Saturday, March 28, 2015

The Efficacy of Zero-Tolerance Drug Policies

In the United States, preventing drug and alcohol use among teenagers is a high priority. At nearly every public school, zero-tolerance drug policies are in place. While the practice may seem to be an effective deterrent against drug use among teenagers, in reality new research indicates that the opposite may be happening.

Analyzing data from the International Youth Development Survey, researchers found that "students attending schools with suspension policies for illicit drug use were 1.6 times more likely than their peers at schools without such policies to use marijuana in the next year."

In Washington State and Victoria, Australia, which are considered to be demographically alike, but have different policies when it comes to drug use, the researchers found that total abstinence policies do not carry with them the desired effect, The Washington Post reports.

The authors point out that "Washington school policies have been more oriented toward total abstinence and more frequently enforced with harsh punishment (such as expulsion or calling law enforcement)."

“Whereas policies in Victoria schools have been more reflective of harm minimization principles."

In Washington, schools involve law enforcement with 70 percent of instances of drug possession, but in Australia the figure is less than 30 percent. The researchers found that there was 60 percent increase in the odds of increased drug use at schools that suspended kids for policy violations, according to the article.

"That was surprising to us," said co-author Richard Catalano in a press release. "It means that suspensions are certainly not having a deterrent effect. It’s just the opposite." And according to Catalano and his colleagues, suspensions "related to unintended negative outcomes for the suspended student, such as disengagement from school, delinquency or antisocial behavior, smoking, and alcohol and drug use."

The findings were published in the American Journal of Public Health.

Sunday, March 22, 2015

Washington State Curbs Prescription Opioid Abuse

The prescription drug epidemic in America is a crisis facing every state; opioid related overdoses continue to claim lives prematurely. While efforts to curb the problem have had some positive outcomes, in most states the opioid crisis has remained relatively unchanged. In one state, however, the implementation of new laws and prescribing practices has resulted in a reversal of overdose death rates from prescription opioids.

In the state of Washington, a new study has found that overdose death rates decreased 27 percent between 2008 and 2012, Medical News Today reports. The findings showed that average opioid doses prescribed in Washington also dropped.

"Our State's ability to shift this epidemic into reverse has been the result of strong partnerships among state agencies, university pain specialists, legislators and health care providers," said lead author and Univ. of Washington professor Gary Franklin, Medical Director, Washington State Department of Labor and Industries.

The turn of the tide is the result of:
  • New Dosing Guidelines
  • Prescription Drug Monitoring Program
  • Telemedicine
  • On-line Programs for Health Care Providers
  • New State Laws
"Health care providers are on the front lines of this transformation," said Dr. Mark Sullivan, Executive Director of COPE, (Collaborative Opioid Prescribing Education), based at the University of Washington School of Medicine. "Provider education is crucial because they write the prescriptions - 259 million nationally in 2012. They need to know how to respond to the suffering of their patients in ways that are safe and effective."

Using advance technology, COPE is able to reach healthcare providers even in the most remote areas across the state and the region, according to the article.

This month, the United States' Department of Health and Human Services will release the National Pain Strategy.

The findings were published in the American Journal of Public Health.

Saturday, March 21, 2015

E-cigarette Ads Increase People's Desire to Smoke

E-cigarettes have become quite popular amongst those in the recovery community. The devices have helped some quit and helped others cut back on traditional cigarette use. As with all new products with the potential for addiction, little research is available regarding the health consequences and even less regulations to keep e-cigarettes out of the hands of teenagers.

A new study has found that viewing advertisements for e-cigarettes can increase people's desire to smoke traditional cigarettes, TIME reports.

The ironic finding indicated that daily smokers who view e-cigarette advertisements had a greater desire to smoke a regular cigarette, and a greater chance of actually smoking traditional tobacco products. The researchers observed the desire to smoke among:
  • 301 Daily Smokers
  • 272 Intermittent Smokers
  • 311 Former Smokers
The researchers asked the study participants to watch three e-cigarette commercials, according to the article. Daily smokers had a greater desire to smoke, intermittent smokers showed no significant changes, and former smokers were more likely to report decreased intention to stay smoke-free.

While most would argue that e-cigarettes are a healthier alternative to traditional tobacco products, the need for more research on this method of nicotine consumption is greatly needed. Perhaps the biggest complaint regarding the devices is the fact that many of the e-juices appeal to younger markets with their fruit-like descriptions.

“The jury is still out on the efficacy of e-cigarettes to reduce tobacco use and tobacco smoking,” says study author and communication professor Joseph N. Cappella. “If it turns out to be the case that e-cigarettes are a good vehicle for reducing tobacco addiction, then we do not want to stand in the way of advertising…but it doesn’t mean we couldn’t carry out that advertising without the vaping cues in order to not have these deleterious consequences.”

The findings were published in the journal Health Communication.

If you are having trouble viewing the video, you can see it here.

Thursday, March 12, 2015

Parents Meet PALCOHOL ~ Just Add Water!

Fda (Photo credit: Wikipedia)

PALCOHOL - AKA Powdered Alcohol

We want to take just a few minutes today to introduce our readers to PALCOHOL, short for powdered alcohol. Yes, we said powdered. PALCOHOL comes in a one ounce 4 X 6 inch package and according to the latest news on March 10, 2015, PALCOHOL received final approval from the Tax and Trade Bureau (TTB) after having received previous approval from the Food and Drug Administration (FDA).

CBS This Morning reports on PALCOHOL

If you are having trouble viewing the video, you can see it here.

This conversation is going to get interesting...

As you can see by the variety of related articles below and by visiting PALCOHOL's website the debate regarding the use, potential misuse, and safety of this product will be the topic of a protracted conversation.

PALCOHOL is expected in stores this summer and perhaps even on-line. As we say, stay informed and stay tuned.  


Wednesday, March 11, 2015

Suicide In Rural America: Isolation, Stigma and Firearms

Have you ever lived in a rural community?
Rural America can be simultaneously beautiful and isolating.

You might find this to be an unusual question. Have you ever lived in a rural community? Based on the 2010 census only 19.3% of the U.S. population lived in rural areas, while 80.7% of the population resided in urban areas. So if you live in a rural community, you are in the minority. We recently asked an associate if she had ever lived in a rural community and we were surprised to learn she had indeed. She offered the following observations:
I lived in small village in New Hampshire. The last census data for 2010 indicated that the village had 294 residents. Of course, this was one of six villages that were part of one town. So the entire town had a combined population of 10,115 in 2010. There was no airport, train service, local bus service, interstate freeway or highway, and only one bus per day stopped to pick up travelers going north or south. We had a regional middle school and high school, one community hospital that could handle basic services; however, any major medical condition would require patients being medevacked to a major medical center. We had one pediatrician, and at that time maybe one psychiatrist. We had volunteer firemen. There were no local colleges or universities. We were, for all intents and purposes, isolated. And it was often lonely.

How living in a rural community may affect suicide rates

This week the results of a new research study were published online in JAMA Pediatrics: Widening Rural-Urban Disparities in Youth Suicides, United States, 1996-2010. The lead author was Cynthia Fontanella, Ph.D. Department of Psychiatry and Behavioral Health, The Ohio State University (OSU) Wexner Medical Center. The research team consisted of professionals from the College of Social Work at OSU, the Center for Biostatistics at OSU, Department of Pediatrics at OSU, Center for Innovation in Pediatric Practice, and the Bureau of Research and Evaluation Ohio Department of Mental Health and Addiction Services Columbus, Ohio. This was a longitudinal study to examine trends in US suicide mortality for adolescents and young adults across the rural-urban continuum.

Study's parameters

  • The data reviewed spanned from January 1, 1996 through December 31, 2010
  • Reseachers reviewed county-level national mortality data from 3141 counties 
  • The studied population was suicide decedents from 10 to 24 years of age
  • The total number of suicides was 66,595

Study's findings

Previous studies have indicated that both adults and adolescents have a higher risk of suicide in more remote rural areas, but it is important to note that the Centers for Disease Control (CDC) reports the third leading cause of death for people 15 to 24 years of age is suicide and the second leading cause of death for those age 25 to 34. If you look at the population as a whole, then suicide is the 10th most common cause of death. 

According to this research study:

  • Rural suicide rates were nearly double those of urban areas for both males (19.93 and 10.31 per 100 000, respectively) and females (4.40 and 2.39 per 100 000, respectively). 
  • Even after controlling for a wide array of county-level variables, rural-urban suicide differentials increased over time for males, suggesting widening rural-urban disparities (1996-1998: adjusted incidence rate ratio [IRR], 0.98; 2008-2010: adjusted IRR, 1.19; difference in IRR, P = .02). 
  • Firearm suicide rates declined, and the rates of hanging/suffocation for both males and females increased. 
  • However, the rates of suicide by firearm (males: 1996-1998, 2.05; and 2008-2010: 2.69 times higher) and hanging/suffocation (males: 1996-1998, 1.24; and 2008-2010: 1.63 times higher) were disproportionately higher in rural areas, and rural-urban differences increased over time (P = .002 for males; P = .06 for females). 

Some conversation starters...

While for many these results may be startling, for many they could have been predicted. Over the years we have often posted about suicide, in fact, it was just about two years ago that we reported on a study that discussed how many suicidal adolescents and young adults have easy access to firearms. But it is not all about access to firearms, as Dr. Fontanella shared with The Atlantic:
“Rural residents often grow up with guns, have guns in their homes and there’s just a general culture of guns in rural areas,” Fontanella says. Even so, she says, suicide rates by all methods were higher in the country [rural] than in the city. The factors that might contribute to this disparity make a snarled web of many threads. Gun access is just one of those. Rural life is isolating—and getting more so...And these areas continue to lose population. Plus, “a lot of young people are out-migrating because of the lack of employment opportunities,” Fontanella says, “which can lead to heightened degrees of social isolation for those left behind.”

So what becomes of those left behind? Few resources of every kind, few mental health resources and people of all ages fear the stigma of seeking help for mental health issues. The starting point is to have a conversation with your family, reach out to your primary care provider...don't be afraid to start the conversation. It could be a life saver.