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National Strategy To Reduce Prescription Drug Abuse: Is Playing Big Brother Ok In An Emergency?

The White House released its plan last week entitled “Epidemic: Responding to America’s Prescription Drug Abuse Crisis” [LINK to pdf of this 10-page plan]. Below are some of the elements in this plan that is part of the National Drug Control Strategy (like that has worked so well :-/).

The areas of this plan involve education of prescribers and users, monitoring programs, making it easy to dispose of controlled dangerous substances (CDS for short), and enhancing enforcement. The plan establishes thirteen goals for the next five years, and also creates a coordinating body, the Federal Council on Prescription Drug Abuse, to oversee and coordinate it all.

If any of our readers have comments on specific items (I’ve numbered them for ease of reference), including unintended (or even intended) consequences, please chime in.

  1. EDUCATION
    1. require training on responsible opiate prescribing
    2. require Pharma to develop education materials for providers and patients
    3. require professional schools and organizations to include instruction on balancing use of opiates for pain while reducing abuse
    4. require state licensing boards to include relevant ongoing education in their licensure requirements
    5. help ACEP develop guidelines for opiate prescribing in the Emergency Department [this should be a big help]
    6. increased use of written patient-provider agreements
    7. facilitate public education campaigns, especially targeting parents
    8. encourage research on low-abuse potential treatments, epidemiology of substance abuse, and abuse-deterrent formulations Read more »

*This blog post was originally published at Shrink Rap*

A Cocaine Vaccine?

Although cocaine use has declined steadily since its peak in the early 1980s, public health officials estimate that about 7 million Americans used the drug at least once last year. Many of these folks are addicted to the drug, and its intense, short-lived euphoric effects mean the addiction is terribly difficult to overcome.

Addiction specialists believe existing treatment paradigms for cocaine addiction can be enhanced by a vaccine that prevents the drug from crossing the blood-brain barrier, thus blunting its euphoric effects. Scientists have worked hard to develop such a vaccine, but have had limited success so far. 

About a year ago for example, Thomas Kosten and colleagues at Baylor reported partial success in a human trial of a cocaine vaccine. In that trial, 38 percent of subjects who received all five shots in the vaccine series achieved sufficient antibody levels to blunt the effects of the drug. In that subset, 53 percent of the subjects stopped using cocaine, meaning that overall, the vaccine worked about 20 percent of the time. Read more »

*This blog post was originally published at Pizaazz*

Stop Smoking Treatment: Don’t Stop It Too Soon

Butt stopDoctors may want their patients to stick with a smoking cessation regimen even if it’s not initially working, report researchers who found that “delayed quitters” accounted for a third of former smokers who went a year without cigarettes.

Quit rates may be significantly increased by just continuing in motivated but initially unsuccessful patients during the first eight weeks of treatment, according to research published online in the journal Addiction. There’s actually two types of successful quitters: Those who quit immediately and those who are “delayed” but eventually successful. Read more »

*This blog post was originally published at ACP Internist*

Soap, Drugs, And Rock And Roll

By ClinkShrink

There’s always something new, even in the world of substance abuse. Lately I’ve been reading a lot in the media about K2, a synthetic cannabinoid that’s being sold (and outlawed) in many states. It’s commonly mixed with herbal incense and smoked. Nicknamed “spice,” it was originally created by scientists and called JWH-018.

Apparently some states’ poison control centers have been getting calls about it due to the physical symptoms it can cause, specifically palpitations and GI problems. The part of the story that I thought was interesting was the fact that originally only 250 milligrams of the stuff was created, in an “official” research lab, but that home chemists quickly took up the experiment and it’s now a part of our national drug culture. Read more »

*This blog post was originally published at Shrink Rap*

Social Drinking: Is It In Your Genes?

Psychological Science, a journal of the Association for Psychological Science, published a very interesting paper focusing on the genetic background of social drinking. Specific gene variants might increase the risk for extensive alcohol use or abuse when spending time with heavy-drinking peers. An excerpt from Medical News Today:

Drinking alcohol increases levels of dopamine –- a brain chemical that causes pleasure and makes us feel good. The dopamine D4 receptor gene (DRD4) has been shown to be involved in motivation of seeking out rewards. Research has suggested that carrying a specific form (or variant) of this gene –- one that includes seven or more repeats of a certain section of the gene –- may be associated with craving caused by alcohol-related cues. Psychological scientist Helle Larsen from Radboud University in The Netherlands and her colleagues wanted to investigate if this 7-repeat gene variant plays a role in how an individual responds to alcohol-related cues.

The results showed an effect between how much the confederate drank and the gene variant on volunteers’ alcohol consumption: When the confederate was seen consuming three or four drinks, carriers of the 7-repeat form of the gene drank more than twice as many glasses of alcohol than did noncarriers of the gene variant. However, when the confederate consumed only one drink, there was no difference in alcohol consumption between carriers and noncarriers. These findings suggest that individuals carrying this form of the DRD4 gene may be more sensitive than noncarriers to other people’s drinking behavior.

*This blog post was originally published at ScienceRoll*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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