The Effect of ObamaCare on Treatment
The Affordable Care Act has gotten a lot of attention since it was first introduced, but how does it change options for treating substance abuse? The Fix offers some practical information.



Does it care for addicts? Shutterstock


By Marissa Rosado

04/21/14
Source The  FIX
The course of events that add up to a substance abuse problem are often complicated and traumatic. The acknowledgment of the problem and the decision to enter a treatment program can be more difficult. And yet the most challenging part of this process, for many, is life after rehab: addiction resolution and continued sobriety.

Rehab can be like a cocoon. But once treatment has ended and the addict returns to society without the structure and support of the facility, he or she often relapses. For recovering addicts, the maintenance of their sobriety is a challenge that dominates their life. Will addicts be able to find continuing care from programs covered by their health insurance plans? With the landscape of health insurance options changing rapidly within the last year, what exactly can recovering addicts count on?

Previous healthcare reforms for the treatment of substance abuse

Alcoholics Anonymous was founded in the US in 1935, but it took the American Medical Association until 1952 to define and acknowledge alcoholism. Case in point: we are used to a government that falls short and lags behind the issues regarding substance abuse.

After mental health insurance coverage was protected with the enactment of 1996’s Mental Health Parity Act, it took another 12 years to get it amended to include the Addiction Equity Act (its name in total, the MHPAEA). The act placed annual or lifetime dollar limits on the cost of treatment for recovering substance abuse addicts. This was a landmark move not only because it recognized the importance of supporting recovering addicts under current insurance plans, but also because it also prevented insurance companies from taking advantage of insured parties. Care for recovering addicts was guaranteed, and it looked like it wouldn’t cost an arm and a leg.

Thanks to this legislation, the cost of substance abuse treatment was no more than the coverage for medical/surgical treatments allotted for in health insurance plans. While this doesn’t necessarily mean the treatments are affordable (especially for many in recovery, money is tight), it does provide a safety net for those seeking help. Copays, coinsurance, and out-of-pocket maximums are the same for someone treating heroin addiction as they are for someone with persistent seasonal allergies.

However: the MHPAEA did not make treatment for substance abuse a mandatory point of coverage for insurance providers. It also did not require plans to offer copays or any financial help for specific treatment of substance abuse, such as rehab programs or addiction resolution. So here is this terrific landmark legislation with giant loopholes embedded in it. This left a gap that left many in recovery without help or care.

The Affordable Care Act

In 2010, President Obama signed the Affordable Care Act (“Obamacare” or “ACA”) into law. In late 2013 and continuing this year, the law has finally been put into practice. Millions (7.5 million, actually) of previously uninsured Americans now have health insurance. One of the tenets of the ACA is to increase the quality and affordability of health insurance. Another is to reduce the cost of healthcare for the government and insurable parties. So what does this mean for those seeking substance abuse treatment?

The good news

In a groundbreaking move, the ACA has declared the treatment of substance use disorders an essential health benefit. Where the MHPAEA fell short, the ACA is picking up the slack. Addiction recovery is now seen as a critical component to physical health. Now many more will have access to rehab programs. More in need of that treatment will receive it, which will decrease the number of abusers and, hopefully, the number of relapses.

The logic behind the ACA’s prioritization of treating substance abuse is simple dollars and cents: previously untreated addiction costs the tax payers billions of dollars accrued through privatized health care and law enforcement. Ideally, having addiction treatment covered will eventually save this country money and diminish the strain on law enforcement occupied with drug related crimes.

The methods of treating people with substance abuse under the ACA reflect a new approach. The law largely promotes the idea of preventative care. Previously, addicts were treated when they “hit bottom," when it was apparent to every outside perspective that the person needed help. Moving forward, the ACA will treat substance abuse the way it should be treated. This will include disease prevention. Think of all the campaigning to prevent obesity that’s sprung up in the last decade. Now think of that attention applied to preventing substance abuse. The ACA also promotes earlier intervention to prevent the addicted person from ever hitting bottom. The act also offers several treatment options when the insured party seeks care for their addiction.

An example of the advanced perspective of the ACA can be found in the way alcohol abuse is addressed. Screening and counseling for alcohol abuse is now considered preventative care, and under the ACA, preventative care must be fully covered. That means no deductible, co-pay or co-insurance for an insured party. People seeking care for alcohol abuse won’t be penalized or unnecessarily charged.

More good news: if someone has a history of substance abuse and is afraid of being disqualified from eligibility, there’s nothing to fear. Under the ACA, an applicant cannot be deemed ineligible for insurance based on a pre-existing condition. Under this law, substance abuse counts as a pre-existing condition; candidates cannot be rejected from the exchange based on previous drug abuse. Think of what this will mean to thousands battling drug and alcohol abuse: full health insurance, access to proper care, and a fresh start.

Are Online Pharmacies Fueling the Prescription Drug Abuse Epidemic?
The Ryan Haight Act of 2008 gave the DEA the power to prosecute and shut down illegal online pharmacies. So why are so many still in business?



Shutterstock


By Allison McCabe

04/23/14
Source The Fix

On the morning of February 12, 2001, Francine Haight found her 18 year old son, Ryan, lying lifeless in his bed. Francine, a nurse, tried to resuscitate her son but it was too late. Ryan was dead of a Vicodin overdose.

“I was in shock,” Francine recounts. “Just the night before, we had dinner together after he came home from work at a nearby retail store. He used my Jacuzzi tub because he said his back bothered him from lifting things at work. At midnight I had kissed him goodnight and he said ‘love you, Mom.’”

After asking Ryan’s friends about the drugs and finding out that he had purchased them on the Internet, Francine sent Ryan’s computer to the DEA. The DEA found that Ryan had purchased the Vicodin from an online pharmacy which had then delivered the drugs directly to the Haights’ home.

If you look in your spam folder, you will probably find an ad for an online pharmacy. The majority advertise Viagra and Cialis and maybe some cholesterol drugs; drugs that require prescriptions but are not controlled substances restricted by the federal government. If you dig deeper, however, you can very quickly find whatever you’re looking for.

I once tried to score on the Internet. Many years ago, mid-kick and desperate, I searched online classifieds, looking for hidden code or secret meanings in every post; I was sure I could find someone discreetly selling heroin or other strong opiates. Why wouldn’t a dealer exploit the new global access of the web? I followed a “Pain Relief, all kinds” to a trailer park in the valley. The woman who answered the door was disheveled and her place was stacked floor to ceiling with newspapers, electronics, clothing. “Do you have the money?” She asked. Turned out she didn’t have the dope, but if I gave her my money she would “make some calls.”

These days you no longer have to wait around for an unreliable dealer, forge prescriptions, doctor shop, or engage in some other hustle to score your dope. While the FBI goes after deep underground drug selling sites like Silk Road, illegal online pharmacies have sprung up on every virtual corner. All you have to do is visit a website, make your choices, give your credit card info, and you’re set with a month’s (or more) supply of Ambien, Xanax, Ritalin, or morphine.

Jennifer was addicted to Ambien. She was the kind of drug addict who would take a handful of pills, lose consciousness, and wake up on the sidewalk in the middle of the night half-dressed. Or she would walk into a favorite restaurant, sober, and find that she’d been 86’d because of some Ambien-induced behavior that she didn’t remember.

“I was getting them prescribed by three doctors with refills, but my tolerance was so high and my body needed them so I wouldn’t go into withdrawal.” Jennifer was constantly requesting early refills and she knew that her behavior was sending up red flags at the pharmacies, so last year she decided to try her luck online.

Jennifer did a search and clicked on the first online pharmacy that popped up. She placed her order and the pharmacy called her back to get her debit card info. There was no request for a prescription, no doctor’s consultation. It was as easy to order Ambien, a federally controlled schedule 4 drug, as it was to order aspirin. Jennifer’s problems getting early refills were over. “This pharmacy doesn’t care about when you order. If I ordered 200 pills on a Tuesday, I could order another 200 on that Friday. They didn’t care, they were all about the money.”

After Ryan’s death, Francine Haight found that there were hundreds of online pharmacies (as of 2013, more than 34,000) selling prescription drugs. These pharmacies were able to dispense federally controlled drugs because there was never any explicit law against it. Laws governing the distribution of controlled substances were written in the 1970s, when no one could have predicted that one day sales could be made over a computer network. Consequently the law included no explicit prohibition against online pharmacies prescribing and distributing controlled substances. If prosecutors wanted to convict, they had to rely on an implicit prohibition, and do some tricky maneuvering in order to prove that online pharmacists’ methods “fall outside the usual course of professional practice.” This argument was used successfully in Ryan Haight’s case, and the online pharmacist and associated doctor were sentenced to prison.

The Ryan Haight Act and the DEA

As a result of Ryan’s case, Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. The act went into effect in April of 2009 and states that “No controlled substance that is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act may be delivered, distributed, or dispensed by means of the Internet without a valid prescription.” “Valid” means that the person writing the prescription has had at least one in-person visit with the recipient of the prescription. Also, each online pharmacy is required to list, on its homepage, the name of the affiliated pharmacist, his or her licensing info, the full name and address and phone number of the pharmacy, and a certification that the pharmacy is licensed to deliver controlled substances through the Internet.

Shortly after the Ryan Haight Act was made law, the DEA announced that the online pharmacy problem was close to being solved. According to a senior DEA official, “The Ryan Haight Act has pretty much eliminated the online business in the United States [and] the DEA hasn’t found a large number of foreign sites selling controlled substances to the U.S." In 2010, the DEA’s pharmaceutical investigations chief said that “(t)he Internet is not as big of a problem as we all think it is…especially dealing with controlled substances.” He added that he thought that the illegal pharmacies that were still in business were probably selling fake and counterfeit drugs. He went on to claim that the lack of any prosecutions (there have since been a couple of successful prosecutions, but they are drops in an ocean of illegal online pharmacies) under the Ryan Haight Act was due to the law having a successful deterrent effect.

Is Social Media Dependence a Mental Health Issue?
Selfie addiction or the inability to stop fishing for likes on Facebook may seem ridiculous, but could they actually be the new addictions of the 21st century?



Shutterstock


By Emma Stein

04/24/14

With the recent traumatic news of Danny Bowman, the 19-year-old UK resident who attempted suicide after being obsessed with taking ‘selfies,’ the general public has vocalized strong opinions on both sides of the social media debate. It’s no question that we are developing a dependence on the technological advance that unifies billions of people, but are we addicted? The Fix spoke with four different leaders in the field to uncover the growing obsession with status updates, and what this means for our psychological well-being.

“In moderation, social media can be a great way for teens to connect to others, to relate to their peers, and to express themselves,” Dr. Karrie Lager, a child psychologist practicing in Los Angeles, says. “However, excessive internet use can have serious negative consequences,” she explains in response to a survey published by CASA Columbia. The survey explores the relationship between teenagers, social media use, and drug abuse. They found that 70% of teenagers age 12-17 spend time on a social media site in a typical day, which amounts to 17 million teenage users. Those that interact via social media on a daily basis are five times likelier to use tobacco, three times likelier to use alcohol, and twice as likely to use marijuana. 40% of these teens surveyed admit to having seen pictures of people under the influence, and are four times likelier to use marijuana than those who haven’t scrolled through these images. The data makes sense: those exposed to pictures of drugs and alcohol are more inclined to seek and experiment with it themselves.

Dr. Charles Sophy, a Los Angeles-based psychiatrist and Medical Director for the Los Angeles Department of Children and Family Services, explains that “no matter what genetics a teen may possess, they are impressionable and adding social media to the already prevalent peer pressure only ramps that pressure up further.” He has treated several young adults that are now confronting the aftermath of prolonged social media exposure.


There is a small minority of people addicted and the good thing is that they can be helped. For some, social media is addictive and can be absolutely lethal.

The danger, Dr. Lager says, is that constant exposure to pictures of teens under the influence glamorizes the use of alcohol and drugs. “Teens may become desensitized and believe that since everyone else is trying them, they should too.” In terms of whether social media addiction exists, she explains that researchers have found some behavioral similarities between excessive Internet use and substance abuse, “including tolerance, withdrawal, unsuccessful attempts to cut back, and impairment in functioning.” However, Dr. Lager clarifies that additional research needs to be done before defining “social media addiction” as a distinct diagnosis.

While many are quick to praise Facebook for transforming our social landscape by connecting millions of people, the conversation that examines whether our dependence on it is reaching destructive levels is a few steps behind. The University of Michigan addressed this issue in a study published in August of 2013 that observed the relationship between Facebook use and well-being. By texting study participants five times a day over two weeks about how they felt after using Facebook and how satisfied they were with their lives after the two-week period, their study found that Facebook negatively impacted them with each variable. The more people used Facebook “the worse they felt” and “the more their life satisfaction levels declined over time." If Facebook makes us feel worse, why can’t we stop ourselves from going back for more?

The reason we can’t keep our thumbs away from updating, liking, and hashtagging was explored in a study conducted by Harvard University’s Psychology Department that found that there is a biological reward that happens when people disclose information about themselves. “Self-disclosure was strongly associated with increased activation in brain regions that form the mesolimbic dopamine system, including the nucleus accumbens and ventral tegmental area,” the study reported. Rewards were magnified when participants knew that their thoughts would be communicated to another person. So why are we so enmeshed in the allure of social media? It’s because we’re programmed that way.

Our desire to disclose personal information about ourselves to others is ingrained in the human condition—it’s not just a product of social media. It’s so ingrained, in fact, that people would actually forgo money to talk about themselves instead of discussing other people or answering fact questions. While this may not be a phenomenon specific to social media, social media does supply the platform to self-disclose to the masses and receive immediate feedback. Dr. Adi Jaffe, who holds a Ph.D in Psychology and serves as the Director of Research, Education, and Innovation at Alternatives, an addiction treatment program, comments on the downside to this phenomenon. “The immediacy and reward associated with social media (especially through mobile avenues) can be thought of as a ‘quick hit’ and would be expected to result in a minority of users experiencing ‘addiction-like’ symptoms,” he says.

Meet Alex, a graduate of the Narconon Program who has been living a happy, healthy and sober life for over 3 years since graduating the Narconon Program.

 ”My name is Alex and I used to be a drug addict.  I was addicted to Opiates and Benzos for almost 10 years.  I was born and raised in West Palm Beach Florida.  I had a pretty normal childhood growing up and was a pretty happy kid.  Right before high school I started to run into certain things in life that I simply couldn’t handle or couldn’t figure out a solution to.  Around this time I was introduced to drugs and they became a great solution to those issues…so I thought.  I could be more social, more confident, work longer, be happier, and just feel “normal”.  All I was actually doing was making it harder and harder to function in life without using drugs.”

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"OUR STORIES HAVE POWER"   A free training for people in recovery from addiction, family members and supporters of recovery, designed to reduce stigma by learning the language of recovery!    Be an advocate for recovery!        Saturday, April 26, 2014 9:00 am - 1:00 pm Everyone welcome! This event is free of charge but you are encouraged to preregister for this training  by calling Karen at 215-788-3738, ext. 100   Location: Southern Bucks Recovery Community Center/PRO-ACT 1286 Veterans Highway, Suite D-6, Bristol, PA 19007    Presenter: Aaron Kucharski, NCADD-NJ Recovery Community Organizer   Join thousands of advocates who have taken this training across the country   This training is in cooperation with

    

	Friday, May 2: Celebration
	You're Invited to an   Overdose Prevention Act   Commemorative Celebration   Friday, May 2, 2014 7:00 pm to 10:00 pm  at the    Old York Country Club  228 Old York Road Chesterfield, NJ 08515    Hors d'oeuvres to be served *** Cash Bar will be available  RSVP TO PAUL RESSLER BY MONDAY, APRIL 28, 2014 press27148@aol.com or by phone at 609-581-0600 (office), 609-947-4296 (cell) _________________________________________ This event commemorates the first anniversary of the signing of this life-saving legislation, honoring those we have lost, and spending time in fellowship with others who  are committed to preventing needless overdose deaths in New Jersey.

Marijuana Edibles Linked to Two Deaths, Increased ER Visits in Colorado
By Join Together Staff | April 24, 2014 | 2 Comments | Filed in Community Related & Drugs

Health officials report legal marijuana edible products have been linked to two recent deaths and an increase in emergency room visits in Colorado, Fox News reports. Edibles include marijuana-laced baked goods, candies and beverages.

The effects of marijuana edibles begin more slowly than the smoked version of the drug, according to Dr. George Sam Wang of Children’s Hospital Colorado. Once the effects begin, they tend to last longer, he said. “One of the dangers that we’ve been seeing with adult recreational retail use is they’ll take the recommended dose, wait, feel no effects and then continue to stack doses. Then before they know it they have a pretty large amount in their system and then they get potentially pretty severe effects,” Dr. Wang noted.

A college student who had never tried marijuana before ate the recommended dose of one-sixth of a marijuana-laced cookie last month. He felt no effects, and then ate the whole cookie—six times the recommended dose. He later jumped off a hotel balcony and died, according to the article. The student’s autopsy report listed “marijuana intoxication” as a contributing factor in his death.

According to Colorado State Representative Jonathan Singer, about 40 percent of the marijuana industry consists of edible products. The products must be sold in child-proof packaging. Labels must state how much of marijuana’s psychoactive ingredient THC is in the product. Singer is co-sponsoring a bill that would require marijuana edibles to have a recognizable symbol on the product, so it can be easily identified even when it is out of the child-resistant packaging.

Childrens Hospital Colorado saw eight cases of marijuana intoxication in children last year. The hospital has seen eight more cases in just the first few months of 2014, according to Dr. Wang. Six of the children had to be admitted to critical care.

Three Teens Hospitalized After Taking LSD-Like Drug in Virginia
By Join Together Staff | April 24, 2014 | Leave a comment | Filed in Community Related, Drugs & Youth

Three teenage girls were hospitalized in Virginia last weekend after taking an LSD-like synthetic drug. The compound is known by names including 25i, N-Bomb or Smiles.

The girls ranged in age from 13 to 18, according to CBS News. Police say the drug first produces a feeling of euphoria, but then can cause disorientation, violent behavior and death.

People who take the drug experience a fast heart rate, said Police Lt. Tony Matos, Assistant Commander of the narcotics division in Fairfax County, Virginia. “It starts off with a lot of sweating, maybe even some nausea and vomiting. But ultimately, it will lead to very aggressive, violent behavior, and ultimately it will lead to death.”

In November, the Drug Enforcement Administration (DEA) made three synthetic N-Bomb compounds illegal for the next two years. The compounds were responsible for the deaths of at least 19 people in the United States between March 2012 and August 2013, the agency said.

The DEA made the synthetic compounds 25I-NBOMe, 25C-NBOMe, and 25B-NBOMe Schedule I, meaning they are illegal drugs under the Controlled Substances Act, for the next two years. These drugs are marketed online and through illegal channels as illicit hallucinogens such as LSD, according to a DEA news release. They are sold as powders, liquid solutions, soaked onto blotter paper, and laced on edible items.

The DEA warns synthetic drugs have no consistent manufacturing and packaging processes and may contain drastically differing dosage amounts, a mix of several drugs, and unknown adulterants. “Users are playing Russian roulette when they abuse them,” the agency states. During the two-year period when the compounds are illegal, the DEA will work with the Department of Health and Human Services to determine if they should be made permanently illegal.

April 24 v 5 TWELVE STEPPING WITH POWER IN THE PROVERB

A wise man is strong,Yes, a man of knowledge increases strength;

STEP 11 - Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God's will for us and the power to carry that out .

The more you read and the more time you spend with others in recovery the stronger you will become. I have seen many take a ride on the relapse roller coaster especially newcomers who get thirty days plus . They are feeling on top of the world and unstoppable . It is that cockiness that gets them all the time. It does not matter how much clean time you got , any one of us can take that ride the trick is stay humble and never ever forget where it is you came from and how hard it was for you to get where you are now .When going to meetings really listen too the stories and keep the good stuff you hear . Your first three hundred and sixty five days in recovery should be you listening and taking notes . We all want to help others but we must first get our minds right and our feet on solid ground . Step eleven is important because it teaches us dependence on God .When we depend on others they let us down and when we depend on ourselves we disappoint but when we depend on God He never disappoints or lets us down .

Psalms 37:5 Commit your way to the LORD, Trust also in Him, and He will do it.

By - Joseph Dickerson

Hello Recovery Registrant!

You previously helped the Addiction Recovery Research Center (ARRC) by registering for the International Quit & Recovery Registry (IQRR). We’ve recently redesigned our website, quitandrecovery.org, and we are now excited to announce its newest feature – the Recovery Research Rewards (RRR).

As a token of appreciation, members of quitandrecovery.org will receive 100 points upon completion of each assessment in the Gemstone Series. Members can then choose to redeem their points at any time for payment via Amazon Payments. In addition, every time you complete any 3 assessments, you will be awarded 100 bonus points. For now, the conversion rate will be 100 points = $1.00, but there may be other options in the future. Let’s look at an example:

RecoveryHeroSallySmith reads this email and wants to participate in future recovery research, but has not had a chance to visit the new IQRR website yet. She goes to quitandrecovery.org and clicks the ‘Register’ tab, which prompts her to enter the same email that she used when registering for the IQRR before. The system confirms that she has already completed the initial assessment, and it directs her to set up a user account on the website. Once logged-in, she clicks the ‘Research Assessments’ tab and chooses to take 3 of the available assessments, earning 400 Research Recovery Reward points right away! She decides she would like to cash-in now, so she goes to her profile page and clicks the “Redeem RRR Now” button, displayed next to her points. The points are deducted from her account and she receives an email from Amazon Payments during the next business day, informing her that she has received a $4.00 payment from the Addiction Recovery Research Center.

This is only the beginning! We hope that over time the Recovery Research Rewards (RRR) will evolve, giving our participants more options for point redemption, such as donation to charities or even purchase of official IQRR and Recovery Hero merchandise. We want people to get involved, we want people to be excited, and, most importantly, we want to make a positive impact for those around the world who are still fighting for freedom from their addictions.

You have already contributed to the IQRR by joining the registry, but there is so much more we would like to know about your recovery. Please join us! Visit quitandrecovery.org, create an account, and select any or all of the following assessments (about 10 minutes and 100 points each) to make a valuable contribution to recovery research and start earning virtual badges and Recovery Research Rewards (RRR):

Garnet Assessment: Complete two short decision-making tasks. One task asks you to rate yourself on a series of statements and another asks you to choose between two hypothetical monetary values.

Amethyst Assessment: Help scientists understand the recovery process by answering these questions about past drug use.

Aquamarine Assessment: Rate the harm and consequences of illicit, legal, and prescription drugs.

Diamond Assessment: Share personal experiences from your childhood and your beliefs about how much control an individual has over the events that occur in his or her life.

Thank you for joining the IQRR. We look forward to the opportunity to learn from your experiences.

Best Regards, 

The ARRC Research Team

Virginia Tech Carilion Research Institute

Please allow 2-3 business days for receipt of your payment from Amazon Payments. If you have any questions about the assessments or payment please contact admin@quitandrecovery.org .

This research is approved by the Virginia Tech Institutional Review Board. For questions or concerns directed toward the Institutional Review Board, please contact Dr. David M. Moore at (540) 231-4991 or moored@vt.edu

www.councilsepa.org Like us on FACEBOOK!                                              Follow us on TWITTER!  The Council is pleased to offer two options for our CERTIFIED RECOVERY SPECIALIST TRAINING  Option 1 Get the whole 54-credit course for $800.00! Option 2 Choose any combination of 3-credit courses  for $45 per course! CRS Training Dates:  Mondays and Wednesdays May 19, 21 and 28, 2014 June 2, 4, 9, 11, 16, 18 and 23, 2014  9:00 am - 4:00 pm     Training Location: Southern Bucks Recovery Community Center 1286 Veterans Highway, Suite D-4, Bristol, PA 19007 Option 1 The whole course The Council is proud to offer a convenient 54-credit training package that allows potential candidates for the CRS to obtain their required training credits in one place over a short period of time. The program is designed to meet the PCB's requirement for education in the domains of Recovery Management, Education & Advocacy, Professional Ethics and Responsibility, Confidentiality, and other Relevant Addiction Topics. To view the complete requirements to become a Certified Recovery Specialist, CLICK HERE. Get the whole 54-credit course for $800.00. This is less than $15 per credit hour! Includes complete manual and FREE test prep study session. CLICK HERE for registration and payment information. Exam Study Prep -- ONLY OFFERED TO THOSE TAKING FULL 54 CREDITS. This three-hour session provides a chance for participants in the full 54-credit course to take a practice CRS credentialing exam and offers study and test-taking tips and strategies. This session is led by Certified Recovery Specialists who have successfully passed the exam and are working in the field. CLICK HERE for course descriptions.
Option 2 Any combination of 3-credit courses If you don't need or want all 54 credits, or if you need to recertify a PCB credential, you can choose to attend one or more of our courses at $45 per 3-credit course. CLICK HERE for course dates, times, and credit hours. CLICK HERE to choose courses and pay by credit card CLICK HERE to choose courses and pay by check
Program Sponsorship and Accreditation: The Council of Southeast Pennsylvania, Inc., is a PCB-approved provider and affiliate of the National Council on Alcoholism and Drug Dependence, serving the southeast region of Pennsylvania. PCB Education Provider #031.

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We are grateful for your loyal readership of the Join Together news service as we celebrate our third anniversary. April 23, 2014     Dear Joseph, Thank you for your loyal readership of the Join Togethernews service. Over the past three years, we have made a commitment in providing free, high-quality addiction prevention and treatment information to you and your community. We are proud to bring you exclusive expert commentaries and original feature articles, right to your inbox. In case you missed any of our top news stories, I invite you to read some here: Experts: People Who Think They Are Taking "Molly" Don’t Know What They're Getting Commentary: Countering the Myths About Methadone FDA Approves New Opioid Addiction Treatment Combining Buprenorphine and Naloxone Study Finds Random Drug Testing Doesn't Deter High School Students' Substance Use Zohydro to be Manufactured by Same Company That Makes Addiction Medicine While it's a privilege to provide you with this free resource, we need your support to continue. Please make your tax-deductible donation to Join Together today. Your generous gift ensures that we can go on to deliver this valuable service that impacts your work, your life and your family. Any amount makes a difference. Please support us with a donation now. Thank you,

Independent Pharmacies Seek Greater Role in Fighting Prescription Drug Abuse

By Celia Vimont | April 23, 2014 | Leave a comment | Filed in Addiction,Community Related, Drugs, Prescription Drugs & Prevention

As the Drug Enforcement Administration (DEA) gears up for another National Prescription Drug Take-Back Day on April 26, the group representing independent pharmacists says its members are eager to help their communities get rid of unwanted or expired drugs year-round.

According to the National Community Pharmacists Association (NCPA), more than 200 tons of medications have been collected at more than 1,600 participating community pharmacies across the country since it created the voluntary Dispose My Meds program in 2009. Many of the medications being dropped off for safe disposal at community pharmacies come from excess mail-order prescriptions that are auto-shipped to patients, whether they want the medication or not.

“Our members are your mom-and-pop community drug store,” says Carolyn C. Ha, PharmD, NCPA’s Director of Professional Affairs and Long-Term Care. “More than half our members are from rural towns with populations of 20,000 or less. The pharmacists know their patients really well. The pharmacists are community leaders, they answer many healthcare questions and are committed to addressing prescription drug abuse.” Many people come into their local pharmacy asking what to do with their unused or expired medicines, often because they have teenagers and don’t want them poking around the medicine cabinet, or because they have grandchildren and don’t want them at risk of accidental poisoning.

People in small towns also want a safe place to dispose of medications, because of concerns they could end up in the water supply if they flushed them down the toilet, Ha noted.

Current DEA regulations do not allow pharmacies to accept unwanted or expired controlled substances including prescription opioid painkillers such as oxycodone or hydrocodone, stimulants such as Adderall or Ritalin, or benzodiazepines like Valium or Xanax. The agency is working to change those rules, and the NCPA supports those changes, according to Ha.

The DEA has proposed new regulations to give the public more options for disposing of unwanted prescription drugs, such as painkillers and sedatives. The new rules are designed to reduce the amount of highly-abused prescription drugs on the streets. The DEA proposes that law enforcement agencies and pharmacies serve as collection boxes for certain medications. The agency also recommends implementing mail-back programs to safely dispose of the drugs.

Under the proposed rules, for the first time, groups outside of law enforcement would be allowed to collect unused drugs for disposal. The proposal would also allow authorized retail pharmacies to voluntarily maintain collection boxes at long-term care facilities. The DEA also calls for continued use of prescription drug “take-back” events. No date has been set for the new regulations to be finalized.

“Pharmacies are a good place for people to drop off medications, because it gives people an opportunity to ask pharmacists questions, and some people may not be comfortable dropping them off at a police station,” Ha says.

If pharmacies are allowed to collect controlled medications such as opioids, the DEA rules will give specific guidance about security measures that need to be in place, to ensure the medications are not diverted. “Pharmacies are held to extremely tight regulatory controls regarding dispensing medications, so we think it’s a natural fit that we should be able to take them back as well,” observed Ha.

Many of the medications community pharmacies collect are the remains of 90-day supplies ordered from insurance companies. Some are expensive specialty drugs, such as inhalation solutions used in nebulizers by people with respiratory conditions, or diabetes drugs and supplies such as test strips and lancets used to test blood sugar levels. “Often, it’s cheaper for patients to order a 90-day supply, even if they don’t need it,” Ha says. The group has documented many cases in which patients or their families have brought in thousands of dollars of mail-order medication.

Some community pharmacies are barred from taking back any medications because of state or local regulations. Those pharmacies that do collect medications generally do so at no cost.

To find the community pharmacy nearest you that collects medications, visit www.disposemymeds.org, and click on the “Pharmacy Locator” tab on the top right side of the page.

Photo credit: National Community Pharmacists Association

FDA Panel Votes to Recommend Against Approving Morphine-Oxycodone Opioid

By Join Together Staff | April 23, 2014 | Leave a comment | Filed inGovernment & Prescription Drugs

An advisory panel of the Food and Drug Administration (FDA) voted Tuesday against approving a combination morphine-oxycodone painkiller, NPR reports. The drug, Moxduo, would be the first medication to combine both opioids in one capsule.

Moxduo’s manufacturer, QRxPharma, says the drug is intended to provide faster relief from moderate to severe pain, with fewer side effects than currently available opioids.

The vote against recommending approval of the drug was unanimous. The panel also voted unanimously that QRxPharma had not proved the drug is less likely to cause potentially life-threatening respiratory suppression, compared with taking oxycodone or morphine alone.

“I certainly wish that there was an opiate that could be counted on to decrease respiratory depression, and maybe one day there will be,” said panel member Gregory Terman of the University of Washington.

The panel questioned whether Moxduo offers any advantages over using oxycodone or morphine alone, the article notes. Panel members disagreed on whether studies conducted by the company showed Moxduo provides better pain relief, fewer side effects or lower risks of potentially fatal complications. Some experts said they were concerned the drug could be more easily abused than opioids such as Vicodin or Percocet.

The FDA is not required to follow its panels’ recommendations, but generally does so.

In a statement, QRxPharma Managing Director and Chief Executive Officer John Holaday said, “We are obviously disappointed in the outcome of today’s meeting, but remain confident in the advantages of Moxduo compared to morphine and oxycodone. This is a necessary therapy for patients with moderate to severe acute pain. We are committed to bringing to market safer therapies for pain, such as Moxduo, and preventing opioid abuse.”

Insurers Should Use Prescription Monitoring Databases to Reduce Overdoses: Report

By Join Together Staff | April 23, 2014 | 1 Comment | Filed in Healthcare,Insurance, Prescription Drugs & Prevention

Health insurers should use state prescription monitoring databases to reduce overdoses from abuse of opioids and other prescription drugs, according to a new report.

Sharing data between prescription monitoring databases and insurers would allow the companies to better detect inappropriate prescribing and dispensing, according to the report by the Prescription Drug Monitoring Program (PDMP) Center of Excellence at Brandeis University.

Most health insurance programs, including Medicare, Medicaid and workers’ compensation programs, only see data about prescriptions for which their particular plans have paid, MedicalXpress reports. PDMPs provide a patient’s complete outpatient prescription history for controlled substances. Allowing insurers to see all of their enrollees’ activity, including prescriptions paid for by other insurers, would allow them to spot patients who are “doctor shopping,” or who are acting in collusion with a street dealer, the report noted.

“At a time when the misuse and abuse of prescription opioids has reached epidemic levels, it’s important that third party payers be able to use states’ prescription monitoring data to make sure these drugs are prescribed appropriately,” Peter Kreiner, Principal Investigator of the Prescription Drug Monitoring Program Center of Excellence, said in a news release.

“Opioid abuse is the most urgent issue in workers’ compensation,” said Bruce Wood, Director of Workers’ Compensation with the American Insurance Association. “Giving workers’ compensation payers access to PDMP information would permit them to see if an injured worker is getting opioids from multiple sources.”

The report is the result of a meeting of more than 75 medical insurers, federal agency leaders and state PDMP administrators. It was discussed this week at the National Rx Drug Abuse Summit in Atlanta.

Those in Recovery Should Speak Out, Give Hope to Others: Drug Policy Official

By Join Together Staff | April 23, 2014 | 1 Comment | Filed in Addiction &Recovery

People in recovery from substance abuse should speak out and give hope to others in similar situations, according to the Acting Director of the Office of National Drug Control Policy.

Michael Botticelli, speaking at a forum in New Haven, noted 23 million Americans are recovery. Only about one in nine people with a substance use disorder receive treatment, he said. Botticelli said stigma and denial about substance abuse are obstacles to treatment, the Associated Press reports.

Botticelli is in long-term recovery from addiction, celebrating more than 24 years of sobriety.

“We know that one of the biggest reasons people don’t ask for help is shame and denial,” he said. “We need to break that silence. We’ve done it with other diseases and we can do it with substance use and we can do it with recovery.”

Music Festival Organizers Plan Greater Security to Prevent Drug-Related Deaths

By Join Together Staff | April 23, 2014 | Leave a comment | Filed in Community Related, Drugs & Prevention

Organizers of the Electric Zoo music festival say they are planning tighter security this year, after two drug-related deaths occurred at last summer’s event.

The three-day festival, held in New York City over Labor Day weekend, will include drug-sniffing dogs, extensive pat-downs, and undercover officers who have a background in narcotics investigations, The Wall Street Journal reports.

Last year, New York Mayor Michael Bloomberg canceled the last day of the festival after the deaths occurred.

The festival’s promoters, Mike Bindra and Laura DePalma, said they plan to hold the festival at the same location. They note they have not yet received a site permit from the Department of Parks and Recreation, but added that usually happens later in the year.

If the festival takes place, fans will be required to view an anti-drug public service announcement online in order for their festival wristbands to activate. The event will start later in the day, to reduce exposure to the sun. In addition, the organizers will scrutinize vendors more closely. The festival may place “amnesty bins” at the gates, so fans can drop off illicit substances before they are searched. These bins are used at music festivals in Europe. They were also used last year at a music festival outside Atlanta called TomorrowWorld, which attracted 50,000 fans.

“We don’t want to be finger-wagging,” Mr. Bindra said. “‘Just say no to drugs,’ we can all agree, has been ineffective in the past.”

Last year’s Electric Zoo festival included safety measures such as on-site emergency treatment centers, free bottled water, and periodic safety announcements. After the event, the promoters brought together an advisory board of doctors, security consultants and DJs to prevent future drug-related deaths.