drug abuse

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My Mother’s Surgery And One Doctor’s Substance Abuse

By Karen Shiffman
Guest contributor

USA Today reports more than 100,000 doctors, nurses, technicians and other health professionals struggle with abuse or addiction. This wasn’t news to my family.

Some 20 years ago, my mother was mauled by a dog. She was on vacation in Florida and went over to a friend’s house for dinner. To understand what happened next, you need to know a few crucial facts about her: She is afraid of dogs and barely five feet tall. When her friend opened the front door, her daughter’s dog — an Akita- tore out of the house and lunged . My mother turned away quickly. The dog lunged again. Because of her short stature, his teeth sunk into her calf. He all but ripped it off.

(Alex E. Proimos/flickr)

(Alex E. Proimos/flickr)

Blood everywhere. Screams. Tears. Ambulance. Thirty-nine stitches at the ER. She would need a skin graft.

And then there was the drama with the friend. Turns out, this wasn’t the first time the dog had bitten someone. Still, the family didn’t want the dog put down. Eventually, he was. My mother and her friend of 30 years never spoke again.

Back home in Boston, my mother was referred to a plastic surgeon at what is now Beth Israel Deaconess Medical Center. He was kind and I agreed with my mother that he should do the surgery.

The operation went well. I went with her to the post-surgery checkup. We both thanked the surgeon for doing such a great job and for taking such good care of my mother.

So, imagine my shock, in 2008, to read in The Boston Globe that my mother’s surgeon was fired for being impaired in the OR. And that he had been struggling with substance abuse for the past six years. Continue reading

Citing Addiction Fears, Group Asks FDA To Revoke Painkiller Approval

Instant Vantage/flickr

Instant Vantage/flickr

By Judy Foreman
Guest Contributor

In an unusual move, a coalition of activists and physicians, concerned about the problem of prescription pain-reliever abuse, yesterday asked the U.S. Food and Drug Administration to revoke its approval of a new type of opioid called Zohydro. The medication is expected to be on the market soon.

“Too many people have already become addicted to similar opioid medications and too many lives have been lost,” said the Feb. 26 letter to the FDA, signed by a coalition of consumer health advocates, addiction treatment and health care providers.

But that request is provoking outrage and anxiety among chronic pain patients who applauded the FDA’s approval of the new medication last fall and would like to see Zohydro added to the list of prescription pain-relievers now on the market.

Zohydro is a type of opioid called hydrocodone and, in its chemical structure, is similar to morphine, said June Dahl, a professor of neuroscience at the University of Wisconsin School of Medicine and Public Health, in a telephone interview and email conversation.

“It’s an advantage to have another pure opioid agonist on the market and to have that agonist in a controlled release formulation,” said Dahl. She questioned, however, whether it is wise to allow the current formulation of Zohydro on the market right away, instead of waiting a few years for an abuse-deterrent, a formulation specifically designed to thwart abusers.

Until recently, the only hydrocodone-containing products on the market were combination medications such as Vicodin which contains both hydrocodone and acetaminophen. The major concern about Vicodin is actually not the opioid it contains but the acetaminophen (which is also the active ingredient in Tylenol), noted Dahl. (Last fall, the FDA took the first steps toward moving medications like Vicodin to a more restrictive category, which would limit the how easily patients could get refills.)

Zohydro is different from Vicodin in that it contains only hydrocodone, with no other ingredients. The company that makes Zohydro argues that this formulation makes the drug safer than the combination products.

Dr. James Cleary, a palliative care specialist at the University of Wisconsin, said in a telephone interview that “it is reasonable to have this product [Zohydro] out there.” Opioids are defined as “essential medications” by the World Health Organization and several other major groups, he added.

“Therefore we need to make sure they are available to appropriate patients and we need to establish a balanced system that also reduces abuse and diversion. We need to understand the opioid crisis much better.” Continue reading

How Doctors Think About ADHD Medication Abuse

By Karen Weintraub
Guest Contributor

Like any other medication, drugs used to treat Attention Deficit Hyperactivity Disorder can be abused.

A story in last Sunday’s New York Times showed the potentially tragic consequences of such abuse, and revealed some of the systemic factors that enabled it.

There is no blood test to diagnose ADHD – no biological marker that says “yes” you have the condition or “no” you don’t. Accurate diagnosis relies on the sophistication and experience of the doctor and the honesty of the patient.

(Adam Crowe/flickr)

(Adam Crowe/flickr)

The New York Times piece suggested that one or both of these factors broke down in the case of Richard Fee, a college graduate who committed suicide at age 24, two weeks after his last prescription for the stimulant Adderall expired.

Drugs like Adderall are far more available now than they used to be, because awareness of ADHD and prescriptions have increased markedly over the last decade, particularly among adults.

Most people tend to see ADHD as a condition of childhood. Research suggests that 5-10 percent of children meet the criteria for ADHD and are impaired by it, while roughly 4 percent of adults do.

Although there has long been discussion about whether ADHD medications are overused in children, this story raised concerns about the drugs in early adulthood, when drug abuse is most common. “We’ve got a lot more drugs out there in that age population,” said Dr. Glen Elliott, chief psychiatrist and medical director at the Children’s Health Council in Palo Alto. “The need to be more alert to possible diversion and misuse and abuse in this population has certainly increased.” Continue reading

Rat Study: Teen Girls’ Pot Use May Incline Future Kids To Drugs

marijuana

(truththeory.com)


WBUR’s Deborah Becker reports:

A new study out of Tufts University suggests that a mother’s use of marijuana — even long before she has children — could lead to drug use in her kids.

The study found that when adolescent female rats were exposed to the active ingredient in marijuana, their offspring were more likely to abuse drugs. One of the study’s authors, Elizabeth Byrnes, Associate Professor at Tufts University School of Veterinary Medicine, says the study proves that some drugs have long-term repercussions:

“You really can’t assume that exposure to drugs prior to pregnancy doesn’t have long-term effects on the next generation,” she said. “These things seem to cause some persistent effects.”

But Byrnes says it’s too early to establish a connection between adolescent drug use and possible effects on future children.

Not that a mere anecdote disproves research, but my late mother liked pot so much she grew it in our backyard, and I could never stand the stuff myself. (And haven’t been drawn to opioids like the rat offspring, either.) I heaped adolescent disapproval upon her when I found her little tin of buds and leaves hidden high on top of our kitchen cupboard.

But for all the current mothers who were not as angelic as yours truly in their teen years, and who just issued profane exclamations of concern when they saw this headline, here’s more from the Tufts press release:

Mothers who use marijuana as teens — long before having children—may put their future children at a higher risk of drug abuse, new research suggests.

Researchers in the Neuroscience and Reproductive Biology section at the Cummings School of Veterinary Medicine conducted a study to determine the transgenerational effects of cannabinoid exposure in adolescent female rats. For three days, adolescent rats were administered the cannabinoid receptor agonist WIN-55, 212-2, a drug that has similar effects in the brain as THC, the active ingredient in marijuana. After this brief exposure, they remained untreated until being mated in adulthood. Continue reading

Study: Rogue Online Pharmacies Linked To Increased Drug Abuse

The proliferation of easily available medications from “rogue” online pharmacies may be driving the epidemic of prescription drug abuse, researchers report.

Investigators from Massachusetts General Hospital and the University of Southern California found “states with the greatest expansion in high-speed Internet access from 2000 to 2007 also had the largest increase in admissions for treatment of prescription drug abuse.”

The report, which focused on online pharmacies that dispense drugs without a doctor’s prescription, was published today online by the journal Health Affairs.

According to the news release:

In their report, [Dana] Goldman, PhD, director of the Schaeffer Center for Health Policy and Economics at USC and lead author Anupam B. Jena, MD, PhD, of the MGH Department of Medicine, note that the recent marked rise in the abuse of prescription narcotic painkillers – drugs like Percocet and Oxycontin – corresponds with an increase in the presence of online pharmacies, many of which do not adhere to regulations requiring a physician’s prescription. Drugs that are frequently abused – painkillers, stimulants, sedatives and tranquilizers – often can be purchased from rogue sites that may be located outside the U.S. The current study was designed to examine the potential link between online availability and prescription drug abuse, an association that has been suspected but not investigated in depth.

Using data available from the Federal Communications Commission, the researchers first compiled statistics on access to high-speed Internet service in each state during the years studied. Since actual rates of prescription drug abuse would be difficult if not impossible to calculate, they used information on admissions to substance abuse treatment facilities from a database maintained by the U.S. Substance Abuse and Mental Health Administration. Changes in both measures over the seven years were analyzed on a per-state basis, and treatment admissions were categorized by the particular types of abused substances involved.

The analysis indicated that each 10 percent increase in the availability of high-speed Internet service in a state was accompanied by an approximately 1 percent increase in admissions for prescription drug abuse. The increases were strongest for narcotic painkillers, followed by anti-anxiety drugs, stimulants and sedatives. During the same period admissions to treat abuse of alcohol, heroin or cocaine, substances not available online, showed minimal growth or actually decreased.

For more on the prescription drug abuse epidemic — accidental overdose deaths from these medications now exceed crack deaths in the 1980s — listen to this segment of On Point. The program examines the “pill mills” in Florida that funnel the drugs into poor communities of West Virginia, Kentucky and Tennessee, and includes interviews with former addicts on how oxycontin and other prescription narcotics decimated their lives.