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Wednesday, October 27, 2010

Iraq Security Forces Using Drugs and Alcohol On Duty

As American forces prepare to depart from Iraq at the end of next year there are serious doubts about the Iraqi security force members readiness to handle it; there have been reports that in some regions of Iraq more than half of the security forces are using drugs and alcohol while on duty. Even high ranking officials are believed to be using drugs, so there is an actual possibility that the Iraqis are not mentally equipped to defend their country from insurgent groups. Interviews have been conducted with a number of: soldiers, police officers, political leaders, health officials, pharmacists and drug dealers around the country, what they have found is that in the last year drug and alcohol use among security forces has become increasingly common.

"The United States has spent more than $22 billion training and equipping Iraqi security forces since 2004, and the American military has repeatedly said Iraq’s Army and police are capable of fending off armed insurgent groups", reported the New York Times. Nevertheless, Iraq is a war torn country full of deadly insurgents and the injection of democracy has not made the transition all that easy for many citizens, using drugs and alcohol to cope with seeing people blown up by improvised explosive devices doesn't seem unlikely. “Pills are cheaper than cigarettes and they make you more comfortable and relaxed,” said Nazhan al-Jibouri, a police officer in Nineveh Province in northern Iraq. “They help us forget that we are hungry, and they make it easier to deal with people. They encourage us during moments when we are facing death.”

Iraq may be equipped with troops and weapons to ward off insurgents, but, medical care like mental health and substance abuse treatment is extremely rare. The country doesn't even have drug tests to determine who is taking drugs, so stopping the growing problem is extremely difficult. “The percentage of the addicted among the police and army has increased because there’s no medical staff to help and there are no drug tests,” said Col. Muthana Mohammed, an army officer in Babil Province, in southern Iraq. Three decades of war have exacerbated the drug problem throughout the country, apparently drugs can be acquired in: cafes, markets, on the street, and even elderly women who sell pills that the hide beneath their abayas. It is believed that insurgents smuggle drugs into the country to fund their terror.

Iraq has gone from a dictatorship to a drug smugglers mecca with heroin, marijuana, and hashish coming in from Afghanistan and Iran, fueling addiction throughout the country. Iraq is starting to resemble Afghanistan after the Soviets invaded the country in 1979 ultimately leading to the creation of the Taliban.

New York Times

Monday, October 25, 2010

Teens Lie About Drug Use and So Do Parents

It is no secret that most people who use or have used drugs in the past are not honest when asked about it, even when asked in anonymous surveys. Both parents and teenagers lie when asked about the substance use history which is a big problem for experts to gauge how many people are using drugs and what they may be using. Most parents have no idea what their teenagers are up to and if they do have an idea they typically pass it off as common teenage behavior which can be quite dangerous. Researchers published a new study in Pediatrics which had some interesting and alarming results.

432 African-American teenagers and their parents were asked to participate in an anonymous survey about their use of cocaine, opiates, and marijuana and that there would also be a drug test in conjunction with the survey:

  • Of the 211 teenagers whose hair was tested for cocaine, 2 said they used it, but 69, or 34 percent, tested positive.
  • Of the 244 parents tested, 15 said they had used cocaine, but 69, or 28 percent, tested positive.
  • Alcohol - 9.6 percent of the parents said their teenager drank, while 25 percent of the teenagers said they did.
  • Marijuana - 9.5 percent of parents said their teenager smoked, while 17 percent of the teens said they did.

"Researchers, at Wayne State University in Detroit, say that relying on anonymous surveys could lead researchers, parents, and pediatricians seriously astray in estimating the health risks teenagers face", according to US News. The younger a teenager starts experimenting with drugs, the greater the chance for addiction, parents should address problems as soon as they can and not pass off drug and alcohol use as typical teenage behavior. Parents should never be afraid to confront their children about drugs or alcohol; the more open parents are with children the better.

US News

Wednesday, October 20, 2010

Emergency Department Visits Involving Accidental Ingestion for Drugs

It is probably fair to say that there is hardly a house in America that does not contain some form of pharmaceutical medications. There are more prescription drugs handed out today than ever before in history, just about every other commercial on television deals with medications that could improve one's quality of life. Parents who take prescription drugs should be aware that more accidental ingestion of drugs happen to children ages five and below; keeping track of medications is crucial, prescription medication should always be locked up and out of reach from young children. A new report recently published by the Substance Abuse and Mental Health Services Administration (SAMHSA), DAWN Report, had some startling statistics that any parent currently taking medications should be made aware.

According to SAMHSA, 68.9 percent of an estimated 100,340 emergency room visits for accidental drug consumption were children age five and younger. The majority was actually three years or younger: 14.4 percent were three-year-olds; about 42.3 percent were two-year-olds; and 29.5 percent were one-year-olds. Only about one percent of the ER visits were children who had ingested illegal drugs, most of the prescription drugs consumed were ones that acted on the central nervous system:

Central Nervous System Drugs 28,186 40.8%
Pain Relievers 14,572 21.1%
Acetaminophen Products 7,008 10.1%
Ibuprofen Products 4,581 6.6%
Narcotic Pain Relievers 2,679 3.9%
Drugs for Anxiety or Insomnia 8,035 11.6%
Benzodiazepines 5,325 7.7%
Central Nervous System Stimulant Medications 1,859 2.7%
Cardiovascular System Medications 10,883 15.7%
Respiratory System Medications 7,111 10.3%
Psychotherapeutic Drugs 5,969 8.6%
Antidepressants 4,286 6.2%
Antipsychotics 2,034 2.9%
Topical Medications 5,964 8.6%
Drugs for Metabolic Disorders 3,444 5.0%

There is no excuse for being lackadaisical with prescription medication and parents need to be vigilant about keeping them out of their children's hands. Visitors to the household, babysitters, and even grandparents need to be informed as well. Fortunately, most the children admitted to the emergency room, about 85 percent, were treated and released; nearly 9 percent had to be admitted as inpatients, the rest of the children had to be referred to another location.


Monday, October 18, 2010

DUIs Involving Prescription Drugs Are Difficult To Prove

The road is a dangerous place for all drivers, accidents happen all the time and there are people out there who are intoxicated that share the roads with us. Traditionally, a DUI was given to people who drove under the influence of alcohol with a blood alcohol content of .08 or higher. Today, with illegal drug use as well as legal prescription drug use, more and more DUIs have to do with drugs in one way or the other. It is very difficult for police officers to determine whether or not someone on prescription medications is too impaired to drive, there is not a nationally accepted test that can quantify how much of a particular drug is in someone's system nor a level that has been set that, if crossed, would result in a DUI. A number of states do not even require a test to quantify the amount of drugs in a person's body in a DUI case, thus impairment is hard to prove. If a person is suspected of being impaired by prescription drugs and chooses to go to court and fight it, the jury is faced with a conundrum; how can a jury prove beyond a reasonable doubt that someone had too much of a particular drug to drive safely?

"What we and other states have run into historically is that there is a well-developed system to quantify the amount of alcohol in the human body, however, when you have oxycodone or an opiate, we do not have a well-developed way to quantify the amount of drugs so that a jury can then compare that value to a standard established as an unlawful when operating an automobile", stated Rob Parker, a Brevard County, Fla., prosecutor. In 2007, a man was charged with four counts of DUI after a crash. Police observed that the 33-year-old driver looked intoxicated with bloodshot eyes, droopy eyelids, and he had difficulty speaking. A blood sample was taken from the driver which tested positive for prescription medication. The driver was acquitted by the jury on the DUI chargers in August, "the jury heard all of that and could not conclude that he was DUI with drugs beyond reasonable doubt," Parker said. There is no doubt that the driver is back on the road putting more peoples' lives at risk.

States need to employ Drug Recognition Experts, (DREs), to go to the scene of a crime to run tests on drivers suspected of being under the influence of drugs in order to determine whether or not the driver is actually impaired. DRE's are police officers who have completed specialized training in detecting impairment due to drugs and it can take three to six months for an officer to become a DRE. Even if a quantitative test is developed, we know that everyone is different and how much of a certain drug it would take to impair one person may be different than another.

USA Today

Wednesday, October 13, 2010

FDA Approves Injectable Drug To Treat Opioid-Dependent Patients

Opioid addiction is one of the more difficult drugs to kick, addicts usually experience terrible: pain, nausea, shaking, and cold sweats. Once an addict has braved their way through detox there are still strong cravings for the drug, as the opioid receptors in the brain scream for their medicine because the brain can no longer produce opiates on their own. Naltrexone is a drug that was originally used to treat alcoholics, it was found to have the ability to block the opioid receptors in the brain, blocking the effects of drugs like morphine, heroin, and other opiates which will help addicts refrain from using those types of drugs because they will no longer work. The U.S. Food and Drug Administration approved a drug called Vivitrol to treat and prevent relapse after patients have detoxed completely.

Vivitrol is an extended-release formulation of Naltrexone administered by intramuscular injection once a month. Vivitrol was studied for six months to make sure that it was safe and effective in preventing opiate addicts from relapsing. The study compared Vivitrol treatment to a placebo treatment with detoxed patients who no longer experienced physical dependence. It was found that those patients that were given Vivitrol were more likely to stay and continue drug treatment and stay away from using opiates. Thirty-six percent of the Vivitrol-treated patients were able to stay in treatment for the full six months without using drugs, compared with 23 percent in the placebo group.

If an addict taking Vivitrol decides he cannot handle it and decides to use one of the various types of opiates available they will have withdrawal symptoms relatively quickly. People who take drugs like Naltrexone become hypersensitive to opiates while taking the drug and if they miss their monthly dose of it and decided to start using drugs again they will be more susceptible to an overdose.

Patients who decide to take part in a Vivitrol regimen once a month will receive an intramuscular injection administered only by a physician. Vivitrol requires a special administration needle that comes with the product; Vivitrol should not be injected using any other needle. Recovering addicts should be aware that Vivitrol is not without side effects including: nausea, tiredness, headache, dizziness, vomiting, decreased appetite, painful joints, and muscle cramps. There are also more serious side effects that may be severe enough to convince one to stay away from Vivitrol altogether; reactions at the site of the injection severe enough to require surgery, also: liver damage, allergic reactions, rashes, swelling of the face, pneumonia, depressed mood, suicide, suicidal thoughts, and suicidal behavior.

"Addiction is a serious problem in this country, and can have devastating effects on individuals who are drug-dependent, and on their family members and society," said Janet Woodcock, M.D., director of FDA's Center for Drug Evaluation and Research. "This drug approval represents a significant advancement in addiction treatment."

It is always best to go through treatment relying more on the program of recovery than on drugs of any kind, sometimes drugs like Vivitrol (Naltrexone) are necessary for people who simply cannot fight off their cravings and need an extra push, but, they are not required for success. Recovery comes from the inside, only you have the power to make the choice to stay clean and sober; preventative drugs like Vivitrol for opiates or Antabuse for alcohol can only do so much.

U.S. Food and Drug Administration

Monday, October 11, 2010

SAMHSA Awards Grants to Children Whose Families Use Methamphetamine

Methamphetamine has torn a hole through a number of communities in the United Sates, countless children are affected by their parents use of the drug and in many cases children will to start to use meth themselves. In an attempt to help children whose parents use methamphetamine the Substance Abuse and Mental Health Services Administration (SAMHSA) will give up to $16.8 million over a four year period in grants to make services more effective in order to help provide better support to children whose families use methamphetamine. The children the program will focus on are those whose parents have enrolled in Family Treatment Drug Court (FTDC) for methamphetamine; the goal is to provide exposed newborns with medical care as early as possible, on top of mental health, medical and dental care to children ages 0-17.

"Children of substance abusing parents are likely to experience guilt, anxiety, embarrassment, inability to have close relationships, confusion, and anger," said SAMHSA Administrator Pamela S. Hyde, J.D. "This program offers children help early on which is important in preventing more serious problems for the child later in life, including substance abuse and mental disorders. The key is helping children understand they are not responsible for the problems of their parents."

There will be 12 grants which will be administered by SAMHSA's Center for Substance Abuse Treatment; using approximately $4.2 million per year, the awardees will be eligible for up to $370,000 per year for up to four years.

The awardees and the first year amounts of their grants are:
  • Superior Court of California, Riverdale, Calif. $370,000
  • Clark County, Vancouver, Wash. $370,000
  • Santa Barbara County, Santa Barbara, Calif. $370,000
  • Colorado Judicial Department, Denver, Colo. $369,090
  • Oklahoma Department of Mental Health & Substance Abuse, Oklahoma City, Okla. $370,000
  • Administrative Office of the Courts/Nebraska Supreme Court, Lincoln, Nebraska $369,856
  • County of Santa Cruz, Santa Cruz, Calif. $370,000
  • San Luis Obispo County Behavioral Health - Drug & Alcohol Services San Luis
    Obispo, Calif. $370,000
  • Dunklin County, Kennett, Mo. $119,082
  • Butte County, Chino, Calif. $370,000
  • Sacramento County Department of Health and Human Services, Sacramento, Calif. $370,000
  • Pima County Juvenile Court, Tucson, Ariz. $369,993
Hopefully, the new program will be able to spare many children from a life of addiction to methamphetamine by providing them with the education, medical, and therapeutic services that children whose parents are meth addicts desperately need.


Wednesday, October 6, 2010

Alcohol Abuse After a Disaster is Pre-Existing

Disasters happen every day around the world in one way or another, acts of God and acts of man can greatly affect and amplify one's problems. Hurricanes, earthquakes, tsunamis, fires, and economic recessions are happening all the time, there are many who respond to these events by trying to dull themselves with drugs or alcohol which has led people to think that the disasters are the cause of certain individuals substance abuse problems. However, scientists analysis of ten recent U.S. disasters has determined that most substance use problems following a disaster represent preexisting problems rather than new disorders, the disasters themselves exacerbate the problem because alcohol and drugs are some peoples only outlet for a mental reprieve from their real life problems.

According to findings published on Oct. 4 in Archives of General Psychiatry, Dr. Carol S. North, of the VA North Texas Health Care System, and her associates studied a large database of survivors of 10 different disasters to determine the link between pre- and post-disaster prevalence of alcohol problems. "Of 811 participants in the index sample, 697 (86%) provided complete pre- and post-disaster alcohol data. Of the respondents, most were white (92%), and more than half (57%) were female. Mean age at the time of the disaster was 46 years, with 28% of patients between ages 18 and 35. More than one-third of subjects (38%) were injured during the disaster, with 20% diagnosed with a disaster-related post-traumatic stress disorder", (Arch. Gen. Psychiatry 2010 Oct. 4 [doi:10.1001/archgenpsychiatry.2010.131]).

The prevalence of an alcohol use disorder (alcohol abuse/dependence) was 25% before the disaster and 19% afterward, wrote Dr. North, also of the University of Texas Southwestern, Dallas, and her colleagues.

Out of the 567 individuals who did not have post-disaster alcohol abuse/dependence at the start of the study:

  • 3% (20) developed an alcohol use disorder during the follow-up period.
  • Twelve of these were new cases, for a 2% incidence.
  • The rate of onset of new alcohol use disorders over the next 2 years (0.08 new cases per month) was the same as the post-disaster rate.
  • Those with a pre-disaster alcohol use disorder, 83% consumed alcohol after the disaster.
  • 22% coped with their emotions by drinking.

“Despite evidence from other studies that alcohol use may increase after disasters, the findings from this study suggest that this increase in use may not regularly translate into new onset of post-disaster alcohol use disorders,” according to Dr. North and her colleagues. “The distinction between alcoholic relapse and continuing or new alcohol problems is important, because people who are in recovery from alcoholism when a disaster strikes may be especially vulnerable to relapse when exposed to highly stressful events, thus constituting a population deserving of particular attention in the post-disaster period".

Internal Medicine News

Monday, October 4, 2010

Painkillers In The Workplace Can Be Dangerous

Most people do not handle pain or discomfort all that well, if there is a quick fix for their suffering people generally will jump on it. Prescription medications are so powerful that it is amazing that people are able to function as much as they do while taking them; people go to work and parent their children all while on prescription narcotics - as more people are prescribed these drugs the greater potential for addictions to form, jeopardizing their lives and the lives of the people around them. People who fear losing their jobs because of pain medication will not let their employers know that they are taking drugs which can bring an element of danger into the work place. According to MSNBC, "The use of painkillers, specifically opiates, by employees has exploded over the past few years, and a growing number of employers are starting to test workers for legal, prescription drugs. It’s generally illegal to fire or demote a worker who is taking a prescribed medication, according to labor experts, but using that medication could still impact your career, not to mention your safety and the safety of others on the job".

There has been a huge increase in the number of employees taking prescription opiates, like Oxycontin and Morphine, in the last month according to Quest Diagnostics which does employee drug screenings for companies. The Quest data was culled from 5.5 million worker urine tests and found:

  • An 18 percent jump in opiate positives in the general U.S. work force in 2009 compared to the previous year.
  • A more than 40 percent climb in opiate positives from 2005 to 2009.

People who have an accident on the job and are drug tested are usually not held liable as long as the can prove that they have been legally prescribed a drug. Prescription drugs are certainly playing a part in accidents in the workplace, Quest showed that post-accident drug tests can back positive for opiates up to four times more often than pre-employment tests: 3.7 percent in post-accident compared with 0.78 percent in pre-employment tests. “We believe that workers taking opiates — regardless of the amount — need to take into consideration the consequences of long-term use, including gradual progression of intake, emotional numbness, delayed reaction/responses and decreased performance,” said Clare Kavin, administrative director of an opiate dependency treatment center.

Prescription drugs are abused more than any other drug, both legal and illegal and the problem is getting worse. Most people do not understand the risk of taking strong prescription pain narcotics. Workers need to know their rights in the work place but they should also be considerate of lives around them and how their drug use could put them in harm's way. It is well known that a number of people that are prescribed opiates do not necessitate them, which means they are taking the drugs purely for the high.

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