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Thursday, August 25, 2016

Hard Liquor Banned At Stanford

alcohol use
Teenagers and young adults are preparing to head off to college for the Fall semester in the United States. For some, it will be returning to a familiar setting, but for others it will be a wholly new experience. Leaving the nest for the first time in 18 years can be an eye-opening experience, meeting new people, making new friends and such. It will also be a time that many will be introduced to the college drinking culture.

The college years are mostly about advancing one’s education in order to find a good job afterwards. But it is also, for many students, a time to let loose and engage in heavy drinking and potential drug use. It is little secret that college students are far from responsible and often engage in unhealthy drinking behaviors, such as "binge drinking." It is a practice that is often defined as having 5 drinks for men and four drinks for women, in a two hour period.

Those who choose to drink as much liquor or beer as they can in short periods of time put themselves at great risk, such as alcohol poisoning and potentially addiction down the road. On top of that, those who binge drink are also more likely to make uninhibited, rash decisions. Fighting and sexual assault are quite common on college campuses.

While it is next to impossible to keep alcohol out of the hands of college students, efforts to mitigate alcohol use are of the utmost importance. Every school has some sort of policy when it comes to alcohol. Yet, every year students are injured or lose their life due to alcohol related causes. Recently, Stanford University has been in the spotlight regarding alcohol use in campus. But first, a little back story…

Former Stanford swimmer and Olympic hopeful, Brock Turner, was charged last year with sexually assaulting a fellow classmate at a party. Turner had claimed that alcohol was the cause leading to his assault of an unconscious female behind a dumpster, and he was caught in the act. While it may have seemed to be an open and shut case, for which he was found guilty, the judge gave Turner a slap on the wrist, sentencing him with six months in jail and some probation time.

In response to the incident which caught national attention, Stanford leaders decided to address “the campus culture around alcohol,” The Atlantic reports. Now two months since the controversial sentencing of Turner, the university has instituted a new alcohol policy—placing a ban on hard liquor at campus parties. The “harm-reduction strategy” bans all liquor over 20 percent alcohol by volume (40 proof) from undergraduate campus parties. Students who are of the legal age to drink will be allowed to have hard-alcohol containers in the residences, as long as they are under 750 milliliters in size. Ralph Castro, director of the Office of Alcohol Policy and Education, said in a press release:

“Our intention is not a total prohibition of a substance, but rather a targeted approach that limits high-risk behavior and has the backing of empirical studies on restricting the availability of and access to alcohol. It also allows us the ability to provide uniformity in a policy that will impact all undergraduate students without banning a substance that is legal for a segment of the student population to use responsibly.”

Wednesday, August 24, 2016

Preventing Opioid Tolerance and Addiction

Opioid addiction in America continues to be an important topic for lawmakers, healthcare professionals and addiction researchers. With over two million Americans addicted to opioids of one form or another, effective measures must be taken to curb our skyrocketing addiction rates. While it is well known that the disease of addiction lives in the brain like any other mental illness, but what is less certain is where to target when developing new medications for the treatment of addiction. Finding such targets could have huge implications and mitigate opioid addiction rates in the United States.

Researchers at Georgia State University (GSU) and Emory University may have determined a particular brain mechanism that could be a promising target for preventing tolerance and opioid addiction, according to a GSU press release. The study showed that blocking a particular cytokine (chemical messengers that trigger an immune response) puts a stop to morphine tolerance. The findings of the study were published in the Nature journal Neuropsychopharmacology.

"These results have important clinical implications for the treatment of pain and also addiction," said Lori Eidson, lead author and a graduate student in the laboratory of Dr. Anne Murphy in the Neuroscience Institute of Georgia State. "Until now, the precise underlying mechanism for opioid tolerance and its prevention have remained unknown." 

If scientists can create a drug that prohibits one from developing a tolerance to opioid painkillers, then doctors would be able to prescribe lower doses for shorter period of times. Addiction often ensues from a patient requiring more and more of a drug to achieve the desired painkilling effect. Taking drugs like morphine for extended periods of time results in dependence, which can easily lead to addiction.

Despite the addictive potential of opioid painkillers, such drugs are invaluable in a number of situations where alternative forms of pain management prove ineffective. So it is fairly safe to say that prescription opioids are not going anywhere, anytime soon. Research that can shine a light on how to mitigate the risk of addiction is crucial.

Friday, August 19, 2016

Mental Health Treatment for Minorities

mental health
There are currently millions of Americans serving time in one penal institution or another, more than half of which are serving time for nonviolent drug offenses. Decades of draconian drug laws, such as mandatory minimum sentencing rules, has resulted in inflated prison populations and have disproportionately affected minorities. While drug sentencing laws are being amended in many states, slowly but surely, there is still much work to be done with regard to how this country treats those living with the disease of addiction or other forms of debilitating mental illness.

Certainly, experts can point to a number of reasons why black and Latino Americans have been disproportionately touched by drug sentencing laws (i.e. stereotyping, poverty and racism); it may be the result of a systemic problem that begins with how people are treated in their adolescent years. The treatment of minority of children in this country may actually put them on path that, more times than not, results in imprisonment during one’s adult years.

New research indicates that minority adolescents and young adults in this country are about half as likely as their white peers to get mental health care, ScienceDaily reports. The findings come from analyzing data on children under 18 and young adults 18-34 from the Medical Expenditure Panel Survey between the years 2006-2012. The research was published in the International Journal of Health Services.

Verily, failing to provide adequate treatment services to those who are living with a mental health disorder is a recipe for disaster. It is well known that jails and prisons are not treatment centers, we cannot arrest away mental health. And as you might imagine, black youths have similar rates of mental health issues as their white counterparts, according to the article. Without receiving proper care, our disenfranchised youth will turn to self-medication with drugs and alcohol. The authors point out:

"The under-provision of mental health care for minority children contrasts starkly with the high frequency of punitive sanctions that their behaviors elicit. Black children suffer excessive rates of school discipline such as suspensions and expulsions starting at preschool ages. Minority teens also have disproportionate contact with the juvenile justice system, with higher arrest rates for nonviolent, low-level offenses such as drug possession, as well as for non-criminal misbehaviors such as truancy and curfew violations. Youthful transgressions that might result in referral for treatment among non-minority children more often incur criminal sanctions for minorities."

Wednesday, August 17, 2016

The Prescription Drug Monitoring Act

Efforts to curb prescription opioid misuse move forward in the wake of the Comprehensive Addiction and Recovery Act (CARA) of 2016—a sweeping piece of legislation that addresses several aspects of the American opioid epidemic. The legislation is meant to, among other things:
  • Expand Access to Addiction Treatment Services
  • Strengthen Prescription Drug Monitoring Programs (PDMPs)
  • Amend Opioid Prescribing Practices
  • Increase Naloxone Availability
The CARA bill was supported by the majority of lawmakers on both sides of the political landscape. While there are some flaws, such as a lack of funding to bring everything the legislation calls for to fruition, its adoption has been widely hailed as a success and good start in the fight to save lives. The opioid epidemic in the United States claims as many as 78 American lives every day, making such measures of paramount importance.

The passing of CARA was a clear sign that lawmakers are willing to change how they think to save lives and help stem the insidious tide of addiction. However, you may find it troubling to learn that many doctors are resistant to being told how to prescribe and who should be prescribed painkillers. Currently, all but one state has some form of PDMP, yet in many states such tools are egregiously underutilized by physicians. It begs the question: Are doctors not interested to know which patients are gaming the system to abuse prescription opioids? Do they not want to know which patients may be in need of addiction treatment services?

Well, the choice may not be theirs to make any longer, in light of new legislation that has been proposed in the Senate. Recently, a bipartisan group of Senators introduced the Prescription Drug Monitoring Act, according to a press release. The bill was co-sponsored by Senators Joe Manchin of West Virginia, Amy Klobuchar of Minnesota and Angus King of Maine.

“The Comprehensive Addiction and Recovery Act is a solid start in launching a broad effort to combat our nation’s opioid epidemic,” said Senator Manchin. “But we must take additional steps to ensure that the federal government’s approach to this epidemic is as comprehensive as possible. The Prescription Drug Monitoring Act goes a step beyond CARA to ensure that states are sufficiently monitoring the prescription drugs within their borders and are communicating with one another to encourage collaboration. This is a crucial step towards establishing a comprehensive approach for putting an end to the opioid epidemic.”

Friday, August 12, 2016

Curbing Cocaine Addiction in the Brain

With each year that passes, researchers continue to make groundbreaking discoveries in the field of addiction medicine. Such revelations can prove to be invaluable for the development of effective addiction treatment therapies. While it is well understood that the disease of addiction resides in the brain, up until the last few decades little was known about how the illness emerged and functioned. Our understanding of how the disease works is light years beyond where it once was, which has allowed addiction counselors to treat those afflicted more effectively.

Over the last decade much of the focus regarding addiction research has dealt with opioid use disorder, due to the fact that the opioid addiction crisis in America has reached epidemic proportions. Nevertheless, there are number of other drugs being abused that have the power to disrupt the course of people’s lives, such as cocaine.

Not too long ago cocaine use was the focus of concern in the U.S, and while “crack” cocaine abuse is no longer considered to be an epidemic—it is still used by a significant number of Americans. Every day, people addicted to cocaine check into substance use disorder treatment centers with the hope of finding recovery.

New research suggests that blocking a molecule in the brain, called hypocretin, could reduce compulsive cocaine-seeking behavior, ScienceDaily reports. With funding from the National Institutes of Health's (NIH) National Institute on Drug Abuse (NIDA) and National Institute on Alcohol Abuse and Alcoholism (NIAAA), researchers conducted and published the study in the journal Biological Psychiatry.

"Understanding the mechanisms underlying cocaine addiction is important for identifying potential new targets for therapeutic use,” said study authors: Marisa Roberto, Brooke Schmeichel, George Koob, the CNAD chairman currently on a leave of absence to direct the NIAAA and Melissa Herman. "The results of this study would suggest that the hypocretin system could be considered a pharmacological target, with the hopes that such a medication could be used in combination with cognitive behavioral therapies."

For cocaine addiction, Hope by the Sea offers an affordable drug and alcohol rehab in the coastal Orange County area that helps cocaine addicts begin the recovery process. Hope by the Sea is a leading quality of care facility on the West Coast with an outstanding clinical staff.

Tuesday, August 9, 2016

ADHD Medications Regularly Abused

Untreated mental health disorders can lead to several serious problems throughout the course of one’s life. The consequences can be dire, especially with conditions like depression and bipolar disorder. Those who have no way of coping with their mental illness will often turn to drugs and/or alcohol, which only serves to exacerbate the problem. Every year, the untreated symptoms of mental illness lead people to make attempts at taking their own life.

Another form of mental health problem worth mentioning is attention deficit hyperactivity disorder (ADHD), a problem characterized by having a problem concentrating on specific tasks. Left untreated, people with ADHD struggle to maintain their class load or workload, a problem that can make it hard to get by in life. While the most common treatments for ADHD involve the use of stimulant medications, such as Adderall or Ritalin, both are a type of drug that can easily be abused and are highly addictive.

Attention deficit medications are commonly used and abused by people without a diagnosis or prescription for such drugs. However, the reasons for use are varied; some use them to get an edge in school or work, while others use them to get high or give them more energy for extended alcohol use. It is fair to say that there isn’t a college campus in America where drugs like Adderall are not be used and abused without a prescription. It is worth pointing out that new research findings suggest that those who use ADHD drugs without a prescription often meet the criteria for ADHD and/or substance use disorder, UPI reports. The findings were published in the Journal of Clinical Psychiatry.

“We know that untreated ADHD is associated with increased risk of alcohol- and drug-use disorders, so it is not surprising that we found high rates of co-occurring ADHD and of stimulant-use and overall substance-use disorders in those misusing stimulants,” said Dr. Timothy Wilens, Chief of Child and Adolescent Psychiatry at the Massachusetts General Hospital for Children, in a press release

The researchers came to their findings by looking at 300 Boston-area college students, according to the article. Of the pool, 100 participants were classified as stimulant misusers and 200 were not considered misusers. There were students in each group who had been diagnosed with ADHD. The study found that students with a diagnosis, or displayed symptoms of the disorder, were more likely to misuse the ADHD meds. The findings indicated that 67 percent of misusers met criteria for stimulant-use disorder, and they were more likely to meet criteria for substance-abuse disorder.

"It's possible that pre-existing cognitive deficits may lead some individuals to develop stimulant misuse as they try to self-medicate," said Wilens. "The extent of an actual stimulant-use disorder in those who misused stimulants at all suggests that this problem may be more prevalent and severe than previously thought."

Friday, August 5, 2016

Gabapentin Increases Opioid High

One facet of addiction treatment is the utilization of certain medicines to help the early recovery process along, typically drugs that lack the potential for abuse. Often times prescription drugs are used “off label” (in unapproved ways) to help with depression, anxiety and/or insomnia. If you are in treatment for drug or alcohol abuse, it doesn’t make sense to give a client drugs which carry the potential for abuse, even if they are effective.

Doctors who work at addiction treatment centers will typically try to avoid anti-anxiety drugs like Xanax or sleep medications like Ambien. If a client is exhibiting signs of insomnia or anxiety, they will often be prescribed a drug like Seroquel, an anti-psychotic; while effective, it does not have a euphoric effect that could eventually lead to abuse. If a patient is having pain and/or anxiety, a doctor may prescribe Neurontin (gabapentin)—a seizure medication that has been found to be effective in treating nerve pain and poses little risk for abuse or addiction. Using drugs off label can be a valuable method for skirting the use of medications with the potential for abuse.

Interestingly, new research suggests that many patients being seen at pain clinics are using gabapentin without a prescription, HealthDay reports. In fact, of 323 patients who were prescribed opioid pain medications, 20 percent were found to have the anti-seizure drug in their system. The findings were presented at the American Association for Clinical Chemistry's (AACC) annual meeting in Philadelphia.

So, if gabapentin poses little risk of abuse and addiction, why would patients be seeking out the drug? The researchers point out that when gabapentin is mixed with opioids, it actually increases the euphoric effects of the painkillers, according to the article. Gabapentin will also increase effects of:
  • Anxiety medications
  • Muscle Relaxants
  • Opioids
“The high rate of misuse of this medication is surprising and it is also a wakeup call for prescribers,” said study author Poluru Reddy, in a news release. “Doctors don’t usually screen for gabapentin abuse when making sure patients are taking medications, such as opioids, as prescribed. These findings reveal that there is a growing risk of abuse and a need for more robust testing.”
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