regions of the United States. DFC is the largest drug prevention program in the U.S.

Original linkOriginal author: Ezra
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New Report Finds That Using E-Cigarettes May Lead Youth to Start Smoking, Adults to Stop Smoking

New Report Finds That Using E-Cigarettes May Lead Youth to Start Smoking, Adults to Stop Smoking

A new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine takes a comprehensive look at evidence on the human health effects of e-cigarettes. Although the research base is limited given the relatively short time e-cigarettes have been used, the committee that conducted the study identified and examined over 800 peer-reviewed scientific studies, reaching dozens of conclusions about a range of health impacts.

Evidence suggests that while e-cigarettes are not without health risks, they are likely to be far less harmful than conventional cigarettes, the report says. They contain fewer numbers and lower levels of toxic substances than conventional cigarettes, and using e-cigarettes may help adults who smoke conventional cigarettes quit smoking. However, their long-term health effects are not yet clear. Among youth -- who use e-cigarettes at higher rates than adults do -- there is substantial evidence that e-cigarette use increases the risk of transitioning to smoking conventional cigarettes.

E-cigarettes are a diverse group of products containing a heating element that produces an aerosol from a liquid that users can inhale via a mouthpiece, and include a range of devices such as “cig-a-likes,” vape tank systems, and vape mods. Millions of Americans use e-cigarettes, and e-cigarette use is generally greatest among young adults and decreases with age. Use varies substantially across demographic groups, including age, gender, race, and ethnicity. For example, among youth and adults, use is typically greater among males than females.

Whether e-cigarettes have an overall positive or negative impact on public health is currently unknown, the report says. More and better research on e-cigarettes’ short- and long-term effects on health and on their relationship to conventional smoking is needed to answer that question with clarity.

“E-cigarettes cannot be simply categorized as either beneficial or harmful,” said David Eaton, chair of the committee that wrote the report, and dean and vice provost of the Graduate School of the University of Washington, Seattle. “In some circumstances, such as their use by non-smoking adolescents and young adults, their adverse effects clearly warrant concern. In other cases, such as when adult smokers use them to quit smoking, they offer an opportunity to reduce smoking-related illness.”

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Walmart to Help Customers Safely Dispose of Opioids

Walmart to Help Customers Safely Dispose of Opioids

Walmart will give customers filling opioid prescriptions a packet of powder they can use to safely dispose of leftover medication, Reuters reports.

Patients filling opioid prescriptions at Walmart or Sam’s Clubs pharmacies will receive a free packet of DisposeRx. To safely dispose of opioids, a person adds warm water and the powder to their pill bottle, which then forms a biodegradable gel around the pills.

According to a Walmart news release, “Beginning immediately, patients filling any new Class II opioid prescription at Walmart pharmacies will receive a free DisposeRx packet and opioid safety information brochure when picking up their prescription. Patients with chronic Class II opioid prescriptions will be offered a free DisposeRx packet every six months.”

Original linkOriginal author: Ezra
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Recreational marijuana legalization: Do more youth use or do youth use more?

Recreational marijuana legalization: Do more youth use or do youth use more?

What impact may legalization of recreational marijuana in Oregon have on teen marijuana use?

Recent results from an Oregon Research Institute (ORI) study indicate that the influence of legalization on youth may depend on whether they were already using at the time of legalization.

Following legalization of recreational marijuana, no significant changes in the numbers of youth who used marijuana occurred, yet increases in the frequency of use by youth who were already using marijuana were found.

For teenagers who had tried marijuana by 8th grade, the frequency of use during the following year increased 26% more for those who were in 9th grade after marijuana was legalized compared to those who were in 9th grade prior to legalization.

The research results are published online in Psychology of Addictive Behaviors.

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DEA Announces Step to Increase Opioid Addiction Treatment

DEA Announces Step to Increase Opioid Addiction Treatment

The United States Drug Enforcement Administration announced a deregulatory measure that will make it easier for residents of underserved areas to receive treatment for opioid addiction.

As published in the Federal Register, nurse practitioners and physician assistants can now become DATA-Waived qualifying practitioners, which give them authority to prescribe and dispense the opioid maintenance drug buprenorphine from their offices.

Prior to the enactment of the Drug Abuse Treatment Act of 2000, only physicians could treat opioid addicts and had to register with DEA as both physicians and operators of Narcotic Treatment Programs. Waiving this second registration prompted more physicians to offer treatment services. The Federal Register notice is available here:

This action brings DEA regulations into conformity with the Comprehensive Addiction and Recovery Act passed by Congress and signed into law in 2016. Because the vast majority of DATA-Waived physicians prior to CARA served urban areas, rural parts of the United States were underserved. This action provides more treatment options for addicts in rural parts of the country.

According to a 2017 report published by the National Rural Health Association, 90 percent of DATA-Waived physicians practice in urban counties, leaving 53 percent of rural counties without any prescribing physician and 30 million people living in counties where treatment is unavailable. As a result, rural patients seeking outpatient buprenorphine treatment must often travel long distances to access care. Rural providers of buprenorphine report a demand far beyond their capacity and say they lack the resources to adequately support themselves and patients in treatment. The NRHA report also found that, with 92 percent of substance use treatment facilities located in urban areas, rural areas offer fewer inpatient and day treatment resources.

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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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