Saturday, February 9, 2013
Fewer Teens Receiving Substance Abuse Prevention Messages From Media
The percentage of teenagers who receive substanced abuse
prevention messages from the media in the past year dropped from 83.2
percent in 2002, to 75.1 percent in 2011, according to a new government report.
Teens also received fewer school-based prevention messages, the
Substance Abuse and Mental Health Services Administration (SAMHSA)
found. Such messages reached 78.8 percent of teens in 2002, and 74.5
percent in 2011. An estimated 40 percent of teens did not talk with
their parents in the past year about the dangers of substance abuse, Newswise reports.
A recent SAMHSA report
found teen attitudes about the risk of substances such as alcohol and
marijuana have changed in recent years. From 2002 to 2011, the
percentage of teens who perceived great risk from heavy drinking
increased from 38.2 percent to 40.7 percent. During that same time,
there was a drop in binge drinking among teens, from 10.7 percent to 7.4
percent.
The report found the percentage of teens who perceived great risk
from marijuana use once or twice a week dropped, from 54.6 percent in
2007, to 44.8 percent in 2011. Teens’ rate of past-month marijuana use
increased during that time, from 6.7 percent to 7.9 percent.
“To prevent substance abuse among our adolescents, our young people
have to know the facts about the real risks of substance abuse, and
we’re not doing a very good job of that right now,” SAMHSA Administrator
Pamela S. Hyde said in a news release.
“It is time for all of us – the public health community, parents,
teachers, caregivers, and peers – to double our efforts in educating our
youth about substance use and engaging them in meaningful conversations
about these issues, so that they can make safe and healthy decisions
when offered alcohol or drugs.”
Relatives of Painkiller Overdose Patients Speak at FDA Hearing
Relatives of patients who overdosed on painkillers told
federal regulators Thursday they want changes on the labels of narcotic
painkillers, The Wall Street Journal reports. Pain patients concerned such action could limit their access to the medications spoke against the proposed changes.
They spoke at a Food and Drug Administration (FDA) hearing on the use of opioids
in the treatment of chronic pain. The FDA said it wants to gather
scientific evidence on issues including diagnosis and understanding of
patient pain, understanding and adhering to the labels of pain-treating
products, limiting opioid prescriptions and use, and abuse and misuse of
opioid medicines.
The FDA is considering a petition by Physicians for Responsible
Opioid Prescribing, a group of doctors and pain specialists, to include a
recommended upper daily dose on the medications’ label, and to limit
opioid treatment to 90 days, the article notes. The doctors’ group is
also recommending that opioids be indicated for severe pain, not
moderate pain, except in cancer patients.
Last month, a FDA advisory panel voted to strengthen restrictions
on hydrocodone combination drugs, such as Vicodin. The panel
recommended the FDA make the drugs more difficult to prescribe. If the
FDA accepts the panel’s recommendation, it will be sent to the
Department of Health and Human Services, which will make the final
decision.
Illegal Street Sales of Take-Home Doses of Methadone on the Rise
Illegal street sales of take-home doses of liquid
methadone, prescribed to treat opioid addiction, are on the rise,
according to law enforcement officials in Indiana, Kentucky, Virginia
and West Virginia.
The diverted methadone has been tracked to clinics operated by CRC
Health Corp., the article notes. CRC, owned by Bain Capital Partners, is
the largest U.S. provider of methadone treatment, according to
Bloomberg. Last year it operated 57 clinics in 15 states, Bloomberg reports.
Former employees say the company’s clinics are chronically
understaffed, which makes it easier for take-home methadone to be
abused. Former counselors say their heavy workload did not allow them to
adequately counsel patients.
The clinics provide take-home packages, some with just one dose, and
others containing as many as 30 doses. Police and prosecutors say in the
small towns where the company has clinics, methadone has surfaced in
criminal cases.
CRC Chief Executive Officer R. Andrew Eckert said take-home dosing
can help keep patients on methadone, and off illegal drugs, by not
making them come to the clinic every day for treatment. “Our mission is
to help these individuals, but sadly, we cannot report 100 percent
success,” he said. “No treatment provider can.”
Philip Herschman, Chief Clinical Officer of CRC, told Bloomberg the
company follows specific and rigid state and federal rules when it
decides which patients may obtain take-home doses. The company conducts
spot-checks, in which it calls back patients to clinics, to account for
their take-home bottles, he said. If a patient tests positive for any
illicit substances, take-home doses are suspended immediately, he added.
State regulatory records show this is not always true. The records
also indicate CRC’s clinics have not met staffing standards on more than
50 occasions.
Commentary: Hazelden Responds to America’s Opioid Epidemic
Too many people are hooked. Too many are dying. The problem is too big to ignore.
Over the past decade, America has experienced a rampant rise in the
number of people addicted to prescription painkillers, heroin and other
opioids. We truly face an epidemic.
According to the Centers for Disease Control (CDC), the death toll
from prescription painkillers has increased from 3,000 overdose deaths
in 1999 to 15,500 in 2009. The CDC also reported almost 500,000
opioid-related emergency room visits in 2009, and found that about 12
million Americans reported nonmedical use of prescription opioids in
2010.
At Hazelden, we are on the front line of this crisis, which is
hitting youth particularly hard. At our youth facility in Plymouth,
Minn., opioid addiction increased from 15 percent of patients in 2001 to
41 percent in 2011.
The problem deserves a vigorous response. That’s why Hazelden has
introduced a new treatment protocol specifically for opioid-dependent
patients.
The new protocol builds on our traditional care in two ways: by
weaving the specific features and challenges of opioid addiction into
all aspects of treatment, and by incorporating certain medications. We
now assess opioid-dependent patients to determine the need for
medication assistance. Some patients get none, particularly those who
refuse it or whose addiction is less severe. Some receive
buprenorphine/naloxone. Others utilize extended-release naltrexone. In
all cases, medication is adjunct to, and never a substitute for, our
usual evidence-based approach, which includes: psychological and
psychiatric care; Twelve Step-based individual and group therapy;
lectures; and a focus on peer, family and recovery community support for
additional structure and accountability. All of those care components,
in turn, now have an opioid emphasis. For example, we provide
opioid-specific groups, lectures and individual therapy to our
opioid-dependent patients.
Buprenorphine — an opioid itself — is a partial agonist, meaning its
effect is significantly less than the full agonists to which so many are
addicted, such as morphine, Vicodin® and heroin. It’s a safe and proven
means of helping people recover from their opioid of choice on the way
to complete abstinence. Taken daily, buprenorphine inhibits craving,
improves treatment retention, reduces relapse and improves support group
attendance. Naltrexone, our other available medication, is an opioid
antagonist. Injected once a month, it blocks the brain’s opioid
receptors, eliminating the ability for opioids to produce intoxication
or reward.
The adjunctive medication assistance helps address this population’s
hypersensitivity to physical and psychic pain, which puts them at higher
risk of leaving treatment early, relapsing and accidentally overdosing.
While abstinence remains the ultimate goal, medication helps to ensure
patients stay in treatment long enough to acquire new information,
establish new relationships and become solidly involved in recovery.
Research shows medication-assisted treatment is both effective and
safe. As such, it has been endorsed by health regulators and policy
advocates throughout America. In our view, medication taken to treat the
disease of addiction is not unlike pain medication given to
post-surgery patients: if used as directed, under the care of a
physician and not as a means of intoxication, it greatly assists in
recovery.
One of Hazelden’s values is to “remain open to innovation.” Another
is to “continue a commitment to Twelve Step fellowship.” This new
program reflects those values and, as a response to the opioid epidemic,
offers additional hope, healing and health to those who need it.
Marvin D. Seppala, MD
Marvin D. Seppala, MD, is Chief Medical Officer at Hazelden,
and an adjunct Assistant Professor at the Hazelden Graduate School of
Addiction Studies. His responsibilities include overseeing all
interdisciplinary clinical practices at Hazelden, maintaining and
improving standards, and supporting growth strategies for Hazelden’s
residential and nonresidential addiction treatment programs. Dr. Seppala
obtained his M.D. at Mayo Medical School in Rochester, Minnesota, and
served his residency in psychiatry and a fellowship in addiction at
University of Minnesota Hospitals in Minneapolis. He is author of Clinician’s Guide to the Twelve Step Principles, and Prescription Painkillers: History, Pharmacology and Treatment, and a co-author of When Painkillers Become Dangerous, and Pain-Free Living for Drug-Free People.
Friday, February 8, 2013
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