2013 National Drug Control Strategy Released

White HouseThe White House Office of National Drug Control Policy (ONDCP) released the 2013 National Drug Control Strategy on April 24. Highlights of the Strategy include:

Make Access to Treatment a Reality for Millions of Americans

  • Details actions to implement the Affordable Care Act, which – for the first time in history – ends discrimination against people with substance use disorders by requiring insurance companies to cover treatment for substance use disorders as they would for any other chronic disease;
  • Work to expand treatment and reentry services for those incarcerated; and
  • Target expansion of care for populations with an unmet need for substance abuse treatment, including veterans, college and university students, and Native Americans.

Give a Voice to Americans in Recovery

  • Work to lift the stigma associated with addiction by partnering with the recovery community to speak out about their successes and encourage others to seek treatment; and
  • Review and reform laws and regulations that unfairly target those with substance use disorders and impede recovery from addiction, including those laws and regulations that restrict access to housing, employment, and attaining a driver’s license or student loan.

The news release highlighting the new strategy is available at: http://www.whitehouse.gov/ondcp/news-releases/2013-national-drug-policy-strategy-release

A fact sheet on the new strategy is available at: https://dl.dropboxusercontent.com/u/2876748/ireta/National%20Drug%20Control%20Strategy%20Fact%20Sheet.pdf

The full 2013 National Drug Control Strategy is at: http://www.whitehouse.gov//sites/default/files/ondcp/policy-and-research/ndcs_2013.pdf

Source: WhiteHouse.gov – April 24, 2013

New Book Available – Clean: Overcoming Addiction and Ending America’s Greatest Tragedy

CleanA new book on addiction was released April 2 that has received a lot of press coverage.

Amazon.com describes the book as “Addiction is a preventable, treatable disease, not a moral failing. As with other illnesses, the approaches most likely to work are based on science — not on faith, tradition, contrition, or wishful thinking. These facts are the foundation of Clean, a myth-shattering look at drug abuse by the author of Beautiful Boy. Based on the latest research in psychology, neuroscience, and medicine, Clean is a leap beyond the traditional approaches to prevention and treatment of addiction and the mental illnesses that usually accompany it. The existing treatment system, including Twelve Step programs and rehabs, has helped some, but it has failed to help many more, and David Sheff explains why. He spent time with scores of scientists, doctors, counselors, and addicts and their families to learn how addiction works and what can effectively treat it. Clean offers clear, cogent counsel for parents and others who want to prevent drug problems and for addicts and their loved ones no matter what stage of the illness they’re in. But it is also a book for all of us — a powerful rethinking of the greatest public health challenge of our time.”

The link to the book at Amazon.com is: http://www.amazon.com/Clean-Overcoming-Addiction-Americas-Greatest/dp/054784865X/ref=sr_1_4?s=books&ie=UTF8&qid=1364908254&sr=1-4&keywords=clean

Join Together interviewed David Sheff the book’s author to discuss his exploration into the science, prevention and treatment of addiction. The two part interview is available at:

http://www.drugfree.org/join-together/addiction/david-sheff-author-of-clean-interview-part-1-of-2?utm_source=Join%20Together%20Daily&utm_campaign=a87b199533-JT_Daily_News_David_Sheff_Author_of&utm_medium=email

http://www.drugfree.org/join-together/addiction/david-sheff-author-of-clean-interview-part-2-of-2?utm_source=Join%20Together%20Daily&utm_campaign=35128f3594-JT_Daily_News_David_Sheff_Author_of&utm_medium=email

David Sheff also wrote an opinion article for Time.com that is available at:
http://ideas.time.com/2013/04/03/we-need-to-rethink-rehab/

Sources: Amazon.com, JoinTogether, Time.com – April 2013

Drug Abuse Treatment Could Save Billions in Criminal Justice Costs

Sending drug abusers to community-based treatment programs rather than prison could help reduce crime and save the criminal justice system billions of dollars, according to a new study by researchers at RTI International and Temple University.

Nearly half of all state prisoners are drug abusers or drug dependent, but only 10 percent receive medically based drug treatment during incarceration. Untreated or inadequately treated inmates are more likely to resume using drugs when released from prison, and commit crimes at a higher rate than non-abusers.

The study, published online in November in Crime & Delinquency, found that diverting substance-abusing state prisoners to community-based treatment programs rather than prison could reduce crime rates and save the criminal justice system billions of dollars relative to current levels. The savings are driven by immediate reductions in the cost of incarceration and by subsequent reductions in the number of crimes committed by successfully-treated diverted offenders, which leads to fewer re-arrests and re-incarcerations. The criminal justice costs savings account for the extra cost of treating diverted offenders in the community.

The findings were based on a lifetime simulation model of a cohort of 1.14 million state prisoners representing the 2004 U.S. state prison population. The model accounts for substance abuse as a chronic disease, estimates the benefits of treatment over individuals’ lifetimes, and calculates the crime and criminal justice costs related to policing, trial and sentencing, and incarceration.

The researchers used the model to track the individuals’ substance abuse, criminal activity, employment and health care use until death or up to and including age 60, whichever came first. They also estimated the benefits and costs of sending 10 percent or 40 percent of drug abusers to community-based substance abuse treatment as an alternative to prison.

According to the model, if just 10 percent of eligible offenders were sent to community-based treatment programs rather than prison, the criminal justice system would save $4.8 billion when compared to current practices. Diverting 40 percent of eligible offenders would save $12.9 billion.

The authors also address a concern common with diversion programs, which is that instead of being incarcerated, offenders are released into the community where they may commit additional crimes. Their analysis showed an immediate, short-lived increase in crimes, however, by the end of the first year, fewer crimes were committed, generating cost savings.

The study builds on previous research led by RTI indicating that increased investment in treatment for substance-abusing prisoners can reduce crime rates and cut criminal justice spending. In a study released earlier this year, Zarkin and colleagues found that increasing and improving prison-based drug treatment programs could save up to $17 billion in criminal justice system costs.

http://www.newswise.com/articles/study-replacing-prison-terms-with-drug-abuse-treatment-could-save-billions-in-criminal-justice-costs

Source: RTI International – January 9, 2013

Researchers Say MRI Could Help Predict Success of Drug Addiction Treatment

Scientists at the University of Pennsylvania say MRI scans may be able to predict which patients will succeed with certain addiction treatments, and which ones will relapse, according to the Philadelphia Daily News.

Researchers at the university’s Center for Studies of Addiction are watching how regions of the brain react to drug-related photos, such as pictures of a heroin needle or a crushed pill. They hope to use this research to develop more effective treatments. One day, they hope that treatment could be tailored to a person’s mental strengths and vulnerabilities. These factors are influenced by genetics, life experiences and drug use, they say.

http://www.drugfree.org/join-together/addiction/researchers-say-mri-could-help-predict-success-of-drug-addiction-treatment?utm_source=Join+Together+Weekly&utm_campaign=16753ecc0b-

Source: JoinTogether.org – January 18, 2013

Sharp Rise in Admissions for Certain Drug Combinations Over 10 Years

Substance abuse treatment admissions for addiction involving combined use of benzodiazepine and narcotic pain relievers (NPR) rose a total of 569.7 percent, to 33,701, from 2000 to 2010, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). Overall substance abuse treatment admissions of people ages 12 and older in the same period rose 4 percent, to 1.82 million, the agency said.

 “Clearly, the rise in this form of substance abuse is a public health problem that all parts of the treatment community need to be aware of,” said SAMHSA Administrator Pamela S. Hyde. “When patients are battling severe withdrawal effects from two addictive drugs, new treatment strategies may be needed to meet this challenge. These findings will help us better understand the nature and scope of this problem and to develop better approaches to address it.”

The report showed that 38.7 percent of those with this combined addiction began use of both drugs in the same year; 34.1 percent first used narcotic pain relievers, and the remaining 27.1 percent started with benzodiazepines.

Almost half of patients admitted for combined use also had a co-occurring psychiatric disorder, were largely self-referred, and were less likely to receive regular outpatient treatment than other admissions.

Specific demographic groups have higher rates of admission for combination benzodiazepine/NPR treatment when compared with admissions for other treatment. Non-Hispanic whites account for 91.4 percent of combination admissions versus only 55.8 percent of other admissions. Females make up 49.2 percent of combined admissions versus 30.2 percent of other admissions, and people aged 18-34 account for 66.9 percent of combined admissions versus 43.7 of other admissions.

“The public health and safety threat we face from the abuse of prescription drugs is indisputable and these data show the increasing need for treatment for those suffering from addiction to prescription drugs,” said Office of National Drug Control Policy Director Gil Kerlikowske. “While prevention is a critically important pillar of our prescription drug prevention plan, equally important is ensuring that treatment is available to those in need.”

http://www.samhsa.gov/newsroom/advisories/1212132836.aspx

Source: Substance Abuse and Mental Health Services Administration – December 13, 2012

Gateway Drugs Linked to Prescription Drug Abuse

Researchers at the Yale School of Medicine analyzed nationally-representative survey data to explore a possible link between alcohol, cigarette, and marijuana use as an adolescent and subsequent abuse of prescription pain medication as a young adult. Their paper, published in the Journal of Adolescent Health, was the first to find that a link between these “gateway drugs” and prescription painkillers. They found that all three drugs are associated with higher levels of prescription drug abuse in men, but only marijuana use is associated with higher levels of prescription drug abuse in in women.

http://www.yaledailynews.com/news/2012/sep/04/gateway-drugs-linked-to-prescription-drug-abuse/

Source: Yale Daily News – September 4, 2012

New Report: The U.S. Drug Policy Landscape Insights and Opportunities for Improving the View

This new report from RAND Corporation provides a nonpartisan primer that should be of interest to those who are new to the field of drug policy, as well as those who have been working in the trenches. It begins with an overview of problems and policies related to illegal drugs in the United States, including the nonmedical use of prescription drugs. It then discusses the efficacy of U.S. drug policies and programs, including long-standing issues that deserve additional attention. Next, the paper lists the major funders of research and analysis in the area and describes their priorities. By highlighting the issues that receive most of the funding, this discussion identifies where gaps remain.

The press release can be accessed at: http://www.rand.org/news/press/2012/09/18.html

The report can be accessed at: http://www.rand.org/pubs/occasional_papers/OP393.html

Source: RAND Corporation – September 18, 2012

Welcome to Dopamine Nation

Despite a proliferation of treatment options in America, addictive behavior and unhealthy coping strategies are more common than ever. Here’s why.

“While we may admire the American impulse to applaud hard work, innovation, and daring, the rewards of these labors aren’t immediate. We’re an impatient nation; we seek more immediate gratification. We’ve come to accept an approach of “why wait?”, so we grab ahold of whatever it takes to feel better, to keep feeling better, to make it through the day. In our addicted culture, we go for the artificially-induced dopamine spike—and not just one, but one right after the next.”

http://www.thefix.com/content/dopamine-nation-richard-juman7987

Source: TheFix.com by Dr. Richard Juman  – July 30, 2012

New Drug Abuse Warning Network (Dawn) Report Issued on Drug-Related Emergency Department Visits

The Substance Abuse Mental Health Services Administration (SAMHSA) issued a report July 2 on drug-related emergency room (ER) visits in 2010. There were 4.0 million drug-related ED visits made by patients aged 21 or older in 2010. Of these visits, 1.9 million, 47.2 percent, involved drug misuse or abuse.

The total number of drug-related ED visits increased 94 percent from 2004 (2.5 million visits) to 2010 (4.9 million visits).

  • ED visits involving misuse or abuse of pharmaceuticals increased 115 percent between 2004 and 2010.
  • ED visits involving misuse or abuse of narcotic pain relievers increased 156 percent between 2004 and 2010.
  • ED visits involving misuse or abuse of oxycodone products increased 255 percent between 2004 and 2010.
  • ED visits involving misuse or abuse of benzodiazepines increased 139 percent between 2004 and 2010.
DAWN Report: Misused or Abused Drugs Most Commonly Involved in Emergency Department (ED) Visits:
2004 to 2010
Drug 2004 Number of ED Visits 2010 Number of ED Visits % Change, 2004 to 2010 2010 ED Visits per 100,000 Population 

 

Alcohol – In Combination with Other Drugs NA 564,796 NA 182.5
Alcohol – Underage Drinking** NA 189,060 NA 215.4
Illicit Drugs 991,640 1,171,024 NC 378.5
Cocaine NA 488,101 NA 157.8
Heroin NA 224,706 NA 72.6
Marijuana 281,619 461,028 64 149.0
Pharmaceuticals 626,472 1,345,645 115 434.9
Anti-anxiety and Insomnia Drugs 210,711 472,769 124 152.8
Benzodiazepines 170,471 408,021 139 131.9
Antidepressants NA 105,229 NA 34.0
Pain Relievers 282.275 659, 969 134 213.3
Narcotic Pain Relievers 166,338 425,247 156 137.4
Hydrocodone Products 46,536 115,739 149 37.4
Oxycodone Products 51,418 182,748 255 59.1

 
* Because a visit may involve multiple drugs, the sum of visits by drug will be greater than the total.
**Underage drinking includes both use of alcohol in combination with other drugs and use of alcohol only for patients aged 20 or younger.

The 8-page report can be accessed at: http://www.samhsa.gov/data/2k12/DAWN096/SR096EDHighlights2010.pdf

Source: 2010 SAMHSA Drug Abuse Warning Network (DAWN) – July 2, 2012

Rapid Rise in Boomer Addicts Reported

State and federal statistics show the number of people in their 50s and early 60s reporting illicit drug use and seeking help with addictions skyrocketed in the past decade.

“We can’t ignore that older adults are using harder substances, that we are seeing increases in emergency room visits where people present with drug abuse,” said Dr. Gayathri Dowling, acting chief of the science policy branch at the National Institute on Drug Abuse. “But when we think about these addictions, we tend to think about younger people. “Nobody thinks to ask older people about substance abuse, and that includes their physicians.”

The NIH has become so concerned about the rapid rise in boomer addicts that it released its first consumer alert this month on prescription and illicit drug abuse signs and dangers on its website, NIHSeniorHealth.gov.

http://www.phoenixhouse.org/news-and-events/rapid-rise-in-boomer-addicts/

Source: SunSentinel.com – June 15, 2012

Study: Individuals with Public Insurance Nearly 90% More Likely to Receive Needed Treatment for Drug Addiction

Those who receive healthcare through public programs such as CHAMPUS/VA, Medicare, and Medicaid are 48% to 88% more likely to receive any treatment for substance use disorders (SUDs) than those with private insurance who need similar services, according to a study recently published in The Journal of Substance Abuse Treatment.

The study, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), with authors from SAMHSA, Mathematica Policy Research and the National Association of State Alcohol and Drug Abuse Directors (NASADAD), concluded that populations with different types of public health insurance have rates of receiving treatment for an SUD that range from two to four times greater than the privately insured.  The study concluded that those who need substance abuse treatment but hold private health insurance plans appear to have the lowest rates of receiving any or specialty treatment services (6.9% and 3.9%, respectively).

“Substance abuse takes a tremendous toll on the health of individuals, the safety of families, and the vitality of our economy and our society,” said Ellen Bouchery of Mathematica, and the study’s lead author.  “These findings highlight the importance of parity in covering behavioral and mental health services at levels similar to those of other medical services.”

Percentage of Population with SUD

Type of Insurance Coverage Receive Any Treatment Receive Specialty Treatment
Private 6.9% 3.9%
Medicare 24.9% 19.3%
Medicaid 18.2% 13.6%
Medicare and Medicaid 27.0% 23.6%
CHAMPUS/VA 16.3% 13.0%
Other 13.3% 9.3%
Uninsured 11.7% 7.9%
Total 9.9% 6.5

(Note: Data from analysis of the 2002-2007 NSDUH)

The study, which examined data from the National Survey on Drug Use and Health, 2002 – 2007, also found that despite relatively better access to treatment services compared to those with private healthcare coverage, public insurance holders with SUDs still face a significant treatment gap – the difference between those who need substance abuse treatment and those who actually receive such services.  The study’s findings indicate that a treatment gap of more than 70% exists within the group with the best treatment access, after controlling for a number of predisposing conditions, including severity, need, and other variables.

According to government estimates, drug use contributed an estimated $193 billion in crime, health, and lost productivity costs during 2007.  Dr. Bouchery’s previous work for the Centers for Disease Control and Prevention estimates that the economic cost to the nation of excessive drinking was $223.5 billion in 2006.  Increasing access to effective, evidence-based treatment could help reduce the health, social, and economic consequences of untreated addiction.

http://www.whitehouse.gov/ondcp/news-releases-remarks/public-insurance-ninety-percent-more-likely-treatment-study

Source: WhiteHouse.gov – June 19, 2012

War on Drugs Fuelling Spread of HIV, Report Concludes

The worldwide war on drugs has been a “remarkable failure,” only serving to drive the spread of HIV among drug users and their sexual partners, suggests a new report published by The Global Commission on Drug Policy.

According to the report, injection drug use now accounts for about one-third of new HIV infections outside sub-Saharan Africa. Tough drug law enforcement policies around the world are driving that spread in a number of ways, including:

  • Forcing drug users underground to avoid arrest, away from HIV testing and HIV prevention services
  • Spreading the HIV pandemic in prisons, where drug use in often rampant, by needlessly incarcerating non-violent drug offenders
  • Encouraging syringe sharing by restricting groups from offering sterile syringes to drug users
  • Wasting funding on ineffective drug law enforcement efforts instead of investing it in proven HIV prevention strategies.

http://www.ctvnews.ca/health/war-on-drugs-fuelling-spread-of-hiv-report-concludes-1.854231#axzz1z1Ctxfkq

Source: CTV News.com - June 26, 2012

Drug Abuse Kills 200,000 People Each Year: UN Report

Drug abuse kills about 200,000 people worldwide each year, according to a new United Nations (UN) report. Global treatment for drug abuse would cost $250 billion per year if everyone who needed help received proper care, according to the UN.

The UN estimates that about 230 million people, or 5 percent of the world’s population, used illegal drugs at least once in 2010. In the United States, female drug use was two-thirds the male rate, while in India and Indonesia, females constituted only one-tenth of those using illegal drugs.

http://www.drugfree.org/join-together/drugs/drug-abuse-kills-200000-people-each-year-un-report

Source: JoinTogether.org - June 27, 2012

I-Team: ER Visits Tied to Xanax, Similar Drugs Soar in NYC

Dr. Jeff Rabrich, who directs the Emergency Medicine Department at St. Luke’s Roosevelt Hospital in Manhattan, said he often sees the negative effects of illegal narcotics exacerbated by benzodiazepines.

“The Xanax potentially makes it a much worse overdose. It could turn a relatively mild overdose into something that could be fatal,” said Dr. Rabrich.

“A history of abuse of other substances, both licit and illicit, is associated with a higher prevalence of benzodiazepine abuse, a greater euphoric response to benzodiazepines, and a higher rate of unauthorized use of alprazolam during treatment for panic disorder.”

http://www.nbcnewyork.com/investigations/Xanax-Anti-Anxiety-Drugs-ER-Visits-Overdose-Deaths-NYC-151438745.html

Source:  NBCNewYork.com – May 15, 2012

Drug Addiction, ‘Personhood’ and the War on Women

Criminal charges are now being brought against women in Alabama for “chemical endangerment of a child” which has been utilized to penalize mothers who use drugs during their pregnancy and has a mandatory sentence of 10 years to life (if the baby dies).

Originally enacted to protect children from meth labs, the law prohibits a “responsible person” from “exposing a child to an environment in which he or she…knowingly, recklessly  or intentionally causes or permits a child to be exposed to, to ingest or inhale, or to have contact with a controlled substance, chemical substance or drug paraphernalia.”

http://newsfeed.time.com/2012/04/26/drug-addiction-personhood-and-the-war-on-women/

 

Source: Time.com – April 26, 2012

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