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California Emergency Rooms Treating Heroin Poisonings

heroin-overdoseAs the federal government and the implementation of state prescription drug monitoring programs make it more difficult for opioid abusers to get their hands on OxyContin ® (oxycodone), many have turned to heroin as an easier, cheaper and stronger alternative. When compared to a decade ago, today it is much easier for opioid addicts to get their hands on heroin – resulting in a surge of heroin overdoses across the country.

“Most people who use heroin in the U.S. today used prescription opioids first. Reducing inappropriate prescribing will prevent overdose from prescription opioids and heroin,” said CDC Director Tom Frieden, MD, MPH, in a news release.

Heroin overdose deaths nearly tripled from 2010 to 2013 in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC).

In California, emergency departments have seen a six-fold increase in heroin poisonings in the last decade, Reuters reports. In 2014 alone, California emergency rooms treated 1,300 young adults between the ages of 20 and 29 for heroin poisoning.

“It’s consistent with what we’re seeing in our narcotic treatment programs – just a lot more young people,” said Tom Renfree, who heads substance abuse disorder services for the County Behavioral Health Directors Association in Sacramento.

“There’s been a real spike.”

Heroin poisoning is not exclusive to overdoses; it also represents those who used a product ‘cut’ with something potentially lethal, according to the article. Across the country, there has been a rise in heroin cut with the opioid analgesic Fentanyl ®, users are often unaware just how powerful Fentanyl ® (100 times the strength of morphine) is, making dosing extremely difficult.

Young adults were not the only age group affected in recent years. During the same period, adults ages 30 to 39 who were seen in emergency rooms for heroin poisoning doubled – from about 300 to about 600. Among teenagers, in 2014 there were 367 teens treated for heroin poisoning – compared with about 250 in 2005.

Synthetic Drug Flakka is Potent and Addictive

AlphaPVPWe recently shared with you a brief history of synthetic drugs, highlighting the dangers of these drugs in the future. As the synthetic drug landscape widens, new variations of drugs like “bath salts” (MDPV) and synthetic cannabis are sending hundreds of people to emergency rooms across the country. These types of products are sprayed with chemicals that mimic the effects of traditional mind altering drugs, but lack the chemical consistency which makes the side effects both unpredictable and dangerous.

One of the latest synthetic drugs to hit the streets is known as Flakka (alpha-PVP). Flakka is a drug which is as potent as a stimulant, and therefore as addictive as its chemical cousin MDPV, Science Daily reports. The findings come from researchers at The Scripps Research Institute (TSRI).

Recently, a number of southern states, especially Florida have seen increased incidents of Flakka use among citizens. The side-effects associated with Flakka use include, but are not limited to:

  • Extreme Violence
  • Paranoid Psychoses
  • Compulsive Nudity
  • Zombie-like Behavior
  • Superhuman Strength

“There have been assertions that flakka is somehow worse than MDPV, but this study shows that the two are very similar,” said Michael A. Taffe, an associate professor at TSRI.

While Flakka may not be worse than bath salts, drugs which have been tied to a number of horrific news stories, co-senior author of the study, TSRI Associate Professor Tobin J. Dickerson added, “That doesn’t mean that flakka use is ‘safe’ — our data show that flakka is as potent as MDPV, making it a very good stimulant, arguably with worse addiction liability than methamphetamine.”

Potential users of synthetic drugs need to understand that they are taking huge risks when they use these types of chemicals. View little, if any in some cases, human testing is conducted with chemicals like MDPV and alpha-PVP – there is no way of knowing what kind of side-effects the user will experience.

The findings were published in the journal Psychopharmacology.

Binge Drinking Has Lasting Effects

addictionThe effort to understand the effects drug and alcohol use has on the brain during developmental years continues. When teenage drinking is talked about, the words “binge drinking” often arise, that is, consuming five or more alcoholic beverages (male), or four or more drinks (female), over a 2-hour period.

The practice is quite common among teenagers who are trying to consume as much alcohol as they can – in the limited time they have. Binge drinking has been associated with a number of health problems, including alcohol poisonings and the potential for addictive behaviors to develop.

New research suggests that teens that binge drink may experience changes in the brain that last into adulthood, The Los Angeles Times reports. Researchers found that repeated exposure to alcohol throughout one’s formative years may cause long-lasting changes in the area of the brain responsible for memory and learning.

“In the eyes of the law, once people reach the age of 18, they are considered adult, but the brain continues to mature and refine all the way into the mid-20s,” lead author Mary-Louise Risher of Duke University said in a news release. “It’s important for young people to know that when they drink heavily during this period of development, there could be changes occurring that have a lasting impact on memory and other cognitive functions.”

The brains of teenagers and young adults are still developing, according to researchers, and are uniquely sensitive to levels of alcohol consistent with binge drinking, the article reports. Using rats, the researchers found that those who regularly consumed alcohol while their brain was developing had problems with:

  • Memory
  • Attention
  • Judgment
  • Learning Ability

“It’s quite possible that alcohol disrupts the maturation process, which can affect these cognitive function later on,” said Risher.

The findings appear in Alcoholism: Clinical & Experimental Research.

OxyContin Overdoses Drop – Heroin Overdoses Rise

needle-exchangeIn the United States, prescription drug overdoses are responsible for taking thousands of lives each year. While efforts to promote abuse-deterrent drugs and the implementation of prescription drug monitoring programs has had some promising results, the drop in prescription drug overdoses and prescribing rates has led to a surge in heroin overdoses, HealthDay reports.

In 2010, the makers of OxyContin released a new version of the drug which incorporated abuse-deterrent properties. New research indicates that in the two years following the drug’s new formulation OxyContin related overdoses dropped 19 percent and prescriptions of the drug decreased 19 percent, according to the article.

“This is the first time in the last two decades that narcotic prescribing had dropped, rather than continued to increase,” said lead researcher Dr. Marc Larochelle, an instructor at Boston University School of Medicine.

“With the pill, you used to be able to crush it up and either snort it or dissolve it and inject it. Now if you try and crush it, it doesn’t turn into a powder — it just kind of balls up, and if you try and dissolve it, it turns into a goo,” Larochelle explained.

Unfortunately, the opioid epidemic exhibits the properties of a hydra, cut off one head only to be faced with another. In the same time period, the researchers found that the rate of heroin overdoses increased 23 percent.

“Reducing supply may have led some people who are abusing these drugs to substitute an illicit narcotic like heroin, and it may partially explain why we have seen an explosion in heroin use across the country,” Larochelle said.

Larochelle points out that simply altering drug formulations will not, in and of itself solve the drug abuse problem.

“But it shows supply could be one part of the issue. Abuse-resistant formulations will not cure people who are addicted to narcotics. It could, however, prevent or slow down the number of new people who become addicted, because many people who use heroin may have started with pills,” he said.

The findings were published in JAMA Internal Medicine.

A Brief History of Synthetic Drugs

spiceIn the United States, there have been a number of horror stories in the news related to designer drugs, such as synthetic marijuana and bath salts. These types of drugs are sprayed with chemicals that when consumed mimic the effects of popular illegal drugs. Governments around the world have had a hard time keeping up with what has quickly become a billion dollar industry; and banning these types of drugs has proven difficult because chemists are constantly altering the drugs chemical composition.

The history of this emerging industry is actually quite interesting and is probably a different story then you may have guessed. In New Zealand, where cocaine distribution is minimal, people started cooking crystal methamphetamine which led to a national crisis. In an attempt to curb methamphetamine use and create drugs safer for consumers, a New Zealander set out to find a drug that mimicked meth but didn’t have those terrible side effects, VICE News reports.

Over the last 15 years, Matt Bowden, a recovering methamphetamine abuser, has created a synthetic drug empire that started with a drug called BZP (Benzylpiperazine). Bowden petitioned the parliament and was able to get BZP legalized. Over an eight year period, 26M BZP pills were used by 400,000 people without injury, according to the report.

After a public outcry, the New Zealand government banned BZP, to which Bowden responded by formulating an unregulated derivative of ecstasy (MDMA) – Methylone. However, it did not take long for that to be banned as well, so Bowden pivoted again creating different synthetic drugs.

Seeing the market value of these types of drugs, synthetic drug labs popped up in countries with little standards for production. The majority of synthetic drugs sold across the United States, the ones associated with the terrible news stories and spikes in emergency room visits were probably formulated in Chinese super labs, the article reports. Synthetic compounds are produced by the kiloton in Shanghai, China. The chemicals are sold to aftermarket companies and placed in packaging marketed as synthetic marijuana and bath salts not for human consumption.

Concerns Mounting Over Powdered Alcohol

powdered-alcoholMinimizing underage drinking is a priority in the United States. This is why many are concerned over the recent approval of Palcohol (powdered alcohol), all it takes is a little bit of water and you have an alcoholic beverage. Lawmakers across the country have made efforts to ban Palcohol before it hits the shelves and gets into the wrong hands.

The producer of Palcohol, Mark Phillips, claims that his product is no more dangerous than traditional alcohol, The New York Times reports. While in essence the product will have the same effect on the human body as liquid alcohol, the reality is that Palcohol will be attractive to underage drinkers for its ability to be concealed.

Phillips says that the idea for powdered alcohol came from his love for hiking, and the hassle of having to carry bottles uphill, according to the article. The product may be practical, but not everyone is on board, six states have already banned the powdered alcohol and Senator Charles Schumer of New York introduced a bill last month that would ban the product nationwide.

“I am in total disbelief that our federal government has approved such an obviously dangerous product, and so, Congress must take matters into its own hands and make powdered alcohol illegal,” said Schumer in a statement. “Underage alcohol abuse is a growing epidemic with tragic consequences and powdered alcohol could exacerbate this.”

Other concerns include the risk of people snorting the product for a quicker fix, but Phillips claims that snorting Palcohol would not be a fun experience.

“It would take you an hour of pain to ingest the equivalent of one drink,” Phillips said in an interview. “It really burns.”

However, in 2012, on the company’s website Phillips wrote that you could sprinkle powdered alcohol on guacamole, “although snorting it would get you drunk quickly and was probably not a good idea.” Now, Palcohol’s website says that snorting would be impractical and unpleasant.

AAP Against Random Drug Testing in Schools

random-drug-testAll would agree the need to prevent substance abuse among teenagers and young adults is of great importance. At every school in the United States, emphasizing to kids the dangers of drugs and alcohol, and identifying those abusing substances is a top concern. Some schools even implement random drug tests to deter and catch those using drugs.

However, the American Academy of Pediatrics (AAP) has released an update policy statement recommending against “suspicionless” drug testing at schools, Reuters reports. The AAP suggests that there is little evidence to support the efficacy of random drug testing practices at public schools.

The new policy statement’s lead author, Dr. Sharon Levy, director of the adolescent substance abuse program at Boston Children’s Hospital, says that there is little evidence that random drug testing identifies kids who use drugs and helps them receive treatment, according to the article. “Evidence on either side is very limited,” said Levy.

“It’s possible that you do get some prevention out of these programs, but on the other hand it seems very expensive, very invasive, and has pretty limited results,” added Levy.

Levy points out that because teen drug use is usually sporadic, many teen drug users could pass an annual drug test, only to go on and use drugs for the rest of the year. Those who do fail a drug test are more likely to receive punishment, rather than substance use disorder treatment services.

“Pediatricians support the development of effective substance abuse services in schools, along with appropriate referral policies in place for adolescents struggling with substance abuse disorders,” the AAP wrote.

The AAP noted that the negative consequences associated with random drug testing include:

  • Eroding of the student-school relationship.
  • The potential for confidentiality breaches
  • Mistaken interpretations of drug tests, resulting in false-positives.

The AAP’s recommendation can be found in the journal Pediatrics.

The Best Approach to Combating Binge Drinking

binge-drinkingIn England, just as the United States, binge drinking is a major problem among young adults. The act of drinking as much as you can, as fast as you can, can lead to a number of problems and even result in addiction. Combating the practice of binge drinking has proven difficult, with research indicating that campaigns against binge drinking have bore little fruit.

A new research conducted by Royal Holloway, University of London, in conjunction with three other UK universities, has found that official messages about binge drinking are unlikely to work and are often dismissed as irrelevant by young drinkers, Science Daily reports. The findings may be due to the consumption of large quantities of alcohol being part of their sub-cultural social identity, a group driven by the need to subvert rules and norms.

“The insight that heavy drinking can be part of a rule-breaking sub-culture may seem obvious, yet huge sums have been spent in the past on Government anti-drinking advertising campaigns that simply fuel the sense that sensible drinking is boring and conformist, while binge drinking is subversive fun,” said Professor Chris Hackley, from the School of Management at Royal Holloway.

“Government messages that say ‘drink sensibly’ ignore the ways many young people actually enjoy drinking. This research also has implications for other areas of Government health policy, where compulsive and excessive consumption can sometimes be fuelled by a need to defy and subvert official rules.”

What’s more, the research showed that high-price tagged ad campaigns may actually have an adverse effect on people most at risk of drinking to excess, according to the report. In the United Kingdom, alcohol related injuries and deaths cost the National Health Service £3.5 billion a year. Clearly, with the price of excessive alcohol consumption being as high as it is, the need for more effective methods is apparent.

The researchers contend that a more targeted and practical approach to alcohol intervention may be more effective than multi-million pound anti-drinking campaigns.

The findings were published in the Journal of Business Research.

Bipolar Disorder and Marijuana Use

cannabisBipolar disorder, also known as manic-depressive illness, is one of the more common co-occurring disorders that people living with addiction experience. Those in the field of addiction are acutely aware that those with co-occurring disorders are some of the most difficult to treat, due to the fact that both the substance abuse and the co-occurring disorder need to be addressed, if a successful recovery is to be achieved. Failure to properly diagnose and medicate co-occurring disorders accordingly usually results in relapse.

Many living with mental health disorders, such as depression and bipolar disorder, often use illicit drugs to cope with their illness. Unlike prescription psychotropic medications, illicit drugs often exacerbate the mental illness, and often times lead to substance dependence and/ or addiction.

New research has found that those living with bipolar disorder who use marijuana experience increased manic and depressive symptoms, Medical News Today reports. Symptoms including:

  • Shifts in Mood
  • Energy
  • Activity Levels
  • The Ability to Carry Out Day-to-Day Tasks

Researchers involved in the study found that around 2% of the UK population has Bipolar Disorder, and 60% of them have used marijuana at some point in their lives, according to the article. “One theory that is used to explain high levels of drug use is that people use cannabis to self-medicate their symptoms of bipolar disorder,” said lead researcher Dr Elizabeth Tyler of the Spectrum Centre for Mental Health Research at Lancaster University.

“The findings suggest that cannabis is not being used to self-medicate small changes in symptoms within the context of daily life. However, cannabis use itself may be associated with both positive and negative emotional states. We need to find out whether these relationships play out in the longer term as this may have an impact on a person’s course of bipolar disorder.”

The findings were published in PLOS ONE.

NPY: Not Only a Treatment for Alcohol Abuse – but a Marker

binge-drinking-NPYThe practice of “binge drinking” is a common occurrence among young adults, especially with young men. Drinking as much alcohol as you can, as fast as you can, may be appealing to those trying to catch up with their peers; however, binge drinking can be extremely dangerous – leading to a number of health problems – as well as dependence and addiction.

As a result, researchers have long sought ways to curb binge drinking behaviors using science. At the University of North Carolina (UNC), a team of researchers used “a series of genetic and pharmacological approaches” to identify a protein in the brain called neuropeptide Y (NPY), which suppressed binge drinking behavior in a mouse model, Medical News Today reports.

“Specifically, we found that NPY acted in a part of the brain known as the extended amygdala (or bed nucleus of the stria terminalis) that we know is linked to both stress and reward,” explained study lead author Thomas L. Kash, PhD, assistant professor in the departments of pharmacology and psychology and a member of UNC’s Bowles Center for Alcohol Studies. This antidrinking effect was due to increasing inhibition (the brakes) on a specific population of cells that produce a ‘pro-drinking’ molecule called corticotropin releasing factor (CRF).”

“When we then mimicked the actions of NPY using engineered proteins, we were also able to suppress binge alcohol drinking in mice,” notes Kash.

What’s interesting, in the study the researchers found that the “antidrinking” NPY system may be susceptible to alteration by long-term drinking in multiple species. The researchers’ findings suggest that NPY may not only be a treatment for alcohol abuse – but a marker.

“The identification of where in the brain and how NPY blunts binge drinking, and the observation that the NPY system is compromised during early binge drinking prior to the transition to dependence, are novel and important observations,” study co-author Todd E. Thiele, PhD, professor of psychology at UNC and a member of the Bowles Center for Alcohol Studies.

The findings were published in Nature Neuroscience.