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Nonmedical Prescription Opioid and Sedative Use Among Adolescents in the Emergency Department

October 30, 2013 Comments off

Nonmedical Prescription Opioid and Sedative Use Among Adolescents in the Emergency Department
Source: Pediatrics

OBJECTIVES:
Nonmedical prescription opiate use (NPOU) and nonmedical prescription sedative use (NPSU) are serious public health concerns. The objectives of this study were to determine the prevalence and emergency department (ED) visit characteristics and other correlates associated with past-year NPOU and NPSU among adolescents and young adults using the ED.

METHODS:
Participants aged 14 to 20 presenting to the ED at the University of Michigan Medical Center between September 2010 and September 2011 were systematically recruited. A computerized self-report screening survey with validated items measuring past-year NPOU, NPSU, substance use, and violence was delivered to participants, and a retrospective chart review was performed.

RESULTS:
Of the 2135 participants (86.0% response rate), 222 (10.4%) reported either NPOU or NPSU. Among the 185 (8.7%) participants that reported NPOU, 14.6% had a current home prescription for an opioid and among the 115 (5.4%) with NPSU, 12.3% had a current home prescription for a sedative. After controlling for demographics (age, gender, race, public assistance), correlates of NPOU or NPSU included other substance use, and drinking and driving or riding with a drinking driver. Additional correlates of NPOU included receiving an intravenous opioid in the ED and for NPSU, dating violence, presenting to the ED for a noninjury complaint, and previous ED visit in the past year.

CONCLUSIONS:
Nearly 1 in 10 young people who use the ED for care report NPOU or NPSU, and only 12.3% and 14.6% report having current home prescriptions for sedatives and opioids. The ED represents a key location for screening and intervention efforts.

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Prescription Drug Abuse: Strategies to Stop the Epidemic

October 11, 2013 Comments off

Prescription Drug Abuse: Strategies to Stop the Epidemic
Source: Trust for America’s Health

Prescription Drug Abuse: Strategies to Stop the Epidemic finds that 28 states and Washington, D.C. scored six or less out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Two states, New Mexico and Vermont, got the highest score, receiving all 10 possible indicators, while South Dakota scored the lowest with two out of 10.

According to the report, prescription drug abuse has quickly become a top public health concern, as the number of drug overdose deaths – a majority of which are from prescription drugs – doubled in 29 states since 1999. The rates quadrupled in four of these states and tripled in 10 more of these states.

Prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C. Misuse and abuse of prescription drugs costs the country an estimated $53.4 billion a year in lost productivity, medical costs and criminal justice costs, and currently only one in 10 Americans with a substance abuse disorder receives treatment.

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings

October 10, 2013 Comments off

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings
Source: Cyberpsychology, Behavior, and Social Networking

Job applicants and incumbents often use social media for personal communications allowing for direct observation of their social communications “unfiltered” for employer consumption. As such, these data offer a glimpse of employees in settings free from the impression management pressures present during evaluations conducted for applicant screening and research purposes. This study investigated whether job applicants’ (N=175) personality characteristics are reflected in the content of their social media postings. Participant self-reported social media content related to (a) photos and text-based references to alcohol and drug use and (b) criticisms of superiors and peers (so-called “badmouthing” behavior) were compared to traditional personality assessments. Results indicated that extraverted candidates were prone to postings related to alcohol and drugs. Those low in agreeableness were particularly likely to engage in online badmouthing behaviors. Evidence concerning the relationships between conscientiousness and the outcomes of interest was mixed.

Prescription Drug Abuse: Strategies to Stop the Epidemic, 2013

October 7, 2013 Comments off

Prescription Drug Abuse: Strategies to Stop the Epidemic, 2013
Source: Trust for America’s Health (via Robert Wood Johnson Foundation)

The Trust for America’s Health (TFAH) worked with a range of partners and experts to identify promising policies and approaches to reducing prescription drug abuse in America.

This report evaluates states on 10 key approaches to combat prescription drug abuse, based on input and review from public health, medical and law enforcement experts, and using indicators. The report also provides a review of national policy issues and recommendations.

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011

October 7, 2013 Comments off

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011
Source: Morbidity and Mortality Weekly Report (CDC)

Male-to-male sex and illicit injection drug use are important transmission routes for human immunodeficiency virus (HIV) infection. Of all new HIV infections in 2010, 80% were among men, of which 78% were among men who have sex with men (MSM), 6% among male injection drug users (IDU), and 4% among men who have sex with men and inject drugs (MSM/IDU) (1). MSM/IDU might have different prevention needs from men who are either MSM or IDU, but not both. A combination of effective, scalable, and evidence-based approaches that address male-to-male sex and injection drug use behaviors might reduce HIV infections among MSM/IDU. To refine calculations of disease rates attributed to MSM and IDU (2,3) by accounting for MSM/IDU, CDC used data from 1999–2008 National Health and Nutrition Examination Survey (NHANES) to estimate the percentage and number of MSM/IDU in the general population. To further describe demographic similarities and differences of MSM/IDU identified by different surveillance systems, CDC also compared data from four HIV surveillance systems: the 2008 and 2009 National HIV Behavioral Surveillance System (NHBS), the 2011 National HIV Surveillance System (NHSS), and the 2007–2009 Medical Monitoring Project (MMP). Of males aged ≥18 years, MSM/IDU comprised an estimated 0.35% in NHANES, 7%–20% in NHBS, an estimated 4%–8% in NHSS, and 9% in MMP. Across surveillance systems, MSM/IDU accounted for 4%–12% of MSM and 11%–39% of male IDU. Risk reduction programs and interventions targeted toward male IDU populations might be more effective if they also incorporate messages about male-to-male sex.
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Opioid Overdose Prevention Toolkit

October 4, 2013 Comments off

Opioid Overdose Prevention Toolkit
Source: Substance Abuse and Mental Health Services Administration

Equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. Addresses issues for first responders, treatment providers, and those recovering from opioid overdose.

Seeking Drug Abuse Treatment: Know What To Ask

September 26, 2013 Comments off

Seeking Drug Abuse Treatment: Know What To Ask
Source: National Institute on Drug Abuse

Offers guidance in seeking drug abuse treatment and lists five questions to ask when searching for a treatment program.

CRS — Synthetic Drugs: Overview and Issues for Congress

September 23, 2013 Comments off

Synthetic Drugs: Overview and Issues for Congress (PDF)
Source: Congressional Research Service

Synthetic drugs, as opposed to natural drugs, are chemically produced in a laboratory. Their chemical structure can be either identical to or different from naturally occurring drugs, and their effects are designed to mimic or even enhance those of natural drugs. When produced clandestinely, they are not typically controlled pharmaceutical substances intended for legitimate medical use. Designer drugs are a form of synt hetic drugs. They contain slightly modified molecular structures of illegal or controlled substances, and they are modified in order to circumvent existing drug laws. While the issue of synthetic drugs and their abuse is not new, Congress has demonstrated a renewed concern with the issue.

From 2009-2011, synthetic drug abuse was reported to have dramatically increased. During this time period, calls to poison control centers for incidents relating to harmful effects of synthetic cannabinoids (such as “K2” and “Spice”) and stimulants (such as “bath salts”) increased at what some considered to be an alarming rate. The number of hospital emergency department visits involving synthetic cannabinoids more than doubled from 2010 to 2011. In 2012, however, the number of calls to poison control centers for incidents relating to harmful effects of synthetic cannabinoids and synthetic stimulants decreased. The Monitoring the Future (MTF) survey results from 2012 indicate that annual prevalence rates for use of “bath salts” among college students and adults ages 18-50 was “very low.” In contrast, MTF reports that, among 12th graders, synthetic marijuana is the “second most widely used class of illicit drug after marijuana.” Media reports indicate that a synthetic substance known as “molly,” a psychoactive drug that may be similar or identical to MDMA (3,4-Methylenedioxymethamphetamine), appears to be gaining popularity among youth. In the summer of 2013, seve ral deaths and drug overdoses have been attributed to molly.

The reported harmful effects of synthetic substances range from nausea to drug-induced psychosis. Due to the unpredictable nature of sy nthetic drugs and of human consumption of these drugs, the true effects of many of these drugs are unknown. Many states have responded to the synthetic drug abuse issue by passing synthetic drug laws banning certain synthetic cannabinoids and stimulants.

In 2011, the Attorney General—through the Drug Enforcement Administration (DEA)—used his temporary scheduling authority to place five synthetic cannabinoids and three synthetic stimulants on Schedule I of the Controlled Substances Act (CSA). Concern over the reported increase in use of certain synthetic cannabinoids and stimulants resulted in legislative action to schedule specific substances. The Synthetic Dr ug Abuse Prevention Act of 2012—Subtitle D of Title XI of the Food and Drug Administration Safety and Innovation Act (P.L. 112-144)—added five structural classes of substances in synthetic cannabinoids (and their analogues) as well as 11 synthetic stimulants and hallucinogens to Schedule I of the CSA. In addition, the act extended the DEA’s authority to temporarily schedule substances. In April 2013, Attorney General Holder— through the DEA and in consultation with the Department of Health and Human Services (HHS)—took administrative action to permanently place methylone on Schedule I of the CSA. Most recently in May 2013, Attorney General Holder—again through the DEA—used his temporary scheduling authority to place three additional synthetic cannabinoids on Schedule I of the CSA.

In considering permanent placement of synthetic substances on Schedule I of the CSA, there are several issues on which Congress may deliberate. Policymakers may consider the implications on the federal criminal justice system of scheduling certain synthetic substances. Another issue up for debate is whether Congress should schedule certain synthetic substances or whether these substances merit Attorney General (in consultation with the Secretary of HHS) scheduling based on qualifications specified in the CSA. Congress may also consider whether placing additional synthetic drugs on Schedule I may hinder future medical research. In addition, policymakers may consider whether it is more efficient to place these drugs on Schedule I of the CSA or to treat them as analogue controlled substances under the Controlled Substances Analogue Enforcement Act. In considering enforcement challenges id entified by the DEA, Congress may consider whether to amend the CSA to better facilitate enforcement action against the illicit synthetic drug market.

Report shows that “Bath Salts” drugs were involved in nearly 23,000 emergency department visits in one year

September 18, 2013 Comments off

Report shows that “Bath Salts” drugs were involved in nearly 23,000 emergency department visits in one year
Source: Substance Abuse and Mental Health Services Administration

A new national report reveals that “bath salts,” a group of drugs containing amphetamine-type stimulants, were linked to an estimated 22,904 visits to hospital emergency departments in 2011. The report by the Substance Abuse and Mental Health Services Administration (SAMHSA) is the first national study to track bath salts drugs to hospital emergency department visits since these drugs emerged a few years ago.

The SAMHSA report shows that about two-thirds (67 percent) of emergency department visits involving bath salts also involved the use of another drug. Only 33 percent of the bath salts-related visits to emergency departments involved just the use of bath salts; 15 percent of the visits involved combined use with marijuana or synthetic forms of marijuana, and 52 percent involved the use of other drugs.

In 2011 there were nearly 2.5 million emergency department visits involving drug misuse or abuse.

Non-Medical Use of Prescription Drugs and Health Services Utilization

September 17, 2013 Comments off

Non-Medical Use of Prescription Drugs and Health Services Utilization (PDF)
Source: Journal of Developing Drugs

Objective:
To provide evidence of the economic burden of the non-medical prescription drug (NMPD) use on health services utilization: emergency room (ER) visits and inpatient hospital nights.

Data:
The 2009 National Survey on Drug Use and Health (NSDUH) cross-section (52,267 observations). Study design. We employ propensity score matching techniques controlling for a rich set of covariates to reduce the potential individual heterogeneity bias.

Principal findings:
Our results reveal a positive, statistically significant, and robust relationship between NMPD use and health services utilization both in adolescents and adults. The estimated effects for adults are slightly smaller in magnitude than those for adolescents.

Conclusion:
These results have important policy implications as the burden imposed on society by NMPD use might be greater than initially assumed. Efforts to curb NMPD use such as expansion of Prescription Drug Monitoring Programs (PDMPs), prevention interventions, and increased funds allocated to treat prescription drug abuse might be economically justified.

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.

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.

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