A Veteran Addiction Researcher Tells All

Whats going on in Iraq and Vietnam with drug addiction? What's up with Obamacare? With research and unlicensed addiction counselors? The word from Dr. Richard Rawson.

By John Lavitt

06/27/14

Dr. Richard Rawson PhD has been on the front line of addiction research and treatment development for 40 years. A member of the UCLA Department of Psychiatry for over 20 years and the Co-Director of the UCLA Integrated Substance Abuse Programs at the Jane & Terry Semel Institute for Neuroscience & Human Behavior, Dr. Rawson oversees an impressive portfolio of addiction research. A major focus of his work is the study of how treatment strategies are applied in a wide range of institutions and societies.

During the past decade, Dr. Rawson has worked with the U.S. State Department on large substance abuse projects, exporting technology and addiction science to the Middle East and Southeast Asia. Currently the principal investigator of the Pacific Southwest Addiction Technology Transfer Center and the NIDA Methamphetamine Clinical Trials Group, Dr. Rawson focuses on improving the educational standards for addiction treatment professionals. 

In his interview with The Fix, Dr. Rawson provides an insightful historical perspective on the evolution of addiction treatment and research. With a body of unique experiences and work, Dr. Rawson elucidates the present state of addiction treatment and research in light of the Affordable Care Act while providing a rare illumination of what is to come.

You recently completed the Iraq Drug Demand Reduction Initiative. You were given a State Department contract to conduct a national household survey of drug use in Iraq. What did you learn from that survey and how is that knowledge being used?

Our work actually predates the survey. From 2011 to 2013, we had a previous State Department contract in collaboration with SAMHSA (the Substance Abuse and Mental Health Services Administration, a federal agency) where we worked with a team from Baghdad Medical University in Iraq. The focus of the work was training them in basic information about addiction and treatment strategies, helping them to develop treatment services in Baghdad. We wanted to understand what were the drug problems in Iraq and where was the treatment needed. 

It’s going to be a fascinating next ten years of figuring out how to move substance use services into mainstream healthcare, how to educate and serve mainstream healthcare. 

To give a little background, during the time of Saddam Hussein from 1980 to 2003, there really were no drug problems in Iraq. From everything I can find and from all the past data that still exists, limited as it is, because of his dictatorship and very tight control of the borders and capital punishment for any drug-related offenses, the availability and use of drugs in Iraq was extremely limited. Some of the first studies done after the Americans went into Iraq suggested the major drug problems were psychiatric medications like anti-psychotics. They were drugs that here in America nobody would ever abuse because they are not particularly enjoyable, but that’s literally all that was available. 

Once the U.S. invaded and once we took down Saddam’s government and the borders opened up, drugs have been coming into the country in large amounts. Next door in Iran they have arguably what could be the world’s worst addiction problems with heroin and methamphetamine. Drugs started coming into Iraq across that very long and porous border. 

In 2011, we went in and started working with the folks in Baghdad. We took them to Cairo where we had connections at Cairo University, then we took them to Beirut to show them Suboxone treatment in practice. As a result, there are about 15-20 Iraqi doctors, nurses, psychologists and pharmacists who now have a basic background in addiction treatment. They have a treatment unit in Iraq that was one of the first treatment options in Iraq and several satellites have branched off from that unit. The United Nations is now providing them with ongoing support to extend the training and expand the treatment options. 

The other piece that we did in that first contract was to chair a meeting called the Community Epidemiology Workgroup in Baghdad that included law enforcement, education, health, security people and army officers to talk about the nature of the drug problem in Iraq. We published a paper about the findings from that report a couple of months ago. One of the major findings from the report and the resulting recommendation was that they needed to do a survey in Iraq, a household survey to get a better handle on the drug problem. That survey is in the field right now.

We have now done interviews with 2,000 individuals and the goal is 3,600. The teams are out surveying as we speak in Iraq. It will be the first national survey of drug use ever done in Iraq and hopefully we’ll have the data sometime this fall. We are both doing interviews and taking saliva samples because it is not clear how forthright the people are willing to be in Iraqi society about their use of drugs and alcohol. Under Saddam which was only ten years ago, if they were using drugs and alcohol, they would be shot. It wasn’t something you were likely to talk about so the accuracy of the survey in the context of Iraq’s history is challenging. That’s why we are also taking saliva drug samples to inform the self-report or confirm the self-report. 

You received both your undergraduate degree in 1970 and your PhD in 1974 in Experimental Psychology from the University of Vermont. What then motivated you to enter the field of addiction treatment? Is there a personal reason why you made this choice? 

I wish I had a better answer to that question. It was 1974 when I finished my PhD, it was during the Vietnam war; a time when many of us were looking for positions in academia. I was expecting to get a position as an assistant professor in a nice college and teach undergraduates and do a little research, but those were not the options available to me. 

One of the options that I found most intriguing was a position at UCLA where they had one of the first grants issued by the National Institute on Drug Abuse. This particular grant was studying the medication naltrexone and a set of behavior therapies for the treatment of heroin addiction. Since that seemed like a very new area and an area where there wasn’t a lot of knowledge, I thought it was a good opportunity. At that point, I must admit I had no particular interest in addiction research or treatment per se.

In 1980, you worked for a nonprofit agency, setting up methadone clinics across California. Do you think methadone treatment for opioid addictions has proven effective? Should methadone clinics continue to operate given the recent advances with opioid antagonists like naltrexone and Suboxone?

After my first five years doing addiction work with patients using naltrexone and behavior therapy, I spent one year in New York City where I got to see the use of naltrexone and those other treatments in action. But I also got to see the use of methadone and the use of LAAM. LAAM was another medicine that was being developed in conjunction with methadone, but it had a longer lasting effect. (Editor’s Note – Like methadone, LAAM or levomethadyl is an opioid analgesic that is not used for relief of pain but was used in the past as a narcotic abuse therapy adjunct in the United States.) I became intrigued by the tremendous benefits that patients seemed to derive from these medications. 

I came back to California and was given the opportunity to work on setting up what was essentially a service delivery system that focused on methadone. While we established those clinics, however, we continued to use naltrexone and LAAM and behavioral strategies for the patients as well. Although labeled as methadone clinics, it wasn’t simply methadone, but a variety of treatments. 

In answer to your question about methadone and its future in relation to the other available medicines, I don’t think we’ve ever heard anyone say, “Well, gee whiz, we have a new antibiotic so maybe we shouldn’t use penicillin anymore.” There’s always going to be a need for methadone. Methadone is a tremendously effective treatment. It has the benefits of being relatively inexpensive as a medication. Around the world where we are seeing big problems with injection drug use and HIV, there’s nothing even close to methadone for its efficacy, effectiveness and efficiency. 

And it will always play a role in the United States as well. There are some patients who need methadone because the other medications are not as effective with them. We are always going to need multiple medications. It’s not that a new one comes along and we drop the old ones. We are going to need all of them. 

In 1984, you started the Matrix Institute in Beverly Hills during the peak of the cocaine epidemic and worked there until the end of 1995. Can you describe the goal of the Matrix Institute, its methodologies in terms of an intensive outpatient treatment program and whether you consider it to be a success?

With a number of partners in 1984, we opened the doors of the Matrix Institute. This was during the Reagan years, and our approach to the drug problem was to ‘Just Say No’ so there really was very little in the way of federal funding for research or the development of new knowledge. I was interested in looking at what kinds of treatments could be developed that would assist this newly emerging group of people who were using and abusing cocaine. The knowledge in the early 80s, at least the purported knowledge, was that cocaine wasn’t addicting, that cocaine was a drug that people took too much of occasionally, but they didn’t really get addicted to it. Well, 30 years later, we’ve recognized that’s certainly not the case. 

Matrix was set up with the expressed intention of collecting information on stimulant dependence and using that information to develop strategies based on evidence that were effective treatments. It was our intention to look at the data we collected and to develop treatments that had evidence to support their use. 

For the first five years or so when patients would come into Matrix and they would pay for the treatment themselves, they would also have to sign a consent form that basically said we don’t really know how to treat cocaine dependence. In fact, by coming into treatment at Matrix, you essentially were entering an experiment where we were trying to learn about cocaine dependence and trying to develop treatment strategies. 

From 1995 to 2002, you focused your work on what would become a national plague – methamphetamine abuse and crystal meth addiction. From 1996 to1999, you were a member of the Federal Methamphetamine Advisory Group for the White House Office of Drug Control Policy and Attorney General Janet Reno. How damaging are methamphetamines and is the battle against them being lost?

While I was still at Matrix in the late 80s, the Department of Public Health in San Bernardino County asked us to open an office out there. While we were seeing hundreds and eventually thousands of cocaine users in Beverly Hills, in San Bernardino they were seeing the same great demand for treatment but for methamphetamine dependence. We opened an office in 1987 and we started seeing hundreds of methamphetamine users. With the same empirical approach we were developing in Beverly Hills, we started to collect data on methamphetamine use – what it did, who it affected, how methamphetamine addictions affected the person, what kind of effects did it have on their body and their brain. 

In 1996, General Barry McCaffrey called a meeting to address the problem of methamphetamines. McCaffrey was Drug Czar under President Bill Clinton. He had been alerted by the Federal Attorney in San Diego who said that methamphetamine abuse was a huge problem on the West Coast and no one was addressing it. McCaffrey calls this meeting, and it turns out that we were the only ones who had any data. The data that we presented helped the government begin to address the methamphetamine problem in a larger way.

Over the next decade, there was a tremendous effort by the National Institute on Drug Abuse to develop medications and behavioral treatments for methamphetamine dependence. There were many other efforts on the law enforcement side to reduce the availability of precursor chemicals to stop the rampant Mom and Pop production of methamphetamine. 

As we sit here now in 2014, methamphetamine is still most definitely a substantial public health problem across much of the country. We have not made significant progress in the area of medication development. The precursor controls of reducing the availability of drugs like ephedrine have reduced the production of methamphetamine in the United States. 

The Mom and Pop labs or, as we used to refer to them, the Beavis and Butthead labs that dominated methamphetamine production in this country in the late 1990s and early 2000s were not able to continue to operate without access to the precursor chemicals. Most of the middle-sized labs in people’s garages and in Breaking Bad-like campers have mostly gone away. Now we have these portable laboratories of small-time users that are found in backpacks and on kitchen counters. Beyond these tiny individual user laboratories, the Mexican drug cartels stepped in and took over both the production and distribution of methamphetamine through giant-sized industrial labs. As fast as we develop laws to restrict the precursor chemicals or we restrict the other ways to get the drugs, the drug traffickers seem to find a way around them.

Today, the methamphetamine problem is still severe in many parts of the United States. We still need a lot more knowledge and information. The good news is that the precursor controls have reduced the spread of methamphetamine from the West Coast to the East Coast by stopping the homemade labs that were springing up when ephedrine was readily available. We actually don’t see very much methamphetamine use on the East Coast or the Northeast because it basically never got there. But it remains a problem in the West, the Southwest and in the Midwest. Many of the people now entering the criminal justice system in those parts of the country are affected by methamphetamines. We have a long ways to go.

Boozy Genes—The Making of an Alcoholic?

The more we learn about the genetics of alcoholism, the clearer it becomes that evidence-based treatment should become the norm.

By Jeanene Swanson

06/23/14

Alcoholism has long been known to run in families. In fact, based on previous twin studies, more than 50% of the overall risk can be attributed to inheritance. This suggests that genetics plays a role. But, how?

Over the past 20 years, scientists have leveraged new genetic—and genomic, or whole-genome—technologies to discover some of the major genetic variants associated with alcoholism. Since 1989, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has funded the Collaborative Studies on Genetics of Alcoholism study, or COGA—a US-based, multi-site study involving many researchers—with the hope of identifying the specific genes that contribute to the susceptibility to developing alcoholism. And, while the study has found a significant handful of genes, the take-away is that alcoholism is not only a complex disease—many genes, each contributing a small effect—but a heterogeneous one: there are different “types” of alcoholism, and each one is defined by one’s personal genetic makeup, or genotype.

Every alcoholic’s story is, in fact, unique. And, science is beginning to back up this idea of multiple pathways to the same disease.

Says Howard Edenberg, a professor of biochemistry and molecular biology at the Indiana University School of Medicine and one of the principal investigators on COGA, “It’s most critical to start any discussion [of the genetics of alcoholism] with the clear understanding that we’re not dealing with a single-gene disease,” he says. “We’re dealing with a complex genetic disease in which there’s good evidence that…no one gene is determinative.” 

Additionally, alcoholism does not have one cause, and it is not entirely genetic—environment and personality play a large role in whether someone will develop a substance use disorder of any kind, including one with alcohol. However, understanding that some people are, in fact, more sensitive to drinking alcoholically than others, scientists are aiming to both determine what makes them more vulnerable and how to better treat people based on their genetic makeup.

COGA

Decades ago, scientists observed that some East Asians—people of Chinese, Japanese, Vietnamese, or Korean descent, among others—became “flushed” when they drank. This so-called “Asian flush” experienced by between 40 and 50 percent of East Asians has since been attributed to a mutation in a gene that metabolizes alcohol. When the by-product of the breakdown of alcohol, called acetaldehyde, builds up in their bodies, they experience an uncomfortable sensation of warmth, rapid heart rate/palpitations, and nausea and/or weakness. Researchers traced this to the ALDH1 gene, the enzyme that breaks down alcohol into acetaldehyde. In small doses, one feels hung over; in large, as with Asians with this specific gene variant, it can be toxic. Needless to say, this gene acts to protect one against alcoholism, for some lending an up-to-six-fold decreased risk.

Out of over 11,000 people interviewed and tested, COGA chose to study 262 families that had two or more first-degree relatives of the patient diagnosed as alcohol-dependent. The study—which used genomics tools like linkage analysis, genome-wide association studies (or, GWAS), and candidate gene studies—identified two genes involved in the metabolism of alcohol (aldehyde dehydrogenase ALDH2 and alcohol dehydrogenase ADH1B) that have the strongest effect on the risk of alcoholism. Significant linkages were found on chromosomes 1, 2, 4, and 7, and later, several more genes were localized, including ADH4 and GABRA2 on chromosome 4, and CHRM2 on chromosome 7. Studies continue to reveal other genes, and with increasingly large sample sizes afforded by meta-analyses, entire biological pathways are beginning to be elucidated.

GABA, or gamma-aminobutyric acid, is the most common inhibitory neurotransmitter in the human nervous system. Mutations in the receptor for this protein, called GABRA2, affect GABA’s function. As seen in many substance use and other psychiatric disorders including alcoholism, decreased GABA function could lead to increased impulsivity. CHRM2 is a gene that makes a specific receptor for acetylcholine, another common neurotransmitter controlling neuronal excitation levels in the brain.

COMPLEX DISEASE

Every alcoholic’s story is, in fact, unique. And, science is beginning to back up this idea of multiple pathways to the same disease. An added prospective arm to the COGA study followed teenagers as they grew up, and those with the ADH gene mutation became early drinkers, whereas those with the CHRM2 risk gene were more apt to be depressed and those with the GABRA2 variant showed more trouble with conduct problems. “The ADH risk variants may contribute to the development of alcoholism directly by promoting heavy drinking, whereas the GABRA2 variants predispose a person to conduct problems, which are themselves a risk factor for alcoholism,” writes Indiana University’s John Nurnberger, Jr., an investigator on COGA, in an article for Scientific American in 2007 (with co-author and COGA researcher Laura Bierut of Washington University). “Meanwhile CHRM2 may act through depression and other internalizing symptoms to foster drinking.”

A recent study adds to the multiple-pathways idea. In a paper appearing in Translational Psychiatry in May, a research team from the United States and Germany led by Alexander Niculescu, III, used a computational approach to discover genes involved in alcoholism. The group narrowed a larger group of associated genes down to a panel of 11, which were then shown to be able to be used to differentiate between alcoholics (and alcohol-dependents) and controls in three independent test cohorts. Niculescu grouped these genes into three “behaviorally relevant” categories—including anxiety, mood, and cognition—which put them into a broader “mindscape-dimensional” view of genes involved in alcoholism and other major psychiatric disorders. 

One of the genes that falls into both the anxiety and cognition category is the DRD2 gene, which makes a dopamine receptor molecule. DRD2 has also been studied as a possible target for personalized treatment.

“Rather than thinking of targeting particular genes, you may be able to target [a] pathway,” Edenberg says, citing a good example unrelated to alcoholism as being the discoveries made surrounding statins, which influence one enzyme but affect cardiovascular disease as a whole by targeting cholesterol production. “If we get a better understanding of the mechanisms behind disease, we will be in a much better [place] to both design and target therapy.”

Unfortunately, the idea of one gene causing alcoholism is nothing more than a myth. A study from a consortium of five UK universities riled up the mainstream science media last fall, encouraging headlines that touted the discovery of an “alcoholism gene.” What co-lead author Quentin Anstee’s lab at Newcastle University found was that mice with a genetic mutation in the GABRB1 gene “overwhelmingly preferred” drinking alcohol over water. While it’s an astonishing finding in mice, humans are much more complex and influenced by myriad environmental factors—which themselves impact the function of many interconnected genes, proteins, and processes.

PERSONALIZED MEDICINE BASED ON GENETIC TESTING

It’s becoming more likely with every discovery that alcoholism—like cancer, for instance—is a heterogeneous disease, meaning that while it looks similar on the outside, it’s actually many different conditions on the inside. In fact, several recent studies have verified that different genetic “types” of alcoholism exist—patients respond differently to the same medication based on their genetic makeup and its effect on how they metabolize the drug (a field known as “pharmacogenetics”). According to a recent review in CNS Drugs, three particular genes—the μ-opioid receptor, the dopamine D4 receptor, and the serotonin transporter gene—have shown the most promise in recent studies as targets for personalized therapy using available drugs for alcoholism (naltrexone and acamprosate, as well as off-label drugs sertraline (Zoloft), olanzapine (Zyprexa), and ondansetron).

In one of the first pharmacogenetic studies, published in early 2011 in the American Journal of Psychiatry, alcoholics were divided into treatment groups based on a specific mutation in their serotonin transporter gene. Mutations in this gene have been linked to many conditions, including not just alcoholism, but depression, obsessive-compulsive disorder, romantic love, hypertension, and generalized social phobia. Those with two specific mutations were better able to reduce their number of drinks on drinking days and their total number of drinking days using the drug ondansetron, a serotonin-3 receptor antagonist typically used to treat nausea and vomiting. Other groups, namely David Goldman’s lab at NIAAA, are studying this specific receptor subtype, also known as the 5-HT3 receptor.

“[The] work on the serotonin transporter and serotonin-3 receptor genotypes is [the] most promising,” says Bankole Johnson, chairman of psychiatry and professor of neurobiology at the University of Maryland School of Medicine and the 2011 study’s lead author. Current research out of Johnson’s lab include a clinical trial entering phase III examining the effectiveness of low-dose ondansetron and a study to examine the effects of naltrexone and acamprosate on liver and kidney function in alcoholics.

Several studies have found specific genotypes to be associated with a better response to naltrexone; in particular, alcoholics with a specific variation of an opioid-receptor gene have a lower rate of relapse than those with a different variation. Naltrexone, an opioid receptor antagonist, works by blocking the opioid receptors—and therefore, the high that drinking alcohol triggers. Other studies are looking at how specific genotypes—mutations in certain genes—affect the way in which alcoholics metabolize disulfiram (Antabuse) and topiramate (Topamax), to name a few.

Just how far are we from being able to hand an alcoholic a genetic test and use this to determine the most personalized—and effective—treatment? It’s still the early days, Edelman says, who doesn’t think “we’re going to be doing genetic testing in terms of prevention work in the foreseeable future.” Genetic testing services, especially direct-to-consumer ones that also typically delve into ancestry genes, offer far from a complete picture. Even if you have a protective version of some gene, there could still be plenty of genes that influence the tendency toward alcoholism that have yet to be discovered.

Still, genetic testing will be “of critical importance,” when it comes to treatment options in the near future, Johnson says. “Alcohol dependence is heterogeneous. Therefore, treatments that target each of the various subtypes will be far more successful than one-size-fits-all. The future is genetic testing to determine who might respond to a particular medication, which [alcoholics] can then be given.”

Jeaneane Swanson is a regular contributor to The Fix. She last wrote about erasing your traumas and side effects of antidepressants.

June 28 v 26 TWELVE STEPPING WITH POWER IN THE PROVERB

He who trusts in his own heart is a fool,
But whoever walks wisely will be delivered.

STEP 3 Made a decision to turn our will and our lives over to the care of God as we understood Him.

What do we do if we were never taught to depend on God . Sure I went to catholic school where I spent eight years following impossible rules and useless dead traditions that we performed lifelessly year after year . Growing up , I learned too survive by trusting my gut ! My world was built on the here and now ,too get what I wanted whenever I wanted it . After time as I got older and colder I began too realize life was wearing me down and , I was tired of running ducking and dodging all the trouble . My self medicating ways were taking a heavy toll and life was getting pretty useless and I was getting tired of me . For most of my life I did not like me and addiction was causing me too really hate myself . I spent years in the sea of regret , fear , and guilt attached too me were the chains of addiction . I was beginning too sink and I did not care anymore ! It is one thing too believe in God but it is useless to live life without God calling the shots . That is why steps one thru three are a must if your tired of being sick and life is way too heavy . God will pick you up ,carry you , protect you , and guide you , but you have to give in , give up , and give Him all of you !

Job 11:13-15

Surrender your heart to God, turn to him in prayer,and give up your sins—even those you do in secret.Then you won’t be ashamed;you will be confident and fearless.

    

	COA on eBay .... Can U Help?
	To raise funds for scholarships to treatment for individuals without health insurance, COA is selling selected high value items thru eBay Giving Works. It's just like the Chinese auctions we have successfully hosted at many COA events....but global! We're hoping this will attract a larger audience for donated items, while also reaching individuals who may need our help. Click here to check out the sale.   If you would like to donate an item for sale, contact CityofAngelsNJ@hotmail.com.    This sale is being held to support Walk With the Angels, a major fundraiser for COA. Walk With the Angels will be held on September 14, 2014 in Mercer County Park to will support continued scholarships for recovery. The goal is to raise $50,000 and 100% of that will be used to send people to treatment for addiction and/or get them into sober living or medical care. Walk With the Angels will be an uplifting event with live music, vendors, food, testimonials from recoverees, live broadcast on COA Recovery Radio (www.coaradio.com) and much, much more! Please make a donation or register to walk - or just "like" the page to share on your Facebook - do it NOW! For details, click here.    * COA is a service organization: all COA services are completely free of charge and everyone who works for COA is a volunteer. That means we can be completely objective and impartial, recommending the best options for our clients, based upon their individual situations. For help with a drug problem, call COA at 609-910-4942 or visit us online at www.cityofangelsnj.org.

	On COARR
	Let's Talk About Recovery!   With 10 original shows, COARR plays Recovery Talk 24/7/365....past shows are available online at www.coaradio.com/pastshows.html and in each show's online archive.  Tune in thru the smartphone app (free in the iphone/droid stores) or on www.coaradio.com to hear what's playing now.....     If you missed COA's Open House this past Saturday, you can listen to one of the speakers on COARR.... Anne Weymouth, CAP, CCJAP, CSAT-C, ICADC, MS is currently the Supervisor of the Women's Program at Destination Hope.  Her background includes training in specialties such as sexual addiction, process addictions and trauma therapy.  Ms. Weymouth has a Masters in Mental Health Counseling, is a Certified Sexual Addiction and Trauma Therapist, Certified Criminal Justice Professional and is a Certified Addiction Professional.     This episode of "Women & Addiction", guest hosted by our own Ashlee M., includes Lisa, a recoveree with whom Anne worked closely and who credits Anne with helping her unravel traumatic memories and thereby control her addictive behavior....to listen, click here    Tune in to "Women & Addiction" this Tuesday, July 1 at 8:30 pm EST as Terri talks with Cheryl, a Mountainside mom with an amazing story of hope and redemption.    Cheryl got clean when she became pregnant with her son, then turned his death last fall into an opportunity to help others. She is now a certified Recovery Coach, and is building COA North in North Jersey.    Tune in to find out more at  www.coaradio.com or the COARR smartphone app....or click the link on the right!   To learn more about the Recovery Coaches, click here New Jersey Mother Has Warning About Heroin Listen to past COARR shows any time: For "Women & Addiction" with Terri Thomas, click here. For "Hope Fiend" with Minister Rich Mollica, click here. For "Emotional Sobriety" with Andy Finley MFT, click here. For "Journey Thru the 12 Steps with the Life Recovery Bible," click here. For "Share Your Scars" with Vicki, click here. For "Wings Over Water: Creativity in Recovery" with recovery musician Kathy Moser,  click here. For "Laughter & Recovery" with stand up comic Wil B. Kleen, click here. For "Relationships in Recovery" with Alexa, click here. For "Saving Lives" with COA Director of Interventions Tom Redneck Clark, click here. For "Nar-Anon Families of Addiction Information Line" click here .

Add Safety Warnings on Energy Drinks, Consumer Group Urges FDA
/By Join Together Staff
June 26th, 2014/


The consumer advocacy group Center for Science in the Public Interest (CSPI) is urging the Food and Drug Administration (FDA) to put safety warnings on energy drinks, according to Reuters. The drinks have been linked to 17 deaths in the past two years.

The group wants the warning labels to tell consumers about the risk of heart attack, convulsion, and other adverse reaction to energy drinks.

CSPI says that while no study has proven that energy drinks have caused these deaths, 34 people have died in the United States in the past 10 years after consuming Monster, Rockstar or 5-Hour Energy. The group also is asking the FDA to reduce the amount of caffeine legally allowed in energy drinks to 71 milligrams per 12 ounces. This is the amount allowed in colas, the article notes.

A spokesperson for the FDA told Reuters, “This does not necessarily mean that the energy drink caused the death. Frequently there are other complicating factors, such as existing disease or medications the person may have been taking.”

“How many deaths will it take to get the FDA to protect consumers from energy drinks, with their high levels of caffeine and untested herbal and chemical ingredients?” CSPI Executive Director Michael F. Jacobson said in a news release. “Since the first batch of adverse event reports became public, the death count has essentially doubled, with dozens more injured. Yet the FDA is just standing by—no public warnings, no regulations, no testing required—nothing.”

In March, 2013, a group of health experts asked the FDA to restrict the amount of caffeine permitted in energy drinks. Eighteen physicians, public health experts and researchers wrote a letter to the FDA, saying the move is needed to protect children and teenagers from the potential risks of consuming large quantities of caffeine.

Some Colleges Starting to Sell Beer at Stadiums to Increase Revenue
/By Join Together Staff
June 26th, 2014/


Southern Methodist University (SMU) in Dallas is among the schools that will start to sell beer and wine at football games this fall, in an effort to increase revenue, according to USA Today.

The school sold beer during basketball season this past year, netting six figures over the course of 12 games, the article notes.

With school athletic departments looking at multimillion-dollar obligations in new player benefits, more schools may look at alcohol sales as a way of increasing revenue. “It seems like it’s going that way, and I think you’ll see more doing it,” said Virginia Tech Athletics Director Whit Babcock. “But it’s a cultural issue at a place of higher education where there’s a tradition (of not selling it). I don’t know that it will be one of the top things on my agenda. But as more people do it … I’ll definitely be watching.”

While Babcock was Director of Athletics at the University of Cincinnati, beer was sold at most on-campus sporting events. “In my 2½ years there, we didn’t have any alcohol-related incidents, so it worked,” he said. “It opened my eyes that it could be done in a responsible way.”

Schools including Houston, Louisville, Memphis and Tulane all sell beer at their games. West Virginia started beer sales at football games in 2011. Arizona started to sell beer at home baseball games, played at an off-campus venue. The University of Texas earlier this year added beer and wine sales at some sporting events, including men’s and women’s basketball.

The NCAA does not sell alcohol at its championship sporting events, including the men’s basketball tournament, according to the newspaper. Most college athletic conferences leave the decision about whether to sell alcohol up to individual schools. The exception is the Southeastern Conference, which prohibits alcohol sales.