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ATOD & Advocacy Update - Week Ending August 2, 2013

Drop in U.S. Cocaine Use Due to Waning Popularity, New Colombian Drug Strategies
The dramatic decrease in cocaine use in America is due to a number of factors, ranging from changing trends to new drug control strategies implemented by Colombia, according to NPR. The 2011 National Survey on Drug Use and Health found the number of Americans ages 12 or older who are current users of cocaine has dropped by 44 percent since 2006. One reason cocaine’s popularity has declined is it simply went out of fashion, according to Peter Reuter, a professor of Public Policy at the University of Maryland, who researches drug problems. “The drug went out of vogue a long time ago,” he told NPR. “Lots of people experiment with it, but very few of the people that experiment with it in the last 20 years have gone on to become regular users of it.” Colombia, a major cocaine producer, implemented new strategies to reduce cocaine production after 2008. In 2000, the country grew 74 percent of the world’s coca leaves. Colombia spent billions of dollars to fight drug cartels and coca crops. Starting in 2008, the country’s new defense minister, Juan Manuel Santos Calderon, began emphasizing drug seizures, and targeting facilities that manufactured cocaine. The supply of cocaine dropped, the price of the drug in the United States rose, and consumption likely decreased as a result, says Daniel Mejia, Director of the Research Center on Drugs and Security at the Universidad de los Andes in Bogota. Earlier this month, the U.S. Office of National Drug Control Policy (ONDCP) announced there has been a 41 percent decrease in worldwide cocaine production since 2001, and a 10 percent drop from the previous year. ONDCP says a U.S.-Columbian partnership has contributed to the drop in worldwide cocaine production. Interceptions by the Coast Guard and Defense Department along drug trafficking routes have also led to a decrease in the amount of cocaine entering the United States.

Treatment for Alcohol Abuse Drops in Pregnant Women, While Drug Treatment Rises

The percentage of pregnant women in substance abuse treatment programs who were being treated for alcohol abuse decreased between 2000 and 2010, according to a new government report. During the same decade, the percentage of pregnant women in these programs being treated for drug abuse rose. Overall, the proportion of women of childbearing age who were pregnant when they entered substance abuse treatment remained relatively stable during the decade, at between 4 and 5 percent, Newswise reports. The percentage of pregnant women who reported alcohol abuse, with or without drug use, dropped from 46.6 percent in 2000, to 34.8 percent in 2010. The percentage of pregnant women reporting drug abuse, but not alcohol abuse, rose from 51.1 percent in 2000, to 63.8 percent in 2010. The findings come from the Substance Abuse and Mental Health Services Administration (SAMHSA). “Any kind of substance use by pregnant women can result in miscarriage, premature birth or a variety of behavioral and cognitive problems in the children they carry,” SAMHSA Administrator Pamela S. Hyde said in a news release. “Pregnant women must have access to prevention, support, and recovery services that meet their specialized needs. These include community programs for both pregnant and postpartum women that can help ensure their full recovery and better lives for them and their children.” A recent study by Australian researchers found most women who drink before becoming pregnant continue consuming alcohol throughout their pregnancy.

A Pill Popping Society
In Aldous Huxley's Brave New World, the populace finds chemical solace in Soma, a daily pill taking ritual that makes existence tolerable. Life unfortunately often follows art. The US may soon realize Huxley's dystopic vision. Already, 20% of the US population regularly pops a psychiatric pill and many pop a whole bunch of them. All demographics are affected- from barely walking toddlers to the geriatric in nursing homes. Although women heavily predominate, men are also well represented. The US leads the world in pill popping, but other developed countries are catching up. The most obvious casualties of excessive medication use are those who die from it. We are in the paradoxical position of having more overdose deaths come from prescription drugs than from street drugs. But the costs go much further. The inappropriate medicalization of individual differences obscures social problems that would be better addressed directly. Vast sums of money are wasted on expensive ADHD drugs that would better be invested in smaller class sizes and more physical education. There would be less PTSD among vets if they got fewer meds and more job retraining, job placement, and other transitional services. Similarly, less mental disorder disability would be needed if there were better work opportunities for the unemployed. Click here to continue reading.

Marijuana Most Commonly Detected Drug Among Male Arrestees Tested by ADAM II in Five U.S. Sites
The Arrestee Drug Abuse Monitoring II (ADAM II) program monitors arrestee drug use through interviews and urinalysis from a sample of arrestees at booking facilities in five U.S. sites. Marijuana continues to be the most commonly detected drug among U.S. male arrestees; the percentage of arrestees testing positive for marijuana ranged from 37% to 58% across the five sites in 2012. While cocaine was the second most commonly detected drug in four of the five sites, cocaine positives have declined significantly among arrestees in all sites over the last ten years. Opiate positives (primarily for heroin) have increased since 2000 in Denver and Sacramento but declined significantly in New York and Chicago over the same period. While not nationally representative, this type of data is important because the arrestee population is often not well represented in other drug monitoring systems or surveys. In addition, ADAM II data highlight regional variations in drug use. For example, methamphetamine was the second most commonly detected drug in Sacramento with 40% testing positive, compared to 13% in Denver and less than one percent in the three other sites. Unfortunately, the ADAM II program is scheduled to end this year.
SOURCE:  Adapted by CESAR from Office of National Drug Control Policy, ADAM II 2012 Annual Report, 2013

Moods and booze: Alcohol's effects differ in men and women
Gender may influence which emotions drive heavy drinkers to drink, and how they feel the next day, according to new research. But the study also showed that neither men nor women who drink heavily effectively drown their sorrows with alcohol. "Some people say they want to use alcohol to improve their mood, and that's not what we found happening," said Valerie S. Harder, lead author of the study, published in June in the journal Alcohol and Alcoholism. For men, anger drove drinking. According to Harder's findings, a man who felt angry was more likely to drink the next day than a man who didn't feel as angry. Happiness and sadness were the other two emotions recorded in the study, and the researchers found that neither had particular sway as a trigger for drinking in one gender over the other. Then, the researchers looked at how drinking affected participants' moods. Harder and her colleagues guessed that people would report less anger or sadness after drinking, and more happiness a day after drinking. But the data showed the opposite. Continue reading here.

Mobile apps could influence drinking culture
Twenty-first birthdays are cause for celebrations, in part because of the right — and responsibility — with which they are associated: permission to legally drink alcohol. Seventy percent of college students, including those younger and older than the coveted milestone, report consuming alcohol monthly. “Alcohol consumption peaks around the age of 20 or 21,” says Kenneth Anderson, executive director of Harm Reduction for Alcohol (HAMS), a program that primarily deals with post-graduate adults. Yet substance dependence subsequently drops because of a natural maturity process.Rest of this story is here.

Can You Guess Where In The World People Are Binge Drinking The Most?
A country's binge drinking rate reveals a great deal about the surrounding culture. Comparing patterns of alcohol consumption between the United States and the majority of European countries, for example, reveals an interesting trend. In the U.S., the nation with one of the highest binge drinking rates worldwide, people tend to abuse alcohol. In Europe, by contrast, more people enjoy drinking alcohol without binge drinking because leisurely drinking is an important part of social interaction. Continue here.

What makes recovery difficult for the criminal justice population?
Seth Ferranti has been in recovery for 10 years and is nearing the end of a 25-year prison sentence.  He writes articles about addiction and incarceration for The Fix, a popular online news source about addiction and recovery. Ferranti’s stories are compelling (and sometimes shocking) because he’s an insider. He has seen how many inmates struggle with substance use disorders (SUDs) and how SUD treatment works or doesn’t work in the criminal justice (CJ) system.  By publishing books and articles as an incarcerated person, he shines a light on certain realities: that drugs flow abundantly in prison and inmates have devised ingenious ways to smuggle, make and trade substances and equipment. Please click here to continue.

“Glee” Star’s Death Highlights Increased Use of Heroin
The death of “Glee” star Cory Monteith from an overdose that involved heroin highlights the growing use of the drug, ABC News reports. The suburbs are being especially hard hit by heroin use, according to law enforcement officials. Lieutenant Thomas Dombroski of the Bergen County, New Jersey, Prosecutor’s Office, told ABC News that of the 28 heroin overdoses in his county last year, most victims were younger than 22. He said in many cases, young people switch to heroin after becoming addicted to prescription painkillers. He noted heroin, at $4 a bag, is much less expensive than oxycodone, which sells for $30 for one 30-milligram pill. Dombroski says that like Monteith, many heroin overdose victims have recently come back from rehab. “They get high for the first time since rehab and that high is what kills them,” he noted. According to the 2011 National Survey on Drug Use and Health, the number of people who were past-year heroin users in 2011 (620,000) was higher than the number in 2007 (373,000).

Patients Seeking Medical Marijuana Recommendations from Doctors Have Long Wait
People seeking a doctor who will write a recommendation for medical marijuana often have a long wait. MarketWatch reports in Massachusetts, many patients have been waiting since the state’s medical marijuana law took effect in January. The waiting list there is about 3,000 people long. In New Hampshire, which last week became the 19th state to legalize medical marijuana, the waiting list for an appointment on the booking site has 650 patients, even though doctors there will not be able to write recommendations for marijuana for another year. In Illinois, where Governor Pat Quinn will sign the state’s medical marijuana bill today, 1,800 patients are on the waiting list for an appointment. The long waits are largely due to the relatively small number of doctors who write recommendations for marijuana, the article notes. In Massachusetts, there are only seven doctors listed on A few more will write recommendations but don’t publicize their services, according to John Nicolazzo, COO of The Medical Cannabis Network, the parent company of the booking site. Because marijuana is still illegal under federal law, doctors cannot write a prescription for marijuana, but they can recommend it, or certify that a patient would benefit from using the drug. Patients take the recommendation to a dispensary to purchase the marijuana. Many doctors are unwilling to write such recommendations. “We feel that marijuana is an untested treatment,” Travis Harker, a family medicine physician and President of the New Hampshire Medical Society, told MarketWatch. “This is uncharted territory, it’s still not a legal drug under federal law, so I think a lot of physicians will be rightly cautious about recommending this.” For those doctors who do recommend marijuana, many find it is profitable. Patients pay $150 to $300 for each marijuana recommendation; insurance will not cover the appointment or the drug.

Post Office mulls booze deliveries to raise cash
Special delivery from the post office — beer, wine and spirits, if Postmaster General Patrick Donahoe has his way.  In an interview with The Associated Press, Donahoe said Thursday delivery of alcoholic beverages is on his wish list as the agency considers ways to raise revenue and save money after losing $16 billion last year. He also said he endorses ending most door-to-door and Saturday mail deliveries as a way to help stabilize the service's finances. Continue reading here.

More Women Could Receive Addiction Treatment Under Health Reform
The number of women receiving treatment for substance use disorders could rise under changes that will be implemented as part of health care reform, according to an expert at UCLA. Christine Grella, PhD, Professor-in-Residence in the Department of Psychiatry & Biobehavioral Sciences at UCLA Integrated Substance Abuse Programs, says some aspects of the Affordable Care Act are likely to make it easier for women to access care. Dr. Grella noted that men are about twice as likely as women to report having a substance use disorder. A higher proportion of men – 30.5 percent – with current substance dependence seek some kind of help, compared with 24 percent of women. Women are likely to cite lack of insurance, as well as social stigma, as barriers to addiction treatment, Dr. Grella said. While men cite these barriers too, they are disproportionately influential in women. Women who seek substance use disorder treatment tend to have a more severe clinical profile, including more co-occurring disorders such as anxiety, depression and trauma. They also tend to have multiple problems such as lack of childcare and employment. But while women are less likely to seek addiction treatment, they are more likely than men to seek health services in general, Dr. Grella noted. They are also more likely to use mental health services.

Ethical Issues Surround Rise in Doctors’ Use of Urine Drug Testing to Prevent Abuse
As a growing number of doctors use urine drug tests in an effort to detect prescription drug abuse in their patients, they face ethical questions about the tests, according to The New York Times. These questions include how accurate the tests are, what doctors should do with the results, and whether doctors are benefitting financially from the tests. This year, sales at diagnostic testing labs that offer urine drug tests are expected to reach $2 billion. Urine tests indicate many pain patients are not taking their prescribed painkillers, or are taking substances not prescribed to them by a doctor. If patients are not taking a prescribed medication, it could mean they simply stopped using it, or it could mean they are selling it. There are two basic types of urine drug tests. A patient taking a qualitative test leaves a urine sample in a cup that is imbedded with strips designed to detect drugs such as opioids, cocaine, amphetamines and barbiturates. These tests have both high false-positive and false-negative rates, meaning they often indicate a drug is present when it is not, or they fail to detect a drug that is present in a person’s urine. The tests detect methadone but not oxycodone, the article notes. Qualitative tests are being used in states that have passed laws requiring welfare recipients to undergo drug screening. A more sophisticated and expensive urine drug test used in pain patients is called quantitative analysis. A patient can beat the test by taking their prescription medicine for a day or two, and selling the rest.

Why America’s Addiction Treatment System Is Broken & What You Can Do
We know a lot about addiction. We know that addiction is a complex brain disease – not a weakness or lack of willpower. We know its risk factors include “genetic predisposition, structural and functional brain vulnerabilities, psychological factors and environmental influences,” according to a groundbreaking 2012 report from the National Center on Addiction and Substance Abuse at Columbia University. We know that the age a person starts using addictive substances can strongly predict risk. Research has found that in 96.5 percent of cases, people began using substances before 21 years old – when the brain is still developing and especially vulnerable. Continue reading here.

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