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Thursday, April 28, 2016

W-18 More Deadly Than Fentanyl

If fentanyl, being 100 times more powerful than morphine, weren't deadly enough, there is a new synthetic opioid emerging on the scene that is even more dangerous. Police officials in Edmonton, Canada seized four kilograms of drug known as W-18, CBC News reports. W-18 is 100 times stronger than fentanyl. Four kilograms of W-18:

"To put in perspective, this is enough to kill every man, woman and child in Alberta about 45 times over," said Edmonton public health doctor Hakique Virani. 

Researchers invented the drug at the University of Alberta in the 1980s; W-18 was patented in 1984, but was only used for scientific research, according to the article. W-18 was part of series of analogues developed; number 18 was the strongest and most deadly. What’s interesting is the fact while W-18 was invented in Canada; the powder that police officials have seized was likely produced in a clandestine laboratory in China.

In the United States, we have been trying to stem the tide of synthetic drugs being produced in China. Many of the chemicals used to make synthetic marijuana and/or bath salts are not banned, both federal and local authorities are doing everything in their power to keep up with the ever changing chemical variations. The story is not too dissimilar with W-18; the drug is not regulated under Canada's Controlled Drugs and Substances Act, the article notes.

"That once again shows a reason to explore other ways of banning substances not just by chemical structure but by their pharmaceutical action in the brain," said Jim Hall, an epidemiologist at Nova Southeastern University in Florida. 

Alberta has been hit hard by fentanyl, much like the U.S., so there is an urgency to get W-18 on the list of controlled substances. Last year, 272 Albertans lost their lives due to a fentanyl overdose. It would seem that W-18 should be a controlled substance in America; we are likely to hear more about this deadly drug in the coming months.

Tuesday, April 26, 2016

The Deadly Fentanyl Story Continues...

“Playing with death,” says Dr. Steven Aks of the Cook County Health and Hospitals System to NBC Nightly News with regard to opioid addicts using the powerful analgesic fentanyl. As if the American opioid epidemic wasn’t tragic enough, across the country law enforcement and health officials are seeing greater use of a drug that is 100 times more potent than morphine. Dealers have been mixing fentanyl with heroin for a number of years, in an attempt to make their product stronger. Users who are unaware of the presence of fentanyl are at great risk of overdose and potentially death.

Commonly, opioid addicts will do their heroin as they normally would, but when fentanyl is present they are in for much stronger side effects, such as severe respiratory depression. Fentanyl was designed to be used in a hospital setting; patients given the drug are under the close eye of both physicians and skilled nurses who constantly monitor the patients' drug reaction. If a problem arises, doctors can act quickly to reverse the drug's effect.

With ever greater demand for heroin in the wake of prescription opioid prescribing crackdowns, heroin manufacturers and distributors have turned to fentanyl as a way to not only strengthen their product but to increase the amount they have - profiting on the most deadly of admixtures. What’s more, much of the fentanyl used illicitly does not come from hospitals or pharmacies. The drug can be manufactured by chemists in clandestine laboratories with relative ease.

While heroin laced with fentanyl overdose deaths have occurred all over the United States, the Midwest has seen a dramatic rise in fentanyl related cases, and some people are just abusing fentanyl by itself, NBC Nightly News reports. The news agency reports that the drug is:
The Centers for Disease Control and Prevention (CDC) has called Ohio, “ground zero for fentanyl overdoses.” Overdose deaths in Cincinnati now surpass both vehicular deaths and murders combined. Please take a moment to watch a short video below:

If you are having trouble viewing the clip, please click here.

Thursday, April 21, 2016

DFCR: The First National Organization of Doctors in Favor of Legalization

Doctors Cannabis Regulation
Last week, we wrote about both the White House administration and the director of National Drug Control Policy (NDCP), Michael Botticelli, being against cannabis legalization efforts. The current “drug czar” is concerned about youth marijuana use being on the rise, and he believes as more states legalize use - we will see an increase in teenage and young adult use. It is worth noting, Botticelli is the first director of the NDCP to be in addiction recovery, and while he is not in favor of legalization - he is firm believer of treatment over incarceration.

Interestingly, the formation of the first national organization of doctors in favor of legalization was announced this week, The Washington Post reports. The group is urging both the federal government and states to legalize and regulate adult recreational cannabis use in the interest of public health. The Doctors for Cannabis Regulation (DFCR) is made up of:
  • A Former Surgeon General
  • Over 50 Physicians
  • Faculty Members from Some of the Nation’s Top Medical Schools
In order to ensure public safety, the DFCR believes marijuana should be legal and regulated, according to the article. The group contends that prohibition and criminalization of the drug has led to hundreds of thousands of marijuana arrests every year. The group of doctors point out that there is racial and economic disparities in how drug laws are enforced.

"You don't have to be pro-marijuana to be opposed to its prohibition," said David L. Nathan, board president and founder of the DFCR. "If you’re going to make something against the law, the health consequences of that use have to be so bad to make it worth creating criminal consequences. That was never true of marijuana. It was banned in 1937 over the objections of the American Medical Association (AMA)." 

While the societal costs of prohibition can be easily measured, it is important that efforts to curb teenage use continue. The drug can be addictive, may require treatment to overcome and can have a negative impact on developing brains.

Tuesday, April 19, 2016

SNL Heroin AM Advertisement?

Heroin AM
On Super Bowl Sunday, a significant number of people were up in arms over a television advertisement for a new drug used to treat opioid-induced constipation. Anybody who has ever taken an opioid narcotic, whether legal or illegal, prescribed or diverted, knows all too well that the drugs can lead to gastrointestinal issues. With more Americans than ever using opioid drugs in recent years, it is fair to say that there is a demand for drugs that can help with the side effects that accompany such drugs.

While opioid-induced constipation is a real condition, with both federal and local officials working tirelessly to curb the opioid epidemic, concerns were raised with the makers of the advertised drug Movantik for not addressing the opioid addiction crisis. This makes sense considering that the makers of the drug are profiting in the hundreds of millions from an epidemic taking over 70 lives every day from opioid overdoses.

A new advertisement was released over the weekend that would be hard to argue was in good form, and the source was not a company making a profit on the American opioid epidemic. Albeit fictional, Saturday Night Live (SNL) produced a comedy skit in the form of a drug advertisement featuring a drug called Heroin AM: "The only non-drowsy heroin on the market" from the "makers of Cocaine PM."

The ad stars Julia Louis-Dreyfus, of “Seinfeld” and “Veep” fame, playing a suburban mother who “went from nodding off to nodding yes to more heroin.” While there is little question as to whether or not both the producers of SNL and NBC Studios were endorsing the use of heroin, in the midst of such a deadly crisis, such comedy is in bad taste. It begs the question as to why they thought that skit was necessary.

Ironically, NBC News affiliates are covering the backlash to the Heroin AM ad. The humor went past southern Wisconsin Sheriff Dale Schmidt, NBC 4i reports. The Dodge County Sheriff’s wrote about it on the department's Facebook page, stating:

“I am angered and frustrated that a national television network would allow SNL to use humor and diminish the importance of something that has been legitimately called an epidemic in our country.” 

Please take a moment to watch the advertisement:

If you are having trouble watching the video, please click here.

Thursday, April 14, 2016

Becoming Addicted to Opioids Later in Life

opioid use disorder
Just as everyone is eligible for addiction, sadly everyone in recovery is eligible for relapse. Addiction recovery requires eternal vigilance when it comes to maintaining one’s program. While everyone’s program is different, there are a number of steps people take daily to ensure they do not pick up a drink or a drug. You may be interested to learn that some people who are treated for opioid addiction may be more at risk of relapse than others, important information if you consider the recent call for more medication assisted treatment (MAT) - such as methadone or Suboxone.

New research has found that people who become addicted later in life are more likely to relapse in treatment than people who started using earlier, Science Daily reports. What’s more, the researchers from McMaster University found that the older the person with drug abuse issues, the less likely they will relapse from treatment. The findings were published in the journal Substance Abuse Research and Treatment.

"We can improve our tailoring of treatment to each patient if we know who among patients taking methadone treatment is at high risk for opioid relapse," said Dr. Zena Samaan, principal author of the study and an associate professor of psychiatry and behavioural neurosciences of McMaster's Michael G. DeGroote School of Medicine. "As well, health care providers can target more aggressive therapies to those at high risk." 

The study showed that people treated for opioid addiction with methadone for their opioid use that were IV drug users, were at double the risk of relapse while on treatment, according to the article. For every year increase in the age of becoming an opioid addict, corresponded with a 10 percent increase in relapse risk. For every day of benzodiazepine use in the previous month leading up to medication assisted treatment, there was a 7% increase in relapse.

"Since opioid disorder is chronic, remitting and relapsing, we wanted to find those factors that led to longer abstinence from illicit opioids," said Leen Naji, a student of McMaster's Michael G. DeGroote School of Medicine and first author of the paper. "There has been little research on this issue of how long a patient can go without the illicit opioid use."

While health officials are calling for greater access to MAT, residential addiction treatment continues to provide the greatest chance for patient success by way of long term recovery. If you are struggling with opioid use disorder, please contact Hope By The Sea.

Wednesday, April 13, 2016

Michael Botticelli Against Legalization

A number of states are expected to vote on legalizing cannabis this November; if passed it could dramatically add to the list of states with active recreational use programs. There are currently four states which allow for recreational marijuana use for people over the age of 21. In 2012, both Colorado and Washington became the first states to pass legalization legislation; many states sat back and watched as these two states navigated the uncharted waters of recreational marijuana use.

While both programs have had their share of problems, many of the fears  that legalization opponents asserted, such as increased teenage marijuana use, seemed to have failed to come to fruition. That is not to say that there hasn’t been a rise in youth marijuana use, but rather that researchers have struggled to directly link the increase to legalization.

So, as November draws near, more states are likely to pass and move forward with legalization in the years that follows. That being said, it is crucial that we accept that legal does not mean safe, and it is even more vital that lawmakers and health experts do everything in their power to educate adolescents about the potential effects that cannabis can have on developing brains. Many teens view marijuana as benign when compared to other mind altering substances, and that there few potential dangers associated with use.

In recent years, for a number of different reasons, the White House has taken a softer stance on marijuana. Calling for law enforcement and federal agents to re-evaluate their efforts to curb use. The President recognizes that many people are serving unjust, lengthy prison sentences for nonviolent drug offenses, as is evident by the over 200 pardons issued during his tenure thus far. In the midst of an prescription opioid and heroin epidemic, the White House has arguably had bigger fish to fry than marijuana users, pushing for treatment not jail for addicts caught with drugs.

Even though the White House has changed its position about how to handle cannabis, it doesn’t mean that the administration is in favor of legalization. In fact, the director of National Drug Control Policy, Michael Botticelli, has come out against legalization efforts, stating that there has been a rise in marijuana use among American youth in recent years, The Herald News reports. It would seem that the “drug czar” believes that because the increase in youth cannabis use coincides with legalization, it is cause for concern.

“I do believe that when you look at the data in terms of the high levels of marijuana use that we have among youth in the country … that we are in for more significant problems in the United States,” said Botticelli. “I think the evidence is pretty clear that early use of alcohol, tobacco and marijuana – often used together – significantly increases the probability that someone will develop a more significant addictive disorder later in their life.”

Friday, April 8, 2016

EU 2016 Drug Markets Report

drug trade
It is fair to say that the rest of the western world has watched the American opioid epidemic in awe, a crisis which takes many lives every day from opioid overdose deaths. Worldwide, the United States consumes the vast majority of prescription opioids. Subsequent government crackdowns on prescription opioid accessibility has lead to a scourge of heroin use - a drug that is cheaper, stronger and easier to come by nowadays. While Europe may not be facing the epidemic we face, they have their own problems that could be potentially more devastating.

This week, the European Union released a report which found that Europeans spend $27 billion a year on drugs, the Associated Press reports. In the decade ending in 2014, Americans spent roughly $100 billion a year on illegal drugs, according to a report published by the RAND Drug Policy Research Center. When you compare $27 billion for 28 countries to $100 billion for one country, the staggering difference in spending can be seen. However, where the proceeds from the drug trade go in Europe may have farther reaching implications than proceeds from the American illegal drug trade.

From the Iraq War to the escalating ISIS crisis, a flood of refugees have been steadily migrating into European nations, and with it concerns of terrorist cells. The "2016 Drug Markets Report" found that drug offenders may be driven towards radicalization while incarcerated. While establishing a direct link between the European drug trade and terrorism is difficult, Europol chief Rob Wainwright has concerns that as the drug trade "becomes entwined with other forms of crime, and even terrorism, it represents a key threat to the internal security of the EU."

The report stated:

"The impacts that drug markets have on society are correspondingly large and go beyond the harms caused by drug use. They include involvement in other types of criminal activities and in terrorism."

Tuesday, April 5, 2016

Keeping The Addiction Conversation Alive

substance abuse
With November steadily approaching, there are many who would like see the conversation about addiction stay alive. Earlier in the year there were a number of presidential candidates who spoke about the prescription opioid and heroin epidemic at various primaries. The opioid epidemic was a major talking point during the New Hampshire primary. While one of the smallest states in the nation, it has been devastated by both opioid overdose deaths and lack of resources available to treat people battling opioid addiction.

Unfortunately, after the New Hampshire primary the conversation about opioid addiction waned. With eight months to go before the polls, addiction advocacy groups and elected officials are determined to keep substance abuse a major focus point during the remainder of the race, The Wall Street Journal reports. In a nation ravaged by opioid addiction, it is crucial that presidential candidates outline their addiction policy recommendations.

“The breadth of the problem is demanding that candidates for president put it on their front burner,” said Republican Rep. Hal Rogers of Kentucky, who launched Operation Unite, which organized the National Rx Drug Abuse and Heroin Summit. “We need a national program, a campaign if you will, that comprehensively deals with the problem.”

Forums are being held in primary and battleground states, where advocates are urging presidential candidates to lay out proactive plans that echo their expressions of compassion, according to the article. Events have been held in:
  • Iowa
  • New Hampshire
  • Kentucky
  • West Virginia
President Barack Obama attended the National Rx Drug Abuse and Heroin Summit last week, and laid out his administration's plan to tackle the crisis. At the summit, the President emphasized the importance of addressing this epidemic, he said:

“When you look at the staggering statistics in terms of lives lost, productivity impacted, cost to communities—most importantly, cost to families—from this epidemic of opioid abuse, it has to be something that is right up there at the top of our radar screen.”

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