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Wednesday, August 26, 2015

Life Saving Open Access Naloxone Programs

naloxone
As state officials continue to fight the good fight against the prescription opioid and heroin epidemic plaguing America, there is no question that naloxone is, and will continue to be, the best weapon. Every day, overdose victims across the country are being saved by naloxone kits in the hands of first responders. In most states, a prescription is required for addicts and their loved ones to obtain naloxone, sold under the brand name Narcan ®. Seeing as first responders cannot always arrive in time to administer the life saving drug, there is a good argument for making naloxone available without a prescription.

At hundreds of pharmacies in Massachusetts and Rhode Island, pharmacists have been granted the authority to distribute naloxone kits to people without a prescription, ScienceDaily reports. The open access naloxone programs are part of a set of opioid protocols led by researchers at:
  • Boston Medical Center (BMC)
  • Rhode Island Hospital
  • University of Rhode Island College of Pharmacy
If the protocols prove to be effective, they may serve as guides for other states and nations to set up similar life saving programs, according to the article. Prescription opioids and heroin are the leading cause of adult injury death in the United States.

"We are encountering an unprecedented public health crisis related to opioid abuse and overdose," said Traci Green, PhD, MSc, deputy director of BMC's Injury Prevention Center, who served as the article's first author. "Given that nearly every community has a pharmacy, there is a tremendous opportunity to help save lives by allowing pharmacists to provide naloxone rescue kits to those at risk for overdose."

"Creating these `behind-the-counter' pharmacy models for naloxone allows greater access and availability to people who may not be comfortable or able to obtain naloxone from syringe exchange programs or drug treatment programs, and especially to communities outside of urban settings," Green said. "Unfortunately, not all communities have harm reduction or treatment services available, but pharmacies are everywhere."

The protocols can be accessed in Harm Reduction Journal.

Tuesday, August 25, 2015

Hiking for Addiction Recovery

addiction-recovery
There is no shortage of hiking trails in the United States; some can be trekked in a few hours while others can take months to accomplish. One of the oldest and most famous journeys is the Appalachian Trail (AT), stretching 2,200 miles between Springer Mountain in Georgia and Mount Katahdin in Maine.

Every year, a number of hikers set their sights on trudging the woodland highway from one end to the other; some do it for the experience, while others set out to raise awareness for a cause. A Connecticut man began the journey on March 19th with the hope of inspiring others to find strength as they navigate the trail of addiction recovery, VPR reports.

Phil Valentine is no stranger to the journey of recovery; it's a path that he has been on since he put down cocaine and alcohol 27 years ago. Valentine is the executive director of the Connecticut Community for Addiction Recovery (CCAR). Those in recovery are no strangers to ups and downs even when living a life free from mind altering substances; obstacles can arise at any moment that can test your recovery, requiring strength and perseverance. Valentine began the AT 5 years to the day after he was first diagnosed with stage four tongue cancer, according to the article.

As of August 18th, Valentine has hiked 1747.1 miles and has lost 50 pounds and no longer requires blood pressure or cholesterol medications, with 444 miles between him and Mount Katahdin. The idea of walking the entire trail came to Valentine while he was still being treated for cancer.

“It was really a calling, as I was healing from the treatment from cancer, to walk the Appalachian Trail, and my first response was, ‘The whole thing?’ And it was. 'Yes,’” recalls Valentine. 

His journey is just as much about living healthy as it about being strong in recovery; two ways of being that are not mutually exclusive.

Wednesday, August 19, 2015

SAMHSA Administrator Will Step Down

mental-health
Substance abuse and mental health problems affect millions of teenagers and adults every year. Fortunately, there are number of services, treatment centers, and agencies committed to helping those afflicted manage and recover from diseases of the mind. One such agency is the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services, whose goal is to reduce the effects of mental health and substance abuse, such as: illness, death, disability, and cost to society.

SAMHSA responsibilities include:
  • Prevention
  • Treatment
  • Rehabilitative Services
This week, SAMHSA's Administrator, Pam Hyde, announced that she would be stepping down from her post after six years of service, according to the National Council for Behavioral Health. Hyde’s position will be filled by SAMHSA Principal Deputy Administrator Kana Enomoto.

“Pam’s commitment to her work at SAMHSA is remarkable,” said Secretary of the Department of Health and Human Services Sylvia Burwell. “She has spent her career as a mental health policy expert and advocate and delivered impact for the American people. I am thankful to have served alongside her at the Department.” 

It is probably fair to say that Hyde’s tenure was in the midst of the administration’s most trying time in its 23 year history. Hyde led the way for President Obama’s Now is the Time initiative, a nationwide effort to increase access to mental health services, according to the article. When she came on board in 2009, the prescription opioid crisis was at its zenith. As Administrator she played a pivotal role in expanding access to medication assisted treatment (MAT) for opioid addiction, and worked to make the opioid overdose reversal drug naloxone more available.

Tuesday, August 18, 2015

Keep What You've Earned Campaign

alcohol-abuse
Drug and alcohol abuse prevention is a top priority among the various military branches in the United States. Many active military personnel and veterans struggle with substance use disorders, identifying problematic users and making recovery services available is of the utmost importance. In an effort to gauge if policies are effective, the Navy Alcohol and Drug Abuse Prevention program launched the Keep What You've Earned campaign three years ago, the Navy Times reports.


The Navy’s campaign, surveyed based, shines a light on sailors':
  • Drinking Behavior
  • Understanding of Alcohol Abuse
  • Willingness to Seek Help
"The Keep What You've Earned campaign has been shaped by feedback from Sailors and its efforts would not be successful without their input," said NADAP director Dorice Favorite. "The annual survey allows our office to determine how well alcohol abuse prevention efforts and messages are being delivered across the fleet and shape the following year's plan to improve those efforts." 

This year, 1,400 Navy personnel and their families participated in the Keep What You've Earned campaign survey, according to the article. The anonymous survey is comprised of 25 questions, while brief, the survey covers a lot of ground.

The range of questions includes:
  • How you think the Navy handles drinking?
  • Are you aware of abuse prevention programs?
  • Are you willing to help yourself or another with a drinking problem?
  • Do you think the Navy has a culture of alcohol abuse.
"This survey gives us a pulse check on how those attitudes and behaviors have changed in the past year, and how we can continue to develop an innovative strategy to promote responsible drinking," said Favorite.

You can take a look at the survey here.

Wednesday, August 12, 2015

The Impact of Marijuana Dispensaries on a Population

marijuana-dispensaries
The state of California is no stranger to marijuana; it was the first state to successfully pass medical marijuana legislation and is expected to pass recreational use legislation next year. With that in mind, there is a lot of research being conducted regarding the impact of the drug on certain populations - research not only valuable to California, but for other states likely to adopt more relaxed laws on marijuana.

In major Californian cities, such as Los Angeles and San Francisco, there was a time when marijuana dispensaries were popping up like weeds. Practically everywhere a person could look an emblematic green cross could be seen. In recent years, concerns of overexposure led municipalities to limit the number of marijuana dispensaries in a given area, making sure to restrict their development in close proximity to schools and neighborhoods.

New research suggests that people who reside in parts of California that have a large number of marijuana dispensaries in a given area, are at a greater risk of marijuana abuse and dependence, ScienceDaily reports. A University of Pittsburgh Graduate School of Public Health analysis, funded by the National Institutes of Health, found that people living in areas with increased access to marijuana by way of dispensaries experienced more marijuana related hospitalizations.

"As marijuana is approved for medical or recreational use, we need to carefully consider where we allow dispensaries to be placed," said lead author Christina Mair, Ph.D., assistant professor in Pitt Public Health's Department of Behavioral and Community Health Sciences. "Our study indicates that there are real problems associated with a higher density of marijuana dispensaries in neighborhoods. More study and monitoring, coupled with thoughtful legislation and community discussion, will be prudent to ensure that marijuana laws have the fewest negative consequences for vulnerable populations." 

Interestingly, the research showed that marijuana dispensary locations and marijuana associated hospitalizations tended to occur most in impoverished and undereducated areas, according to the article. However, Dr. Mair points out:

"It's unclear if the marijuana dispensaries are simply locating in neighborhoods that tend to be more disadvantaged and already have underlying problems with marijuana abuse, or if the presence of the dispensaries is causing an increase in abuse and hospitalizations. It could be a combination of both factors." 

The research will be published next month in the journal Drug and Alcohol Dependence.

Tuesday, August 11, 2015

Hospitals Move from Universal Screening to Universal Testing

nas
The dramatic rise of opioid abuse in the United States has led to a crisis in delivery rooms across the country. The heroin scourge plaguing Americans cannot help but touch those who have yet to be born. Expectant mothers who use opioid narcotics of any kind put their unborn child at serious health risks, often requiring intensive neonatal treatment upon delivery - a disorder known as neonatal abstinence syndrome (NAS). The syndrome is the direct result of a 100 percent rise in heroin addiction between 2002 and 2013, according to the U.S. Centers for Disease Control and Prevention (CDC).

In response to the problem, areas hardest hit by the heroin epidemic are taking extreme caution with all newborn babies. In Ohio, a state which has been witness to the growing rates of NAS first hand, a collective of Cincinnati hospitals announced its plans to test all mothers or their babies for the presence of opioid narcotics, Reuters reports. Over the last ten years, a recent study found that the number of babies treated for NAS has almost quadrupled.

The group of Cincinnati hospitals hopes that testing will help doctors identify babies with the potential for developing the symptoms of NAS. “The key thing we wanted to do is identify these infants early on,” said Dr. Scott Wexelblatt of the Cincinnati Children’s Hospital Medical Center.

Babies born with opioids in their system, such as illegal heroin or legal oxycodone, often experience the symptoms of opioid withdrawal. Symptoms of NAS can include:
  • Extreme Irritability
  • Poor Feeding
  • Diarrhea for 48 to 96 Hours
The program will be funded by a state grant, allowing Cincinnati hospitals to go from universal screening to universal testing, according to the article. Universal screening involved asking mothers questions to determine if they may be using drugs. Under universal testing, if mothers refuse to submit to a drug test their babies will be tested anyway.

Wednesday, August 5, 2015

Electronic Alcohol Interventions May Not Work In The Long Run

electronic-alcohol-interventions
An analysis of several studies found that electronic programs designed to reduce the use of alcohol may not be that effective in the long run, but may have more promise with problematic drinkers, HealthDay reports. The findings come from a review of 28 different studies concerning electronic alcohol intervention programs.

 The forms of electronic programs studied included:
  • CD-ROM
  • Desktop Computers
  • Online
  • Mobile Apps
  • Phone/Computer Based Interactive Voice Response
“At this point, the effects of the available brief electronic interventions are small, and evidence that they help people to drink within recommended limits is lacking,” said lead researcher Eric Dedert of Duke University School of Medicine in Durham, N.C. “However, electronic interventions for alcohol misuse hold significant promise, and there is a need to develop more intensive interventions.” 

The most common programs used involved a single intervention, participants answer alcohol use related questions and then get info on how their drinking compares to their peers, according to the article. Overall, there were limited reports of alcohol use reductions from electronic interventions.

Dr. James Garbutt, a professor of psychiatry from the University of North Carolina, Chapel Hill, told HealthDay:

"The underlying idea is of interest -- can we use brief and inexpensive electronic interventions to help individuals reduce their harmful drinking?" He adds, "These data suggest that stronger electronic interventions, possibly including interventions from a live human being, may be necessary to attain more meaningful improvements in drinking behavior." 

The findings were published in the Annals of Internal Medicine.
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