NEWS ARCHIVE 2007
How We Get Addicted
First published in July 23, 2007 Time Magazine
By Michael D. Lemonick
I
was driving up the Massachusetts Turnpike one evening last February
when I knocked over a bottle of water. I grabbed for it, swerved
inadvertently – and a few seconds later found myself blinking into the
flashlight beam of a state trooper. "How much have you had to drink
tonight, sir?" he demanded. Before I could help myself, I blurted out
an answer that was surely a new one to him. "I haven't had a drink," I
said indignantly, "since 1981."
It was both perfectly true and
very pertinent to the trip I was making. By the time I reached my late
20s, I'd poured down as much alcohol as normal people consume in a
lifetime and plenty of drugs – mostly pot –as well. I was, by any
reasonable measure, an active alcoholic. Fortunately, with a lot of
help, I was able to stop. And now I was on my way to McLean Hospital in
Belmont, Mass., to have my brain scanned in a functional
magnetic-resonance imager (fMRI). The idea was to see what the inside
of my head looked like after more than a quarter-century on the wagon.
Back
when I stopped drinking, such an experiment would have been
unimaginable. At the time, the medical establishment had come to accept
the idea that alcoholism was a disease rather than a moral failing; the
American Medical Association (AMA) had said so in 1950. But while it
had all the hallmarks of other diseases, including specific symptoms
and a predictable course, leading to disability or even death,
alcoholism was different. Its physical basis was a complete mystery –
and since nobody forced alcoholics to drink, it was still seen, no
matter what the AMA said, as somehow voluntary. Treatment consisted
mostly of talk therapy, maybe some vitamins and usually a strong
recommendation to join Alcoholics Anonymous. Although it's a totally
nonprofessional organization, founded in 1935 by an ex-drunk and an
active drinker, AA has managed to get millions of people off the
bottle, using group support and a program of accumulated folk wisdom.
While
AA is astonishingly effective for some people, it doesn't work for
everyone; studies suggest it succeeds about 20% of the time, and other
forms of treatment, including various types of behavioral therapy, do
no better. The rate is much the same with drug addiction, which experts
see as the same disorder triggered by a different chemical. "The sad
part is that if you look at where addiction treatment was 10 years ago,
it hasn't gotten much better," says Dr. Martin Paulus, a professor of
psychiatry at the University of California at San Diego. "You have a
better chance to do well after many types of cancer than you have of
recovering from methamphetamine dependence."
That could all be
about to change. During those same 10 years, researchers have made
extraordinary progress in understanding the physical basis of
addiction. They know now, for example, that the 20% success rate can
shoot up to 40% if treatment is ongoing (very much the AA model, which
is most effective when members continue to attend meetings long after
their last drink). Armed with an array of increasingly sophisticated
technology, including fMRIs and PET scans, investigators have begun to
figure out exactly what goes wrong in the brain of an addict – which
neurotransmitting chemicals are out of balance and what regions of the
brain are affected. They are developing a more detailed understanding
of how deeply and completely addiction can affect the brain, by
hijacking memory-making processes and by exploiting emotions. Using
that knowledge, they've begun to design new drugs that are showing
promise in cutting off the craving that drives an addict irresistibly
toward relapse – the greatest risk facing even the most dedicated
abstainer.
"Addictions," says Joseph Frascella, director of the
division of clinical neuroscience at the National Institute on Drug
Abuse (NIDA), "are repetitive behaviors in the face of negative
consequences, the desire to continue something you know is bad for you."
Addiction
is such a harmful behavior, in fact, that evolution should have long
ago weeded it out of the population: if it's hard to drive safely under
the influence, imagine trying to run from a saber-toothed tiger or
catch a squirrel for lunch. And yet, says Dr. Nora Volkow, director of
NIDA and a pioneer in the use of imaging to understand addiction, "the
use of drugs has been recorded since the beginning of civilization.
Humans in my view will always want to experiment with things to make
them feel good."
That's because drugs of abuse co-opt the very
brain functions that allowed our distant ancestors to survive in a
hostile world. Our minds are programmed to pay extra attention to what
neurologists call salience – that is, special relevance. Threats, for
example, are highly salient, which is why we instinctively try to get
away from them. But so are food and sex because they help the
individual and the species survive. Drugs of abuse capitalize on this
ready-made programming. When exposed to drugs, our memory systems,
reward circuits, decision-making skills and conditioning kick in –
salience in overdrive – to create an all consuming pattern of
uncontrollable craving. "Some people have a genetic predisposition to
addiction," says Volkow. "But because it involves these basic brain
functions, everyone will become an addict if sufficiently exposed to
drugs or alcohol."
That can go for nonchemical addictions as
well. Behaviors, from gambling to shopping to sex, may start out as
habits but slide into addictions. Sometimes there might be a
behavior-specific root of the problem. Volkow's research group, for
example, has shown that pathologically obese people who are compulsive
eaters exhibit hyperactivity in the areas of the brain that process
food stimuli – including the mouth, lips and tongue. For them,
activating these regions is like opening the floodgates to the pleasure
center. Almost anything deeply enjoyable can turn into an addiction,
though.
Of course, not everyone becomes an addict. That's
because we have other, more analytical regions that can evaluate
consequences and override mere pleasure seeking. Brain imaging is
showing exactly how that happens. Paulus, for example, looked at
methamphetamine addicts enrolled in a VA hospital's intensive four-week
rehabilitation program. Those who were more likely to relapse in the
first year after completing the program were also less able to complete
tasks involving cognitive skills and less able to adjust to new rules
quickly. This suggested that those patients might also be less adept at
using analytical areas of the brain while performing decision-making
tasks. Sure enough, brain scans showed that there were reduced levels
of activation in the prefrontal cortex, where rational thought can
override impulsive behavior. It's impossible to say if the drugs might
have damaged these abilities in the relapsers – an effect rather than a
cause of the chemical abuse – but the fact that the cognitive deficit
existed in only some of the meth users suggests that there was
something innate that was unique to them. To his surprise, Paulus found
that 80% to 90% of the time, he could accurately predict who would
relapse within a year simply by examining the scans.
Another
area of focus for researchers involves the brain's reward system,
powered largely by the neurotransmitter dopamine. Investigators are
looking specifically at the family of dopamine receptors that populate
nerve cells and bind to the compound. The hope is that if you can
dampen the effect of the brain chemical that carries the pleasurable
signal, you can loosen the drug's hold.
One particular group of
dopamine receptors, for example, called D3, seems to multiply in the
presence of cocaine, methamphetamine and nicotine, making it possible
for more of the drug to enter and activate nerve cells. "Receptor
density is thought to be an amplifier," says Frank Vocci, director of
pharmacotherapies at NIDA. "[Chemically] blocking D3 interrupts an
awful lot of the drugs' effects. It is probably the hottest target in
modulating the reward system."
But just as there are two ways to
stop a speeding car – by easing off the gas or hitting the brake pedal
– there are two different possibilities for muting addiction. If
dopamine receptors are the gas, the brain's own inhibitory systems act
as the brakes. In addicts, this natural damping circuit, called GABA
(gamma-aminobutyric acid), appears to be faulty. Without a proper
chemical check on excitatory messages set off by drugs, the brain never
appreciates that it's been satiated.
As it turns out,
vigabatrin, an antiepilepsy treatment that is marketed in 60 countries
(but not yet in the U.S.), is an effective GABA booster. In epileptics,
vigabatrin suppresses overactivated motor neurons that cause muscles to
contract and go into spasm. Hoping that enhancing GABA in the brains of
addicts could help them control their drug cravings, two biotech
companies in the U.S., Ovation Pharmaceuticals and Catalyst
Pharmaceuticals, are studying the drug's effect on methamphetamine and
cocaine use. So far, in animals, vigabatrin prevents the breakdown of
GABA so that more of the inhibitory compound can be stored in whole
form in nerve cells. That way, more of it could be released when those
cells are activated by a hit from a drug. Says Vocci, optimistically:
"If it works, it will probably work on all addictions."
Another
fundamental target for addiction treatments is the stress network.
Animal studies have long shown that stress can increase the desire for
drugs. In rats trained to self-administer a substance, stressors such
as a new environment, an unfamiliar cage mate or a change in daily
routine push the animals to depend on the substance even more.
Among
higher creatures like us, stress can also alter the way the brain
thinks, particularly the way it contemplates the consequences of
actions. Recall the last time you found yourself in a stressful
situation – when you were scared, nervous or threatened. Your brain
tuned out everything besides whatever it was that was frightening you –
the familiar fight-or-flight mode. "The part of the prefrontal cortex
that is involved in deliberative cognition is shut down by stress,"
says Vocci. "It's supposed to be, but it's even more inhibited in
substance abusers." A less responsive prefrontal cortex sets up addicts
to be more impulsive as well.
Hormones – of the male-female kind
– may play a role in how people become addicted as well. Studies have
shown, for instance, that women may be more vulnerable to cravings for
nicotine during the latter part of the menstrual cycle, when the egg
emerges from the follicle and the hormones progesterone and estrogen
are released. "The reward systems of the brain have different
sensitivities at different points in the cycle," notes Volkow. "There
is way greater craving during the later phase."
That led
researchers to wonder about other biological differences in the way men
and women become addicted and, significantly, respond to treatments.
Alcohol dependence is one very promising area. For years, researchers
had documented the way female alcoholics tend to progress more rapidly
to alcoholism than men. This telescoping effect, they now know, has a
lot to do with the way women metabolize alcohol. Females are endowed
with less alcohol dehydrogenase – the first enzyme in the stomach
lining that starts to break down the ethanol in liquor – and less total
body water than men. Together with estrogen, these factors have a net
concentrating effect on the alcohol in the blood, giving women a more
intense hit with each drink. The pleasure from that extreme high may be
enough for some women to feel satisfied and therefore drink less. For
others, the intense intoxication is so enjoyable that they try to
duplicate the experience over and over.
But it's the brain, not
the gut, that continues to get most of the attention, and one of the
biggest reasons is technology. It was in 1985 that Volkow first began
using PET scans to record trademark characteristics in the brains and
nerve cells of chronic drug abusers, including blood flow, dopamine
levels and glucose metabolism – a measure of how much energy is being
used and where (and therefore a stand-in for figuring out which cells
are at work). After the subjects had been abstinent a year, Volkow
rescanned their brains and found that they had begun to return to their
predrug state. Good news, certainly, but only as far as it goes.
"The
changes induced by addiction do not just involve one system," says
Volkow. "There are some areas in which the changes persist even after
two years." One area of delayed rebound involves learning. Somehow in
methamphetamine abusers, the ability to learn some new things remained
affected after 14 months of abstinence. "Does treatment push the brain
back to normal," asks NIDA's Frascella, "or does it push it back in
different ways?"
If the kind of damage that lingers in an
addict's learning abilities also hangs on in behavioral areas, this
could explain why rehabilitation programs that rely on cognitive
therapy – teaching new ways to think about the need for a substance and
the consequences of using it – may not always be effective, especially
in the first weeks and months after getting clean. "Therapy is a
learning process," notes Vocci. "We are trying to get [addicts] to
change cognition and behavior at a time when they are least able to do
so."
One important discovery: evidence is building to support
the 90-day rehabilitation model, which was stumbled upon by AA (new
members are advised to attend a meeting a day for the first 90 days)
and is the duration of a typical stint in a drug-treatment program. It
turns out that this is just about how long it takes for the brain to
reset itself and shake off the immediate influence of a drug.
Researchers at Yale University have documented what they call the
sleeper effect – a gradual re-engaging of proper decision making and
analytical functions in the brain's prefrontal cortex – after an addict
has abstained for at least 90 days.
This work has led to
research on cognitive enhancers, or compounds that may amplify
connections in the prefrontal cortex to speed up the natural reversal.
Such enhancement would give the higher regions of the brain a fighting
chance against the amygdala, a more basal region that plays a role in
priming the dopamine-reward system when certain cues suggest imminent
pleasure – anything from the sight of white powder that looks like
cocaine to spending time with friends you used to drink with. It's that
conditioned reflex – identical to the one that caused Ivan Pavlov's
famed dog to salivate at the ringing of a bell after it learned to
associate the sound with food – that unleashes a craving. And it's that
phenomenon that was the purpose of my brain scans at McLean, one of the
world's premier centers for addiction research.
In my heyday, I
would often drink even when I knew it was a terrible idea – and the
urge was hardest to resist when I was with my drinking buddies, hearing
the clink of glasses and bottles, seeing others imbibe and smelling the
aroma of wine or beer. The researchers at McLean have invented a
machine that wafts such odors directly into the nostrils of a subject
undergoing an fMRI scan in order to see how the brain reacts. The
reward circuitry in the brain of a newly recovering alcoholic should
light up like a Christmas tree when stimulated by one of these alluring
smells.
I chose dark beer, my absolute favorite, from their
impressive stock. But I haven't gotten high for more than a
quarter-century; it was an open question whether I would react that
way. So after an interview with a staff psychiatrist to make sure I
would be able to handle it if I experienced a craving, I was fitted
with a tube that carried beer aroma from a vaporizer into my nose. I
was then slid into the machine to inhale that still familiar odor while
the fMRI did its work.
Even if the smells triggered a strong
desire to drink, I had long since learned ways to talk myself out of it
– or find someone to help me do so. Like the 90-day drying-out period
that turns out to parallel the brain's recovery cycle, such a strategy
is in line with other new theories of addiction. Scientists say
extinguishing urges is not a matter of getting the feelings to fade but
of helping the addict learn a new form of conditioning, one that allows
the brain's cognitive power to shout down the amygdala and other lower
regions. "What has to happen for that cue to extinguish is not for the
amygdala to become weaker but for the frontal cortex to become
stronger," says Vocci.
While such relearning has not been
studied formally in humans, Vocci believes it will work, on the basis
of studies involving, of all things, phobias. It turns out that phobias
and drugs exploit the same struggle between high and low circuits in
the brain. People placed in a virtual-reality glass elevator and
treated with the antibiotic D-cycloserine were better able to overcome
their fear of heights than those without benefit of the drug. Says
Vocci: "I never thought we would have drugs that affect cognition in
such a specific way."
Such surprises have even allowed experts
to speculate whether addiction can ever be cured. That notion goes
firmly against current beliefs. A rehabilitated addict is always in
recovery because cured suggests that resuming drinking or smoking or
shooting up is a safe possibility – whose downside could be
devastating. But there are hints that a cure might not in principle be
impossible. A recent study showed that tobacco smokers who suffered a
stroke that damaged the insula (a region of the brain involved in
emotional, gut-instinct perceptions) no longer felt a desire for
nicotine.
That's exciting, but because the insula is so critical
to other brain functions – perceiving danger, anticipating threats –
damaging this area isn't something you would ever want to do
intentionally. With so many of the brain's systems entangled with one
another, it could prove impossible to adjust just one without throwing
the others into imbalance.
Nevertheless, says Volkow, "addiction
is a medical condition. We have to recognize that medications can
reverse the pathology of the disease. We have to force ourselves to
think about a cure because if we don't, it will never happen." Still,
she is quick to admit that just contemplating new ideas doesn't make
them so. The brain functions that addiction commandeers may simply be
so complex that sufferers, as 12-step recovery programs have emphasized
for decades, never lose their vulnerability to their drug of choice, no
matter how healthy their brains might eventually look.
I'm
probably a case in point. My brain barely lit up in response to the
smell of beer inside the fMRI at McLean. "This is actually valuable
information for you as an individual," said Scott Lukas, director of
the hospital's behavioral psychopharmacology research laboratory and a
professor at Harvard Medical School who ran the tests. "It means that
your brain's sensitivity to beer cues has long passed."
That's
in keeping with my real-world experience; if someone has a beer at
dinner, I don't feel a compulsion to leap across the table and grab it
or even to order one for myself. Does that mean I'm cured? Maybe. But
it may also mean simply that it would take a much stronger trigger for
me to fall prey to addiction again – like, for example, downing a glass
of beer. But the last thing I intend to do is put it to the test. I've
seen too many others try it – with horrifying results.
With reporting by Alice Park
Find this article at: www.time.com/time/magazine/article/0,9171,1640436,00.html
Technology Targets Drunk Drivers
July 13, 2007 (HealthDay News) – The war against drunk driving is turning high-tech.
Devices that can sense the amount of alcohol in the air around your face or even in your sweat are already on the drawing board, to join current technology aimed at stopping you from getting behind that wheel if you've had too much to drink, researchers say.
"People continue to drive drunk because they can," said Heidi Castle, a spokeswoman for Mothers Against Drunk Driving (MADD). "That's when technology comes into play. Technology has the potential to not allow someone who is intoxicated to operate a motor vehicle. It essentially separates the weapon – the car – from the drunk driver."
But even though some technology has been on the market for a generation, impaired driving is still a problem.
Last year, almost 17,000 deaths and half a million injuries were caused by drunk driving crashes in the United States.
One of the featured technologies at a recent MADD symposium was the "ignition interlock," essentially a tube connected to the vehicle ignition. The driver breathes into the tube and, if his blood alcohol concentration (BAC) is over a certain threshold, the system prevents the car from starting.
"This is the gold standard," said Paul Marques, senior research scientist with the Pacific Institute for Research and Evaluation (PIRE), a nonprofit public health research institute.
"As far as deterrents or prevention, this is probably the most common," Castle added.
"We have 20 years' experience with interlock, but it's underutilized," Marques said. "It won't have an impact on impaired driving unless it's used."
The problem in the United States is getting courts to order it.
With 1.4 million DUI arrests every year, no more than 100,000 interlocks are being used. Studies have shown that the device results in a 65 percent reduction in recidivism.
A number of other futuristic technologies are also on the horizon. Among them:
Transdermal alcohol sensors, such as SCRAM (Secure Continuous Remote Alcohol Monitor), to measure alcohol that is lost through the skin through sweat. The gadget, worn as an ankle bracelet, "sniffs" every 30 minutes and transfers data via a wireless connection to a probation officer or other law-enforcement official. Passive sensors to sample the air around a person's face, usually without the person knowing it. The sensor can be hidden in a police officer's flashlight and, if it senses alcohol, represents probable cause for more sobriety tests. A 2.5-ounce device to monitor the movements of someone convicted of drunk driving. Worn as a bracelet or anklet, this gadget uses global positioning system technology to alert law-enforcement personnel if an offender has entered a bar or gone someplace he shouldn't. It's part of the Southwest Riverside County (Calif.) "Watch Your Step" program. Near-infrared spectroscopy to determine blood alcohol composition under the skin. These devices would go into every car and be totally passive -- in other words, the driver wouldn't need to do anything, even breathe into a tube. The device is still in development and is being used by former U.S. Defense Department physicists. "It's totally unaffordable today," Marques noted. But technology can only do so much to combat drunk driving.
"When you're talking about drunk driving, there's no silver bullet," Castle said. "What we need is a comprehensive solution. One of the main components is law enforcement, but we will likely never have enough police officers on the street to arrest every drunk driver."
Marques added: "Drunk driving is a slowly unfolding tragedy that doesn't get better. Technology can help, but we can't do it without a human program."
Source: http://www.forbes.com/
$2 Heroin Aimed at Young Teens
This report first appeared on CNN.com on June 12, 2007.
DALLAS,
Texas (CNN) – A cheap highly addictive drug known as "cheese heroin"
has killed 21 teenagers in the Dallas area over two years, and
authorities say they are hoping they can stop the fad before it spreads
across the nation.
"Cheese heroin" is a blend of so-called black
tar Mexican heroin and crushed over-the-counter medications that
contain the antihistamine diphenhydramine, found in products such as
Tylenol PM, police say. The sedative effects of the heroin and the
nighttime sleep aids make for a deadly brew.
"A double whammy –
you're getting two downers at once," says Dallas police detective Monty
Moncibais. "If you take the body and you start slowing everything down,
everything inside your body, eventually you're going to slow down the
heart until it stops and, when it stops, you're dead." (Audio slide
show: A father describes his teen son's death)
Steve Robertson,
a special agent with the Drug Enforcement Administration in Washington,
says authorities are closely monitoring the use of "cheese" in Dallas.
Trying
to keep the drug from spreading to other cities, the DEA is working
with Dallas officials to raise public awareness about the problem.
Authorities also are trying to identify the traffickers, Robertson says.
"We are concerned about any drug trend that is new because we want to stop it," he says.
Why should a parent outside Dallas care about what's happening there?
Robertson
says it's simple: The rise of the information technology age makes it
easy for a drug trend to spread rapidly across the country.
"A
parent in New York should be very concerned about a drug trend in
Dallas, a drug trend in Kansas City, a drug trend anywhere throughout
the United States," he says.
Middle schoolers acknowledge 'cheese'
"Cheese"
is not only dangerous. It's cheap. About $2 for a single hit and as
little as $10 per gram. The drug can be snorted with a straw or through
a ballpoint pen, authorities say. It causes drowsiness and lethargy, as
well as euphoria, excessive thirst and disorientation. That is, if the
user survives. (Interactive: What is "cheese"? )
Authorities
aren't exactly sure how the drug got its name "cheese." It's most
likely because the ground-up, tan substance looks like Parmesan cheese.
The other theory is it's shorthand for the Spanish word "chiva," which
is street slang for heroin.
By using the name "cheese," drug
dealers are marketing the low-grade heroin to a younger crowd – many of
them middle schoolers – unaware of its potential dangers, authorities
say.
"These are street dealers, dope dealers," Moncibais
recently warned students at Sam Tasby Middle School. "They give you a
lethal dose. What do they care?"
Moncibais then asked how many
students knew a "cheese" user. Just about everyone in the auditorium
raised a hand. At one point, when he mentioned that the United States
has the highest rate of drug users in the world, the middle schoolers
cheered. (Watch middle schoolers raise hands, admit they know drug
users )
"You know, I know being No. 1 is important, but being
the No. 1 dopeheads in the world, I don't know whether [that] bears
applause," Moncibais shot back.
Authorities say the number of
arrests involving possession of "cheese" in the Dallas area this school
year was 146, up from about 90 the year before. School is out for the
summer, and authorities fear that the students, with more time on their
hands, could turn to the drug.
'Cheese' as common a problem as pot
School
officials and police have been holding assemblies, professional
lectures, PTA meetings and classroom discussions to get the word out
about the drug. A public service announcement made by Dallas students
is airing on local TV, and a hotline number has been created for those
seeking assistance.
Drug treatment centers in Dallas say teen
"cheese" addicts are now as common as those seeking help for a
marijuana addiction. "It is the first drug to have even come close in
my experience here," says Michelle Hemm, director of Phoenix House in
Dallas.
From September 2005 to September 2006, Phoenix House
received 69 "cheese" referral calls from parents. Hemm says that in the
last eight months alone, that number has nearly doubled to 136. The
message from the parents is always, "My kid is using 'cheese,' " she
says.
Phoenix House refers them to detoxification units first,
but Hemm says at least 62 teens have received additional treatment at
her facility since last September.
Fernando Cortez Sr. knows all
too well how devastating cheese heroin can be. A reformed drug user who
has spent time in prison, Cortez had spoken to his children about the
pitfalls of drug use. He thought his 15-year-old son was on the right
track.
But on March 31, his boy, Fernando "Nando" Cortez Jr., was found dead after using cheese heroin.
"I
should have had a better talk with him," he says. "All it takes is
once. You get high once and you die, and that's what happened to my
son."
He knows it's too late for his son. Now, he is using his son's story to help others.
"All I can do is try to help people now. Help the kids, help the parents."
Candy-Flavored Meth Targets New Users
First published by cbs.com, May 2, 2007By Jon Gambrell
"It's really a bitter substance ... so if you're going to try to make it more consumable for the masses, then you're going to want to try to take that edge off whichever way you can," said Chris Harrison, chief illicit laboratory chemist at the Arkansas lab.
"The drug cartels operate just like any other corporation would — if they want to increase their market share, then they're going to have to change something about it. This is just an evolution. They've saturated the heavy users, now they are moving onto some other people," he said.
The latest meth cut, known as "Strawberry Quick," uses powdered drink mix to give the drug a pink coloring. The sweetness of the powder can make meth more palatable and partially masks its harsh chemical taste.
The new cut has been the focus of several law enforcement bulletins in western states. While there have been several reported cases of police finding the cut in Arkansas, it is "not widespread," said William Bryant, assistant special agent in charge of the Drug Enforcement Agency's Little Rock district office.
"It's a different spin, like a marketing thing," Bryant said.
That marketing has taken a variety of forms for methamphetamine, found in powder and in a crystalized form similar to broken glass. Its low boiling point allows for it to easily be smoked or injected as a liquid into the bloodstream.
Because of its chemical properties, meth easily mixes into any water-based liquid. Caffeinated, high-sugar energy drinks and sodas often litter areas where meth cookers manufacture the drug, sometimes used as a chaser to the stimulant, Harrison said.
Outside of drinks, police also have seen meth mixed with a variety of candy, cola and chocolate flavors. Cutting it with something else also may help cutting down the burning sensation some have when snorting powdered meth, Harrison said. When snorted, he said meth can destroy a person's septum.
"You have some hard-core users that are prepared for the burn that methamphetamine will have," Harrison said. "Snorting it is supposed to be really hard on the nostrils."
Some meth cookers also have dyed meth different colors using a process similar to that used to make rock candy, though Harrison said it didn't help cover the taste.
"Strawberry Quick" came to prominence in January, after the Nevada Department of Public Safety issued a bulletin describing the type of meth there, said Steve Robertson, a Washington-based spokesman for the DEA. In the time since, Robertson says DEA agents have heard reports of flavored meth appearing in Missouri, Texas, Washington state and Wisconsin — though he stressed it was not a nationwide phenomenon.
"Traffickers are out there and are trying to sell it to customers, whether they are young customers or older, brand-new customers by changing the color or the taste or just giving it a less-intimidating name, they are trying to make it seem less dangerous and lure this new customer base," Robertson said. "If someone was completely terrified of trying it, it might diminish the threat."
The reports of flavored meth come as the DEA and local police department keep increased pressure on the drug's manufacturers. In 2005, the Arkansas Legislature required those purchasing over-the-counter medications that can be used to cook meth show identification and that the drugs be stored in a secure location. This year, the Legislature approved creating an electronic database to monitor sales of the medications.
Bryant says those crackdowns contributed the number of found methamphetamine labs in Arkansas dropping from 1,206 in 2004 to 446 last year. In the first quarter of this year, he said there have been only 56 labs found.
However, Harrison cautioned as the number of discovered labs has dropped, the amount of methamphetamine being seized by police has increased steadily. He said that could be coming from operations not being found by police, as well as meth coming into the state from the west coast and Mexico.
Rick Gallagher, assistant director of the state Crime Laboratory, said the drug remains one of the most abused in the state.
"It might vary from place to place like alcohol and marijuana, but you'd hear the word 'methamphetamine' a whole lot," Gallagher said.
The NSDUH Report - Work Absences and Past Month Cigarette Use: 2004 and 2005
> PDF format (recommended for printing)> Full report on-line
The short report:
Work Absences and Past Month Cigarette Use: 2004 and 2005,
is based on SAMHSA's National Survey on Drug Use and Health (NSDUH),
conducted by the Office of Applied Studies (OAS) in the Substance Abuse
and Mental Health Services Administration (SAMHSA). SAMHSA's National
Survey on Drug Use & Health is the primary source of information on
the prevalence, patterns, and consequences of drug and alcohol use and
abuse in the general U.S. civilian non institutionalized population,
age 12 and older.
Highlights:
- Based
on combined data from SAMHSA's annual National Surveys on Drug Use and
Health in 2004 and 2005, worker absenteeism by cigarette smoking status
was assessed among adult workers aged 18 to 64 currently employed full
time.
- Current cigarette smoking (i.e., smoked cigarettes
in the month prior to the survey) was reported by 42.8% of full-time
employed adults aged 18-25, 33.1% of those aged 16-34, 28.8% of those
aged 35-44, and 22.3% of those aged 45-64.
- Among adults
aged 18 to 64 who were currently employed full time, 20.1% missed at
least one day of work in the past month due to illness or injury.
- Among currently full time employed adults, current cigarette smokers were more likely to have missed work on 5 or more days in the past month due to illness or injury than those who did not smoke cigarettes in the prior month.
Getting to the Bottom of how Speed Kills
Allan J. Comeau, Ph.D.
This article was first published April 9, 2007 on sbsun.com
Also
known as "speed," "meth" and "chalk," methamphetamine is an easily
manufactured drug that is very stimulating, highly addictive and
results in potentially serious physical and mental health consequences
for users and, potentially, their friends and families.
Methamphetamine
has consistently been the fastest growing drug of abuse, particularly
in urban communities. According to data from the National Institute on
Drug Abuse (NIDA), more than 10 million Americans ages 12 and older
report having tried this drug and more than half a million are current
users (having used in the past month). Hospital admissions studies
reveal that in 1992 only 1 percent of drug-related admissions were
attributed to this drug, while by 2004 the number had increased to 8
percent, with more than 150,000 admissions.
Recently a news item
came across my desk about a study that examined the causes of more than
8,000 strokes in a recent four-year period. Arthur N. Westover and
colleagues at the University of Texas Southwestern Medical Center in
Dallas searched a database of more
than 3 million discharges from
Texas hospitals from 2000 through 2003. They assessed the correlation
between strokes and substance abuse, including cannabis, opioids,
cocaine and methamphetamine. They found, among patients with strokes,
that alcohol was the most commonly abused substance, followed by
cocaine, with drugs from the amphetamine class ranking fifth.
There
are two different kinds of strokes, one called ischemic - caused by
blocked arteries - and the other called hemorrhagic, resulting from
bursting blood vessels and the subsequent bleeding into and destruction
of adjacent brain tissue. While experts already were already aware that
substance abuse is a significant risk factor for strokes, no one had
analyzed the data in this way before. When Westover and colleagues
examined the relationship of these drugs to the different types of
strokes, they found that young people ages 18 to 44 who used
methamphetamine are five times more likely to suffer a hemorrhagic
stroke than nonabusers. By contrast, they found that cocaine abusers
were twice as likely to have one or the other kind of stroke than
nonusers. Overall, they found that one in seven strokes of either type
was likely caused by substance abuse, including tobacco.
"Using
amphetamines or cocaine significantly increases an individual's risk
for a stroke," concludes Dr. Westover. Pointing out the public health
implications of substance abuse prevention efforts, he adds, "If we
decrease the number of people who are using these substances, then we
likely can reduce the number of strokes in this younger population. The
implication is that it's preventable."
As rates of
methamphetamine abuse are on the rise, the authors are heading in the
right direction and national, regional and family efforts must be
allocated accordingly.
According to information available at the
NIDA Web site, effective treatment for methamphetamine addiction often
involves a combination of cognitive behavioral therapies and a method
called contingency management, where patients are given rewards when
goals are achieved. They endorse a comprehensive approach, the Matrix
Model, which was developed in collaboration with UCLA's Integrated
Substance Abuse Programs. While there is no medication that effectively
eliminates craving for methamphetamine, a number of medications show
promise and have been effective in individual cases, according to some
of my colleagues.
Readers wanting to follow up on the Westover
research at the University of Texas can find his article in the current
issue of the Archives of General Psychiatry. Those wishing to contact
the Matrix Institute for information about treatment programs can call
at (800) 310-7700.
Allan
J. Comeau, Ph.D., is a psychologist on the clinical faculty at UCLA and
a former president of the Inland Southern California Psychological
Association. Write him at 2001 S. Barrington Ave., Suite 304, Los
Angeles, CA 90025, or visit www.drcomeau.com.
HBO's Groundbreaking Television Series: Addiction
14-part series premieres March 15-18
AddictionAction.org is a grassroots partnership to help communities mobilize around it, bringing the hope of treatment and long term recovery to individuals and families affected by addiction to alcohol and drugs.
This
HBO program is part of a multi-platform campaign to educate America
about addiction and its treatment as a brain disease. The program is
made possible by HBO, in partnership with the Robert Wood Johnson
Foundation, the National Institute on Drug Abuse, the National
institute on Alcohol Abuse and Alcoholism, Join Together, CADCA, and
Faces and Voices of Recovery.
Here
are ways you can get started to involve your community in promoting the
show and its message of hope for treatment and long-term recovery:
- Tell family and friends to watch the show:
http://members.jointogether.org/addiction/join-forward.tcl
- Sign up to host or attend an Addiction Action House Party:
http://houseparties.addictionaction.org/
- Find out if there's a community event in your area, such as a Town Hall meeting or special preview screening:
http://addictionaction.org/events/
For more information go to www.addictionaction.org
Related content:
"Documentary Highlights Montana's Meth Problem," NPR Morning Edition, March 13, 2007.National Institute on Drug Abuse Launches Public Service Campaign
for Hispanic Youth on the Link between Non-Injection Drugs and HIV
WEBWIRE – Monday, Nov. 26, 2007The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH), marks World AIDS Day on December 1st with the launch of its new, national public service campaign to educate Hispanic teens on the link between non-injection drug use and HIV transmission. The campaign features an innovative television spot blending English and Spanish; a Webisode series that will launch soon on www.hiv.drugabuse.gov; outdoor, transit and print placements; community events and partnerships.
The new Hispanic spots, "After the Party" build on an earlier English series, but continue the storyline from the point of view of a teen who used drugs and alcohol, engaged in risky behavior and now has HIV. In the new series, a young woman calls on her aunt for comfort and support. Rather than simply translating the original spots that were launched in 2005, NIDA incorporated culturally relevant scenarios that would resonate with the Hispanic audience — in this case, turning to family in times of distress. There are two versions of the new series — one set for Spanish-language television stations and a bilingual set for English-language stations located in markets with large Hispanic populations.
The award-winning Text Message spot, which continues to run on stations across the country, was endorsed by The Ad Council, screened in film festivals, featured in the Dallas Transit system and in Washington Metropolitan Area Transit Authority (WMATA), and aired in Times Square.
"Drug use and alcohol consumption disrupt the parts of the brain that people use to weigh risks and benefits before making decisions" said NIDA Director Dr. Nora Volkow. "Research has shown that substance use increases the chances of engaging in risky sexual behavior — such as unprotected sex — that can lead to HIV. This campaign urges teens to learn more about the risks of risky behavior and drives them to our Website"
Hispanic youth are potentially at risk for contracting HIV/AIDS. They currently represent 16 percent of the United States teenage population, but over the next decade this diverse and multicultural group is expected to grow by 25 percent. According to 2005 CDC data, Hispanics/Latinos accounted for 18 percent of the 37,367 new HIV/AIDS diagnoses in the 33 states with long-term, confidential name-based HIV reporting.
Materials for NIDA’s Hispanic campaign include bilingual and Spanish television public service ads (PSAs) in 15-, 30- and 60-seconds; Web pages in Spanish on the www.hiv.drugabuse.gov site; English and Spanish print PSAs, promotional cards, posters, and Web banners. This holiday season, the PSA is running on the CBS Super Screen in New York City’s Times Square and inside New York City buses that travel through areas with large Hispanic populations.
NIDA also has participated in community-based events and collaborations during the phased rollout of the campaign. The Washington, D.C. Department of Health’s HIV/AIDS Administration recently shared NIDA’s campaign materials with community partners through its Youth and HIV/AIDS Prevention Initiative. NIDA also participated in Fiesta DC on September 30th, and the D.C. Metropolitan National Latino AIDS Awareness Day on October 15th.
To arrange an interview with NIDA Director Dr. Nora Volkow about the "Drugs + HIV > Learn the link" campaign, please contact Dorie Hightower at 301-496-1545. For more information about the campaign or to request the TV PSA or other materials, please call Sara Rosario Wilson at 301-594-6145.
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at www.drugabuse.gov.
The National Institutes of Health (NIH) – The Nation’s Medical Research Agency – includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
TWO STUDIES IN 2007 REACH OPPOSITE CONCLUSIONS
Study 1: Teen Drug Use Declining; Painkillers Still Popular
This article first appeared on cnn.com Dec. 12, 2007
WASHINGTON (AP) – Illicit drug use by teens continued to decline gradually overall this year, but the use of prescription painkillers remains popular among young people, according to a federally financed study released Tuesday at the White House.
At least one in every 20 high school seniors has at least tried OxyContin in the past year, the study said.
The survey, by the University of Michigan's Institute for Social Research, looked at the behavior of eighth-, 10th- and 12th-graders nationwide. The study, in its 33rd year, found that overall drug use is falling, thanks to a drop in the popularity of marijuana and methamphetamines. But it also found that teen use of other drugs, such as cocaine, is holding steady, and narcotics like OxyContin and Vicodin remain in vogue.
Overall, the proportion of eighth-graders reporting use of an illicit drug at least once in the 12 months before the survey was 24 percent in 1996. It now has fallen to 13 percent -- a drop of nearly half.
Among 10th-graders, the rates dropped from 39 percent to 28 percent between 1997 and 2007. Twelfth-graders saw a decline from a peak of 42 percent in 1997 to 36 percent this year.
"The cumulative declines since recent peak levels of drug involvement in the mid-1990s are quite substantial especially among the youngest students," said Lloyd Johnston, the principal investigator for the study, which was financed by the National Institute on Drug Use. It surveyed 50,000 teens.
The drugs most responsible for this year's decline in illicit drug use are marijuana and various stimulants, including amphetamines, methamphetamine and crystal methamphetamine.
"The most encouraging statistic relates to the use of methamphetamine, which has plummeted by an impressive 64 percent since 2001," President Bush said.
"One exception to this trend is a rise in the abuse of certain prescription painkillers," Bush said. "This is troubling, and we're going to continue to confront the challenge and the overall direction is hopeful."
At least one in every 20 high school seniors has at least tried OxyContin, a powerful narcotic drug, in the past year, the study said. The popularity of the painkiller Vicodin also remained constant. The percentage of students using Vicodin was 2.7 percent, 7.2 percent and 9.6 percent in 8th, 10th and 12th grades, respectively.
While the use of most illicit drugs has shown declines in the past decade or so, most prescription psychotherapeutic drugs did not. A number of them showed steady increases in use outside of their legitimate medical purpose. These include sedatives, tranquilizers and narcotic drugs other than heroin.
The study also reported an increase in the use of ecstasy. Ecstasy use among teens dropped dramatically in the early 2000s, as concern about the consequences of use grew. However, the proportion of students seeing great risk in using this drug has been in decline for the past two or three years at all three grade levels, and use has begun to increase, at least in the upper grades.
Among 10th-graders, annual prevalence with ecstasy has risen from a recent low of 2.4 percent in 2004 to 3.5 percent in 2007, while in 12th grade it has risen from a recent low of 3 percent in 2005 to 4.5 percent in 2007. While none of the one-year increases were statistically significant for 2007, a clear pattern of gradually rising use is discernible in the upper grades; and their cumulative increases over the past couple of years are statistically significant.
"These prevalence rates are not very high yet, but there is evidence here of this drug beginning to make a comeback," Johnston said. "Young people are coming to see its use as less dangerous than did their predecessors as recently as 2004, and that is a warning signal that the increase in use may continue."
Among the study's other findings:
• Amphetamine use peaked in the mid-1990s among eighth- and 10th-graders, but since then, use has fallen by more than one-half among eighth-graders to 4 percent and by one-third among 10th-graders to 8 percent this year. Amphetamine use peaked a little later among 12th-graders and has fallen by about one-third to 8 percent this year.
• Use of methamphetamine, called "meth," has been declining since it was first measured in 1999. Annual prevalence is now down by about two-thirds in all three grades from what it was in 1999.
• Marijuana still remains the most widely used of all the illicit drugs. The decline in 2007 in the annual prevalence of marijuana use among eighth-graders fell from 11.7 percent in 2006 to 10.3 percent in 2007. Tenth-graders showed a modest continuing decline in marijuana use, while 12th-graders showed no further change this year after a significant decline in 2006.
• Cocaine was the one stimulant that did not show a decline this year. Between 2 percent and 5 percent of the eighth-, 10th- and 12th-graders surveyed said they had tried it in the 12 months before the survey. Crack use, which previously declined in all three grades, showed no further decline this year.
• The study tracked a fairly sharp increase in the use of anabolic steroids by male teens in the late 1990s, 2000, 2001 and 2002. Since those peak years, the annual prevalence rate has dropped by more than half among the eighth- and 10th-grade males -- to 1.1 percent and 1.7 percent, respectively -- and by 40 percent among 12th-grade males to 2.3 percent this year.
• The number of U.S. teens who smoke has shown significant declines in recent years, particularly among those in their early teens. The rate of teens who reported smoking in the 30 days before the survey is now down by two-thirds among eighth-graders to 7 percent from the peak level reached in 1996 of 21 percent. Study 2: Teen Drug Use Worsening
This article was first published Aug. 16, 2007, on www.time.com
As
teenagers say drug problems at school are getting worse, many parents
are expressing doubts about ever making such schools drug free, and a
majority of parents are seemingly less concerned about drug dangers, a
new study says.
The percentage of teens who say they attend
high schools with drug problems has increased from 44 percent to 61
percent since 2002, and the percentage in middle schools has increased
from 19 percent to 31 percent, according to the survey to be released
Thursday by Columbia University's National Center on Addiction and
Substance Abuse.
And such activity is not easily hidden: The
study has found that eight in 10 high schoolers and 44 percent of
middle schoolers have witnessed illegal drug use, dealing or
possession, or have seen students high or drunk on school grounds.
Thirty-one percent have witnessed this activity at least once a week.
According
to the study, 17 percent of high school students say they could buy
marijuana somewhere on their campus in an hour, while 37 percent say
they could do it in a day, reports CBS News national correspondent
Byron Pitts.
Some 13 percent of teens said they had tried
marijuana, and 4 percent said they had used it in the past month. (Such
survey results are often understated because respondents are hesitant
to admit such drug use.)
The group calls institutions where
illicit drug use is so rampant as "drug infested," and says popular
kids who attending such schools are five and a half times more likely
to use drugs than the same teens at drug-free schools.
"Those
kids who consider themselves among the most popular were likely to get
drunk at least once a month, likely to use drugs, likely to smoke
marijuana," Joseph Califano, the center's chairman and president, told
CBS News Early Show anchor Harry Smith. "The world these kids are
living in, that's cool. We've got to change that."
"It has become such a commonplace experience for teens that their concern about it has come down," said Califano.
And
with drug use becoming embedded in the high school experience, despair
and denial are increasingly characterizing parents' attitudes.
Of
parents queried in the survey, only 11 percent said drugs are their
child's biggest concern. Asked how they'd feel if their kids smoked
pot, 48 percent of parents said they were more worried about sex, 52
percent about shoplifting, and 82 percent about their child driving
while intoxicated.
Califano, a former Secretary of Health,
Education and Welfare, recommends that parents pull their kids out of
schools where drug dangers are high.
"Parents refuse to send
their kids to a school when asbestos is there." Califano told CBS News
correspondant Barry Bagnato. "They'd refuse to send their kids to
school if it were infested with rats.
"They've got to start
saying, 'I'm not going to allow this situation to continue where my
kids have to go to a school where drugs are used, kept and sold, or
where they're going to see classmates that are high or drunk," Califano
said.
The survey also found:
- About six in 10 parents of teens at schools with a drug problem say they believe the goal of making that school drug free is unrealistic.
- Most parents (86 percent) say drinking is a big part of the college experience, but only 29 percent think their own teens will do a lot of drinking in college.
- Students who consider themselves popular were more likely to use drugs, drink or smoke than students who do not view themselves as popular.
- The survey found 24 percent of teens named drugs as their number one concern, down from 32 percent who listed it as a top concern in 1995.