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Wednesday, July 1, 2015

FDA Would Like Public Opinion On E-Cigarettes

The exponential rise in e-cigarette use has government agencies taking a closer look at the devices, and it is expected that it will only be a matter of time before restrictions go into place. In the mean time, there are growing concerns about the highly concentrated nicotine e-juices, which ‘vapers’ use to fill their e-cigarettes. Exposure to e-juices has led to a surge in calls and visits to poison control centers and emergency rooms, Reuters reports.

While e-juices are intended for adults and carry disclaimer warnings about dermal contact and ingestion, as more people use the devices there is a increased likelihood that a child may get their hands on the liquid nicotine. The Food and Drug Administration (FDA) is considering a mandate for child-resistant packaging, and warning the public about the dangers of nicotine exposure, according to the article.

The journal Clinical Toxicology lists the symptoms of nicotine poisoning, some of which include:
  • Nausea
  • Vomiting
  • Hypertension
  • Ataxia
  • Seizures
The FDA posted a 15-page "notice of proposed rulemaking" on its website, giving the public 60 days to give their two cents on e-cigarettes and e-juices with regard to warnings and packaging regulation. The agency is requesting "comments, data, research results or other information that may inform regulatory actions FDA might take."

"The continuing rise in popularity of electronic nicotine devices (ENDS), such as e-cigarettes, which often use liquid nicotine and nicotine-containing e-liquids, has coincided with an increase in calls to poison control centers and visits to emergency rooms related to liquid nicotine poisoning and other nicotine exposure risks," the FDA said in the notice.

The Advance Notice of Proposed Rulemaking (ANPRM) will begin accepting comments today, July 1, 2015.

Tuesday, June 30, 2015

Reformulating Opioid Medications May Not Solve The Problem

In recent months there has been much debate regarding the efficacy of tamper-resistant opioid medications. Prescription drugs with abuse-deterrent properties are designed to make it more difficult for addicts to crush medications to be snorted or injected. While there is some evidence that reformulated OxyContin ® (oxycodone) has reduced overall use of the drug, there is data which suggests that the overall number of opioid overdose number has not decreased, ScienceDaily reports.

Many addicts that are presented with tamper resistant medications will often turn to other opioid drugs that do not host such properties. Sadly, a number of addicts have turned to heroin as a stronger and less expensive alternative. Reformulating existing opioid medications to make them harder to abuse may not do the trick, especially if addicts will just pivot to other narcotics, according to a new commentary in the Canadian Medical Association Journal (CMAJ).

"Misuse and diversion of opioids is a complex problem that requires a comprehensive solution; simply substituting one formulation for another will not work," writes Dr. Pamela Leece, Dalla Lana School of Public Health, University of Toronto, with coauthors. 

While the United States uses the vast majority of prescription opioid narcotics, Canada has seen a dramatic rise of opioid use in recent years. From 1991 to 2007, oxycodone prescriptions in Ontario rose 850%, according to the report. The number of opioid overdose deaths doubled between 1991 and 2004.

The authors conclude:

"Regulations requiring tamper resistance represent an expensive, technical approach that is influenced by pharmaceutical interests and cannot solve the opioid crisis. An evidence-based, multifaceted strategy is needed -- one that has real potential to curb opioid-related harms at a population level." 

The commentary can be read in the Canadian Medical Association Journal.

Wednesday, June 24, 2015

Medical Marijuana Does Not Lead to Increased Teenage Use

The legalization of marijuana for both medical and recreation use is a hot button topic in the United States. There are currently 23 states and D.C. which have approved medical marijuana programs, as well four states which have legalized the drug for adult recreational use. It is expected that those numbers will rise after the polls close in 2016.

Marijuana, no matter the purpose for its use, causes euphoria and can lead to addiction. It is for those reasons that many are opposed to states adopting more relaxed views about the drug; and many have concerns that such tolerances will lead to greater adolescent use. However, new research suggests that there is no evidence indicating that medical marijuana legislation leads to increased use among teenagers, Medical News Today reports.

"Our findings provide the strongest evidence to date that marijuana use by teenagers does not increase after a state legalizes medical marijuana," states study author Dr. Deborah Hasin, professor of epidemiology at Columbia University Medical Center in New York.

The findings arise from the national Monitoring the Future survey data, which involves more than one million students aged 13-18, and was analyzed by researchers. Between 1991 and 2014, there were 21 of the 48 contiguous states which passed medical marijuana laws, according to the article.

While there were higher rates of marijuana use among adolescents in medical marijuana states, the researchers found no evidence suggesting that the rates change after legislation was passed. This research is important, because of the dangers associated with adolescent marijuana use, which include:
  • Short-Term Impairments in Memory
  • Short Term Co-ordination Loss
  • Risks of Psychiatric Symptoms
  • Cognitive Impairments
  • Substance Abuse
If medical marijuana is not responsible for the increased use among adolescents, the researchers point out that it is important to identify the cause. "Because early adolescent use of marijuana can lead to many long-term harmful outcomes, identifying the factors that actually play a role in adolescent use should be a high research priority," notes Hasin.

The findings were published in The Lancet Psychiatry.

Tuesday, June 23, 2015

Over 25,000 Lives Saved by Naloxone

All over the country lives are being saved daily by the opioid overdose reversal drug naloxone - sold under the brand name Narcan ®. If naloxone is administered in a timely fashion, the drug can induce nearly instantaneous opioid withdrawal and can potentially save the lives of those who would have otherwise perished. In fact, a new government study has found that naloxone kits were responsible for nearly 27,000 drug overdose reversals between 1996 and 2014, HealthDay reports.

The American Society of Health-System Pharmacists reports that the drug can reverse the common symptoms of an overdose, including:
  • Depression of the Central Nervous System (CNS)
  • Depression of the Respiratory System
  • Hypotension
“U.S. and international health organizations recommend providing naloxone kits to laypersons who might witness an opioid overdose; to patients in substance use treatment programs; to persons leaving prison and jail; and as a component of responsible opioid prescribing,” the researchers wrote.

Paramedics and law enforcement are not the only ones saving lives; the friends and families of addicts who are equipped with Narcan ® nasal kits have saved thousands of lives. There are a number of organizations throughout the country who provide and train non-medical personnel to use naloxone, with more than 600 such groups; in 2013, the report found that there were 20 states that had no organizations in place to train friends and family members to use the life saving drug, according to the article. Research indicates that that allowing greater access to naloxone will only result in more lives saved.

“Overdoses are often witnessed by other drug users and family members of drug users,” notes lead researcher Eliza Wheeler, DOPE Project Manager at the Harm Reduction Coalition in Oakland, California. “There is a reluctance to call 911 among people who use drugs, so people were managing overdoses on their own — unsuccessfully in many ways. So programs started educating people who are likely to witness overdoses in how to deal with them.”

The findings were published in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Wednesday, June 17, 2015

New Conservative Support for Needle Exchanges

A recent outbreak of AIDS and Hepatitis C has led a number of conservative lawmakers to change their long held beliefs about the importance of needle exchanges in their home states, The New York Times reports. Intravenous drug use is a major problem, a rise in heroin use across the country and IV prescription opioid use has resulted in increased rates of disease transmission. This problem could be mitigated if addicts had greater access to clean needles.

Traditionally, House Republicans have had a tough stance on needle exchanges, banning them outright. However, as states grapple with increased IV drug use which has resulted in the outbreak of disease, such as Kentucky and Indiana, the need for needle exchanges becomes more apparent.

Governor Mike Pence of Indiana, a Republican, recently reversed his position of banning needle exchanges, allowing such programs in parts of his state, according to the article. Representative Harold Rogers of Kentucky, a Republican, was always an opponent to needle exchanges, but with the rise in IV heroin use in his district, a change in position was warranted.

“I would count this cautiously as a win,” said Daniel Raymond, Policy Director for the Harm Reduction Coalition, an advocacy group focused on health issues related to drug use. “I think that Congress is listening, including members from red states and purple states.”

A proposed bill put before the house would give officials the power to use federal grant money to provide support for state and local drug treatment programs that include needle exchanges. Although, the House annual health spending measure would still prohibit the use of federal dollars to buy sterile needles or syringes, the article reports.

The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have both recommended needle exchange programs.

Tuesday, June 16, 2015

Many American Adults Want to Ban Powdered Alcohol

Despite the approval of powdered alcohol in March, a new poll suggests that sixty percent of American adults want a complete ban on powdered alcohol in their state. The potential for teenage misuse of powdered alcohol is what fuels adult concerns, HealthDay reports. A number of states have already taken measures to ban the use and sale of powdered alcohol, including Louisiana, South Carolina and Vermont.

Powdered alcohol, most notably Palcohol, created by the company Lipsmark, is sold in pouches and comes in a number of different flavors. When the powder is mixed with water, users can quickly create variations of popular mixed drinks. Opponents of Palcohol have fears that the product can be easily concealed by teenagers in their pockets.

"Given that several states are considering legislation about powdered alcohol, our poll looked at what the public thinks about this new product," Dr. Matthew Davis, director of the University of Michigan's C.S. Mott Children's Hospital National Poll on Children's Health, said in a news release. "The majority of adults agree that powdered alcohol may spell trouble for young people."

The poll found that:
  • 81 percent are concerned that it will be easy for minors to buy powdered alcohol.
  • 84 percent support banning online sales.
  • 85 percent believe powdered alcohol should not be marketed on social media sites.
  • 85 percent worry that powdered alcohol will increase alcohol use among minors.
  • 90 percent of adults are concerned that powdered alcohol will be misused by minors.
"In the U.S., parents, communities and health care providers already face serious challenges with underage alcohol abuse and its harmful effects on children's health. This poll indicates common concern among our communities over potential abuse and misuse of powdered alcohol, as well as the product's potential to exacerbate the problem of underage drinking," Davis said.

Several other states are considering legislation that would put a stop to powdered alcohol, according to the article.

Wednesday, June 10, 2015

Using Social Media to Quit Smoking

Young adults looking to quit smoking may consider using nicotine patches and gums to aid them in their efforts; these are smoking cessation programs which may prove fruitful. However, new research suggests that young adults who use social media may be twice as successful when compared to those using traditional methods, Science Daily reports.

"These finding suggest that the creators of public health campaigns need to evaluate how they use social media channels and social networks to improve health, especially with regards to younger demographics," said lead study author Bruce Baskerville, a senior scientist at the Propel Centre for Population Health Impact at Waterloo.

Researchers at the University of Waterloo looked at two smoking cessation programs. One was a telephone hotline for young adults, the other was a social media-based campaign called “Break It Off." The research team found that of the young adults who used Break It Off, 32 per cent of smokers had quit after 90 days of using the programs apps and web tools. Only 14 percent of those who used the telephone hotline had quit after three months in the program, according to the article.

"Traditional cessation services can have limited reach and this reduced visibility lessens their impact in a digital era," said Baskerville. "Because they are such heavy users of social media, these platforms provide an alternative and successful way of reaching smokers who are less likely to relate to other cessation programs."

Break It Off was launched in January 2012, a project of the Canadian Cancer Society. The program uses interactive website, social media, and a smartphone app to reach young adults, the article reports.

The findings were published in Nicotine & Tobacco Research.
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