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Friday, February 6, 2015
Founder of Silk Road, Website That Sold Drugs, Convicted
February 5th, 2015/
Ross W. Ulbricht, the man who founded Silk Road, was convicted this week on seven federal charges. Silk Road sold illegal drugs including heroin, cocaine and LSD, The New York Times reports.
Prosecutors called Ulbricht a “digital kingpin.” Silk Road generated revenues of more than $213 million from January 2011 to October 2013, when the Federal Bureau of Investigation arrested Ulbricht.
Federal prosecutor Serrin Turner said in a closing argument that the website “lowered the barriers to drug dealing by enabling drug dealers to reach customers online they could have never met on the street.”
Four of the convictions, including distributing narcotics on the Internet and engaging in a continuing criminal enterprise, carry potential life sentences, the article notes. Ulbricht will be sentenced May 15.
Last month, a drug dealer testifying at the trial said he sold up to 600 small bags of heroin a day on the site. Michael Duch said he used most of the money to support his $2,000-to-$3,000-a-week heroin addiction.
Silk Road could only be accessed by using encryption software called Tor, which shields computers’ IP addresses, allowing people to make purchases anonymously. The website did not use credit cards, instead relying on “Bitcoins,” an untraceable digital currency that is available through online currency exchange services.
Last month, federal agents arrested a man who told them he was a top assistant to the operator of Silk Road 2.0. The site allowed anonymous users to buy and sell illegal drugs, weapons and other illegal items. Silk Road 2.0 emerged as a copycat site a month after Ulbricht was arrested.
Study on Cocaine Use Could Help Explain Destructive Decisions by Users
February 5th, 2015/
A new study of how cocaine affects the brain may help explain why people who use the drug make many destructive decisions, according to the Los Angeles Times.
Chronic cocaine use changes brain circuits that help people learn from mistakes, the researchers said. They measured electrical activity in the region of the brain associated with managing errors in reward prediction. When things go better than expected, nerve cells release and absorb more of the chemical dopamine. When events fail to meet expectations, nerve cells in that area of the brain release less of the chemical. When outcomes match predictions, nerve cells release a steady amount of dopamine, the article explains.
The study included 75 people, including some who don’t use cocaine, some who chronically use cocaine but tested negative for cocaine use in the past 72 hours, and some who chronically use cocaine and tested positive for recent use.
All the participants played a computer gambling game in which they had to predict whether or not they would win or lose money on each turn. Participants who were chronic cocaine users showed no significant difference between expected and unexpected losses, while people who did not use cocaine had a greater feedback signal for unexpected outcomes.
“This study shows that individuals with substance use disorder have difficulty computing the difference between expected versus unexpected outcomes, which is critical for learning and future decision making,” study lead researcher, Muhammad Parvaz of the Icahn School of Medicine at Mount Sinai in New York said in a news release. “This impairment might underlie disadvantageous decision making in these individuals.”
The study appears in the Journal of Neuroscience.
Thursday, February 5, 2015
Home / Join Together / Commentary: Abuse-Deterrent Opioids: Who Needs Them, and at What Cost?
Commentary: Abuse-Deterrent Opioids: Who Needs Them, and at What Cost?
February 4th, 2015/
Ending prescription drug abuse is not easy. It’s a complex problem, and solving it is going to take a complex solution made up of many components. One such component capturing the spotlight recently is the development and marketing of so-called “abuse-deterrent formulations” (ADFs) of extended-release/long-acting (ER/LA) opioid pain relievers. Policymakers are touting these medications as being so important that they are willing to consider legislation requiring that ADFs be used for all ER/LA opioid prescriptions. What many of those policymakers apparently haven’t considered, however, is how much this is going to cost, and who is going to bear that cost.
First, let me just say this about the term “abuse-deterrent”: it’s a misnomer. Currently approved ADFs are designed either to make it hard for people to crush, cut or otherwise alter the pills obtained from the pharmacy (e.g., OxyContin®, Hysingla®) or with a sequestered opioid antagonist that is released if the product is altered, rendering the opioid totally ineffective if it is ingested (e.g., Targiniq®, Embeda®). Other ADF mechanisms are envisioned in the draft guidance issued by the U.S. Food and Drug Administration (FDA) in 2013, but the common theme for all of them is an attempt to discourage people from altering the medication to snort, inject, smoke or otherwise ingest it by an unintended route. Doing this with an ER/LA opioid is dangerous because the medication in it is intended to be released over 12 to 24 hours, but when altered and taken by another route, the entire dose of the drug hits the bloodstream immediately, increasing the risk of overdose exponentially. ADFs deter this kind of abuse; but what they don’t deter is the most common form of abuse: swallowing more of the intact medication than is intended. In a sense, the “ADF” acronym really ought to stand for “alteration-deterrent formulation.”
Altering ER/LA opioids is a behavior most often seen among those who have a long history of abusing drugs. It is a behavior that is very rarely seen in people with pain who are prescribed these medications by their healthcare providers. As one panelist observed at a recent FDA meeting about ADFs, it’s a little odd that we’re designing these medications to protect people who shouldn’t be using them in the first place, rather than designing them to benefit those who SHOULD be using them. Requiring universal use of ADFs, which is the track on which the policy train is currently gathering speed, unquestionably would benefit the public health and reduce fatal overdoses involving prescription opioids. From that standpoint, such policies make a great deal of sense, and should be supported.
Unfortunately, it’s not that easy. Because these are new medications, the companies who make them have development costs to recoup, which is why the government grants them patent protection to exclusively market these new ADFs for several years. Like all such monopolistic situations, the result is a new product with a much higher price tag than the older products being replaced. This leads to another consideration: If the vast majority of people who are prescribed ER/LA opioids don’t alter them, why should they have to pay considerably more for medications designed to protect someone else? And, if some of these medications have older (cheaper) non-ADF versions on the market, why shouldn’t they be able to use these and save some money?
Clearly, if we want to encourage wide-spread adoption of ADF opioid pain relievers (and I think we certainly do), we need to take the necessary steps to make them affordable. That is why many pain management advocates support legislation that requires the use of ADFs in most instances, but only when coupled with a provision that third-party payers (insurance companies, Medicare, Medicaid, etc.) cover them so that patients’ out-of-pocket cost is as low as possible. Massachusetts did just that in a law it passed last year, and we at the Academy are advocating for similar provisions in bills that are now popping up in many state legislatures.
As is the case with every policy addressing prescription drug abuse, ADFs are not THE solution to the problem, but they are A solution – another vital piece in the policy puzzle we have to put together to end this complex public health crisis and save precious lives.
Dartmouth Says It Will Ban Hard Liquor on Campus
February 4th, 2015/
Dartmouth College has announced it will ban hard liquor on campus in an effort to reduce alcohol-related incidents. Hard liquor will no longer be served at events open to the public, and penalties for underage students found in possession of hard alcohol will increase in severity, according to The New York Times.
Colleges and universities across the country have been dealing with alcohol-related problems including sexual assaults, fraternity hazing and hospitalizations, the article notes. Few other colleges, except for ones with religious affiliations, ban hard liquor. It is unlikely other institutions will follow the lead of Dartmouth, despite its Ivy League affiliation, the newspaper states.
“I think you’re going to continue to see smaller efforts to step up enforcement, but not a lot of big statements like this,” said Kevin Kruger, President of Naspa, a national association of student affairs professionals in Washington. Kruger said while hard alcohol is particularly destructive, the core of the problem is that for many college students, “they’re under 21 and it’s illegal to drink, period.”
Jake G. Rascoff, a student who edits The Dartmouth Review, predicted the new rule will have a negative effect. “It will increase the incidence of surreptitious binge drinking and increase the risk of binge drinking off campus, which will lead to drunk driving,” he said.
Several other colleges, including Bowdoin, Bates and Colby in Maine, also have hard-alcohol bans. Some institutions, including Stanford, Swarthmore and Colgate, ban hard alcohol in certain places, and at certain types of events. Brown recently announced it is reviewing its alcohol policy after reports of sexual assaults at two fraternity parties.
Some schools have strong alcohol policies but do not strictly enforce them. At many colleges, fraternities own their houses and the land beneath them, allowing them to operate outside of college policy.
Moms-
Please join me in welcoming the a.mazing Nicole Montalbano as our guest expert for “In The Rooms,” on Thursday, Feb 5, at 7 PM ET. Nicole is the brilliant and beautiful daughter of our founder, Barbara Theodosiou. Nicole is currently a senior at Florida State University. She has recently been admitted into the Physician Assistant Program at Barry University in South Florida.
Nicole will be presenting for us her point of view as the sibling of Daniel, who suffers fro...m the disease of addiction. Most of us remember the path that led Barbara to create “The Addict’s Mom,” but allow me to remind you. When Barbara learned that two of her sons were addicted to drugs, she was devastated, as all of us are. She felt desperate and alone, convinced that no one could ever understand her heartbreak and pain as a mother of a child (children) who is battling addiction. So, certain that there were others who felt as she did, Barbara founded our wonderful TAM as a safe forum to “Share Without Shame” the tragedies, small victories, and grief as mothers’ of children with drug addiction. Of course, under Barbara’s excellent guidance, TAM has grown to include initiatives in education, advocacy, the legal system, and most recently, scholarships for treatment. Nicole was very young, at age 12, when the tragedy of addiction entered her house.
Nicole has written a very poignant memoir of her experiences with her beloved brother. As a guest on “In The Rooms,” Nicole will share her memoir, and her special insight as Daniel’s sister. We will invite her to suggest coping strategies for families, especially the siblings, when addiction becomes part of their daily lives. We will ask her to share with us what she would have done differently, and what is her most difficult obstacle to overcome. She can discuss the stigma, the pain of watching Daniel’s downward spiral, and her own healing process. I would also like to ask Nicole how Daniel’s tragic journey has affected her own life choices in relationships and career goals. Then you, the viewers, will have the o.pportunity to ask questions of Nicole.
Nicole Montalbano is a very brave young lady. With the example set by her mother, Barbara, it is no wonder that Nicole is able to “Share Without Shame” her journey, hand-in-hand with her family, on the devastating path that is addiction.
Please join us online at: www.intherooms.com (you will need to download Google Chrome or Firefox )
Further instructions how to access can be found in our files section on In the Rooms.
Visit The Addict's Mom at: http://addictsmom.com/?xg_source=msg_mes_network
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