Thursday, June 14, 2012
Kerlikowske: Addiction is a Disease, Not a Moral Failure
By Join Together Staff | June 11, 2012 | Leave a comment | Filed in Addiction,Alcohol, Drugs, Government, Recovery & Treatment
Addiction is a disease, not a moral failure, according to Gil Kerlikowske, Director of the White House Office of National Drug Control Policy. He is scheduled to speak about addiction and drug control policy Monday at the Betty Ford Center in California.
He will call for more alternatives to current drug policy, including early intervention through health care, better access to treatment, more support during recovery, and effective public education, The Desert Sun reports. “Recovery is this long-term, lifelong process, with its own set of challenges and its own needs — and yet we fail to highlight that process,” he told the newspaper in an interview.
In 2010, 23 million people aged 12 or older needed treatment for an illicit drug or alcohol use problem, according to the Substance Abuse and Mental Health Services Administration. Of these, 2.6 million received treatment at a specialty facility.
Kerlikowske also will call for a review of laws that can add to the challenges of recovery, such as barriers that prevent many minor drug offenders from obtaining housing and federal student aid. His goal is to curb the growing number of prison inmates, many of whom are coping with drug abuse, while reducing the $50 billion cost of incarcerating them.
Kerlikowske will be joined by U.S. House Representative Mary Bono Mack of Palm Springs, who has been raising awareness about prescription drug abuse. Bono Mack, who co-chairs the Congressional Caucus on Prescription Drug Abuse, has introduced legislation that would revise Food and Drug Administration drug classifications to ensure that drugs containing controlled-release oxycodone hydrochloride would be prescribed only for sever
Wednesday, June 13, 2012
Medication for Alcoholism: An Expanding Field
By Celia Vimont | June 12, 2012 | Leave a comment | Filed in Alcohol,Healthcare & Treatment
Many people struggling with alcohol dependence who could benefit from medication are not receiving it, according to an expert who spoke at the recent American Psychiatric Association Annual Meeting.
“Antidepressant prescribing is 100 to 200 times as great as prescriptions for medications approved to treat alcohol dependence, despite the fact that the prevalence of disorders for which antidepressants are prescribed—major and minor depression and anxiety disorders—is only two to three times that of alcohol dependence,” says Henry Kranzler, MD, Professor of Psychiatry at the Treatment Research Center at the University of Pennsylvania and the Philadelphia VA Medical Center.
The reasons why medications to treat alcoholism are not more widely prescribed are complex. A main factor is that pharmaceutical companies and physicians have been afraid to deal with alcohol-dependent patients because they are concerned about the potential for out-of-control drinking to result in liability, for example, if a patient under treatment drives under the influence and has an accident, he says. Some doctors, as well as patients and their family members, also believe that alcoholism is not a suitable target for medication because, in their view, it only substitutes dependence on one substance for another.
Medication also may not be offered to many people with alcohol dependence because they are treated exclusively by non-medical personnel, such as counselors, Dr. Kranzler added.
Currently, three drugs are approved by the U.S. Food and Drug Administration to treat alcoholism: disulfiram (Antabuse), naltrexone (ReVia and Vivitrol) and acamprosate (Campral). “These drugs all exert modest effects,” notes Dr. Kranzler. Another drug that is prescribed off-label for alcoholism is topiramate (Topamax), which is approved to treat certain types of seizures and to prevent migraines. Topamax appears to correct a chemical imbalance in the brain caused by chronic drinking. Unlike treatments currently approved for alcoholism, it has been shown to be effective in people who are still drinking. However, it can cause side effects such as memory and thinking problems, as well as sedation.
Lundbeck, a Danish pharmaceutical company, has submitted anapplication for approval by the European Medicines Agency of the medication nalmefene to be used on an as-needed basis to reduce heavy drinking, according to Dr. Kranzler. “This is a novel approach and could have an impact on treatment throughout the European Union and possibly the U.S.,” he adds.
Last year, the company announced that nalmefene showed promising results in three clinical trials in Denmark. The drug can be used in patients who are still drinking.
“There are a number of companies in the United States and Europe that are developing novel compounds to treat alcohol dependence,” Dr. Kranzler says. “As we learn more about the neurobiology and genetics of alcohol dependence, it will be possible to identify novel mechanisms through which to intervene pharmacologically.”
This is an exciting time in the treatment of alcoholism, because the field of medication treatment for alcohol dependence is expanding into the arena of personalized medicine, he says. “There is growing interest in the use of a patient’s genetic variation to predict the response to specific medications,” he points out. “However, these findings are not yet ready for widespread clinical implementation. Additional research is required to allow them to be widely applied.”
Even with new medications, counseling should still be an important part of alcohol dependence treatment, Dr. Kranzler observes. “However, the personnel who are trained to provide counseling are not widely enough available to use this as the only model for treatment,” he adds. “There appears to be a role for medication combined with brief interventions that focus on promoting adherence to the medication and can be delivered in a primary care setting.”
Tuesday, June 12, 2012
A BIG THANK YOU TO ALL FROM LIVINGRIN!
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Monday, June 11, 2012
Fruit Fly Study May Provide Clues to Human Alcohol Dependence
By Join Together Staff | March 16, 2012 | 1 Comment | Filed in Alcohol,Research & Treatment
Male fruit flies spurned by females are more likely to turn to food soaked in alcohol than their male counterparts who successfully mate, according to a study that may provide clues about humanalcohol dependence.
Researchers at the University of California, San Francisco, let one group of male fruit flies mate with available females, while another group of males mingled with females who had already mated, and were not interested in the males’ advances. After four days, the flies in both groups were able to feed from glass tubes that contained either yeast and sugar, or yeast, sugar and alcohol. The male flies that could not mate drank the alcohol mixture about 70 percent of the time, compared with about 50 percent of males who had mated, The New York Times reports.
The study found a strong link between levels of a brain chemical called neuropeptide F, or NPF, and the fruit flies’ appetite for alcohol. When NPF levels were low, alcohol consumption was high, and high levels of NPF were correlated with low levels of alcohol consumption.
NPF in fruit flies is thought to be similar to a brain chemical in humans called neuropeptide Y, or NPY, according to the article.
This study suggests the development of drugs that enhance the activity of NPY might be useful in treating alcohol dependence, said George Koob, Professor of Neurobiology and Addiction at the Scripps Research Institute in La Jolla, California.
“The study implies that it is this system that goes haywire in addiction, and that it’s very sensitive to stress,” he told the newspaper. “For instance, after you lose a loved one, or a relationship has crashed, you get dysphoric, your NPY goes down, and this provides a strong urge to drink a lot — whether you’re a mammal or a fruit fly.”
The study appears in the journal Science.
Adapting 12-Step Programs For Teenagers
By Celia Vimont | June 1, 2012 | 6 Comments | Filed in Addiction, Recovery,Young Adults & Youth
Twelve-step programs can be extremely helpful for teens who are struggling with addiction or who are on the road to becoming addicted, but they are more useful if they are adapted to the particular needs of adolescents, according to an expert on teenage addiction.
“These programs were developed for adults, and teenagers are not little adults—they are in a totally different developmental stage,” says Steven Jaffe, MD, Professor Emeritus of Psychiatry at Emory University, and Clinical Professor of Psychiatry at Morehouse School of Medicine, in Atlanta.
Dr. Jaffe, who has spent the past 25 years working to modify 12-step programs to make them developmentally meaningful for teenagers, spoke about his work at the recent American Society of Addiction Medicine conference. “These programs are free, they’re everywhere, they provide big brothers and sisters as sponsors, and they offer recovering friends,” he notes. “That’s really important, because if teens go back to their friends who use drugs or alcohol, they will start using again, too.”
Often, teens who are treated for substance use disorders are simply told to go to 12-step meetings. “You can’t just tell them to go, and leave it at that,” Dr. Jaffe says. “They have tremendous anxietyabout going, so you need to link them with a sponsor who will take them to a meeting, or else they won’t go.”
Just getting them to the meetings may not be enough, however. Some of the basic concepts of 12-step programs may be troublesome for teenagers, according to Dr. Jaffe. The first step talks about being powerless over drugs and alcohol, but the word “powerless” can be a big turn-off for teens, he observes. “The goal of a teen is to have power, and they think, ‘Who wants to be part of a group that’s powerless?’”
Instead, Dr. Jaffe encourages them to think about getting clean and sober in order to enhance their power. “It’s the same step, but it’s rephrased and reemphasized to make it developmentally appropriate,” he says. “I tell them, flunking out of school, being thrown out of the house and being arrested as a result of drugs or alcohol is not powerful.”
Another concept in 12-step programs that teens can have trouble with is surrender. “Many teens, especially girls, have found themselves in very vulnerable situations when they are drunk or high, and the last thing they want to do is surrender. I tell them if they get clean and sober, they’ll be strong, and never have to put themselves in a position where bad things like that can happen.”
Dr. Jaffe developed two workbooks he uses with teenagers to make 12-step programs more meaningful to them. “So often, teens will tell me the negative consequences of using drugs and alcohol one day, and the next day they’ll deny it. So I have them write down the consequences in the workbook, so they can’t deny it the next day.” It takes one hour to complete the Adolescent Substance Abuse Intervention Workbook, which is then presented to a counselor individually or at a group. The Step Workbook for Adolescent Chemical Dependency structures the working of the first five steps.
Dr. Jaffe can be contacted about his work with teens and 12-step programs at srjaffe@bellsouth.net.
Sunday, June 10, 2012
Commentary: Responding to America’s Medicine Cabinet Epidemic
By Congressman Hal Rogers | June 8, 2012 | Leave a comment | Filed in Drugs,Government & Prescription Drugs
A high school homecoming queen and a Hollywood bombshell. A rural sheriff and a college rugby-player. A small-town pharmacist and an expectant mother.
These individuals may not appear to have much in common – but tragically these are all among the thousands of lives fallen prey to the abuse of pain pills around our country. The Centers for Disease Control has described this as a national epidemic, and the statistics don’t lie.
While overdose deaths from prescription opioids have long exceeded deaths from heroin and cocaine combined, alarmingly in 2009, prescription overdoses also overtook motor vehicle crashes as a leading cause of accidental death. As a result of dangerous misconceptions about the recreational use of painkillers, ourmedicine cabinets have become more dangerous than our cars.
When this problem began to take root in southern and eastern Kentucky, we realized the unique nature of prescription drug abuse would require a multi-pronged solution. At the local level, our Kentucky communities coalesced around an organization called Operation UNITE (Unlawful Narcotics Investigations, Treatment and Education). UNITE has harnessed the energy of health, law enforcement and community leaders in a coordinated fight against pain pill abuse. At the same time, undercover UNITE detectives zero in on drug dealers, and school counselors help start up meaningful alternatives to youth drug use through UNITE clubs and extracurricular activities. Thousands of mothers, daughters, fathers and sons have been given a second lease on life through UNITE’s treatment programs or by participating in a drug court.
People in our region of Kentucky have taken a stand, and the nation is taking note. At the first of its kind National Rx Drug Abuse Summitin Orlando earlier this year, leaders from around the country joined with UNITE to think strategically about the path forward. Office of National Drug Control Policy Director Gil Kerlikowske, federal and local law enforcement, organizations like The Partnership at Drugfree.org, public health officials, prosecutors and medical researchers all rallied together to share ideas for reducing drug abuse in rural and urban communities alike and mending families ripped apart by this scourge.
For my part, through the Congressional Caucus on Prescription Drug Abuse, I have worked to alert Washington decision-makers to the serious dangers posed by our nation’s fastest growing drug threat. Members of the Caucus collaborate across the political spectrum toward immediate and long-term policy solutions in our battle against prescription drug abuse.
This week, I was particularly proud to speak at the Annual Meeting for the Alliance of States with Prescription Monitoring Programs (ASPMP). Prescription drug monitoring programs (PDMPs) are among the most efficient and cost-effective tools in our arsenal, bridging the gap between legitimate medical need and potential misuse. Since Congress established a grant program at the U.S. Department of Justice in 2002, the number of states with authorized PDMPs has tripled from 15 to 48; however, a secure interstate exchange system to combat so-called “doctor shopping” has lagged.
I was pleased to stand with these trailblazing members of ASPMP as they voted to adopt the PMIX Architecture – a landmark, consensus-based set of technical standards to facilitate interoperability among state-run PDMPs. Soon data exchanges will allow doctors, pharmacists and investigators to sniff out the interstate doctor shopping that has fueled the pill pipeline in our country.
While this marks a huge victory for those of us who have been engaged in this fight for years, our work is far from done. This is an epidemic which crosses socioeconomic and gender lines and which threatens the very fiber of our society. I would encourage you to reach out to your Member of Congress and request that he or she join the Congressional Caucus on Prescription Drug Abuse or cosponsor one of the several measures that seek an end to the abuse of painkillers; only together can we curb this rising tide.
Rogers has served Kentucky’s 5th Congressional District since 1981 and is currently serving as Chairman of the House Appropriations Committee. As part of his efforts to fight this growing epidemic, Rogers joined with Representatives Mary Bono Mack (CA-45) and Stephen Lynch in forming the bi-partisan Congressional Caucus on Prescription Drug Abuse, which aims to raise awareness of abuse and to work toward innovative and effective policy solutions, incorporating treatment, prevention, law enforcement and researc
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