Alcoholism , Sniffing Bath Salts, and Prescription Medication Abuse

If you care about addiction you’re going to want to read our weekly update from across the globe. It’ll make you smarter – promise (at least when it comes to alcohol and drug abuse issues)!

Drug Abuse – Vaccines to treat addictions, and Sniffing Bath Salts

Medical News Today-A biochemical breakthrough by researchers at Cornell  produces a unique vaccine that combines bits of the common cold virus with a particle that mimics cocaine. Researchers believe the vaccine could be tailored to treat other addictions, such as to nicotine, heroin, and methamphetamine. While similar to other vaccine discussions we’ve had here, the method and generalizability here are of specific interest.

BBC News-Publicity of scholastic journals back fired on Dr. David E. Nichols as drug makers profit off his research findings. Dr. Nichols says while some drugs can be manufactured in the kitchen the scale to which these “legal high” drugs are produced indicates some small companies are involved.

Fox News.com– A new “drug abuse” trend of sniffing bath salts to try to get high is emerging in Louisiana and is creating a issue for the Louisiana Poison Center. It appears that more kids are attempting this “trend” resulting in of paranoia, hallucinations, delusions, as well as hypertension and chest pain. The problem’s gotten so bad in the state that the Governor had to make the active ingredient in the bath salts illegal. The bath salts contain a chemical called “Mephadrone and Methylenedioxypyrovalerone or MDPV, which is known to be a stimulant that may also cause paranoia and hostility.

Alcoholism – Studies and Personal Stories about alcohol

Science Daily- A new study has been conducted which shows that midlife alcohol consumption may be related to dementia which is often assessed about 20 years later. The study found that both abstainers and heavy drinkers had a greater risk for dementia and cognitive impairment than light drinkers. Again, it seems that drinking no-alcohol is associated with risk factors and outcomes that are not as ideal as moderate consumption and somewhat similar to heavy drinking.

Counselor Magazine Blog- Everyone loves watching a good and inspirational movie from time to time. The new movie “Country Strong” deals with many issues that everyday individuals face such as alcoholism, mental illness, co-dependency, ageism, and grief. These are elements that a person goes through when they are dealing with alcoholism. The movie depicts that alcoholism is a family disease and does not affect just the alcoholic. Another great point that the movie shows is that if there are underlying issues that are often not resolved that relapse is very common.

Prescription Drug abuse and death

Reuters- A new study has found that an increasing amount of individuals are dying from abusing and misusing prescription drugs as well as illegal drugs. In recent times deaths from “accidental poisonings” or overdose are more than ten times higher than they were in the late 1960s. This increase in drug deaths is higher across almost all age groups than it was in previous decades, especially amongst white Americans.

Chicago Sun Times- Prescription drug abuse is a growing problem in our country, and deaths from unintentional drug overdoses in the US have increased five-fold over the last two decades. The drugs that are commonly causing these deaths are particularly painkillers such as OxyContin (oxycodone), Vicodin (hydrocodone) and fentanyl. What many individuals do not realize is prescription drugs can be much more deadly than illegal drugs. In 2007 alone, abuse of prescription painkillers was responsible for more overdose deaths than heroin and cocaine combined. Prescription painkillers, most of which are opioids, are synthetic versions of opium used to relieve moderate to severe chronic pain, however in large and excessive quantities, they can suppress a person’s ability to breathe and are very dangerous when they are mixed with alcohol or other drugs.

Addiction Treatment Admissions in the United States: Everyone, meet TEDS

Dirk Hanson

What a difference a decade makes.

Do you know what drug use trends are ongoing?Between 1998 and 2008, addiction treatment admissions in the U.S. increased markedly for methamphetamine (crystal meth), prescription opiates, and marijuana. Treatment admissions for alcohol and cocaine declined over the same period, while heroin admissions remained roughly the same.

The Treatment Episode Data Set (TEDS), which the Substance Abuse and Mental Health Services Administration (SAMHSA) uses to compile its report, includes only those addiction treatment facilities that receive state alcohol or drug agency funds, and which are represented in state administrative data systems. Despite this caveat, the TEDS study matters, because states use reports of this kind to shift limited resources from one treatment focus to another, based on demand. Continue reading “Addiction Treatment Admissions in the United States: Everyone, meet TEDS”

About Addiction: Prescription drugs, Alcohol prices, and prevention among teens

You know you care about addiction, and you know you love reading addiction news and research – A3 does it all for you and gathers things up in a nice little package we call our weekly “about addiction” post. It’s the fastest way to get the information you want, even if you didn’t know it was out there!

Prescription Drugs, drug safety, and sales

Reuters– Walgreen’s offers its customers a convenient way of disposing of their prescription drugs. This allows individuals to safely dispose of unwanted or expired drugs. The way that the program works is to place the unwanted prescription drugs in an envelope and send it to a medication incinerator. Controlled substances however are excluded from the program, I guess they’re afraid of bags of heroin and cocaine showing up at Walgreen offices?

Wales online– After being bugged to see if a man was in possession of illegal drugs, a number of men were sentenced to 48 years in jail for selling heroin. This undercover investigation lasted for six months, revealing a magnificent economy of drug use, abuse and profit.

Discovery News– Authorities discovered that eight illicit drugs, including cocaine, ecstasy, and methamphetamines, were detectable in the waterways of a Spanish national park. They’re worried about the threat of the drugs’ side effects to animals, but I have to say it makes me wonder why so many drug addicts are dumping their drugs there…

Alcohol Prices

Telegraph (U.K.)– A “price fixing”  system for alcohol prices has been suggested in the U.K., which is supposed to help reduce binge drinking encouraged by bottom priced alcohol. Economics experts in England suggest that all the policy will likely do will be increase profits for store that sell cheap alcohol. If our work here is any indication though, driving alcohol price up (as much as 100% in some stores) will certainly have an effect on some drinkers.

Health DayTax increases in alcohol prices may aid in alleviating alcohol problems. A study was conducted which showed that increasing the alcohol prices will result in significant reductions in many of the undesirable outcomes associated with drinking. So next time you go to buy alcohol and the price is too high just think of all the help you’re providing the community.

Addiction interventions and addiction treatment of teens

Time to act!- Perhaps one of the most important ways to prevent an addiction from happening is to catch it in its early stages and prevent it from ever developing. This website promotes primary prevention of as a means of addiction intervention and urges parents to act as soon as possible if you think your child is using drugs or alcohol.

DBtechno– Children who have regular meals are less likely to drink (read our coverage of teen drinking). This was attributed to parents having better, more consistent, interactions with their children at the dinner table. Kids who did not eat regular meals were twice as likely to drink and use cigarettes. Talk about a great way at starting on an addiction intervention early on in life – a nice relaxing dinner, and maybe some dessert…

ABC News– This article tells of the ill effects that alcohol can have to a child when alcohol is consumed during pregnancy. It tells the story of one family who could not stand their child’s “out of control behavior” likely brought on by FAS (Fetal Alcohol Syndrome). Read All About Addiction’s coverage of drinking during pregnancy.

Addiction Inbox– A great article using Dock Ellis’ perspective on LSD. Ellis is now speaking to inmates in correctional facilities, telling his story of how he was addicted to drugs and alcohol while playing baseball.

The benefits of marijuana: Things are far from all bad for weed

Marijuana can certainly be beneficial.

It’s true that essentially every drug has some abuse liability. However, somewhere in the vicinity of 85% of those who try any given drug will never develop abuse or addiction problems (yes there are probably variations based on specific drugs, but that’s a good estimate).  As we all know, marijuana is a drug that receives a lot of attention and drives intense debate when it comes to its benefits and harms.  While most of the posts on my site focus on the other 15%, there is, and continues to be, evidence for the benefits of marijuana and other drugs that directly activate cannabinoid receptors.

Some of the shown benefits of marijuana

THC, the active ingredient in cannabis, is known to cause sedation, euphoria, decrease in pain sensitivity, as well as memory and attention impairments.  But there are some aspects of the cannabinoid receptors that have been shown to be effective in AIDS, glaucoma and cancer treatments.

Stimulation of cannabinoid receptors causes an increase in appetite and therefore helps with the wasting syndrome often seen as a side effect in AIDS treatments or those with eating disorders. Since THC activation decreases intra-ocular pressure, another area in which marijuana has been proven to be effective is in the treatment of glaucoma.  THC’s anti-emetic (or anti-vomiting) properties also make it a very useful tool for combating the side effects of cancer treatments.

Still, the activation of cannabinoid receptors is not synonymous with smoking weed. In fact, there are a number of other possible ways to consume THC and other cannabinoid-receptor activators. Also, THC is a potent immune suppressing agent, so in someone who already has a compromised immune system, such as AIDS patients, marijuana and other THC compounds could increase the risk of infection.

Future promise for the use of THC in medicine

There is some evidence that of the 2 major THC receptors (CB1 and CB2), one is associated with the immuno-suppression that occurs after chronic usage and the other is associated with the the more beneficial aspects we’d discussed. In the future, we may be able to produce a compound that activate only the behavioral effects and could therefore be used more safely for AIDS patients. Marijuana lovers will say that we should leave things as they are, but I’m all for less immuno-suppression with my cancer therapy.

Again, just because activation of THC receptors can provide the above benefits does not necessarily mean one should smoke marijuana. As usual, the benefits and risks have to be considered and one has to reach an educated, informed, conclusion. Still, there’s little doubt that in some situations, the use of marijuana, or other THC activators is not only prudent, but indeed recommended.

Co-authored by: Jamie Felzer

Brittany Murphy dead at 32 – Anemia, pneumonia, and yes, drugs…

Toxicology update

Well, it seems the toxicology reports are in and Brittany’s death was, at least partially, caused by her taking of multiple prescription drugs. Still, it seems that she was trying to medicate a host of conditions brought on by her underlying anemia and pneumonia. It’s sad to think that this death could have likely been prevented had she simply taken better care of herself and gone to seek emergency care rather than loading her body with those pills. Unfortunately, this seems to be another in a string of medically preventable deaths… Sad.

Original post:

Brittany Murphy, the actress from “Clueless,” and “8 Mile” died last night at Cedars-Sinai in Beverly Hills at the age of 32. Brittany has been rumored to be suffering from severe eating disorders, and recent pictures seem to support that notion. Given that she apparently died from cardiac arrest, I’m wondering if drugs (even prescription drugs) played a role in the death as well… I’ll keep updating the story as more becomes available.

My heart goes out to her family and friends. Certainly a loss suffered far too early.

UPDATE: According to the police report, a number of prescription drugs were discovered in Brittany’s bedroom including (read past the list for my take on this):

  1. Topamax –  While TMZ reported this drug to be used as anti-seizure medication, it is also used to reduce weight-gain associated with the use of many other prescription drugs on this list. Lastly, it is considered to be a mood stabilizer.
  2. Methylprednisolone – An anti-inflammatory that may be used to treat bronchial infections
  3. Prozac – A commonly prescribed SSRI anti-depression med.
  4. Klonopin – A benzodiazepine anti-anxiety prescription medication that is also used to help with insomnia. Like most benzos, the probability of overdose is low if used properly, but overdose would lead to cardiac arrest.
  5. Carbamazepine – Another anti-convulsant mood stabilizer often used to treat bipolar disorder. This prescription drug can be very dangerous when combined with other medications due to its actions on GABA and extensive alteration of Sodium channel activity. It is also a bipolar med.
  6. Ativan – Once again a benzodiazepine that is often used to treat anxiety and insomnia.
  7. Vicoprofen – A pain reliever that includes an opioid (it sounds like vicodin for a reason).
  8. Propranolol – Prescription med used to treat hypertension and as an alternative, less habit-forming anti-anxiety drug.
  9. Biaxin – An antibiotic.
  10. Hydrocodone – Same as Vicoprofen, an analgesic (pain reducing) prescription drug.

What do I think killed Brittany?

With 2 benzodiazepine medications, 2 opiates, and antidepressant, and a drug that is made to lower one’s heart pressure, it’s no wonder that Brittany was found not breathing. I’m going to wait until the final toxicology report to draw a definite conclusion, but from this list, it seems highly likely that a dangerous combination of these prescription drugs was taken, which resulted in Brittany’s heart stopping. Even when taken at their prescribed strengths, these medication, when combined, can form a lethal cocktail.

You should ALWAYS check with your doctor regarding interactions between different prescriptions you’re taking, especially when those medications haven’t all been prescribed by the same physician!

The Prescription drug use problem: Unethical marketing strategies for Oxycontin

080727-oxycontin-vmed-4p.widecIn 1996, Purdue Pharma L.C. introduced Oxycontin to the drug market. Oxycontin is a sustained-release oxycodone preparation used in treating chronic pain. Purdue put together an aggressive marketing plan to promote the sale of the drug. In it’s first year, Purdue sold $48 million dollars of Oxycontin. By 2000, Purdue was making a staggering 1.1 billion dollars a year from Oxycontin.
The enormous commercial success of Oxycontin would not have been surprising if it had been a revolutionary drug. However, numerous studies have shown many other opioid medications to be just as safe and effective as Oxycontin. So how did Purdue get so many people to buy Oxycontin? Below are some of the tactics Purdue Pharma used to increase it’s sales:
– From 1996-2001, Purdue put on more than 40 national pain-management and speaker-training conferences. More than 5000 physicians, nurses, and pharmacists attended these all-expenses-paid conferences where they were trained for Purdue’s national speaker bureau. Although many physicians deny it, research has shown that attending these types of conferences influences physician’s prescribing tendencies.
-Purdue implemented a bonus system to encourage their sales representatives to increase sales of Oxycontin in their territory. In 2001 alone, Purdue paid approximately $40 million dollars in incentive bonuses.
-Purdue used marketing data which allowed them to see nationwide statistics on physicians prescribing patterns. Purdue used this data to aim their marketing campaign at physicians with the highest rates of opioid prescription. While in theory this strategy targets physicians with the most chronic pain patients, it also ends up targeting physicians with loose standards for prescribing drugs.
– Purdue gave out coupons for a free prescription good for one 7-30 day supply of Oxycontin. By the time the offer ended, 34,000 coupons had been claimed.
-Purdue claimed that the risk of addiction to Oxycontin was less than one percent. Long term studies of opioid treatment for chronic pain patients have shown the risk of addiction to range from 0% to 50%. In 2007, Purdue Frederick Company Inc (an affiliate of Purdue Pharma) and three company executives pled guilty to misbranding the risk of addiction for Oxycontin and will pay $646 million dollars in fines.
Together these strategies helped shoot Oxycontin sales through the roof. In 2001, Oxycontin became the most frequently prescribed opioid in the United States for treating moderate to sever pain.
The problem is not that Purdue made a lot of money. The problem is that in the process of making money, Purdue created a huge drug problem. Between 1997-1999, the state of Maine experienced a 460% increase of people treated for opioid abuse. In southwest Virginia, the number of deaths related to prescription opioids increased 830% from 23 deaths in 1997 to 215 deaths in 2003. In eastern Kentucky, there was a 500% percent increase in the number of patients entering methadone maintenance treatment programs. In each case, these increases were correlated with increases in Oxycontin availability in those regions.
Currently the FDA is in charge of ensuring that prescription all drug advertising is honest and truthfully communicated. Aggressive marketing strategies like those used by Purdue end up making prescription drugs easier to obtain and easier to abuse. Tougher FDA restrictions on acceptable marketing practices would make the pharmaceutical industry more like honest evidence-based medicine and less like a car sale.

Contributing co-author: Andrew Chen080727-oxycontin-vmed-4p.widec

If you’ve read our Hellish Heroin story, you know how addictive Oxycontin can be for some people, especially when used recreationally, and not to treat severe pain. This article will talk about some of the unethical practices used to market that drug.

The story of oxycontin

In 1996, Purdue Pharma L.C. introduced Oxycontin to the drug market. Oxycontin is a sustained-release oxycodone preparation used in treating chronic pain. Purdue Pharma put together an aggressive marketing plan to promote the sale of the drug. In it’s first year, Purdue sold $48 million dollars of Oxycontin. By 2000, Purdue was making a staggering 1.1 billion dollars a year from Oxycontin.

The enormous commercial success of Oxycontin would not have been surprising if it had been a revolutionary drug. However, numerous studies have shown many other opioid medications to be just as safe and effective as Oxycontin. So how did Purdue get so many people to buy Oxycontin? Below are some of the tactics Purdue Pharma used to increase it’s sales:

  • From 1996-2001, Purdue put on more than 40 national pain-management and speaker-training conferences. More than 5000 physicians, nurses, and pharmacists attended these all-expenses-paid conferences where they were trained for Purdue’s national speaker bureau. Although many physicians deny it, research has shown that attending these types of conferences influences physician’s prescribing tendencies.
  • Purdue implemented a bonus system to encourage their sales representatives to increase sales of Oxycontin in their territory. In 2001 alone, Purdue paid approximately $40 million dollars in incentive bonuses.
  • Purdue used marketing data which allowed them to see nationwide statistics on physicians prescribing patterns. Purdue used this data to aim their marketing campaign at physicians with the highest rates of opioid prescription. While in theory this strategy targets physicians with the most chronic pain patients, it also ends up targeting physicians with loose standards for prescribing drugs.
  • Purdue gave out coupons for a free prescription good for one 7-30 day supply of Oxycontin. By the time the offer ended, 34,000 coupons had been claimed.
  • Purdue claimed that the risk of addiction to Oxycontin was less than one percent. Long term studies of opioid treatment for chronic pain patients have shown the risk of addiction to range widely, from 0% to 50%. In 2007, Purdue Frederick Company Inc (an affiliate of Purdue Pharma) and three company executives plead guilty to misbranding the risk of addiction for Oxycontin and will pay $646 million dollars in fines.

Together these strategies helped shoot Oxycontin sales through the roof. In 2001, Oxycontin became the most frequently prescribed opioid in the United States for treating moderate to severe pain.

Improper prescription marketing

The problem is not that Purdue made a lot of money. The problem is that in the process of making money, Purdue created a huge drug problem. Between 1997-1999, the state of Maine experienced a 460% increase of people treated for opioid abuse. In southwest Virginia, the number of deaths related to prescription opioids increased 830% from 23 deaths in 1997 to 215 deaths in 2003. In eastern Kentucky, there was a 500% percent increase in the number of patients entering methadone maintenance treatment programs. In each case, these increases were correlated with increases in Oxycontin availability in those regions.

Currently the FDA is in charge of ensuring that all prescription drug advertising is honest and truthfully communicated. Unfortunately, in it’s current state, this department of the FDA is understaffed and underfunded so the review of promotional materials is both slow and lax. Aggressive marketing strategies like those used by Purdue end up making prescription drugs easier to obtain and easier to abuse. Tougher FDA restrictions on acceptable marketing practices would make the pharmaceutical industry more like honest evidence-based medicine and less like a car sale.

Citation:
Zee, A.V. (2009) The promotion and marketing of OxyContin: Commercial triumo, public health tragedy. American Journal of Public Health. 99(2)