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Tuesday, September 30, 2014

E-Cigarette Warning Labels Questioned by Critics

Not much is known about e-cigarettes and the dangers which accompany the devices. Many argue that they are healthier than traditional tobacco products, but there is still a high risk of nicotine addiction. The federal government has not mandated that e-cigarettes have warning labels, yet big tobacco companies which own their own e-cigarette products have begun placing warning labels on the devices.

Critics of the tobacco industry are questioning the motives of big tobacco companies who have issued strong voluntary warning labels on their e-cigarettes, according to The New York Times. In many cases the e-cigarette warnings are stronger than the warnings they place on their traditional tobacco products.

The makers of Marlboro, Altria, which also makes the e-cigarette MarkTen, has placed a label on the devices which reads, “nicotine is addictive and habit forming, and is very toxic by inhalation, in contact with the skin or if swallowed.” The makers of Vuse e-cigarettes, Reynolds American, have created a warning label that states the devices are not intended for persons “who have an unstable heart condition, high blood pressure, or diabetes; or persons who are at risk for heart disease or are taking medicine for depression or asthma.”

William Phelps, a spokesman for Altria, said its MarkTen warnings reflect “a goal to openly and honestly communicate about health effects.”

“Is this part of a noble effort for the betterment of public health, or a cynical business strategy? I suspect the latter,” said Dr. Robert K. Jackler, a professor at the Stanford School of Medicine who studies cigarette and e-cigarette advertising.

It is interesting that the warnings on the back of Marlboro's packs fail to mention the addictive nature of cigarettes, or that the use of cigarettes can lead to fatal health problems like heart disease and cancer.

“Why wouldn’t you warn about ‘very toxic’ nicotine in your cigarettes when you do so on e-cigarettes?” said Dr. Jackler.

Thursday, September 25, 2014

FedUp! Calls for FDA Head Resignation

Food and Drug Administration logo
The prescription opioid addiction epidemic and the consequent rise of overdose death rates in the United States have led to public outrage. The brunt of criticism has been directed towards the Food and Drug Administration (FDA) due to its lack of or late response to the problem. What’s more, the FDA continues to approve new opioid medications, like Zohydro ER (pure hydrocodone), despite warnings from doctors that such drugs would only add to the problem.

A coalition of doctors, addiction specialists, and family members who have lost loved ones have joined forces; the group is demanding that the head of the FDA, Commissioner Margaret A. Hamburg, resign from her position, The Washington Post reports.

The group of activists, known as FedUp!, states that the Food and Drug Administration (FDA) has hindered more than helped the opioid overdose epidemic. FedUp! is planning a rally on Sunday, September 28th in Washington, D.C. with the hope of making more people aware of what they call “a slow and tragically ineffective federal response” to the “worst drug addiction epidemic in our nation’s history.”

“We have come to believe that without new leadership at FDA the opioid crisis will continue unabated,” the group wrote this week to Health and Human Services Secretary Sylvia Burwell. “We are especially frustrated by the [FDA’s] continued approval of new, dangerous, high-dose opioid analgesics that are fueling high rates of addiction and overdose deaths.”

In a statement, the FDA stated that Hamburg has been a “tireless public health advocate” for more than two decades and “is committed to continuing to champion the rights of patients.” The FDA claims that ensuring pain sufferers have access to appropriate medications and preventing opioid abuse are “both top public health priorities for the FDA.”

Tuesday, September 23, 2014

Testing the Drug Substitution Hypothesis

Recovering from a substance use disorder is no small feat. While the rewards of recovery are great, it is often the case that addicts who give up one addiction will substitute one problem for another or relapse into old behavior. In order to stop the cyclical nature of addiction it requires eternal vigilance and a continued program of spiritual maintenance.

Researchers at Columbia University have found that people who overcome a substance use disorder actually reduce the risk of developing a new addiction by half - when compared to people who have not overcome an addiction. The new findings fly in the face of the traditional beliefs and stereotypes of addiction.

“The results are surprising, they cut against conventional clinical lore, which holds that people who stop one addiction are at increased risk of picking up a new one,” Senior Author Dr. Mark Olfson told Reuters. “The results challenge the old stereotype that people switch or substitute addictions, but never truly overcome them.”

Data from surveys taken in 2001 and 2004, including 35,000 adults, was analyzed by researchers. The survey participants were asked about their use of:

  • Tobacco
  • Alcohol
  • Marijuana
  • Cocaine
  • Heroin
  • Sedatives
  • Tranquilizers
  • Painkillers

The researchers at Columbia looked at the occurrence of a new substance use disorder among adults who already had a disorder. About 20 percent of those who had a substance use disorder in 2001 had one by 2004. Only 13 percent of people in recovery from their original dependence had developed an addiction to something else.

“While it would be foolish to assume that people who quit one drug have no risk of becoming addicted to another drug, the new results should give encouragement to people who succeed in overcoming an addiction,” Olfson said. “I hope that these results contribute to lessening the stigma and discrimination that many adults and young people with a history of substance abuse face when they seek employment.”

The findings appear in JAMA Psychiatry.

Thursday, September 18, 2014

Colleges Combat Binge Drinking

The consumption of alcohol on college campuses continues to be a major concern among faculties and staffs across the country. Especially, the common practice of “binge drinking,” that is having four or more drinks; many students are unaware that binge drinking can lead to a host of medical and/or social problems.

In an attempt to combat campus sexual assaults, colleges are looking for new ways to reduce binge drinking, NPR reports.

Many colleges around the country have their own police force, separate from the local authorities. Campus police typically do not have the ability or the authority to police off campus. Conversely, many local police forces do not have the time, money, or manpower to target underage drinking, one of the leading causes of sexual assault. Naturally, the aforementioned scenario allows for a lapse of coverage concerning college drinking and everything that comes along with it.

However, Maryland’s Frostburg State University and city police agreed in 2012 to joint jurisdiction, allowing campus police to patrol off campus in search of house parties - the goal is to help prevent bad behavior before it starts. “We know there’s going to be underage drinking,” said Frostburg State University police officer Derrick Pirolozzi. “We can’t card everybody. But we want to make sure everybody does it the right way and safe way.”

The university has agreed to pay overtime costs for state, county, city and campus police near the school.

“The thing that’s so striking to me is that many universities perceive [binge drinking] as an intractable problem and that there’s nothing they can do,” Jonathan Gibralter, president of Frostburg State University, told NPR.

Gibralter stated that heavy drinking at Frostburg has led to:
  • Poor Grades
  • Injuries
  • Mental Health Problems
  • Campus Sexual Assaults
  • Deaths
Many parents and alumni have told Gibralter that they drank in college and don’t see it as a big problem. “When I tell parents that 1,800-plus college students drink themselves to death every year, they are stunned,” he said. “They have no idea.”

Tuesday, September 16, 2014

CDC Reports Slower Rise In Prescription Drug Deaths

After years of sharp elevation in prescription drug related deaths, deaths from prescription narcotic painkillers appear to be leveling out, or rising at a slower pace than in previous years, reports the CDC. Any death related to prescription drugs is a sad occurrence and while the number of deaths every year is still on the rise, it is nice to read a report that indicates a decrease in the rise.

The report showed that from 1999 to 2006 prescription painkiller overdose deaths rose by 18 percent each year, but from 2007 to 2011 the number of deaths only rose by 3 percent each year, according to USA Today. In 1999, prescription opioids were involved in 2,749 overdose deaths, in 2011 opioids like hydrocodone and oxycodone were involved in 11,963 overdose deaths, according to the CDC report.

Benzodiazepines, drugs like Xanax or Valium, are commonly prescribed anti-anxiety medications that can be extremely dangerous if mixed with other prescription drugs like opioids. The report showed that Benzodiazepines were involved in a growing number of opioid-related deaths; in fact such drugs were involved in 31 percent of opioid-related deaths in 2011, up from 13 percent in 1999.

What’s more, there has been in increase in the number of drug-poisoning deaths involving methadone, a controversial pain medication that has been used for treating opiate dependent people for decades. In 1999, methadone was involved in 784 deaths, a number which rose to 5,518 by 2007, and then declined to 4,418 deaths in 2011.

It remains clear that prescription drug abuse is still a major concern in America and there is still cause for great concern despite the efforts from a number of government agencies to make the abuse of certain medication more difficult. The DEA has announced that it will reclassify hydrocodone from a Schedule III to a Schedule II narcotic, which will decrease peoples' ability to abuse the medication; patients will be able to receive the drug for up to 90 days without receiving a new prescription.

Thursday, September 11, 2014

Teenage Chronic Marijuana Use Leads to Dropouts

English: Leaf of Cannabis עברית: עלה של קנביס
The use of marijuana at some point during the high school years is quite common; in fact it is difficult to attend a high school party without being exposed to the drug in one form or another. A number of kids are able to stay away from marijuana altogether, some try it a few times at certain social gatherings, and then there are those teenagers who engage in chronic marijuana use.

Chronic use of marijuana affects everyone differently; many teenagers find ways to function under the influence of the drug, still managing to get through high school and even go on to college. Sadly, not everyone has that experience and end up dropping out of high school.

New research indicates that teens under the age of 17, who use marijuana chronically every day, are 60 percent less likely to graduate from high school, according to CNN.

Researchers at the University of New South Wales analyzed data from three previous studies that included almost 4,000 participants. Their findings showed that teen cannabis users are 18 times more likely to become dependent, seven times more likely to attempt suicide, and eight times more likely to use other illicit drugs later in life.

“The results provide very strong evidence for a more direct relationship between adolescence cannabis use and later harm,” said lead author Edmund Silins with the National Drug and Alcohol Research Centre at the University of New South Wales, Australia. “The findings are particularly timely given the growing movement to decriminalize or legalize cannabis because this has raised the possibility the drug might become more accessible to young people.”

“Our results provide strong evidence that the prevention or delay of cannabis use is likely to have broad health and social benefits,” Silins noted in a news release. “Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse effects on adolescent development.”

The findings were published in The Lancet Psychiatry.

Tuesday, September 9, 2014

Pharmacies Can Now Collect Unused Prescription Drugs

The effectiveness of prescription drug “take back” days, which happen twice a year in the United States, has prompted officials to allow pharmacies to receive unused prescription narcotics. Until now, pharmacies were not allowed to accept unused opioid painkillers, according to The New York Times.

The U.S. Drug Enforcement Agency's (DEA) new regulations are designed to give people more options in the fight to curb the prescription drug epidemic. “These new regulations will expand the public’s options to safely and responsibly dispose of unused or unwanted medications,” DEA Administrator Michele Leonhart said in a news release. “The new rules will allow for around-the-clock, simple solutions to this ongoing problem. Now everyone can easily play a part in reducing the availability of these potentially dangerous drugs.”

People with unused prescription narcotics will be allowed to mail unused prescription medications to authorized collectors, using packages that will be available at pharmacies and locations including senior centers and libraries, The New York Times reports.

In the last four years, prescription drug “take-back” collected 4.1 million pounds of prescription drugs, according to the DEA. The agency pointed out that during that time period; about 3.9 billion prescriptions were filled. “They only removed an infinitesimal fraction of the reservoir of unused drugs that are out there,” said Dr. Nathaniel Katz of Tufts University School of Medicine in Boston, who studies opioid abuse. “It’s like trying to eliminate malaria in Africa by killing a dozen mosquitoes.”

The Controlled Substances Act required patients to dispose of their unused drugs themselves or give them to law enforcement officials at national “take-back” events. The new ruling will surely aid in the fight to keep unused drugs out of the wrong hands.

Thursday, September 4, 2014

Doctor Shopping Common Amongst Surgery Patients

Despite the fact that many states around the country have implemented prescription drug monitoring systems, many are still finding ways to get pain medications from multiple doctors - “doctor shopping.” In fact, a new study has found that one-fifth of patients who have surgery for orthopedic trauma, visit multiple doctors for painkiller prescriptions, according to HealthDay.
The medical and pharmacy records of 130 patients treated for orthopedic trauma at Vanderbilt University Medical Center were looked at by researchers.

Going to multiple doctors can be extremely dangerous, often times leading to addiction and, or overdoses. The new research implies that doctors are not sharing information amongst each other regarding the needs of their patients, says lead author Dr. Brent Morris. “There needs to be coordination if additional pain medications are needed,” said Morris. “Patients should not be receiving multiple narcotic pain medication prescriptions from multiple providers without coordinating with their treating surgeon.”

Researchers found that patients with a high school degree or less were 3.2 times more likely to doctor shop, compared to patients with more education. Patients who used prescription opioids in the past were 4.5 times more likely to doctor-shop, the researchers report.

The findings showed that most of the doctor shoppers used narcotic painkillers for about 3.5 months after surgery, obtaining a median of seven narcotics. Those who did not doctor shop typically used painkillers for one month after surgery, using a median of two narcotic painkillers.

“Our study highlights the importance of counseling patients in the postoperative period, and that it is important to work together to establish reasonable expectations for pain control as part of treatment plan discussions and follow-up visits,” Dr. Morris said in a news release.

The findings can be found in the Journal of Bone & Joint Surgery.

Tuesday, September 2, 2014

Alcohol and Marijuana Comparison Study

There has been an ongoing debate as to whether or not alcohol is worse than marijuana; especially since more states have become tolerant of marijuana, the seemingly benign drug. Even President Obama has stated that he is not convinced that marijuana is more harmful than alcohol. It is no secret that both alcohol and marijuana are a part of teenage life, many high school students experiment with both substances just about every weekend and in some cases more often than just on the weekends.

In an attempt to gather more data, researchers at NYU conducted a comparison study of alcohol and marijuana. The study was titled "Adverse Psychosocial Outcomes Associated with Drug Use among US High School Seniors: A Comparison of Alcohol and Marijuana,” according to Newswise.

On September 1, 2014, researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR) published their findings in the American Journal of Drug and Alcohol Abuse, (on-line ahead of print). Researchers gathered data to analyze from a nationally representative sample of high school seniors in the Monitoring the Future (MTF) study. Data from 7,437 students (modal age: 18) from 2007 through 2011 who reported using alcohol or marijuana in their lifetime was looked at in the study.

"The paucity of research is of particular public health concern as alcohol and marijuana are the two most commonly used psychoactive substances among adolescents," said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "Nearly half of high school seniors have used marijuana in their lifetime and over two-thirds have used alcohol, but few studies have compared adverse psychosocial outcomes of alcohol and marijuana directly resulting from use."

“The most alarming finding was that alcohol use was highly associated with unsafe driving, especially among frequent drinkers," said Dr. Palamar. "Compared to non-drinkers, frequent drinkers were over 13 times more likely to report that their alcohol use has led to unsafe driving. Marijuana users, compared to non-users, were three times more likely to report unsafe driving as a direct result of use."

Researchers found that alcohol use was more commonly reported to compromise relationships with friends and significant others. Alcohol use also led to more regret, particularly among females. On the other side, marijuana use was more commonly reported to:
  • Compromise Relationships With Teachers or Supervisors
  • Lower School Performance
  • Result in Less Energy or Interest
  • Lower Job Performance

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