Wednesday, April 27, 2016

United Nations Special Session On Global Drug Policy

Despite the good intentions and best efforts of the last eight Presidents dating back to Richard Nixon, the “war on drugs” in the United States has been a failure. While various campaigns have managed to imprison drug dealers, the true casualties have been those who suffer from the disease of addiction. With treatment and continued maintenance people can, and do recover. The goal of sustained, long term recovery is rarely accomplished inside a prison cell, as is evident by the high recidivism rates of nonviolent drug offenders.

Slowly but surely, both federal and local officials in the U.S. are coming to terms with the fact that we can’t simply lock up drug addicts to eradicate addiction. It’s a reality everyone in America has come to terms with after over a decade and half of being faced with an opioid epidemic, taking nearly hundred lives a day from overdoses. Efforts are currently underway to expand access to both addiction treatment and mental health services; in various parts of the country addicts are being encouraged to surrender their drugs to local police and ask for help without fear of reprisal. That type of humanitarian approach would never have been believed possible just a short time ago.

America is not the only country which has waged war on illegal drugs in the past, nor the only country continuing the fight. Last week, hundreds of government officials, non-governmental organization representatives and individuals met at the headquarters of the United Nations to attend a special session on global drug policy.

There were a number of people, including former UN Secretary-General Kofi Annan, who were hopeful that the gathering might bring about a major shift in policy, one that would call for a more humanitarian approach towards addiction. Unfortunately, the first special session in nearly 20 years concluded without any significant shift in policy, The Wall Street Journal reports. The president of the U.N. General Assembly, Mogens Lykketoft, was hopeful that the gathering would be “an encouragement for new thinking, unconventional thinking.”

“Law enforcement efforts should focus on criminal organizations — not on people with substance use disorders who need treatment and recovery support services,” said Michael Botticelli, the Director of the U.S. Office of National Drug Control Policy, at the forum. 

An “outcome document” was drafted and agreed upon which continues to ban all recreational drugs, and criminalizes their use, according to the article. However, the outcome document did call for a more humanitarian approach and better cooperation between nations, but failed to touch on capital punishment for drug traffickers.

“The declaration is long and rhetoric and very short on substance. It’s out of step with world sentiment and doubles down on status quo,” said Richard Branson, head of the Virgin Group and a member of the Global Commission on Drug Policy.

Tuesday, April 26, 2016

Opioid Addiction Champions of Change

opioid addiction
Medical epidemics in the United States are nothing new; we have faced and found solutions to some of the most insidious of diseases, including the virus Poliomyelitis - commonly referred to as polio or infantile paralysis. Not too long ago, the fear of contracting polio was great, but thanks to the tireless efforts of a number of scientists an effective vaccine was finally developed by Jonas Salk and colleagues at the University of Pittsburgh in 1952. Across the country people began lining up to receive the miracle treatment, in 1994 the America’s were declared polio-free and Europe was declared polio-free in 2002.

It is probably fair to say, that most Americans, especially young adults, never think about polio. But in 1952, the year the first effective vaccine was developed, there were 57,628 reported cases of polio, 3,145 of which died and 21,269 were left with mild to disabling paralysis, according to the History of Vaccines. The polio virus was both debilitating and deadly, but it could be argued that the American opioid epidemic is far more deadly - taking over 70 lives a day. Between 2000 and 2014, nearly a half million people lost their lives from an opioid overdose, according to the Centers for Disease Control and Prevention (CDC).

While addiction is not a virus, it is a disease that requires treatment and continued maintenance. Unlike polio, there is not a vaccine for the disease, but access to addiction treatment and recovery services can save countless lives. Addiction is an unorthodox epidemic, which requires an unorthodox approach to save lives. Both lawmakers and law enforcement are by and large in accord with the idea that incarceration is not a viable solution to the nation’s opioid crisis. Some officials have taken a novel approach in their districts to combating addiction, and they have found great success.

On April 29, 2016, ten people will be honored at the White House for their roles in “advancing prevention, treatment and recovery,” CBS Boston reports. One of the “Champions of Change” is the chief of police in Gloucester, Massachusetts, Leonard Campanello. In May 2015, the Gloucester Angel program came into being, heroin addicts were encouraged to bring their drugs to the police station and request help without fear of arrest. In the last year, 100 communities in 22 states have joined the Angel program approach.

“In the 10 months since it began, the Gloucester Program has brought 425 people directly to treatment with no criminal penalty and no solicitation of information, and has reduced crime and costs associated with addiction in Gloucester and rebuilt trust between the police and the community,” the White House said in a statement.
Does your community have something like an Angel program? Consider contacting your local authorities and share this information with them. The life you help save could be your own or your loved ones.

Friday, April 22, 2016

Alcohol Mixed With Cocaine = Suicide?

Substance use disorder has the power to bring people to despair, affecting them both mentally and physically. Without treatment, many people who find themselves looking up from the bottom will choose a permanent solution to a temporary problem - suicide. The link between substance abuse and taking one’s life is complex; and while the reasons are not well understood - a significant number of people who have battled with addiction and found recovery will tell you that the thought crossed their mind one time or another.

Researchers from Brown University sought to uncover the relationship between substance use and suicide, and the findings may not be what you would expect. The study looked at hundreds of suicidal emergency room patients from all over the United States, according to a Brown news release. The findings showed that the link between substance abuse and suicide varied with:
  • Age
  • Gender
  • Race
“It’s not a clear-cut, straightforward association,” said lead researcher Sarah Arias, assistant professor (research) of psychiatry and human behavior in the Alpert Medical School of Brown University. “Even though substance use is often touted as a very strong predictor of suicidal intentions and behaviors, when we look at individual substances we’re seeing that there’s not that consistency in the future association with behavior.”

However, when alcohol was used in conjunction with cocaine, the researchers found that the admixture appeared to have the only significant association with suicide risk, the press release reports. Risks of attempting suicide were 2.4 times greater among those who use alcohol and cocaine together, compared to the study population who did not. They also found that Caucasians and women were less likely to have attempted suicide due to substance misuse.

“We’re on our way to trying to identify factors that can be used to better assess and identify people who are at risk for suicide, and ultimately I think this is a step in the right direction to get a better picture,” she said. “Patients who have potentially comorbid alcohol and cocaine use may be at a higher risk. Findings like these can be useful for informing suicide risk assessment.”
The findings were published in the journal Crisis.

Wednesday, April 20, 2016

E-Cigarettes Impact Teenage Tobacco Use Rates

Marijuana has long been considered by many, right or wrongly, the “gateway drug;” the drug first used that leads to the use of other mind altering substances. While that may be true in some cases, research tells us that true gateway drugs are alcohol, followed by tobacco. Marijuana is actually comes in third when it comes to substances first used by 12th graders.

That being said, the research tells us that greater efforts are needed to prevent teenage alcohol and tobacco use. Teenage tobacco use rates are lower than in previous decades; however, it turns out that teenage tobacco product use hasn’t fallen since 2011, according to HealthDay. Federal officials believe that this may be the result of electronic cigarettes, commonly referred to as e-cigs.

The Centers for Disease Control and Prevention (CDC) reports that one in four high school students use a tobacco product of some kind, and e-cigarette use has become more common than the use of traditional tobacco products. E-cigs produce a vapor that contains nicotine along with a fruity flavor of some kind, which might be the reason for the devices becoming a favorite among teens. The findings were published in the CDC's Morbidity and Mortality Weekly Report.

"E-cigarettes are now the most commonly used tobacco product among youth, and use continues to climb," said CDC Director Dr. Tom Frieden. "No form of youth tobacco use is safe. Nicotine is an addictive drug, and use during adolescence may cause lasting harm to brain development." 

The U.S. National Youth Tobacco Survey indicates that three million middle and high school students used e-cigs in 2015, the article reports. In 2014, only 2.5 million students reported e-cigarette use. The exponential increase in use among teenagers is concerning, especially when you consider the findings mentioned earlier from the gateway drug study. Teens that become addicted to nicotine are often times more likely to try other addictive substances.

"Overall, early onset substance initiation, whether that is alcohol, tobacco, or other drugs, exerts a powerful influence over future health risk behaviors," writes researchers from Texas A&M University. 

If your teenage daughter has formed an unhealthy relationship with mind altering substances, please contact Cottonwood Tucson. Our 90-day Sweetwater Adolescent Girls Treatment Program can help her get back on the right track, free from drugs and alcohol.

Thursday, April 14, 2016

Reevaluating Pain Management Standards

"On a scale from 1 to 10, how bad is your pain?" It is a question that is asked countless times in hospitals across the country every day. Those who are experiencing moderate to severe pain will usually be given a prescription opioid of some kind, such as hydrocodone or oxycodone. You may find it interesting to learn nurses and doctors did not always regularly ask questions about patient pain, which raised concerns that some patients were not being treated adequately.

Today, as result of the opioid crisis we face in America, everyone from lawmakers to health experts are tirelessly working to combat this unprecedented epidemic. A group of 60 senior health officials, doctors and consumer advocates from various states are calling for a reassessment of pain management standards, The Wall Street Journal reports. The health officials recommend that new guidelines be developed for the treatment of pain.

So, how did we get here? In the 1990s a number of doctors and nurses were found to be neglecting patient pain. This lead the Joint Commission to create new standards for pain management in 2001, which happens to coincide with the time when prescription opioid abuse began to get out of hand. What’s more, the new pain management rules came out when the prescribing of OxyContin ® (oxycodone) became more common, amidst claims that the drug was less addictive than other opioid narcotics. Doctors were required to assess and regularly reassess the level of patient pain, according to the article. The Joint Commission essentially declared pain management as a patient “right.”

“There was a time where pain wasn’t assessed,” said David Baker M.D., executive vice president of the Joint Commission. 
There is not a doctor in this country that is ignorant about the problems that the 2001 guidelines led to, but they are still required to treat a patient who reports that they are experiencing pain. Naturally, something has to give; Americans use the vast majority of opioid medications on the planet, far more than any other country. The Centers for Disease control and Prevention (CDC) reports that 44 people die from a prescription opioid overdose every day.

The group also sent a letter to the head of the Centers for Medicare and Medicaid Services asking the agency to discontinue surveying patients about how well their pain was managed at the hospital, the article reports. The surveys are used by the agency to gauge how well the hospital performed and determine how much they should pay. Knowing that information, it can clearly be seen that hospital and doctors have an incentive to over treat pain. The group states that the surveys “have had the unintended consequence of encouraging aggressive opioid use.”
CARF - Commission on Accreditation of Rehabilitation FacilitiesNATSAP | National Association of Therapeutic Schools and ProgramsNBCCNAADAC