Friday, March 21, 2014

Authorities Issue Warning About Deadly Street Drug, Fentanyl

Posted: Mar 20, 2014 4:30 PM EDTUpdated: Mar 20, 2014 4:30 PM EDT

MEDIA, Pa. -

District Attorney Jack Whelan, Marcus Hook Police Chief John Ireland and the Delaware County Medical Examiner Dr. Fredric Hellman have issued a warning regarding Fentanyl, a deadly, synthetic opioid narcotic that has claimed the life of a Delaware County woman.

Delaware County Medical Examiner Dr. Fredric Hellman said toxicology results returned on March 19 indicated that the recent death of a 30-year-old Marcus Hook woman was the result of the intravenous administration of pure Fentanyl. The name on the packet is "Black Dahlia," and the substance was packaged in a blue glassine packet with red lettering. According to Dr. Hellman, this is the first case in 2014 involving a death from pure Fentanyl. Fentanyl can come in the form of powder, pill or patch and has been known to be snorted or injected into the bloodstream. Authorities are warning the community that the use of this lethal drug will result in death.

"These drugs are manufactured in clandestine labs by criminals, and every single packet has the potential to kill the user," warned District Attorney Jack Whelan. "Those who believe they are purchasing heroin end up with a much more dangerous drug that is 100 percent pure and, when ingested, rapidly shuts down the central drive for breathing, resulting in death."

The Delaware County Heroin Task Force continues its efforts to educate and prevent the use of heroin and abuse of prescription drugs. "We are moving forward on many fronts to combat the heroin epidemic that has plagued Delaware County," said District Attorney Jack Whelan, chairman of the Heroin Task Force. "We are determined to do everything possible to protect our children, our families and our communities from the devastating effects of drug addiction." For more information visit the Heroin Task Force website at

Residents who have any information concerning illegal drugs should contact the Marcus Hook Police Department at 610-485-1611 or the Delaware County Criminal Investigation Division at 610-891-4700


No human wisdom or understanding or plan
can stand against the Lord.

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

Did you ever notice when in active addiction that everything in your life is falling apart . No matter how hard you try to make sense of the insanity that is your life you keep asking yourself what  am I doing wrong  ,well at least I did. I would always justify the insanity by lying to myself and convincing myself someone upstairs hates me or someone put a curse on me . Wow the excuses I had ! It took a lot of heartache , confusion , pain , and homelessness to hit the bottom. I am going to make this simple so you wont have to suffer as much as I did , and I hope you hear this message take it to heart so you wont lose it all like I did. Read the Proverb and commit step three , that's the answer ! You sincerely and whole heartily follow these two , God will Help and fix you ! 

Matthew chapter 10 v 38 - Those who do not take up their cross and follow in my STEPS are not fit to be my disciples .

Republicans Who Oppose Mandatory Minimum Sentences Say They’re Costly, Ineffective

Republicans, who have traditionally taken a tough approach on crime, are increasingly opposing mandatory minimum sentences, The New York Times reports. They see the sentences as ineffective, as well as too costly and punitive.

Fiscal conservatives are looking to save billions of dollars in the federal budget by closing prisons and releasing inmates who no longer appear to pose a threat to society. Religious conservatives view sentencing reform as a way to offer compassion and to reunite families.

Many Republicans and Democrats agree mandatory minimum sentences should be reduced, the newspaper notes. Attorney General Eric Holder is pushing to eliminate mandatory minimum sentences for nonviolent drug crimes. He is joining with libertarian Republicans, including Senator Rand Paul of Kentucky, in this effort.

Last week, Holder testified in favor of changing federal guidelines to reduce the average sentence for drug dealers. He told the United States Sentencing Commission the Obama Administration supports changing guidelines to reduce the average drug sentence by about one year, from 62 months to 51 months.

The proposed changes would reduce the federal prison population by about 6,550 inmates over the next five years. Currently, half of the 215,000 inmates in the federal prison system are serving time for drug crimes.

Republicans and Democrats in the Senate are discussing combining two bills on sentencing reform. One would give judges more leeway to depart from mandatory minimum sentences in lower-level drug cases, reduce mandatory sentences for other drug offenses, and make the 2010 law that reduced the disparity between cocaine and crack-cocaine sentences retroactive.

A second bill would establish a skills training and early release system for people who are incarcerated, but who are considered to be at low risk for committing another offense.
Teen Inhalant Use Decreasing: Government Report

By Join Together Staff | March 20, 2014 | Leave a comment | Filed in Drugs &Youth

Fewer American teens are abusing inhalants, such as spray paint, glue and gasoline, according to a new government report. The number of teens ages 12 to 17 who used inhalants dropped from 820,000 in 2011, to about 650,000 in 2012.

The Substance Abuse and Mental Health Services Administration (SAMHSA), which released the findings, defines inhalants as “liquids, sprays and gases that people sniff or inhale to get high or to make them feel good,” UPI reports.

“This downward trend of inhalant use in adolescents is very encouraging,” Pamela S. Hyde, administrator of the SAMHSA, said in a statement. “Nevertheless, we must all continue our efforts to raise awareness about the dangers and health risks of this deadly and addictive problem among our youth.”

When inhalants are breathed in through the nose or mouth in a variety of ways they are absorbed quickly through the lungs into the bloodstream and the user experiences a rapid but short-lived intoxication.

There are hundreds of household products on the market today that can be misused as inhalants. Examples of products kids abuse to get high include model airplane glue, nail polish remover, cleaning fluids, hair spray, gasoline, the propellant in aerosol whipped cream, spray paint, fabric protector, air conditioner fluid (freon), cooking spray and correction fluid.

These products are sniffed, snorted, bagged (fumes inhaled from a plastic bag), or “huffed” (inhalant-soaked rag, sock, or roll of toilet paper in the mouth) to achieve a high. Inhalants are also sniffed directly from the container.

Within seconds of inhalation, the user experiences intoxication along with other effects similar to those produced by alcohol. Alcohol-like effects may include slurred speech, an inability to coordinate movements, dizziness, confusion and delirium. Nausea and vomiting are other common side effects. In addition, users may experience lightheadedness, hallucinations, and delusions.

Compulsive use and a mild withdrawal syndrome can occur with long-term inhalant abuse. Additional symptoms exhibited by long-term inhalant abusers include weight loss, muscle weakness, disorientation, inattentiveness, lack of coordination, irritability, and depression.

Thursday, March 20, 2014


Avoiding a fight is a mark of honor;
only fools insist on quarreling.

STEP 10 - Continued to take personal inventory and when we were wrong promptly admitted it.

As I get older the more and more I realize the proverb is right . Why are we so hell bent on proving our point. Back in the day not so long ago I knew everything and you could not tell me nothing . You could have been a world renown expert and I would find a reason to argue. Its ok too want to be right but if you don't have all the facts you need to make your point and don't push the person your haggling with they will eventually see the truth if they are the one at fault . It is not your job to beat it into their heads . The truth will always win out ! When we are wrong we need to man up and admit it that is called maturity and that is what us sober folks do. It will keep your mind and heart free of negativity , resentment , anger , bitterness , and denial .These are all fatal triggers that can push anyone into relapse.

JAMES CHAPTERP 1 v 19 v20 Understand this, my dear brothers and sisters: You must all be quick to listen, slow to speak, and slow to get angry.Human anger does not produce the righteousness God desires.

Teens will be teens. They sleep late, fail a test here and there or get uncharacteristically moody. But what if these behaviors are happening more often than usual, or all at the same time? You know your teen better than anyone, but it is important to know what to look for if you suspect he or she may be abusing medicine.
  1. Health concerns. Keep an eye out for changes in your teen’s physical health, like constricted pupils, nausea or vomiting, flushed skin or dizziness. Look further into anything that seems strange.
  2. Changes in behavior. The signs of medicine abuse aren’t always physical. Look for changes in behavior – like sudden changes in relationships with their family or friends, anxiety, erratic mood swings or decreased motivation. It’s no secret that teens can be moody, but be on the lookout for drastic differences in the way your child behaves.
  3.  Home-related signs. If you’ve noticed belongings  disappearing around the house, or found some unusual objects appearing – like straws, burnt spoons, aluminum foil or medicine bottles – this could be a sign of medicine abuse. Count – and lock up – the medicine you have in your home and safely dispose of any expired medicine.
  4. Trouble in school. Take note of how your teen is doing in school, including any change in homework habits and grades. A rapid drop in grades, loss of interest in schoolwork and complaints from teachers could be indicators that there’s a problem.
  5. Things just seem off. You know your child better than anyone and you know when something’s not right. Trust your gut, and talk to your teen about your concerns. 
With one in four kids reporting abuse of prescription drugs in their lifetime, it’s important to take action right away if you do suspect medicine abuse. Don’t be afraid to talk – and listen – to your teen, work through things together and get help if necessary.


Vaporizers Gain Popularity Among Marijuana Smokers

By Join Together Staff | March 18, 2014 | 1 Comment | Filed in Drugs

A growing number of marijuana smokers are choosing to use vaporizers, which are similar to e-cigarettes, according to USA Today. The popularity of the devices is changing the way marijuana is packaged and sold in states where it is legal.

The vaporizers, known as “vape pens,” are compact and portable. Steve DeAngelo, a marijuana entrepreneur and activist who founded the Harborside Health Center medical marijuana dispensary in Oakland, California, says his dispensary does about half of its business in raw marijuana leaf or flowers. The rest are sold as edibles or concentrates, some of which are prepackaged for use in vape pens. “The percentage of raw (pot) flowers we sell has been dropping steadily,” he said. “The percent of extracts and concentrates … has been rising steadily.” Some vape pens use concentrated marijuana extractions, while others use marijuana leaves and flowers.

“This really portends the next generation of marijuana use,” John Lovell, a Sacramento attorney and lobbyist for the California Narcotics Officers’ Association and California Police Chiefs Association, told the newspaper. His group is concerned about the high-strength concentrates used in vape pens. Concentrates can be composed of as much as 80 percent or 90 percent THC, the psychoactive ingredient in marijuana.

Others are concerned that vape pens allow teens to smoke marijuana without being detected, because the pens leave no odor.

OxyContin Manufacturer Tests Tamper-Resistant Form of Hydrocodone

By Join Together Staff | March 18, 2014 | Leave a comment | Filed in Prescription Drugs & Prevention

The maker of OxyContin announced promising results from a study of a tamper-resistant form of hydrocodone, The Washington Post reports. The Food and Drug Administration (FDA) has been criticized for approving Zohydro ER (extended release), a pure form of hydrocodone that is not tamper-resistant.

Purdue Pharma, which manufactures OxyContin, said it will soon seek FDA approval for its version of an extended-release form of hydrocodone. The company says its version is difficult for a person to crush, in order to inject or snort the drug. In 2010, the company reformulated OxyContin to make it harder to crush or dissolve.

The new study showed a majority of patients with chronic low back pain treated once daily with the hydrocodone drug experienced at least a 30 percent improvement in pain intensity, compared with a placebo. Almost half achieved a 50 percent improvement.

“This is another step forward in our efforts to develop therapeutic options for use by chronic pain patients that are designed to be unattractive to drug seekers,” Gary L. Stiles, the company’s Senior Vice President of Research and Development, said in a statement.

Last week, West Virginia Senator Joe Manchin called on Health and Human Services Secretary Kathleen Sebelius to overrule the FDA decision to approve Zohydro ER. Late last year, Manchin and three other senators wrote to the FDA, saying they disagreed with the agency’s decision to approve the drug. In October, the FDA approved Zohydro for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Drugs such as Vicodin contain a combination of hydrocodone and other painkillers such as acetaminophen.

In December, the attorneys general from 28 states asked the FDA to reassess its decision to approve Zohydro.

Study Finds Alcohol Deaths Most Likely to Impact Working-Age Adults

By Join Together Staff | March 18, 2014 | Leave a comment | Filed in Alcohol

The majority of alcohol-related deaths in the United States occur among working-age adults, a new government study concludes. Adults ages 20 to 64 account for more than two-thirds of these deaths.

The study by the Centers for Disease Control and Prevention (CDC) found in the 11 states studied, alcohol caused a median of 1,650 deaths annually between 2006 and 2010, HealthDay reports.

“It’s really important to drive home that excessive alcohol use is a leading cause of preventable death,” lead author Katherine Gonzales said. “It really is right up there with tobacco and physical inactivity, especially among working-age adults.”

The study included accidental alcohol-related deaths such as car crashes, firearm injuries, drownings and occupational injuries, as well as illnesses such as liver disease, stroke, high blood pressure, cancer, and fetal alcohol syndrome.

The CDC researchers found men were much more likely than women to die of alcohol-related causes. While the most alcohol-related deaths occurred among whites, deaths linked to excessive drinking were more likely among blacks, American Indians and Alaska natives.

Teens’ Definition of “Designated Driver” Can Be Loose, Survey Finds

By Join Together Staff | March 19, 2014 | Leave a comment | Filed in Alcohol & Youth

Teens’ definition of a “designated driver” can be loose, according to a new survey. About one in five teens say their designated person is allowed to have “a little” alcohol or other drugs, as long as they aren’t too impaired to drive.

The survey found 4 percent of teens describe their designated driver as the most sober person in the group, Bloomberg News reports. One in 10 teens who said they have never driven under the influence of alcohol admitted to driving after having a drink.

The survey, conducted by Liberty Mutual and Students Against Destructive Decisions (SADD), calls attention to risky behaviors by young people, the article notes. Teens “seem to think that unless they’re really falling-down drunk, that it’s OK for them to drive,” David Melton, Managing Director for Global Safety at Liberty Mutual, told Bloomberg News.

According to the National Highway Traffic Safety Administration, the driver was intoxicated in about 18 percent of fatal crashes involving drivers ages 16 to 20 in 2011.

The survey included 2,537 students in 11th and 12th grades. U.S. drivers with a blood alcohol concentration above .08 grams per deciliter are considered alcohol-impaired. “Long before you’re at .08, you’re definitely impaired in terms of your judgment,” Melton said. “You may not be over the legal limit, but you are driving with a buzz on and that’s not a good thing.”

In a statement, Stephen Gray Wallace, Senior Advisor for Policy, Research and Education at SADD, said, “With teens reporting these lax definitions of what it means to be ‘under the influence,’ a zero tolerance approach is the only answer to prevent potential tragedy. The parents and community have a responsibility to initiate and maintain an open dialogue with teens about exactly what driving under the influence means.”

Monthly Number of Federal Drug Defendants Drops to Lowest Level in 14 Years

By Join Together Staff | March 19, 2014 | Leave a comment | Filed in Drugs, Government, Legal & Legislation

Soon after Attorney General Eric Holder began making changes to drug laws, the number of drug defendants charged by the federal government dropped in January to its lowest monthly level in almost 14 years, according to a new report.

The report, by Syracuse University, found there were 1,487 new drug prosecutions in January 2014, down 7.8 percent from December, and down 11.5 percent from January 2013. “The number observed during the most recent six month period appears to be the lowest seen since the end of the Reagan Administration,” the researchers noted.

The drop in prosecutions follows the launch of Holder’s “Smart on Crime” initiative, The Huffington Post reports. The initiative’s goals include prioritizing prosecution to focus on the most serious cases, reforming sentencing to eliminate unfair disparities and reduce overburdened prisons, and pursuing alternatives to incarceration for low-level, non-violent crimes.

A spokeswoman for the Justice Department, Ellen Canale, told The Huffington Post, “It makes sense to reserve the harshest sentences for the most serious drug offenders. The department’s charging policies are aimed at empowering federal prosecutors to consider the individual circumstances of each defendant in order to determine what outcome best improves public safety.”

Last week, Holder testified before the United States Sentencing Commission in favor of changing federal guidelines to reduce the average sentence for drug dealers.

FDA Commissioner: Zohydro Offers Unique Option to Treat Pain

By Join Together Staff | March 19, 2014 | 1 Comment | Filed in Government & Prescription Drugs

Food and Drug Administration (FDA) Commissioner Margaret Hamburg defended the agency’s decision to approve the pure hydrocodone drug Zohydro ER (extended release). At a Senate hearing, Hamburg said, “If appropriately used, it serves an important and unique niche with respect to pain medication and it meets the standards for safety and efficacy.”

Speaking before the Senate Health, Education, Labor and Pensions Committee, Hamburg acknowledged Zohydro is a powerful drug. She noted that unlike other hydrocodone drugs, Zohydro does not contain acetaminophen, which can be toxic to the liver.

Zohydro is designed to be released over time, and can be crushed and snorted by people seeking a strong, quick high. “I would love if we had abuse-deterrent formulations that were actually meaningful and effective at deterring abuse in all instances. We are moving in that direction,” Hamburg said. “Right now, unfortunately, the technology is poor.”

The FDA’s decision to approve Zohydro has been criticized by some legislators and public health groups, Reuters reports. Hamburg has received letters protesting the decision from 28 state attorneys general and four senators, among others.

Law enforcement agencies and addiction experts predict approval of the drug will lead to an increase in overdose deaths.

Zohydro was approved for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. In December 2012, a panel of experts assembled by the FDA voted against recommending approval of Zohydro ER. The panel cited concerns over the potential for addiction. In the 11-2 vote against approval, the panel said that while the drug’s maker, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone.

Wednesday, March 19, 2014


Sensible people control their temper;
they earn respect by overlooking wrongs.

STEP 4 - Made a searching and fearless moral inventory of ourselves.

Someone told me along time ago that anger undealt with becomes resentment and in return we become bitter . When working step four get ready to stir up some pretty heavy stuff. The tough part is we take stuff sweep it under a rug but that does not mean its not there . You are gonna have to dig deep on this one and be brutally honest with yourself and your sponsor. If we don't learn how to deal with and properly dispose of anger then we and everybody around us will suffer . Have you ever been around someone who is bitter they hate everything and everybody .They are the Kings and Queens of cynicism and self pity .They can and will suck the joy and life out of you . They are the people you cant stand being with .Are you one of those bitter joy killers ,if you are follow the Proverb and the step. Not everyone in your life has to be punished because of your undealt with resentments and anger. Show mercy and start controlling your anger and turn the other cheek.

JAMES CHP 1 v 19 v20 Understand this, my dear brothers and sisters: You must all be quick to listen, slow to speak, and slow to get angry.Human anger does not produce the righteousness God desires.

Getting to Rehab
RIDGWAY, ELK COUNTY PA - Drugs are something police everywhere have to deal with almost everyday.

"When I first moved here, there wasn't any. We didn't have that. I raised my kids here and it's gotten worse since then" said Ridgway resident Ketta Melzer.

"There is a real problem in this county of drug and alcohol use and abuse" added Salvation Army Lt. Esther Wilson.

She says the Ridway Salvation Army is now offering transportation to those seeking rehabilitation at one of their facilities throughout the country. The Salvation Army has over 150 and serves tens thousands of people each year.

" It is a 6 month program. It is in house. You get your rooming, your board and everything provided for you and it's no cost" she said.

The Salvation Army says since the transportation program began about a month ago they've already had someone, who was near overdosing, go to rehab.

"I believe in it. Threes a lot of good success cases that come out of it" said Wilson.

To get information on the program you can call (814)772-0485. They will give you the numbers you need to call to see if their is space for you at a center and then, they will help you get there and get clean.

Tuesday, March 18, 2014


Flipping a coin can end arguments;
it settles disputes between powerful opponents

STEP 3 - We made a decision to turn our wills and our lives over to the care of God.

Stop fighting with everybody including yourself. The Proverb mentions flipping a coin it settles disputes between powerful opponents and all I can think about is every single sport s game in the world . it goes too show you that Gods big book is a must for life and it contains all the answers you need for now and after your dead . Still trying to control the world and everybody else s well there's way too much stress for that , start focusing on you and NO you don't know everything ! That,s ok though that's why its called recovery , if want our lives back we have to let the old life go .When we do God will help up build a new one !
Tuesday, March 18th  
7:00 – 8:30pm
At The Council office, Unit 12

Please pass along the attached flyer to anyone you feel would benefit from this program.  As always, you must register yourself or your group ahead so that we may be prepared with enough materials and food/beverages.  If you have any questions, please let me know!

Thank you,

Jessica Schwartz
Volunteer Coordinator & Prevention Specialist
The Council of Southeast Pennsylvania, Inc.
252 West Swamp Road, Unit 33
Doylestown, Pennsylvania 18901
(800) 221-6333 - 24 Hour Information Line

Daily Quote

"What you are aware of you are in control of; what you are not aware of is in control of you." - Anthony De Mello

Today's Online Meetings
AA Meeting - 7:00 pm CST: "Face to Face"


Copyright 2011 Community of Recovering People LLC
Privacy Policy

Find us on Facebook

Monday, March 17, 2014


Better a dry crust eaten in peace
than a house filled with feasting—and conflict.

STEP 9 - Made direct amends to such people wherever possible, except when to do so would injure them or others.

Better to live in a house with nothing and have peace ! Conflict is a number one trigger for a lot of folks . When all hell is breaking lose at home sometimes its a good idea to step out of the situation call your sponsor or hit your knees until the craziness start to settle down . Once the smoke settles get rid of the source of conflict by committing step nine . Remember when we were out there doing our thing we caused a lot of heartache to the ones we live with . That heartache has destroyed our credibility and our loved ones who are victims of our insanity will have a lot of resentment and bitterness towards us . We have to earn there respect and trust and that is not going to happen overnight . They will need the most time to heal so be patient with them and try and see it from their point of view don't push and get angry like the old days. Love them unconditionally like they did for you even though your every other word was lie and you cannot count on your hands how many times you robbed them .

Matthew chapter 10 v 38 - Those who do not take up their cross and follow in my STEPS are not fit to be my disciples .

Staying Cool With Glutamate
Can an over-the-counter supplement now becoming popular for mental health and mood elevation help a person stay sober? The early research is promising.



Most addicts will tell you that it’s easier to get sober than it is to stay sober. And, the more we learn about the neurobiology of addiction, the more addiction treatment specialists are inclined to say that relapse is a part of recovery.

Do addicts have to “white knuckle” it in order to get sober and stay clean? Yes, replacement and anti-craving medications exist, but many still suffer from generally poor outcomes. Replacement therapies for opioid addiction, such as methadone and buprenorphine, and for nicotine addiction are widely accepted. Alcoholics have naltrexone and acamprosate. However, all these are substance-specific, which is a disadvantage to using them to treat addicts who have more than one substance use disorder. Also there are no FDA-approved medications for treating addiction to cocaine and other stimulants. 

Peter Kalivas, a professor and researcher at the Medical University of South Carolina, has been studying the role of glutamate—a ubiquitous excitatory neurotransmitter in the brain—in addiction for over a decade. He believes that addicts can’t learn how to improve or alter their behavior because their substance use has actually impaired a critical brain circuit involving glutamate, one that allows them to translate the desire to change into action.

He’s not alone. The glutamate homeostasis hypothesis of addiction has not only gained traction in the lab in the past 15 years, but in the past five years, hundreds of clinical trials have ramped up with a focus on attempting to heal those damaged glutamate circuits using NAC. NAC, or N-acetylcysteine, is a precursor of the naturally occurring amino acid cysteine, and it is one particular compound that has shown immense clinical promise in treating all sorts of disorders, but especially compulsive ones like addiction. NAC is not found in food, but when taken as a supplement, it breaks down into cysteine and then, glutathione—a powerful antioxidant. What’s more, cysteine is essential to maintaining optimal levels of glutamate.

You might have seen NAC at your local Whole Foods, in fact—it’s a common supplement. It received FDA approval in 1963, and has been used since to treat symptoms of bronchitis, COPD and Tylenol overdoses, among many other diverse, off-label uses. It has gained attention in recent years as scientists learn more about its role in addiction—and preventing relapse.

Preliminary clinical studies have shown the promise of NAC in terms of safety, tolerability, and potential efficacy for encouraging abstinence from cocaine, nicotine, and cannabis. There are hundreds of clinical trials underway in the US studying NAC in the treatment of various disorders, including addiction to alcohol, cocaine, marijuana, nicotine, and methamphetamine, and for behavioral addictions, namely gambling. And, with trials underway for Alzheimer’s and Parkinson’s diseases, autism, compulsive and grooming disorders, schizophrenia, depression, and bipolar disorder—well, it makes NAC one of the most promising drug candidates in neuropsychiatry.

Glutamate homeostasis

A growing body of research has linked changes in the glutamate neurotransmitter system to addiction. When addicts use, they deplete this chemical, which is essential for transmitting signals from the cortex to the nucleus accumbens. The cortex can be thought of as the decision-making center of the brain, while the nucleus accumbens—which is also involved in the dopamine circuit—is the habit area. In addicts, this circuit becomes weak at best, broken at worst. “Even though they know it’s bad, they can’t use this information to change their behavior effectively,” Kalivas says. Because they can’t update their “habit” in response to different instructions from the cortex, they keep on using despite their own better judgment.

The glutamate system maintains a balance of synaptic—between two neurons—and extracellular—outside of neurons—glutamate via a few different ways. One is an “exchange” molecule, which maintains an optimal level of glutamate inside and outside neurons; another is the number of receptors themselves. In any case, when levels of glutamate become off-balance, addictive behavior trumps so-called reason: cravings and relapse result.

A number of research studies have implicated glutamate dysfunction in addiction. In a 2002 study, David Baker, then at the Medical University of South Carolina and now at Marquette University in Wisconsin, found that repeated administration of cocaine in rats lowered glutamate levels. A paper the following year showed that these changes underlie relapse in cocaine users. In 2009, Kalivas published a study in rats that showed treatment with NAC re-activated stalled glutamate pumps and restored glutamate levels to normal. In 2011, he found that NAC treatment not only restored synaptic plasticity, but that it could be tied to less relapse behavior in rats. 

“When glutamate transmission is in balance, we can learn; when it’s out of balance, we can’t learn,” Kalivas says. This is called synaptic plasticity, and in addiction, this flexibility of our brain circuits to adapt to change all but dries up. 

NAC—on trial

While the FDA approved NAC for treating specific conditions unrelated to addictive disorders over 50 years ago, some recent preliminary clinical trials suggest that NAC could be useful in the treatment of many other disorders, including SUDs.

Kevin Gray, also a professor and researcher at the Medical University of South Carolina, led the first randomized controlled trial for treating marijuana addiction, and they published their results in 2012. The trial involved cannabis-dependent adolescents, and participants received either 1200 mg NAC or a placebo twice daily throughout the 8-week treatment. They found that those who received NAC had more than twice the odds of achieving marijuana abstinence—reflected in “clean” urine drug tests—than those who received placebo. It is important to note that subjects received traditional behavioral treatment along with their dose of NAC.

“Given the controlled nature of the trial, we feel it reflects a real effect of NAC in enhancing response to behavioral treatment,” Gray says. “It targets one of many factors involved in addiction—nobody has, to date, tested whether it could work as a standalone treatment. For now, the evidence indicates that it is a helpful complement to psychosocial [or] behavioral treatment.” His group is currently conducting a follow-up study of sorts, across multiple sites and spanning 12 weeks, to test how NAC affects treatment success of cannabis-dependent adults.

Clinical trials for using NAC to treat relapse in cocaine addicts have also shown promising, albeit mixed, results. This is important because currently, there are no medications to treat cocaine and stimulant addiction. In a trial published in 2013, researchers tested the effect of NAC on treating cocaine addicts. The study, led by Robert Malcolm, also at MUSC, found that among users who received either 1200 milligrams NAC, 2400 milligrams NAC, or a placebo on a daily basis over the course of eight weeks, only subjects who were already abstinent had longer times to relapse and lower cravings if they were taking the 2400 milligrams. This suggests that NAC may be useful in preventing relapse among cocaine addicts who have already gotten sober, says Kalivas, who was involved with the trial study. In fact, they’ve already begun a trial along these lines. 

Not a cure-all 

To be sure, a supplement like NAC isn’t going to be a cure-all. As Kalivas says, “cure is a little strong of a word.” NAC works by ultimately increasing the amount of glutamate available to neurons—and, the more glutamate, the better signal transmission and the easier it becomes for addicts to break habits and learn new behaviors. “Basically it resets synapses and so they now have the opportunity to learn.” And while it may enable recovery, it won’t make any difference if an addict doesn’t change his lifestyle.

Trials have focused on determining the efficacy of using NAC in conjunction with traditional therapies, not as a replacement. “The reason for this whole line of research is the limited—[even] poor—abstinence outcomes with existing psychosocial [or] behavioral treatments,” Gray says. “We see NAC as a strong candidate for safe pharmacological augmentation of psychosocial treatment for substance use disorders.”

While he and others prescribe it to their patients “off-label,” some specialists are reluctant. “I don’t prescribe it since it is not FDA approved for this indication and there hasn’t been a large clinical trial to prove its efficacy yet,” says Khaled Moussawi, previously at MUSC and now a neurology resident at Massachusetts General Hospital, who has done research himself on glutamate and its role in addiction. “All the data we have are preliminary.” And, unfortunately, some don’t see FDA approval in the future: “There will never be FDA approval because why would a company go to those lengths when the supplement is available in every health food store in the country?” says Jon Grant of the University of Chicago, who led a recent trial for using NAC to treat obsessive hair pulling, a condition known as trichotillomania.


NAC can be purchased at any health foods store, but…you might want to consult with your doctor before starting to “pop” any pill, even an antioxidant supplement. According to multiple sources, it seems safe; however, there can be side effects, even if they’re relatively benign: nausea, indigestion, headache, and abdominal pain. It has been suggested that NAC may increase excretion of trace minerals; some evidence, however, suggests that this effect is too minimal to make a real difference. Nutritionists would suggest that individuals taking NAC for an extended period of time should also consider taking a multivitamin supplement.

Oral bioavailability of NAC has been shown to range from a mere 4 to 10 percent. It typically comes in 600-milligram capsules, which is much lower than the doses given in most of the clinical trials—it doesn’t necessarily have to be delivered orally, but that’s what’s safest and available to consumers at the moment. Given those two facts, it might not work at all.

There can be dangers to taking too much of it, as well as with other medications. According to the University of Maryland Medical Center, recommended adult doses of NAC vary depending on the health condition being treated; however, very high doses (more than 7 grams) of cysteine may be toxic. UMM also advises against drug-drug interactions. If you are being treated with medications that suppress the immune system (azathioprine (Imuran), cyclophosphamide (Cytoxan), or prednisone (Deltasone)); nitroglycerin and isosorbide (Isordil), two medications commonly used to treat chest pain; oxiconazole (Oxistat), an antifungal medication used for athlete’s foot; or activated charcoal; you should not use cysteine supplements without first talking to your doctor.

Jeanene Swanson is a regular contributor to The Fix. She last wrote about mental disorders and addiction.
Death by Lethal Incompetence

The state of Missouri got its latest batch of death penalty drugs in a backroom deal as shady as any street drug deal. If we can't do the death penalty right, maybe we should reconsider doing it at all.



25 years ago on the morning of March 22nd Michael Taylor and Roderick Nunley abducted Ann Harrison, a 15-year-old high school student, from her home in Kansas City, Missouri. They raped and murdered her and left her body in the trunk of a stolen car.

After their arrest the two men confessed to the crime. In an unsuccessful gambit they waived their right to a trial to appear before a judge to avoid the death penalty, but there was no mercy and they were both sentenced to death by lethal injection.

People actually support the idea of the death penalty. In reality it's highly selective, takes forever, costs a bundle and they still can’t get it right!

Nunley is not yet able to mark his execution date on his calendar but his partner in crime was executed on Wednesday, February 26th. It took him just under ten minutes to die. Ann Harrison’s father was present at the execution but made no comment after the event.

Taylor and Nunley did it. They confessed to the crime. DNA evidence connects them both to Ann and the basement where she was murdered; there’s no doubt about that. Justice has been served. But whether you believe the death penalty is an appropriate form of punishment or not, the way Missouri’s department of corrections has behaved in the run-up to the execution of Michael Taylor is undignified and embarrassing. 

Missouri is on a roll. Taylor’s execution makes four in as many months. In Taylor’s final appeal, hours before his death, his lawyers demanded to know what drugs would be used to kill him and where they were coming from—facts that the state of Missouri refused to reveal. How could the efficacy of these drugs be verified? Where were they purchased? But although the U.S. Court of Appeals for the Eighth Circuit allowed Missouri to complete the execution as planned, the three judges were clearly not impressed:

'Because Taylor seeks to determine whether the drug to be used in his execution will result in pain or in a lingering death, it bears repeating the importance of the identities of the pharmacists, laboratories, and drug suppliers in determining whether Missouri’s execution of death row inmates is constitutional.'

Michael Taylor was killed with an overdose of the anesthetic pentobarbital. But this dose didn’t come from the manufacturer. In last minute behind-the-scenes shenanigans, the Missouri Department of Corrections was forced to change the supplier of the drug and refused to reveal anything about the new pharmacy or its product. 

There are two main ways of executing a prisoner by lethal injection. The three-drug protocol and the one-drug protocol. The three-drug version begins with an injection of an anesthetic followed by a paralytic agent (a muscle relaxant) to stop breathing and finally a drug to stop the heart. The one-drug protocol is basically fatal overdose of a single sedative/anesthetic.

In the last few years pharmaceutical companies, upset that drugs intended to alleviate pain are being misused in the U.S., have done everything they can to keep their products out of the hands of the executioners. Missouri and the other 34 death penalty states are running out of options.

In 2010 when Hospira, the sole U.S. manufacturers of thiopental sodium—one of the three key drugs in the three drug cocktail preferred for execution in most U.S. states—discovered Ohio’s DOC using their product they took the unusual step of abandoning its production. Hospira states on its website:

‘Hospira makes its products to enhance and save the lives of the patients we serve, and, therefore, we have always publicly objected to the use of any of our products in capital punishment.’

What followed was a black comedy of errors. Death penalty states scrambled for fresh supplies and several successfully imported fresh stocks from Europe but that source dried up after European Union governments banned its export, effectively re-licensing the drug as it would arms or munitions. Importing sodium thiopental to the U.S. is actually illegal because its importation has to be approved by the Federal Drugs Administration (FDA). Unbelievably, the FDA turned a blind eye to this breach of law and during a fiasco that ended up in the Federal Appeals court, the court ruled the FDA was in utter‘derogation of its duty’ by allowing the drug into the country untested and the Drug Enforcement Agency (DEA) confiscated the stockpiles. 

All over the country DOCs were getting desperate. Last year Colorado came up empty after sending out a begging letter to compounding pharmacies all over the state to provide the sodium thiopental needed to execute murderer Nathan Dunlap. Governor John Hickenlooper finally stepped in to stop the drama and issued a reprieve for Dunlap.

Missouri switched to a single drug protocol to speed things up. Initially they planned to use the commonly used propofol (the anesthetic that killed Michael Jackson) until not only that manufacturer objected but the Missouri Society of Anesthesiologists complained that the DOC was putting their access to a drug they use for over 95% of their surgeries in danger. They fished around again until they came up with the current favorite, pentobarbital—a drug that is sometimes used for physician-assisted-suicide in Oregon State. Of course the moment pentobarbital’s manufacturers, Lundbeck, got wind of the practice they attempted to cut off the supply. 

It looks like The Missouri DOC did some pretty shady dealing to get hold of the pentobarbital that killed Taylor. Missouri ignored Lunbeck’s wishes and though they won’t reveal the company where they finally obtained the death dose, we do know it was a distributor known as a ‘compounding pharmacy’.

Compounding pharmacies make custom drugs to order. They alter drugs to suit the needs of specific patients, for example they might remove inactive ingredients from a pill if a patient discovers an allergy to part of the medication, say the capsule itself. The drugs are mixed to order, and it stands to reason that a custom batch may have slightly different amounts in each dose and their ingredients might differ from the manufacturer's. Some larger compounding pharmacies have been producing copies of drugs on a much larger scale, creating a gray market. As these ‘pill mills’ aren’t required to meet the same standards the FDA requires of Big Pharma, the legitimacy of these ‘bootleg’ drugs is in question.

In September 2012 the Center for Disease Control (CDC) traced an outbreak of fungal meningitis that killed 64 across 20 states to the New England Compounding Center in Framingham, Massachusetts and though a bill was passed in response to the tragedy, the additional oversight from the FDA still only puts compounding pharmacies on an honor system when it comes to regulation.

The most damning criticism of Missouri’s behavior came from the U.S. Court of Appeals following their dismissal of Taylor’s final appeal. They attacked the state for:

‘..using [a] shadow pharmac[y] hidden behind the hangman's hood' [and using] 'copycat pharmaceuticals' to execute another death row inmate.'

Clearly appalled that Missouri was unable to execute death row inmates with an FDA-approved form of pentobarbital the court suggested the DOC had resorted to:

'[A] pharmacy [that] could be nothing more than a high school chemistry class.'

The DOC should have been transparent about its procedures—Taylor had a right to know. 

In fact the only information released about the Missouri’s drug hunt is from their previous buys. They sent a guard down to Oklahoma with cash, he paid for the drug and drove it back up to Missouri. Not, one might imagine, the usual protocol for states obtaining pharmaceuticals. (AP reports that it cost Missouri $8000 per dose.) That pharmacy wisely stepped away from the furor, leaving Missouri again with an empty syringe.

Add to this the evidence that lethal injections are being carried out by inexperienced DOC personnel who sometimes botch the procedure completely. Missouri does not require physicians to be present at executions. Unsurprisingly, professionals who are ethically bound to protect life are also in short supply when it comes to shooting up a lethal dose, but it is precisely those professionals who are needed to ensure a humane procedure.

In September of 2009 the governor of Ohio halted Ronell Broom's execution after an execution team struggled for two hours to find a vein to end the life of the convicted murderer-rapist. He remains on death row. Could being executed twice be seen as a cruel and unusual punishment?

Americans are slowly turning against the death penalty. 60% of the nation is in favor of execution. That’s the lowest figure since 1972, and only a slim majority now think the sentence is applied fairly.

Richard Dieter from the Death Penalty Information Center says the death penalty is falling apart not from a human rights perspective but a lack of enthusiasm for it.

“There’s too many problems. Lethal injection [of Michael Taylor] is one more example of the ineptitude of the state in carrying out this law. People actually support the idea of the death penalty. In reality, it's highly selective, takes forever, costs a bundle and they still can’t get it right! I think the death penalty is becoming irrelevant.”

Questions surrounding the effectiveness of the drugs, the transparency of their origin and their application are giving more and more death row prisoners an opportunity to appeal their sentences, and rightly so. If we are going to use lethal injection and assume the responsibility of taking a human life then we should take it seriously. If we can’t do it with dignity then perhaps we shouldn’t do it at all. 

Neville Elder is a regular contributor to The Fix. He last wrote about the man behind the first supervised injection site in North America.