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Thursday, May 26, 2016

E-Cigarettes: What is Your Perception?

E-cigarettes continue to be a source of division on a number of points. Mainly, people are in dispute as to whether or not the devices are healthier than traditional cigarettes. People also disagree about the use of e-cigs for smoking cessation. Unfortunately, there is little research to draw from, and the studies that do exist are at times at odds. It often the case that people's perceptions about all things health related is not rooted in science, without having all the facts one puts himself at risk.

Let's face it; there was time when doctors supported the use of one brand of cigarette over another. While tobacco had been smoked for hundreds of years by European-Americans, it was not until 1964 that the Surgeon General of the U.S. Public Health Service, Luther L. Terry, M.D., released the first report on the Surgeon General's Advisory Committee on Smoking and Health. After reviewing over 7,000 studies that were published at the time, it was concluded that cigarettes, in fact, cause chronic bronchitis and cancer—the Centers for Disease Control and Prevention (CDC) reports. Since that time, there have been thousands of studies conducted, and we have learned that tobacco can lead to a number of forms of cancer and heart disease; nevertheless, people continue to smoke despite the apparent risks.

So here we are now, 52 years since the first Surgeon General’s warning on cigarettes, debating points of health regarding e-cigarettes which deliver nicotine in a vapor form rather than smoke. It is fair to say that there isn’t even a minute fraction of research available dealing with e-cigs for the Surgeon General to deliberate on, compared to the report released in the 1960’s. In the meantime, Americans are using e-cigarettes with little idea what kind of health problems may develop down the road.

It is worth noting, that e-cigarette sales rose exponentially for the last several years, becoming a multi-billion dollar industry. However, e-cigarette sales were down 6 percent in the first quarter of 2016, according to Wells Fargo Securities. Even still, sales in the United States are estimated to reach $4.1 billion in 2016. So why the sudden drop in sales? A survey conducted by Reuters/Ipsos found that people's views on electronic cigarettes are changing, compared to the same time last year. A significant number of the polls' respondents conveyed negative attitudes about e-cigarettes.

The Reuters/Ipsos poll compared this year's findings to last years and found:
  • 66 percent believed e-cigs could be addictive, compared with 61 percent.
  • 49 percent said nicotine vapor could be as unhealthy as second-hand tobacco smoke, compared with 42 percent.
  • 47 percent said vaping isn’t healthier than traditional cigarettes, compared with 38 percent.
  • 43 percent did not believe “vaping” could help people quit smoking, compared with 39 percent.
The poll of 9,766 adults found that about 10 percent of adults say they use e-cigarettes. It will be interesting to see if that number goes up or down in the coming years as people amend their perception. Nevertheless, nicotine is still addictive and can have negative effects on one’s health. It's also worth noting that other forms of smoking cessation therapies have been found to be more effective.

"We think there are certainly more and better ways to help smokers to quit," Erika Sward of the American Lung Association told Reuters. "When you're going to e-cigarettes, you're not quitting, you're switching."

Tuesday, May 24, 2016

From Opioid Overdose to Addiction Recovery

People who actively work a program of recovery know all too well that they have an obligation to help others find what they have found. If you are working a program, or have attended a 12-Step recovery meeting, it is likely that you have heard someone say: “If you want to keep what you have, you have to give it away.” While the aforementioned statement may seem simple, or even trite, the reality is that those words could not be further from the truth.

Addiction is something that occurs in solitude, recovery is a life changing experience that happens collectively. People who are new to recovery rely on those who came before them, people who can teach them how to walk a line out of the cold night of addiction into the daylight of recovery—providing them with tools to mitigate the chance of relapse. Typically, someone who is new to recovery will be introduced to the program at their own volition; however, there are times when recovery seeks outs those who are active in their addiction.

In the United States, we face an opioid epidemic of unparalleled proportions, and without fail, over 70 people lose their life to an opioid overdose every day. Such a staggering daily death toll has prompted both health experts and lawmakers to call for expanded access to the miracle opioid overdose reversal drug naloxone, otherwise known as Narcan. The drug can be administered with relative ease, and if given in a timely manner has the power to reverse the life threatening effects of a prescription opioid or heroin overdose.

Opioid addicts, who experience an overdose and survive, are extremely vulnerable. If overdose survivors did not realize they had hit a bottom, an overdose will often times tell them that they are looking up from the bottom. They are in a unique position; a near fatal experience should be a big enough scare for them to want to get help. Sadly, the majority of opioid overdose survivors end up going back to drugs after being released from the emergency department.

People admitted to emergency rooms after an overdose, are more likely to be receptive to the idea of treatment. This is why it is paramount that someone talks to overdose survivors about their options why they are in a state of total despair in the wake of a near death experience. In New Jersey, hospitals are contacting addiction recovery specialists when someone is revived from an overdose, CBS News reports. There are currently five hospitals working with the Opioid Overdose Recovery Program.

Funding from by the New Jersey Department of Human Services, Division of Mental Health and Addiction Services (DMHAS) enables 15 recovery specialists to work closely with both law enforcement and medical services in two NJ counties with heightened overdose rates, according to the article. The goal of the program is to explain to overdose survivors that there is another way to live, that recovery is possible—hopefully they can be convinced that if they want to live recovery and rehabilitation programs are the only option.

"We come into a room like this, and a lot of the time the family members will be here, maybe outside of the room - sometimes we've had patients who don't have anyone here, they're kind of at the end of the road," said Angela Cicchino, a recovery specialists. "As a recovery specialist we're trained to get the temperature of all of that: like what's going on, what is their life, what brought them to this place?" 

Please take a moment to watch a video on the subject below:

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

Thursday, May 19, 2016

Take the Pledge, End the Stigma

mental illness
Take the pledge to be #StigmaFree this month as May is Mental Health Month (MHM) 2016. The National Alliance on Mental Illness (NAMI) is calling on individuals, companies, organizations to take the pledge to inform themselves and raise awareness about mental health disorders. The organization asks that you to:
  • Become informed about mental health.
  • See the person not the illness—strive to listen, understand, tell your story.
  • Spread the word, raise awareness and make a difference.
Mental illnesses are debilitating diseases that can hinder people from living productive lives. While mental health disorders are scientifically accepted medical conditions, they are more times than not viewed in a different light— as if the afflicted has control over the condition. People often say: “If you are depressed, just think happy thoughts” or “If you are anxious, don’t worry—be happy.” Those suffering from a mental illness wish that it were as simple as that, but it simply is not.

Those living with mental health disorders often require intensive behavioral therapy, usually in conjunction with one or more medications. Conditions that live in the mind do not just work themselves out, and go elsewhere. There are not any cures currently in existence for conditions like addiction and depression, but with continued maintenance such conditions can be kept in check. Sadly, a large number of those whose lives are affected by mental illness do not receive any form of treatment for their disorder(s). Much of the reason for this is due to the stigma that is hoisted upon them by society, and even one’s close peers who just can’t wrap their head around an invisible illness.

In fact, only 41 percent of American adults who live with mental illness received treatment for their condition in the past year, according to NAMI. Only 62.9 percent of adults with a serious mental illness accessed mental health services during the same time period. People with mental health conditions that go untreated are at risk of: involuntary hospitalization, incarceration and suicide.

This month, if we come together as a society, we can pull mental illness out of the shadows and into the light where it belongs. If people no longer fear scrutiny and shame, they can get the help they need. You probably have a close friend or a loved one living with mental illness, considering that approximately 1 in 5 adults in this country experienced a mental health disorder every year.

Take the Pledge, End the Stigma.

Tuesday, May 17, 2016

Safe Disposal of Children's Opioid Narcotics

Over the last several years there has been a huge push to educate people about the dangers of keeping unused medication around the home and encourage Americans to safely dispose of their prescription drugs—especially opioid painkillers. A significant number of people first acquire a prescription narcotic through diversion, getting their hands on such drugs through a friend or a family member.

Despite calls to action for safely disposing of used medications, many teenagers and young adults still manage to acquire painkillers in the family medicine cabinet. Parents are oftentimes unaware that anything is amiss in their medicine chest. Parents are the first line of defense at home in preventing medication diversion, yet parents are rarely instructed about what to do with unused medication by prescribers, according to new research regarding children's prescription narcotics.

Children are usually sent home with some form of prescription painkiller after surgery or painful illness. The drugs will be doled out by parents until their child’s pain subsides, but parents do not always safely dispose of the unused medication which could be risky. A new poll shows that nearly half of parents do not dispose of their children’s unused prescription opioids, HealthDay reports. What you may find even more alarming is that about a third of parents report that their child had been prescribed an opioid painkiller, most commonly:
  • Oxycontin (oxycodone)
  • Percocet (oxycodone/paracetamol)
  • Vicodin (hydrocodone)
The findings come from a poll of nearly 1,200 parents with at least one child ages 5 to 17, according to the article. The research indicated that 30 percent disposed of the drugs in the trash or toilet, nine percent said they didn’t remember what was done with the drugs and only 8 percent returned medication that was unused to their pharmacy or doctor. Six percent of parents said that the unused medication ended up being consumed by other family members.

“We found that the amount of pain medication prescribed for children is frequently greater than the amount used, and too few parents recall clear direction from their provider about what to do with leftover medication,” said Sarah Clark, co-director of the C.S. Mott Children's Hospital National Poll on Children's Health, in a news release.

“This is a missed opportunity to prevent prescription drug misuse among children,” she added. “Many parents simply keep extra pain pills in their home. Those leftover pills represent easy access to narcotics for teens and their friends.”

Friday, May 13, 2016

Opioid Epidemic Legislation Lacks Funding

opioid addiction
This week, the House of Representatives passed 10 of 18 new bills put forward that are designed to combat opioid addiction; this should be hailed as a victory—one that should take the nation one step closer to ending the insidious epidemic. Unfortunately, the legislation may not have a leg to stand on due to insufficient funding, USA Today reports. After the bills were passed this Wednesday, the White House doesn’t believe that $1 billion is enough to fund the programs attached to the bills.

In March, the Senate passed the Comprehensive Addiction and Recovery Act (CARA) which many believe—especially democrats—lacks the funding necessary to be fully effective. It is worth noting that the House’s ten bills will be combined with CARA. The new legislation covers a number of important areas specific to preventing and treating opioid addiction. Just to get an idea, the new bills voted on would:
  • Authorize the creation of an interagency task force that would review, modify and update opioid prescribing practices.
  • Require states that receive federal grants for child protective services to enact laws or programs to ensure the protection of babies.
  • Give law enforcement more authority for fighting drug trafficking.
  • Make it easier for doctors to provide treatment for patients addicted to opioids.
The House bills much like CARA only authorizes $725 million for federal grants, but does not allocate any actual funds, according to the article. Senate democrats tried to pass an amendment to CARA that would allocate $600 million in emergency funding to the bill, but republicans voted it down. A similar effort unraveled with the House bills, democrats put forward an amendment to allocate $600 million in emergency funding for the bills—like the Comprehensive Addiction and Recovery Act republicans voted against a funding increase.

"We need to not only pass these bills, but we need to commit in a bipartisan way that we’re going to provide the necessary funding, and I hope we can do that," said Rep. Jim McGovern, D-Mass. "If we don’t do that, all the speeches that we give this week will amount to empty rhetoric."

Wednesday, May 11, 2016

What We Can Learn from Surviving Opioid Overdoses

overdose deaths
Most of the nation and the world were saddened to learn of the death of the beloved musician Prince Rogers Wilson (June 7, 1958 – April 21, 2016). His music was both remarkable and revolutionary; selling 100 million records worldwide - winning seven Grammys, an Academy award and a Golden Globe Award. Prince is considered to be one of the best musical artists of all time. His death came as shock to his fans and even his close friends. The cause of his death came as even bigger surprise, when the world learned that the artist's death was likely the cause of a drug overdose, and that he had plans in the works to attend a substance use disorder treatment center right up until his passing.

Sadly, as we have seen over the last decade in the wake of an opioid epidemic, many overdoses have fatal outcomes. A large number of such overdose death victims never had the opportunity to receive help and give recovery a shot. The dramatic surge in fatal overdoses in the United States has led lawmakers, law enforcement and health experts to call for greater access to the overdose opioid reversal drug naloxone. The drug has been hailed as a miracle drug that carries the power to reverse the deadly symptoms of an overdose.

In the past, when someone was fortunate to survive a drug overdose they would usually have to do some explaining to police officers - the overdose survivor would likely have to do some time behind bars for the crime of addiction. Today, in many areas around the country, as opposed to incarcerating overdose victims, both law enforcement and doctors are using the nearly fatal experience as an eye opener. Surviving an overdose is a scary event, and can serve as a perfect opportunity to convince an opioid addict to seek help with their addiction.

Living to talk about one's overdose is a miracle. Those who experience an overdose have been found to be exponentially more likely to experience another, and the likelihood of surviving a second overdose is exponentially less likely. This is why it is paramount that overdose victims get help immediately after recovering from the experience. Unfortunately, Prince’s death last month has become a prime example of just how critical it is that overdose survivors get into addiction treatment with haste.

It turns out that six days prior to the artist's untimely death, Prince overdosed on the prescription painkiller Percocet, The Wall Street Journal reports. Even though the overdose happened while in flight, the plane made an emergency landing and the artist was brought to a hospital in Moline, Ill. Medical personnel administered naloxone and were able to revive Prince. After which, he began discussing treatment plans with a center in California. While the coroner’s toxicology report has not been released, the general consensus is that his death was the result of another overdose - considering that the artist had opioids in his possession at the time of his premature passing.

No one can deny that Prince’s death, like so many other preventable drug related deaths, was a tragedy. However, perhaps a silver lining can be drawn from Prince’s overdose death, and that is just how important it is to get into treatment immediately after surviving an overdose. Such events could be a part of one’s story, rather than the end; an overdose could be the turning point in one’s life that jettisons them into a life of recovery.

Thursday, May 5, 2016

FDA Advisory Panel in Favor of Opioid Training for Doctors

In the United States, if a doctor would like to prescribe drugs for treating opioid addiction, such as Suboxone (buprenorphine), they are required to have specific training. After the training, they can only prescribe Suboxone to 30 patients during the first year, after which the probation is lifted and they are allowed to prescribe to 100 patients. There is no scientific reason for the buprenorphine prescribing cap and in light of the American opioid epidemic efforts that are underway to amend the restriction.

You may find it ironic to learn that doctors are not required to undergo any specific training to prescribe opioid narcotics to their patients for the treatment of pain, the same drugs that lead to addiction and the need for medications like Suboxone to treat the problem. It should go without saying, that doctors should be well versed in the field of pain management and be taught how to spot med-seeking behavior; it could be argued that a lack of training was one of the causes of the opioid epidemic raging in the U.S.

This week, at the urging of the Food and Drug Administration (FDA), an outside group of experts met to discuss requiring training for doctors if they are going to prescribe opioids. On Wednesday, the FDA advisory panel voted unanimously in favor of recommending that doctors undergo opioid training, The Wall Street Journal reports. While the agency often follows the recommendations of the expert panels, they are not required to do so.

In 2012, a similar advisory panel made the same such recommendation which the FDA failed to heed. The reasons for this had less to do with pressure from the pharmaceutical industry than you might think; in fact the pressure to go in the other direction came from the American Medical Association (AMA). The nation’s largest doctors' organization opposed mandatory opioid training because the majority of doctors do not prescribe opioid narcotics.

Here we are, nearly four years later, the epidemic is still ever present, and the need for action is paramount - the time is now. The Centers for Disease Control and Prevention (CDC), the FDA and even the pharmaceutical companies who manufacture opioid painkillers are in favor of such training. Hopefully, the FDA will be on the right side of history regarding the recommendation from the advisory panel.

“We need to teach people to use these drugs sparingly,” said committee member Jeanmarie Perrone, a professor of emergency medicine and toxicologist at the University of Pennsylvania.

Tuesday, May 3, 2016

Addiction Treatments Receive Foreign Investments

addiction treatment
America has long been called the land of opportunity; people from all over the world, from China to Mexico, have sought and continue to seek United States visas. Naturally, gaining a green card to this country is no easy task, often requiring persons to have special skills that are unique and may prove invaluable. It turns out, for better or worse, one of those skills can be the size of your pocket book.

It is no secret to Americans, or the rest of the world, that the United States is rife with opioid addiction, an epidemic taking thousands of lives every year. In its wake, there is unparalleled demand for addiction treatment centers, oft considered to be the best weapon against addiction. Seeing an opportunity, foreign investors have begun pouring money into the American addiction treatment market, The Boston Globe reports. The treatment industry is estimated to be worth $35 billion.

Foreigners who invest at least $500,000 into developments that creates jobs on American soil qualify for a U.S. visa under the EB-5 program. The dire need for increased access to addiction treatment services has resulted in more and more people seeking a green card to invest in drug rehabilitation and psychiatric clinics, according to the article. A new 104-bed facility in Massachusetts is being partially funded with $10 million from investors from overseas through the EB-5 program.

“Everybody is chasing the pot of gold at the end of the rainbow of the opioid issue,” said Philip Levendusky, the Director of Psychology at McLean Hospital, an affiliate of Harvard Medical School. “There’s an epidemic of opioid abuse, so there’s a tremendous demand.”

Another 209-bed center in Danvers, MA, is scheduled to open in August, with the help of foreign investments through the EB-5 program, the article reports. While the facility admits to receiving foreign funding, they did not say how many foreign investors are involved.

“We are regularly exploring a variety of financing and other capital-raising opportunities which can expand our business, increase our bed capacity, and help as many individuals and families affected by the disease of addiction,” said Brad Greenstein, chief executive of the facility.

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