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Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings and Detailed Tables

September 16, 2013 Comments off

Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings and Detailed Tables
Source: Substance Abuse and Mental Health Services Administration

This report and the detailed tables present a first look at results from the 2012 National Survey on Drug Use and Health (NSDUH), an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older. Both the report and detailed tables present national estimates of rates of use, numbers of users, and other measures related to illicit drugs, alcohol, and tobacco products, with a focus on trends between 2011 and 2012 and from 2002 to 2012, as well as differences across population subgroups in 2012. NSDUH national estimates related to mental health and NSDUH State-level estimates related to both substance use and mental health will be published in separate releases in the fall of 2013.

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CRS — Reauthorizing the Office of National Drug Control Policy: Issues for Consideration

September 3, 2013 Comments off

Reauthorizing the Office of National Drug Control Policy: Issues for Consideration (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The Office of National Drug Control Policy (ONDCP) is located in the Executive Office of the President and has the responsibility for creating policies, priorities, and objectives for the federal Drug Control Program. This national program is aimed at reducing the use, manufacturing, and trafficking of illicit drugs and the reduction of drug-related crime and violence and of drug- related health consequences. The director of ONDCP has primary responsibilities of developing a comprehensive National Drug Control Strategy (Strategy) to direct the nation’s anti-drug efforts; developing a National Drug Control Budget (B udget) to implement the National Drug Control Strategy, including determining the adequacy of the drug control budgets submitted by contributing federal Drug Control Program agencies; and evaluating the effectiveness of the National Drug Control Strategy implementation by the various agencies contributing to the Drug Control Program. Authorization for ONDCP expired at the end of FY2010, but it has continued to receive appropriations. Congress, while continuously charged with ONDCP’s oversight, is now faced with its possible reauthorization.

In May 2009, Director R. Gil Kerlikowske called for an end to use of the term “war on drugs.” This is in part because while drug use was previously considered a law enforcement or criminal justice problem, it has transitioned to being viewed more as a public health problem. Indeed, the Obama Administration has indicated that a comprehensive strategy should include a range of prevention, treatment, and law enforcement elements. The 2013 National Drug Control Strategy outlines seven core areas—ranging from strengthening international partnerships to focusing on intervention and treatment efforts in health care—aimed at reducing both illicit drug use and its consequences. The overall goal is to achieve a 15% reduction in the rate of drug use and its consequences over a five-year period (2010-2015).

In creating the National Drug Control Strategy, ONDCP consults with the various federal Drug Control Program agencies. ONDCP then reviews th eir respective drug budgets and incorporates them into the National Drug Control Budget (Budget), which is submitted to Congress as part of the annual appropriations process. As requeste d by Congress in the ONDCP Reauthorization Act of 2006 (P.L. 109-469), the Budget was restructur ed in FY2012, incorporating the activities and budgets of 19 additional federal agencies/programs, to reflect a more complete range of federal drug control spending. The FY2013 Budget incorporated four additional federal agencies/programs, and the FY2014 Budget incorporates one additional federal program. In the FY2014 Budget, there are five priorities for which resources are requested across agencies: substance abuse prevention and substance abuse treatment (both of which are considered demand- reduction areas), and drug interdiction, domestic law enforcement, and international partnerships (the three of which are considered supply-reduc tion areas). The FY2014 Budget proposes to use 58.0% of the funds ($14.723 billion) for supply-side functions and 42.0% of the funds ($10.670 billion) for demand-side functions. Federal drug control activities were appropriated $24.536 billion for FY2013 (P.L. 113-6).

In considering ONDCP’s reauthorization, there are several issues on which policymakers may deliberate. Congress may consider whether to authorize specific supply-reduction or demand- reduction programs. Congress may also exercise oversight regarding ONDCP’s implementation of evidenced-based activities. Another issue that might be debated is whether the revised Budget structure captures the full scope of the nation’s anti-drug activities. Further, ONDCP has created a new Performance Reporting System (PRS) to eval uate annual progress toward each of the Drug Control Program’s strategic goals. Congress ma y exercise oversight regarding the new PRS.

Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010

August 29, 2013 Comments off

Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010
Source: The Lancet

Background
No systematic attempts have been made to estimate the global and regional prevalence of amphetamine, cannabis, cocaine, and opioid dependence, and quantify their burden. We aimed to assess the prevalence and burden of drug dependence, as measured in years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs).

Methods
We conducted systematic reviews of the epidemiology of drug dependence, and analysed results with Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) Bayesian meta-regression technique (DisMod-MR) to estimate population-level prevalence of dependence and use. GBD 2010 calculated new disability weights by use of representative community surveys and an internet-based survey. We combined estimates of dependence with disability weights to calculate prevalent YLDs, YLLs, and DALYs, and estimated YLDs, YLLs, and DALYs attributable to drug use as a risk factor for other health outcomes.

Findings
Illicit drug dependence directly accounted for 20·0 million DALYs (95% UI 15·3—25·4 million) in 2010, accounting for 0·8% (0·6—1·0) of global all-cause DALYs. Worldwide, more people were dependent on opioids and amphetamines than other drugs. Opioid dependence was the largest contributor to the direct burden of DALYs (9·2 million, 95% UI 7·1—11·4). The proportion of all-cause DALYs attributed to drug dependence was 20 times higher in some regions than others, with an increased proportion of burden in countries with the highest incomes. Injecting drug use as a risk factor for HIV accounted for 2·1 million DALYs (95% UI 1·1—3·6 million) and as a risk factor for hepatitis C accounted for 502 000 DALYs (286 000—891 000). Suicide as a risk of amphetamine dependence accounted for 854 000 DALYs (291 000—1 791 000), as a risk of opioid dependence for 671 000 DALYs (329 000—1 730 000), and as a risk of cocaine dependence for 324 000 DALYs (109 000—682 000). Countries with the highest rate of burden (>650 DALYs per 100 000 population) included the USA, UK, Russia, and Australia.

Interpretation
Illicit drug use is an important contributor to the global burden of disease. Efficient strategies to reduce disease burden of opioid dependence and injecting drug use, such as delivery of opioid substitution treatment and needle and syringe programmes, are needed to reduce this burden at a population scale.

Funding
Australian National Health and Medical Research Council, Australian Government Department of Health and Ageing, Bill & Melinda Gates Foundation.

Free registration required.

Categories: drug abuse, The Lancet

Marijuana Admissions to Substance Abuse Treatment Aged 18 to 30: Early vs. Adult Initiation

August 27, 2013 Comments off

Marijuana Admissions to Substance Abuse Treatment Aged 18 to 30: Early vs. Adult Initiation (PDF)
Source: Substance Abuse and Mental Health Services Administration

IN BRIEF

+ The proportion of all marijuana admissions aged 18 to 30 reporting early marijuana initiation (started using at age 17 or younger) remained relatively constant between 2000 and 2010 (83.7 and 86.8 percent, respectively)

+ A higher proportion of early initiates than of adult initiates reported 6 or more years of marijuana use (81.1 vs. 45.8 percent)

+ Marijuana admissions reporting early initiation were more likely than those reporting adult initiation to have had at least one prior admission to treatment (56.5 vs. 40.5 percent)

Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 Increased between 2005 and 2011

August 20, 2013 Comments off

Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 Increased between 2005 and 2011 (PDF)
Source: Substance Abuse and Mental Health Services Administration

Central nervous system (CNS) stimulants include prescription drugs, like those used to treat attention deficit/hyperactivity disorder (ADHD) or to block sleepiness. They also include over-the-counter products that contain caffeine. Nonmedical use of these drugs has been linked to heart and blood vessel problems, as well as to drug abuse or dependence. When combined with alcohol, CNS stimulants can hide the effects of being drunk and increase the risk of alcohol poisoning or alcohol-related injuries.

According to data from the Drug Abuse Warning Network (DAWN), the number of emergency department (ED) visits related to nonmedical use of CNS stimulants among adults aged 18 to 34 increased from 5,605 in 2005 to 22,949 in 2011. The number of ED visits involving CNS stimulants and alcohol also increased. 4 Each year, about 30 percent of ED visits involving nonmedical CNS stimulant use also involved alcohol. To learn more about nonmedical use of prescription drugs, including ways to prevent misuse, please visit http://www.drugabuse.gov/publications/ research-reports/prescription-drugs.

Drug Abuse Warning Network, 2011: National Estimates of Drug – Related Emergency Department Visits

July 18, 2013 Comments off

Drug Abuse Warning Network, 2011: National Estimates of Drug – Related Emergency Department Visits (PDF)
Source: Substance Abuse and Mental Health Services Administration

This publication presents national estimates of drug – related visits to hospital emergency departments (EDs) for the calendar year 2011 , based on data from the Drug Abuse Warning Network (DAWN). Also presented are comparisons of 20 11 estimates with those for 2004, 200 9, and 2010 . DAWN is a public health surveillance system that monitors drug – related ED visits for the Nation and for selected metropolitan areas. The Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), is the agency responsible for DAWN. SAMHSA is required to collect data on drug – related ED visits under S ection 505 of the Public Health Service Act.

DAWN relies on a nationally representative sample of general, non – Federal hospitals operating 24 – hour EDs , with oversampling of hospitals in selected metropolitan areas. In each participating hospital, ED medical records are reviewed retrospectively to find the ED visits that involved recent drug use. All types of drugs — illegal drugs, prescription drugs, over – the – counter pharmaceuticals (e.g., dietary supplements, cough medicine), and substances inhaled for their psychoact ive effects — are included. Alcohol is considered an illicit drug when consumed by patients aged 20 or younger. For patients aged 21 or older, though, alcohol is reported only when it is used in conjunction with other drugs.

Marked findings of this report a re (a) a 29 percent increase in the number of drug – related ED visits involving illicit drugs in the short term between 2009 and 2011 ; (b) simultaneous, short – term increases in the involvement of b oth illicit and licit stimulant – like drugs ; and (c) some ind ications that the pace of increases in pharmaceutical involvement is slowing down.

AU — New psychoactive substances: Key challenges and responses

July 9, 2013 Comments off

New psychoactive substances: Key challenges and responses
Source: Parliamentary Library of Australia

As outlined in an earlier FlagPost, the availability and use of new psychoactive substances (NPS) have increased globally over the past decade. This has created new public health and law enforcement challenges that existing frameworks have failed to address, prompting a search for workable alternatives.

False sense of safety associated with use NPS are often marketed as ‘legal highs’ and professionally packaged, which can give the impression that they are safer to use than illicit drugs with similar effects. However, very little is known about their health impacts, partly due to the dynamic nature of the market and because the content and concentration of different batches of the same branded product may vary. A NSW Parliamentary inquiry was advised that synthetic cannabis products could actually be more harmful than cannabis itself, and that NPS may present a higher risk of overdose.

Number of NPS entering the market The United Nations Office on Drugs and Crime (UNODC) observed in June 2013 that ‘the multitude of new psychoactive substances and the speed with which they have emerged in all regions of the world is one of the most notable trends in drug markets over the past five years’. In a submission to the NSW inquiry, one forensic science facility stated that new products claiming to be legal highs were submitted for testing every week. The NZ Ministry of Health advised that it had classified 31 NPS, but knew of around 2,000 cannabis mimics, ‘with the potential for there to be tens of thousands more’. Ease of evading prohibitions To date, measures to address NPS internationally and in individual countries have mainly involved their listing as prohibited substances. This has proven ineffective. A 2011 UK report outlines a typical example:

Despite the broad chemical generic ban on psychoactive cathinones imposed in April 2010, suppliers were able to find some loopholes, and within days a naphthyl derivative, Naphthylpyrovalerone (commonly referred as NRG-1) which lay outside the generic scope was offered for sale by internet retailers – advertised as “the legal alternative to mephedrone”.

When NSW prohibited seven synthetic cannabinoids in July 2011, ‘manufacturers quickly re-synthesised their products, replacing banned compounds with other synthetic cannabinoids not covered by the ban’. WA had the same experience in June 2011, with alternative synthetic cannabinoids on the market within days of its ban. Availability NPS are widely available through tobacconists, adult stores and online. In a UNODC survey, 88% of countries with a domestic NPS market indicated that the internet was a key source for NPS. Monitoring by an EU agency identified 693 online stores in 2012 selling NPS within Europe (up from 314 in January 2011 and 170 in January 2010). Between July 2011-July 2012, Australian researchers similarly identified:

+ 43 unique online stores selling stimulant/psychedelic NPS to Australian consumers • 212 unique products with purported stimulant/psychedelic effects and • 86 unique chemical substances.

Recent and proposed Australian responses Recent measures at the national level include:

+ the decision in February 2012 to create a group entry in Schedule 9 (Prohibited Substances) of the Poisons Standard, covering all synthetic cannabinomimetics except those separately specified (the Standard represents recommendations to States/Territories on the level of control that should apply to a substance)

+ moving the list of substances to which the Commonwealth’s serious drug offences apply from the Act to regulations in May 2013 to facilitate faster listing of NPS and • on 18 June 2013, a national interim ban under the Competition and Consumer Act 2010 on 19 named products and products that contain any of 20 substances already prohibited under the Poisons Standard (following interim bans on the same products in NSW and SA).

On 16 June 2013, the Government announced plans to ban the importation of NPS based on a ‘reverse onus of proof’ under which ‘new drugs coming onto the market are presumed to be illegal until the authorities know what they are and clear them as safe and legal’. The announcement states such a system already operates in Ireland and is due to begin in NZ in August 2013, but the Irish and proposed NZ systems are actually quite different. The NZ Bill would allow psychoactive substances to be legally sold where the manufacturer can demonstrate they present no more than a low risk to users. The Irish system instead represents a prohibitionist approach. Advocates for a public health-based response, including representatives of the Australian National Council on Drugs, the National Drug and Alcohol Research Centre and the Greens health spokesperson, are hoping Australia’s response will resemble NZ’s. The Government also announced a national drug monitoring system that will ‘[make] use of existing intelligence sharing networks and information sources from around Australia and internationally’. This sounds like a more modest version of the EU’s Early Warning System, which the NSW Parliamentary inquiry recommended be replicated in Australia.

Prescription Painkiller Overdoses: A growing epidemic, especially among women

July 3, 2013 Comments off

Prescription Painkiller Overdoses: A growing epidemic, especially among women
Source: Centers for Disease Control and Prevention

Nearly 48,000 women died of prescription painkiller* overdoses between 1999 and 2010.

Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men.

For every woman who dies of a prescription painkiller overdose, 30 go to the emergency department for painkiller misuse or abuse.

About 18 women die every day of a prescription painkiller overdose in the US, more than 6,600 deaths in 2010. Prescription painkiller overdoses are an under-recognized and growing problem for women.

Although men are still more likely to die of prescription painkiller overdoses (more than 10,000 deaths in 2010), the gap between men and women is closing. Deaths from prescription painkiller overdose among women have risen more sharply than among men; since 1999 the percentage increase in deaths was more than 400% among women compared to 265% in men. This rise relates closely to increased prescribing of these drugs during the past decade. Health care providers can help improve the way painkillers are prescribed while making sure women have access to safe, effective pain treatment.

Spotlight On… Drug Diversion

July 1, 2013 Comments off

Spotlight On… Drug Diversion
Source: U.S. Department of Health and Human Services, Office of Inspector General

It is becoming so pervasive that the Centers for Disease Control and Prevention has formally labeled it an “epidemic.” It is one of our nation’s fastest growing public health problems, and it takes a hefty toll on individuals, families, taxpayers, and society. What is the crisis? Prescription drug abuse.

According to the Congressional Budget Office, the Federal Government spent $62 billion on prescription drugs in 2010. Drug diversion, or the redirection of prescription drugs for illegitimate purposes, takes a portion of Medicare and Medicaid funds away from legitimate care. Furthermore, Federal health programs bear the added costs of additional health care as a result of patients misusing prescription drugs.

Office of Inspector General (OIG) investigations of drug diversion are on the rise. A contributing factor may be that this type of fraud can be very lucrative. In Northern California, for example, OIG agents report that a bottle of 30mg Oxycodone tablets are trafficked at a price of $1100 – 2400 a bottle! This is up to 12 times the normal price of a legally filled script. Furthermore, drug diverters may be drawn to prescription drugs because they are more “reliable” than street drugs like heroin or cocaine. Drug users know what they’re getting. Meanwhile, the risk for dealers is lower because trafficking in pharmaceutical drugs is generally less dangerous than with traditional street drugs.

2013 World Drug Report notes stability in use of traditional drugs and points to alarming rise in new psychoactive substances

June 27, 2013 Comments off

2013 World Drug Report notes stability in use of traditional drugs and points to alarming rise in new psychoactive substances
Source: United Nations

At a special high-level event of the Commission on Narcotic Drugs (CND), the United Nations Office on Drugs and Crime (UNODC) today launched in Vienna the 2013 World Drug Report. The special high-level event marks the first step on the road to the 2014 high-level review by the Commission on Narcotic Drugs of the Political Declaration and Plan of Action which will be followed, in 2016, by the UN General Assembly Special Session on the issue.

While drug challenges are emerging from new psychoactive substances (NPS), the 2013 World Drug Report (WDR) is pointing to stability in the use of traditional drugs. The WDR will be a key measuring stick in the lead up to the 2016 Review.

Prescribers With Questionable Patterns in Medicare Part D

June 20, 2013 Comments off

Prescribers With Questionable Patterns in Medicare Part D

Source: U.S. Department of Health and Human Services, Office of Inspector General

Summary

WHY WE DID THIS STUDY

Under the Medicare Part D program, CMS contracts with private insurance companies, known as sponsors, to provide prescription drug coverage to beneficiaries who choose to enroll. In recent years, prescription drug abuse has emerged as a serious and growing problem. The Centers for Disease Control and Prevention has characterized prescription drug abuse as an epidemic. With the rise in prescription drug abuse, concerns about Medicare fraud, particularly prescriber fraud, have increased.

HOW WE DID THIS STUDY

We based this study on an analysis of Prescription Drug Event records. Sponsors submit these records to CMS for each drug dispensed to beneficiaries enrolled in their plans. Each record contains information about the pharmacy, prescriber, beneficiary, and drug. We analyzed all of the records for drugs billed in 2009. We developed five measures to describe Part D prescribing patterns and to identify general-care physicians with questionable patterns.

WHAT WE FOUND

Over 1 million individual prescribers ordered drugs paid by Part D in 2009. Prescribing patterns varied widely by specialty. Over 700 general-care physicians had questionable prescribing patterns. Each of these physicians prescribed extremely high amounts for at least one of the five measures we developed. For example, many of these physicians prescribed extremely high numbers of prescriptions per beneficiary, which may indicate that these prescriptions are medically unnecessary. Moreover, more than half of the 736 general-care physicians with questionable prescribing patterns ordered extremely high percentages of Schedule II or III drugs, which have potential for addiction and abuse. Although some of this prescribing may be appropriate, such questionable patterns warrant further scrutiny.

WHAT WE RECOMMEND

These findings show the need for increased oversight of Part D. We recommend that CMS (1) instruct the Medicare Drug Integrity Contractor to expand its analysis of prescribers, (2) provide sponsors with additional guidance on monitoring prescribing patterns, (3) provide education and training for prescribers, and (4) follow up on prescribers with questionable prescribing patterns. CMS concurred with all four recommendations.

The Drug Problem in the Americas

May 26, 2013 Comments off

The Drug Problem in the Americas (PDF)
Source: Organization of American States
From press release:

The Report on the Drug Problem in the Americas was delivered, by the OAS Secretary General, José Miguel Insulza, to the President of Colombia, Juan Manuel Santos on Friday, May 17, 2013. The document is composed of two parts: the Analytical Report, which explains the reasons that lead society to worry about drug consumption and to try to control its effects on human health and the Scenarios Report, an examination of the paths that the phenomenon could take in the coming years in the region.

For his part, the CICAD Chair and Minister of Public Security of Costa Rica, Mario Zamora Cordero, closed the session by stating that “more judges, more prosecutors and more police will mean more people arrested but not fewer crimes committed. In this Report we have the key to how to address the issue of violence associated with drug use.”

2013 National Drug Control Strategy

May 1, 2013 Comments off

2013 National Drug Control Strategy

Source: White House

The Obama Administration’s inaugural National Drug Control Strategy, published in 2010, charted a new course in our efforts to reduce illicit drug use and its consequences in the United States—an approach that rejects the false choice between an enforcement-centric “war on drugs” and drug legalization. Science has shown that drug addiction is not a moral failing but rather a disease of the brain that can be prevented and treated. Informed by this basic understanding, the 2010, 2011 and 2012 Strategies established and promoted a balance of evidence-based public health and safety initiatives focusing on key areas such as substance abuse prevention, treatment, and recovery.

The 2013 National Drug Control Strategy, released on April 24, builds on the foundation laid down by the Administration’s previous three Strategies and serves as the Nation’s blueprint for reducing drug use and its consequences. Continuing our collaborative, balanced, and science-based approach, the new Strategy provides a review of the progress we have made over the past four years. It also looks ahead to our continuing efforts to reform, rebalance, and renew our national drug control policy to address the public health and safety challenges of the 21st century.

Nonmedical Use of Prescription-Type Drugs, by County Type

April 25, 2013 Comments off

Nonmedical Use of Prescription-Type Drugs, by County Type
Source: Substance Abuse and Mental Health Services Administration

  • About 15.7 million persons aged 12 or older used prescription-type drugs nonmedically in the past year, and 6.7 million did so in the past month.
  • Past year nonmedical use of prescription-type drugs was lower among persons living in rural counties than among those in metropolitan and urbanized non-metropolitan counties (5.4 vs. 6.4 and 6.6 percent); past month use was similar among all three types of counties.
  • The rate of past year nonmedical use of pain relievers was lower in rural counties than in metropolitan and urbanized non-metropolitan counties (4.2 vs. 4.9 and 5.1 percent), as was the rate of nonmedical use of tranquilizers (1.8 vs. 2.1 and 2.3 percent); the rate of nonmedical use of stimulants and sedatives did not vary by type of county.

First Do No Harm: Responding to Canada’s Prescription Drug Crisis

April 4, 2013 Comments off

First Do No Harm: Responding to Canada’s Prescription Drug Crisis (PDF)

Source: Canadian Centre on Substance Abuse

Certain prescription drugs, like opioids, sedative – hypnotics and stimulants, are associated with serious harms like addiction, overdose and death. These drugs can have a devastating impact on individuals and their families, as well as place a significant burden on our health, social services and public safety syst ems. In countries like Canada, where these prescription drugs are readily available, the associated harms have become a leading public health and safety concern. Canada is the world’s second largest per capita consumer of one type of these drugs, opioids ( International Narcotics Control Board, 2013). Some First Nations in Canada have declared a community crisis owing to the prevalence of the harms associated with prescription drugs (Dell et al., 2012). While Canadian cost data is lacking, recent research from the United States estimates the annual cost of the non – medical use of prescription opioids to be more than $50 billion, with lost productivity and crime accounting for 94% of this amount (Hansen, Oster, Edelsberg, Woody, & Sullivan, 201 1).

DrugFacts: Nationwide Trends

March 1, 2013 Comments off

DrugFacts: Nationwide Trends

Source: National Institute on Drug Abuse

Illicit drug use in America has been increasing. In 2011, an estimated 22.5 million Americans aged 12 or older—or 8.7 percent of the population—had used an illicit drug or abused a psychotherapeutic medication (such as a pain reliever, stimulant, or tranquilizer) in the past month. This is up from 8.3 percent in 2002. The increase mostly reflects a recent rise in the use of marijuana, the most commonly used illicit drug.

Acute Kidney Injury Associated with Synthetic Cannabinoid Use — Multiple States, 2012

February 21, 2013 Comments off

Acute Kidney Injury Associated with Synthetic Cannabinoid Use — Multiple States, 2012
Source: Morbidity and Mortality Weekly Report (CDC)

In March 2012, the Wyoming Department of Health was notified by Natrona County public health officials regarding three patients hospitalized for unexplained acute kidney injury (AKI), all of whom reported recent use of synthetic cannabinoids (SCs), sometimes referred to as “synthetic marijuana.” SCs are designer drugs of abuse typically dissolved in a solvent, applied to dried plant material, and smoked as an alternative to marijuana. AKI has not been reported previously in users of SCs and might be associated with 1) a previously unrecognized toxicity, 2) a contaminant or a known nephrotoxin present in a single batch of drug, or 3) a new SC compound entering the market. After the Wyoming Department of Health launched an investigation and issued an alert, a total of 16 cases of AKI after SC use were reported in six states. Review of medical records, follow-up interviews with several patients, and laboratory analysis of product samples and clinical specimens were performed. The results of the investigation determined that no single SC brand or compound explained all 16 cases. Toxicologic analysis of product samples and clinical specimens (available from seven cases) identified a fluorinated SC previously unreported in synthetic marijuana products: (1-(5-fluoropentyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl) methanone, also known as XLR-11, in four of five product samples and four of six patients’ clinical specimens. Public health practitioners, poison center staff members, and clinicians should be aware of the potential for renal or other unusual toxicities in users of SC products and should ask about SC use in cases of unexplained AKI.

Amphetamine-induced psychosis – a separate diagnostic entity or primary psychosis triggered in the vulnerable?

December 6, 2012 Comments off

Amphetamine-induced psychosis – a separate diagnostic entity or primary psychosis triggered in the vulnerable?

Source: BMC Psychiatry

Use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders. To distinguish the two types of psychosis on the basis of acute symptoms is difficult. However, acute psychosis induced by amphetamines seems to have a faster recovery and appears to resolve more completely compared to schizophrenic psychosis. The increased vulnerability for acute amphetamine induced psychosis seen among those with schizophrenia, schizotypal personality and, to a certain degree other psychiatric disorders, is also shared by non-psychiatric individuals who previously have experienced amphetamine-induced psychosis. Schizophrenia spectrum disorder and amphetamine-induced psychosis are further linked together by the finding of several susceptibility genes common to both conditions. These genes probably lower the threshold for becoming psychotic and increase the risk for a poorer clinical course of the disease.The complex relationship between amphetamine use and psychosis has received much attention but is still not adequately explored. Our paper reviews the literature in this field and proposes a stress-vulnerability model for understanding the relationship between amphetamine use and psychosis.

Parental Drug Use as Child Abuse

November 15, 2012 Comments off

Parental Drug Use as Child Abuse
Source: Child Welfare Information Gateway

This factsheet discusses laws that address the issue of substance abuse by parents. Two areas of concern are the harm caused by prenatal drug exposure to the health and development of affected infants and the harm caused to children of any age by exposure to illegal drug activity in their homes or environment. Summaries of laws for all States and U.S. territories are included.

National survey shows reduction in non-medical prescription drug use among young adults

September 26, 2012 Comments off

National survey shows reduction in non-medical prescription drug use among young adults

Source: Substance Abuse and Mental Health Services Administration

The number of people aged 18 to 25 who used prescription drugs for non-medical purposes in the past month declined 14 percent — from 2.0 million in 2010 to 1.7 million in 2011 — the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) announced today, during the 23rd annual national observance of National Recovery Month. Non-medical use of prescription drugs among children aged 12 to 17 and adults aged 26 or older remained unchanged.

In addition, the 2011 National Survey on Drug Use and Health (NSDUH), a survey conducted annually by SAMHSA, showed that the rates of past month drinking, binge drinking and heavy drinking among underage people continued a decline from 2002. Past month alcohol use among 12 to 20 year olds declined from 28.8 percent in 2002 to 25.1 percent in 2011, while binge drinking (consuming 5 or more drinks on a single occasion on at least 1 day in the past 30 days) declined from 19.3 percent in 2002 to 15.8 percent in 2011, and heavy drinking declined from 6.2 percent in 2002 to 4.4 percent in 2011.

Overall, the use of illicit drugs among Americans aged 12 and older remained stable since the last survey in 2010. The NSDUH shows that 22.5 million Americans aged 12 or older were current (past month) illicit drug users — (8.7 percent of the population 12 and older in 2011 versus 8.9 percent in 2010).

Marijuana continues to be the most commonly used illicit drug. In 2011, 7.0 percent of Americans were current users of marijuana — up from 5.8 percent in 2007. Among youths aged 12 to 17, the rate of current marijuana use remained about the same from 2009 (7.4 percent) to 2011 (7.9 percent). Increases in the rate of current marijuana use occurred from 2007 to 2011 among adolescents (ages 12-17), young adults (ages 18 to 25), and adults (ages 26 or older). Additionally, the number of people aged 12 and older who used heroin in the past year rose from 373,000 in 2007 to 621,000 in 2010 and 620,000 in 2011.

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