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Saturday, May 3, 2014
The Ramblings of a Palcoholic
Recent news on Palcohol—booze in a powdered form—gets those alcoholic wheels turning, no matter how long you've been sober.
Shutterstock
By Jodi Sh. Doff
04/28/14
SOURCE THE FIX
In case there were any doubts in my mind as to whether or not, after almost 24 years away from the booze cruise that was my life, I’m still really an alcoholic—well the advent and near legal actuality of Palchol is my defining moment. Everyone says it’s a stupid idea and everyone is probably correct, but stupid ideas were my calling card for 20 years before I got sober, and more years than I’d like to remember after. And this is a stupid idea I cannot stop thinking about.
It’s a headline making miracle of the highest sort. Jesus turned water into wine? Not such a big a deal anymore. Mark Phillips, the genius behind Palcohol, has gone one better, and figured out how to turn water into vodka. And rum. He’s one-upped Jesus with a powdered and portable Mojito. And that’s saying something.
Despite the fact that the Alcohol and Tobacco Tax and Trade Bureau (TTB) has—for the moment at least—revoked the label license, Palcohol is out there and everyone has an opinion. Doctors. Educators. I’m sure booze manufacturers from Smirnoff to Schlitz have opinions as well. I’m sure the airlines and concert venues are already trying to figure out how to handle this stuff once the paperwork finally goes through. And idiots of every order have commented on articles of every standpoint. It’s good. It’s bad. It’s fun. But has anyone asked a real alcoholic? Has anyone taken the pulse of the You-wouldn’t believe-the-things-I’ve-done-to-get-stoned-community of addicts?
Well, here I am, to fill in those gaps.
Finding new ways to get various kinds of mood-altering substances and liquids into your body is nothing new. A Texas man died after ingesting 1.5 liters of sherry in what frat boys call butt chugging, and the rest of the world knows affectionately as an enema. I’d have been surprised when I read that if I hadn’t remembered being advised in the 80s by a lawyer to shove Tuinals up my ass for the quickest result because the blood vessels are so close to the surface the drugs get into your system lickety-split, no pesky waiting for digestion and metabolizing. He also pointed out that I was wasting my cocaine by snorting it, that the smart money would bend over and let someone blow it up my butt with a straw. I should mention he was a disbarred lawyer, although not for anything having to do with drugs, just the mob. So nothing directly related to drugs. Oh, nevermind. Amazing, considering how little I remember of the 80s at all, that this stuck in my head. This is what is known as an “alcoholic obsession of the mind.”
Real 100% dyed in the wool, down to your bones alcoholics do not waste time screwing around with baby drinks. Or alcoholic vapor.
Someone thought of using a nebulizer to “smoke” booze. Vaporized alcohol was now more than just the bad booze breath of the bum sleeping next to you on the E train, it was moving on up. The upside was you could consume all you wanted and there were no calories. No worries of that horrible alcoholic bloat and belly. Bypassing the liver and going straight to the bloodstream through the lungs, you didn’t have to worry about hangovers. Which also meant there was no way to monitor how much you were actually consuming, so no one could point a finger and say, “I think you’ve had enough young lady,” but there was also nothing to vomit up when you’d gone passed enough and entered into the realm of too much. So what if you’ve increased your chance of alcohol poisoning—did you not hear me when I said 'no calories'? Fancy pants people bought Vaportinis and kids used bicycle pumps and like any good drunk eventually will, vaporized booze fell flat on its face. It was a novelty for people who simply couldn’t live up to their alcoholic potential and drink straight from the bottle.
Recent news on Palcohol—booze in a powdered form—gets those alcoholic wheels turning, no matter how long you've been sober.
Shutterstock
By Jodi Sh. Doff
04/28/14
SOURCE THE FIX
In case there were any doubts in my mind as to whether or not, after almost 24 years away from the booze cruise that was my life, I’m still really an alcoholic—well the advent and near legal actuality of Palchol is my defining moment. Everyone says it’s a stupid idea and everyone is probably correct, but stupid ideas were my calling card for 20 years before I got sober, and more years than I’d like to remember after. And this is a stupid idea I cannot stop thinking about.
It’s a headline making miracle of the highest sort. Jesus turned water into wine? Not such a big a deal anymore. Mark Phillips, the genius behind Palcohol, has gone one better, and figured out how to turn water into vodka. And rum. He’s one-upped Jesus with a powdered and portable Mojito. And that’s saying something.
Despite the fact that the Alcohol and Tobacco Tax and Trade Bureau (TTB) has—for the moment at least—revoked the label license, Palcohol is out there and everyone has an opinion. Doctors. Educators. I’m sure booze manufacturers from Smirnoff to Schlitz have opinions as well. I’m sure the airlines and concert venues are already trying to figure out how to handle this stuff once the paperwork finally goes through. And idiots of every order have commented on articles of every standpoint. It’s good. It’s bad. It’s fun. But has anyone asked a real alcoholic? Has anyone taken the pulse of the You-wouldn’t believe-the-things-I’ve-done-to-get-stoned-community of addicts?
Well, here I am, to fill in those gaps.
Finding new ways to get various kinds of mood-altering substances and liquids into your body is nothing new. A Texas man died after ingesting 1.5 liters of sherry in what frat boys call butt chugging, and the rest of the world knows affectionately as an enema. I’d have been surprised when I read that if I hadn’t remembered being advised in the 80s by a lawyer to shove Tuinals up my ass for the quickest result because the blood vessels are so close to the surface the drugs get into your system lickety-split, no pesky waiting for digestion and metabolizing. He also pointed out that I was wasting my cocaine by snorting it, that the smart money would bend over and let someone blow it up my butt with a straw. I should mention he was a disbarred lawyer, although not for anything having to do with drugs, just the mob. So nothing directly related to drugs. Oh, nevermind. Amazing, considering how little I remember of the 80s at all, that this stuck in my head. This is what is known as an “alcoholic obsession of the mind.”
Real 100% dyed in the wool, down to your bones alcoholics do not waste time screwing around with baby drinks. Or alcoholic vapor.
Someone thought of using a nebulizer to “smoke” booze. Vaporized alcohol was now more than just the bad booze breath of the bum sleeping next to you on the E train, it was moving on up. The upside was you could consume all you wanted and there were no calories. No worries of that horrible alcoholic bloat and belly. Bypassing the liver and going straight to the bloodstream through the lungs, you didn’t have to worry about hangovers. Which also meant there was no way to monitor how much you were actually consuming, so no one could point a finger and say, “I think you’ve had enough young lady,” but there was also nothing to vomit up when you’d gone passed enough and entered into the realm of too much. So what if you’ve increased your chance of alcohol poisoning—did you not hear me when I said 'no calories'? Fancy pants people bought Vaportinis and kids used bicycle pumps and like any good drunk eventually will, vaporized booze fell flat on its face. It was a novelty for people who simply couldn’t live up to their alcoholic potential and drink straight from the bottle.
The Buying of Prison Time for Drug Offenders -
A Special Fix Report
Why are so many drug possessors sent to prison rather than treatment? Look no further than the “prison-industrial” complex, including the bail bond industry, which lobbies for harsh penalties that increase the volume of those arrested and jailed.
Shutterstock
By Michelle Renee Matisons and Seth Sandronsky
SOURCE : FIX
According to the Prison Policy Initiative, there are 330,000 people in state or federal prisons nationwide for drug offenses. Just ask recovering drug user Daniel Romero, 41, of East Los Angeles about the toll incarceration has taken on him and the cost to the rest of us. He has 25 felony convictions. “My 19 years in court and behind bars cost maybe $2 million,” he said.
From his time spent in and out of the system, Romero knows bail and jail intimately. He also understands that both bail and jail are profit centers for others determined to keep the present “war on drugs” penalty system working to their financial advantage.
One such profit center is the U.S. bail bond industry (BBI). The industry does $2 billion of business annually, according to the American Civil Liberties Union and Justice Policy Institute. That is real money, with chunks of it being made available via campaign donations and lobbying to shape criminal law policy and the votes of lawmakers. Tracking these political and commercial ties reveals what criminal justice rhetoric tries to conceal:
The bail industry, along with other powerful forces such as prison guards and private prison companies, invests extensive resources in promoting legislation that leads to mass incarcerations. This is especially true for drug offenses that disproportionately harm nonwhite and poor communities.
To the degree that the public is even minimally aware of how moneyed players in the prison-industrial complex push for extensive and harsh arrest laws, it is usually the private prison industry and prison guard unions that are pointed to as playing the lead roles in this nasty game. Job-protecting police unions and war-on-drug agencies play strong support roles. The role of bail bonders is virtually invisible to the public.
But the BBI has grown into quite a political force over four decades even as their individual operations are largely obscured behind contrasting popular images of mom and pop bail bonds storefronts or less-than-friendly outlaw bounty hunters. Currently, it is pushing conservative legislation by courting politicians via bipartisan campaign donations and lobbying efforts. It also plays a visible role in the American Legislative Exchange Council (ALEC) - an influential right wing national group significantly funded by the oil magnate and far-right wing Koch Brothers. ALEC creates and then promotes “model legislation,” including, most famously, the controversial Stand Your Ground gun law and attacks on public employee unions.
One dramatic example of recent BBI activity is in the realm of pretrial services. These services mitigate jail and prison overcrowding through pretrial release based on factors other than one’s ability to post money bail, such as a detainee’s offense record, drug history and employment status.
The bail industry has targeted such “no-bail-required” practices for hammer blows along with other modern reforms. These reforms tend toward reducing drug possession charges from felonies to misdemeanors that require no bail and favor treatment rather than jail. Many experts and the public at large regard these reforms as more sensible and more effective.
Other than the generalized and vast legalized political corruption and vote selling that results from the need to obtain campaign funds in America, there is no specific pattern that describes the many politicians who crash their own principles under bail industry pressures. These pols occupy the racial, ethnic, gender and regional spectrum. If you are stuck believing the paradigm that Democrats offer a progressive alternative to the drug war’s brutal mass incarceration policies - as opposed to Republican ideological commitment to being “tough on crime and drugs” - think again. In a time which demands alternatives to drug war decimation of nonwhite communities, many Democrats across the country line up alongside Republicans to collect, with California, Florida and Texas as the top three BBI donor states.
Furthermore, in poor nonwhite districts that lack robust economic resources to support progressive change, we have historically seen a wedding of politicians’ campaign piggy banks to bail bonds industry interests. This keeps many nonwhite politicians beholden to the status quo and surprisingly opposing liberal reforms. Accordingly, communities most affected by the drug war lose a real place at the bail and prison alternatives table.
In fact, voters are given mixed messages by the Dems' reform rhetoric which pushes watered-down initiatives that, in fact, continue status quo criminalizing, policing, arresting, detaining and bailing for often quite minor drug and parole violations.
This influencing BBI money flows from arrested individuals’ pockets, as detained drug offenders and others - often charged with minor crimes - scramble to make bail by any means necessary, even at the expense of their own family's security. Then, taxpayer dollars pay the bill for courts, jails, police and prisons. On that spending note, the Great Recession hammered local and state budgets and brought reform-minded attention to the so-called criminal justice system. But how much is really changing?
BBI STYLE REFORM
California enjoys a liberal reputation, but it is unclear why when it comes to criminal justice issues. The state, for example, led the way in “three strikes and you do life without parole” legislation, now partially repealed because of its devastating effects on many lives.
Consider that last November, Gov. Jerry Brown, Jr., a Democrat, vetoed an important bill, SB 649, initiated by the Drug Policy Alliance and introduced by Sen. Mark Leno (D-SF). The bill, which was adamantly opposed by BBI as well as by elements of the pro three-strike complex of guards and prison-industry companies, would have allowed judges and prosecutors to reduce the criminal penalty for simple drug possession of small amounts from a felony to a drug “wobbler” (the choice of felony or misdemeanor charges, with prosecutor and court discretion). It would also have given judges and prosecutors discretionary authority to send defendants to treatment centers, probation or community service.
“This bill would allow possession of heroin or cocaine to be charged as a misdemeanor instead of a felony,” Brown declared misleadingly in a veto message fully in accord with other strong support Brown has provided for prison-industrial complex issues over the last year as he goes into an election year determined to amass a campaign treasury that dwarfs competitors.
Brown’s other stated reason for the veto was improper timing. Citing another bill making its way through the state legislature, Brown declared: “We are going to examine in detail California's criminal justice system, including the current sentencing structure.” Critics charged that Brown simply caved to law enforcement interests such as the BBI and punted the issue to a process whereby such interests would have more influence over final policy decisions.
“The governor let down the people of California, the majority of whom support going even farther than this bill would have gone,” said Lynne Lyman, California state director for the Drug Policy Alliance. “The vast majority of voters agree with the experts - locking up drug users is stupid, unproductive, cruel and expensive.” Later, in a phone interview with The Fix, she added: “Up to 10,000 more people will serve time in state prisons this year.”
(The Fix asked Brown spokesperson Daniela Dabel to comment on the bail amounts and bail fees these pretrial detainees face because of the Governor’s veto. Dabel declined to do so.)
As Michelle Alexander’s bestselling book, The New Jim Crow: Mass Incarceration in the Age of Colorblindness (2012), reports, in the drug war nine out of ten arrested drug offenders are black and Latino, far outstripping their number in the general populace where, percentage wise, studies have shown that more whites use more drugs more frequently than minorities. Further, felons do the time long after they do the crime; they face a lifelong fate of second-class citizenship. Depending on the state in which they reside, they are ineligible for a range of government help including food stamps, housing, student loans, temporary cash assistance and voting. Brown’s veto ensures that this year alone, 10,000 more people, disproportionately people of color, face some elements of this fate.
SB 649 was specifically designed to mitigate this racial – and racist - discrepancy.
In California, Brown is hardly alone in protecting the industry. Recently convicted (for voter fraud and perjury) and then suspended State Senator Roderick Wright, an African-American, earlier accepted $3,000 from the BBI and introduced pro-BBI legislation that would increase the number of defendants applicable for bail if they applied to the court for an electronic monitoring program. In a conversation with The Fix, Maggie Kreins, president of the California Bail Agents ( CBAA) and herself a bail bonds company owner, said the CBAA supports Wright’s bill and opposes bills that reformers want that requires no-bail be posted for low-level defendants who accept monitoring.
Why are so many drug possessors sent to prison rather than treatment? Look no further than the “prison-industrial” complex, including the bail bond industry, which lobbies for harsh penalties that increase the volume of those arrested and jailed.
Shutterstock
By Michelle Renee Matisons and Seth Sandronsky
SOURCE : FIX
According to the Prison Policy Initiative, there are 330,000 people in state or federal prisons nationwide for drug offenses. Just ask recovering drug user Daniel Romero, 41, of East Los Angeles about the toll incarceration has taken on him and the cost to the rest of us. He has 25 felony convictions. “My 19 years in court and behind bars cost maybe $2 million,” he said.
From his time spent in and out of the system, Romero knows bail and jail intimately. He also understands that both bail and jail are profit centers for others determined to keep the present “war on drugs” penalty system working to their financial advantage.
One such profit center is the U.S. bail bond industry (BBI). The industry does $2 billion of business annually, according to the American Civil Liberties Union and Justice Policy Institute. That is real money, with chunks of it being made available via campaign donations and lobbying to shape criminal law policy and the votes of lawmakers. Tracking these political and commercial ties reveals what criminal justice rhetoric tries to conceal:
The bail industry, along with other powerful forces such as prison guards and private prison companies, invests extensive resources in promoting legislation that leads to mass incarcerations. This is especially true for drug offenses that disproportionately harm nonwhite and poor communities.
To the degree that the public is even minimally aware of how moneyed players in the prison-industrial complex push for extensive and harsh arrest laws, it is usually the private prison industry and prison guard unions that are pointed to as playing the lead roles in this nasty game. Job-protecting police unions and war-on-drug agencies play strong support roles. The role of bail bonders is virtually invisible to the public.
But the BBI has grown into quite a political force over four decades even as their individual operations are largely obscured behind contrasting popular images of mom and pop bail bonds storefronts or less-than-friendly outlaw bounty hunters. Currently, it is pushing conservative legislation by courting politicians via bipartisan campaign donations and lobbying efforts. It also plays a visible role in the American Legislative Exchange Council (ALEC) - an influential right wing national group significantly funded by the oil magnate and far-right wing Koch Brothers. ALEC creates and then promotes “model legislation,” including, most famously, the controversial Stand Your Ground gun law and attacks on public employee unions.
One dramatic example of recent BBI activity is in the realm of pretrial services. These services mitigate jail and prison overcrowding through pretrial release based on factors other than one’s ability to post money bail, such as a detainee’s offense record, drug history and employment status.
The bail industry has targeted such “no-bail-required” practices for hammer blows along with other modern reforms. These reforms tend toward reducing drug possession charges from felonies to misdemeanors that require no bail and favor treatment rather than jail. Many experts and the public at large regard these reforms as more sensible and more effective.
Other than the generalized and vast legalized political corruption and vote selling that results from the need to obtain campaign funds in America, there is no specific pattern that describes the many politicians who crash their own principles under bail industry pressures. These pols occupy the racial, ethnic, gender and regional spectrum. If you are stuck believing the paradigm that Democrats offer a progressive alternative to the drug war’s brutal mass incarceration policies - as opposed to Republican ideological commitment to being “tough on crime and drugs” - think again. In a time which demands alternatives to drug war decimation of nonwhite communities, many Democrats across the country line up alongside Republicans to collect, with California, Florida and Texas as the top three BBI donor states.
Furthermore, in poor nonwhite districts that lack robust economic resources to support progressive change, we have historically seen a wedding of politicians’ campaign piggy banks to bail bonds industry interests. This keeps many nonwhite politicians beholden to the status quo and surprisingly opposing liberal reforms. Accordingly, communities most affected by the drug war lose a real place at the bail and prison alternatives table.
In fact, voters are given mixed messages by the Dems' reform rhetoric which pushes watered-down initiatives that, in fact, continue status quo criminalizing, policing, arresting, detaining and bailing for often quite minor drug and parole violations.
This influencing BBI money flows from arrested individuals’ pockets, as detained drug offenders and others - often charged with minor crimes - scramble to make bail by any means necessary, even at the expense of their own family's security. Then, taxpayer dollars pay the bill for courts, jails, police and prisons. On that spending note, the Great Recession hammered local and state budgets and brought reform-minded attention to the so-called criminal justice system. But how much is really changing?
BBI STYLE REFORM
California enjoys a liberal reputation, but it is unclear why when it comes to criminal justice issues. The state, for example, led the way in “three strikes and you do life without parole” legislation, now partially repealed because of its devastating effects on many lives.
Consider that last November, Gov. Jerry Brown, Jr., a Democrat, vetoed an important bill, SB 649, initiated by the Drug Policy Alliance and introduced by Sen. Mark Leno (D-SF). The bill, which was adamantly opposed by BBI as well as by elements of the pro three-strike complex of guards and prison-industry companies, would have allowed judges and prosecutors to reduce the criminal penalty for simple drug possession of small amounts from a felony to a drug “wobbler” (the choice of felony or misdemeanor charges, with prosecutor and court discretion). It would also have given judges and prosecutors discretionary authority to send defendants to treatment centers, probation or community service.
“This bill would allow possession of heroin or cocaine to be charged as a misdemeanor instead of a felony,” Brown declared misleadingly in a veto message fully in accord with other strong support Brown has provided for prison-industrial complex issues over the last year as he goes into an election year determined to amass a campaign treasury that dwarfs competitors.
Brown’s other stated reason for the veto was improper timing. Citing another bill making its way through the state legislature, Brown declared: “We are going to examine in detail California's criminal justice system, including the current sentencing structure.” Critics charged that Brown simply caved to law enforcement interests such as the BBI and punted the issue to a process whereby such interests would have more influence over final policy decisions.
“The governor let down the people of California, the majority of whom support going even farther than this bill would have gone,” said Lynne Lyman, California state director for the Drug Policy Alliance. “The vast majority of voters agree with the experts - locking up drug users is stupid, unproductive, cruel and expensive.” Later, in a phone interview with The Fix, she added: “Up to 10,000 more people will serve time in state prisons this year.”
(The Fix asked Brown spokesperson Daniela Dabel to comment on the bail amounts and bail fees these pretrial detainees face because of the Governor’s veto. Dabel declined to do so.)
As Michelle Alexander’s bestselling book, The New Jim Crow: Mass Incarceration in the Age of Colorblindness (2012), reports, in the drug war nine out of ten arrested drug offenders are black and Latino, far outstripping their number in the general populace where, percentage wise, studies have shown that more whites use more drugs more frequently than minorities. Further, felons do the time long after they do the crime; they face a lifelong fate of second-class citizenship. Depending on the state in which they reside, they are ineligible for a range of government help including food stamps, housing, student loans, temporary cash assistance and voting. Brown’s veto ensures that this year alone, 10,000 more people, disproportionately people of color, face some elements of this fate.
SB 649 was specifically designed to mitigate this racial – and racist - discrepancy.
In California, Brown is hardly alone in protecting the industry. Recently convicted (for voter fraud and perjury) and then suspended State Senator Roderick Wright, an African-American, earlier accepted $3,000 from the BBI and introduced pro-BBI legislation that would increase the number of defendants applicable for bail if they applied to the court for an electronic monitoring program. In a conversation with The Fix, Maggie Kreins, president of the California Bail Agents ( CBAA) and herself a bail bonds company owner, said the CBAA supports Wright’s bill and opposes bills that reformers want that requires no-bail be posted for low-level defendants who accept monitoring.
Friday, May 2, 2014
MAY 2 v 6 TWELVE STEPPING WITH POWER IN THE PROVERB
For the Lord grants wisdom!
From his mouth come knowledge and understanding.
STEP 3 - Made a decision to turn our will and our lives over to the care of God as we understood Him.
Step three is one of the most important steps on your recovery journey. For many of us being lonely due to our addiction was enough to push anyone over the edge. Your journey into recovery was meant for you to have God and others walk right beside you into sobriety. The Proverb is the promise and the step is the key . Find God and humbly seek His help and hand Him control of your life , His Holy Spirit , will give you wisdom , knowledge , understanding and courage to live a new sober life.
For the Lord grants wisdom!
From his mouth come knowledge and understanding.
STEP 3 - Made a decision to turn our will and our lives over to the care of God as we understood Him.
Step three is one of the most important steps on your recovery journey. For many of us being lonely due to our addiction was enough to push anyone over the edge. Your journey into recovery was meant for you to have God and others walk right beside you into sobriety. The Proverb is the promise and the step is the key . Find God and humbly seek His help and hand Him control of your life , His Holy Spirit , will give you wisdom , knowledge , understanding and courage to live a new sober life.
John 14 : 26 -But the Advocate, the Holy Spirit, whom the Father will send in my name, will teach you all things and will remind you of everything I have said to you.
By Joseph Dickerson
By Joseph Dickerson
Q&A with Addiction Medicine Expert: The Impact of Zohydro
By Celia Vimont | April 30, 2014 | 2 Comments | Filed in Addiction, Government & Prescription Drugs
The Food and Drug Administration’s (FDA) decision to approve Zohydro ER (extended release), a pure form of the painkiller hydrocodone, has stirred opposition from many addiction medicine experts, public health officials and legislators. Join Together spoke with Dr. Richard Blondell, Vice Chair for Addiction Medicine in the State University of New York at Buffalo Department of Family Medicine, about the issue.
Why is there such controversy about Zohydro’s approval?
Dr. Blondell: It’s a question of risk versus benefits. Zohydro, unlike combination hydrocodone products such as Vicodin, does not contain acetaminophen. The FDA says since acetaminophen has safety risks—including potentially deadly liver damage when taken at a high level—Zohydro can be a good option for patients who need high doses of the medication, without the associated liver toxicity risk. They also say it gives doctors another option for prescribing opiates, so they can rotate medications.
However, the risks are great. There is no mechanism in the Zohydro pill for tamper resistance. If people want to abuse it, they can extract high doses of hydrocodone and inject it. The risk is it will create more addiction in people who are prone to misuse and addiction.
What about the argument that more, better opiate medications are needed to treat patients in pain?
Dr. Blondell: There are already a lot of opiate medicines available—there is not a critical need for another one. Zohydro is only a slight variation from many other opiates that are already on the market, and the benefits are minimal. Zohydro is not a big new discovery that will be a watershed moment in medicine.
Why do you think Zohydro poses such an addiction danger?
Dr. Blondell: We already have experience with opioids extracted from pills causing death. Before OxyContin became tamper-resistant, people died after injecting it. Since Zohydro is not tamper-resistant, people who want to abuse it can extract a pretty stiff dose and inject it, which can be fatal for people with a low tolerance.
What needs to be done to reduce the risk of addiction to Zohydro and other opiate painkillers?
Dr. Blondell: We need to better educate our physicians about how to use these medications, how to assess patient risk for abuse, how to screen patients for the development of addiction, and how to intervene early to get patients into treatment before they ruin their lives. This is what we should be doing instead of spending all our efforts developing another opiate, when the market is already flooded with opiate products. We should instead be educating our physicians to use the products already out there.
What do you want the FDA to consider as Zohydro comes to market?
Dr. Blondell: I’m sure the cost of developing a tamper-resistant pill is high, but what is the cost of hundreds of overdose deaths each year? The success in the marketplace has to be balanced against the negative effects to human life. If we see overdose deaths from Zohydro, will the people who approved it take ownership for being part of the problem? As an addiction medicine specialist I’ve seen misery and suffering. I’ve talked to parents of children who have overdosed. I see the human cost of addiction on a daily basis. I think that it’s too big of a price to pay.
Richard D. Blondell, MD, is a Professor and Vice Chair for Addiction Medicine in the State University of New York at Buffalo (University at Buffalo) Department of Family Medicine, and is the Director of Research on Addictions for the University at Buffalo Primary Care Research Institute. Dr. Blondell is a founding member of the American Board of Addiction Medicine and the ABAM Foundation, serving on their Boards of Directors since 2008.
By Celia Vimont | April 30, 2014 | 2 Comments | Filed in Addiction, Government & Prescription Drugs
The Food and Drug Administration’s (FDA) decision to approve Zohydro ER (extended release), a pure form of the painkiller hydrocodone, has stirred opposition from many addiction medicine experts, public health officials and legislators. Join Together spoke with Dr. Richard Blondell, Vice Chair for Addiction Medicine in the State University of New York at Buffalo Department of Family Medicine, about the issue.
Why is there such controversy about Zohydro’s approval?
Dr. Blondell: It’s a question of risk versus benefits. Zohydro, unlike combination hydrocodone products such as Vicodin, does not contain acetaminophen. The FDA says since acetaminophen has safety risks—including potentially deadly liver damage when taken at a high level—Zohydro can be a good option for patients who need high doses of the medication, without the associated liver toxicity risk. They also say it gives doctors another option for prescribing opiates, so they can rotate medications.
However, the risks are great. There is no mechanism in the Zohydro pill for tamper resistance. If people want to abuse it, they can extract high doses of hydrocodone and inject it. The risk is it will create more addiction in people who are prone to misuse and addiction.
What about the argument that more, better opiate medications are needed to treat patients in pain?
Dr. Blondell: There are already a lot of opiate medicines available—there is not a critical need for another one. Zohydro is only a slight variation from many other opiates that are already on the market, and the benefits are minimal. Zohydro is not a big new discovery that will be a watershed moment in medicine.
Why do you think Zohydro poses such an addiction danger?
Dr. Blondell: We already have experience with opioids extracted from pills causing death. Before OxyContin became tamper-resistant, people died after injecting it. Since Zohydro is not tamper-resistant, people who want to abuse it can extract a pretty stiff dose and inject it, which can be fatal for people with a low tolerance.
What needs to be done to reduce the risk of addiction to Zohydro and other opiate painkillers?
Dr. Blondell: We need to better educate our physicians about how to use these medications, how to assess patient risk for abuse, how to screen patients for the development of addiction, and how to intervene early to get patients into treatment before they ruin their lives. This is what we should be doing instead of spending all our efforts developing another opiate, when the market is already flooded with opiate products. We should instead be educating our physicians to use the products already out there.
What do you want the FDA to consider as Zohydro comes to market?
Dr. Blondell: I’m sure the cost of developing a tamper-resistant pill is high, but what is the cost of hundreds of overdose deaths each year? The success in the marketplace has to be balanced against the negative effects to human life. If we see overdose deaths from Zohydro, will the people who approved it take ownership for being part of the problem? As an addiction medicine specialist I’ve seen misery and suffering. I’ve talked to parents of children who have overdosed. I see the human cost of addiction on a daily basis. I think that it’s too big of a price to pay.
Richard D. Blondell, MD, is a Professor and Vice Chair for Addiction Medicine in the State University of New York at Buffalo (University at Buffalo) Department of Family Medicine, and is the Director of Research on Addictions for the University at Buffalo Primary Care Research Institute. Dr. Blondell is a founding member of the American Board of Addiction Medicine and the ABAM Foundation, serving on their Boards of Directors since 2008.
Heroin on College Campuses is a Hidden Issue, Experts Say
By Join Together Staff | April 30, 2014 | Leave a comment | Filed in Drugs, Prevention, Treatment, Young Adults & Youth
While most colleges focus their substance use prevention and treatment programs on alcohol, marijuana and prescription drugs, heroin use is a serious but little-discussed problem, Inside Higher Ed reports.
Campus and national surveys indicate that fewer than 1 percent of college students use heroin, the article notes.
The University of Rochester is now focusing on heroin use among its students, after a freshman died of a heroin overdose. University President Joel Seligman issued a plea to students using heroin to “please get help,” the article notes. The school’s health service director, Ralph A. Manchester, said there is little research on what types of programs are effective in helping college students who use heroin.
The University of Vermont says starting this fall, it will begin screening all patients at the school health center for hard drug use. Students who use drugs will be given a short talk on their risky behavior, and will be referred to treatment. Jon Porter, Director of the school’s Center for Health and Wellbeing, said, “The students who use opiates and heroin are immune to traditional outreach efforts that we might use for alcohol and marijuana.”
While the health center has worked with about 25 students who use heroin, the number is likely to rise since Vermont is experiencing what Governor Peter Shumlin characterized as a “full-blown heroin crisis.”
Yale University Campus Medical Director Michael Rigsby emailed students this month that “several recent incidents have raised our concern that use of drugs such as LSD, cocaine, and heroin is on the rise among college students, fueled in part by a mistaken belief that occasional use is really not that dangerous.”
Some college students who become addicted to prescription painkillers such as oxycodone switch to heroin because it is cheaper, according to Robert Reff, Substance Abuse Prevention Coordinator at Oregon State University.
By Join Together Staff | April 30, 2014 | Leave a comment | Filed in Drugs, Prevention, Treatment, Young Adults & Youth
While most colleges focus their substance use prevention and treatment programs on alcohol, marijuana and prescription drugs, heroin use is a serious but little-discussed problem, Inside Higher Ed reports.
Campus and national surveys indicate that fewer than 1 percent of college students use heroin, the article notes.
The University of Rochester is now focusing on heroin use among its students, after a freshman died of a heroin overdose. University President Joel Seligman issued a plea to students using heroin to “please get help,” the article notes. The school’s health service director, Ralph A. Manchester, said there is little research on what types of programs are effective in helping college students who use heroin.
The University of Vermont says starting this fall, it will begin screening all patients at the school health center for hard drug use. Students who use drugs will be given a short talk on their risky behavior, and will be referred to treatment. Jon Porter, Director of the school’s Center for Health and Wellbeing, said, “The students who use opiates and heroin are immune to traditional outreach efforts that we might use for alcohol and marijuana.”
While the health center has worked with about 25 students who use heroin, the number is likely to rise since Vermont is experiencing what Governor Peter Shumlin characterized as a “full-blown heroin crisis.”
Yale University Campus Medical Director Michael Rigsby emailed students this month that “several recent incidents have raised our concern that use of drugs such as LSD, cocaine, and heroin is on the rise among college students, fueled in part by a mistaken belief that occasional use is really not that dangerous.”
Some college students who become addicted to prescription painkillers such as oxycodone switch to heroin because it is cheaper, according to Robert Reff, Substance Abuse Prevention Coordinator at Oregon State University.
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