Monday, September 29, 2008

Pregnant and Addicted to Heroin

Expectant Mother Is One of Many Addicts in America's Heartland

RICHLAND COUNTY, Ohio, Sept. 29, 2008

Merry Doerr has spent her whole life in the American farmbelt, a rural pocket of green tucked into the middle of Ohio. She's close to her family, living with her mother and 4-year-old daughter.

With her blond hair and blue eyes, Doerr embodies the classic American look -- and says she grew up with classic American values.

"When I grew up, my mom had raised me in Christian beliefs," she said, "and I knew ... right from wrong based on the Bible. I was a cheerleader. I had a lot of friends."

But life is different now. Doerr, who is five months pregnant and preparing for her second child, is not like other young mothers. She's a heroin addict.

"I wake up at 4 o'clock in the morning, dope sick with my stomach in cramps and sweating," she said, describing the symptoms of heroin withdrawal. "I have to get up out of bed at 4 o'clock in the morning, and go and use. And then I go back to bed and I wake up a few hours later and have to go use again."

Doerr said she uses heroin to keep that pain at bay.

"This is what I need to be normal," Doerr said. "You know I have to do dope every day to be normal. If I didn't have my dope this morning, I would be laying in bed right now thrashing around and vomiting. I wouldn't be able to function. I need [heroin] to function every day."

'Snowing Heroin' in Rural Ohio

It turns out that in the rural heartland of Ohio, halfway between the big cities of Cleveland and Columbus, heroin is everywhere.

"I would say it's up to epidemic proportions as far as the heroin," said Dane Howard of the Huron County Sheriff's Office. "Everywhere you go, it's like it's snowing heroin."

People here say heroin is indeed blanketing the main streets of tiny towns such as Plymouth, Ohio, where Doerr grew up. Doerr's mother, Patti Case, a schoolteacher, said so many people in their town of 1,800 were addicted to heroin that she moved her family, hoping to distance her daughter from the problem. But they found that the problem stretched across the region.

"There's probably not a family here, not just Plymouth but the surrounding area, that hasn't been touched by heroin," said Charlie Doan, chief of the Plymouth Police Department. "I think a lot of that started with Oxycontin."

In the mid-1990s, OxyContin, the highly addictive prescription pain killer, was being widely abused in rural communities like this one.

"About a decade ago, OxyContin got a strong foothold here in this whole region" said Howard. "The dealers drove the price up."

Click here to continue reading article at ABC News Health

Sunday, September 28, 2008

A Message from Dr. Andrew Tatarsky

Dear Friends,

I am putting together a piece on empirical support for harm reduction psychotherapy for my website. I have thought for years that we need one spot where people can go to find the evidence supporting this approach and this will be a beginning for me.

There is much indirect support for harm reduction psychotherapy from 50 years of research on therapeutic alliance, goal choice, motivational interventions, etc. I wonder if you are aware of any studies that have looked specifically at harm reduction psychotherapy that you can let me know of, send copies of or point me to. I am also interested in gathering the work on indirect support and would love to know what you are aware of in this area as well.

I will keep you posted on my results and I appreciate any and all thoughts on this subject.

Andrew Tatarsky, PhD

House vs. House: Vicodin Addiction and Hearing Loss

Hearing Expert Dr. John House Calls Out Dr. Gregory House on Vicodin Addiction

Sept. 20, 2008

"Are you the famous Dr. House on television?"

During my career as a physician, there has been confusion regarding which Dr. House I am. I was confident that they were referring to my father, Dr. Howard House, the founder of the House Ear Institute, or my uncle, Dr. William House, who created and implanted the first FDA-approved cochlear implant.

But now I have discovered that there is another popular "Dr. House," TV's Dr. Gregory House on Fox's "House, M.D."

The show's popularity is not to be denied, but I have a very real concern about a message and theme that runs through each episode. It is not his poor bedside manner. It is not his mistreatment of residents. It is his addiction to Vicodin (acetaminophen/ hydrocodone) that is the problem.

Here at the House Clinic, my colleagues and I have seen a significant number of patients who have become addicted to Vicodin and have gone completely deaf. They have been taking 15 to 75 tablets per day and in a short period of time have developed a rapidly progressive hearing loss, which leads to permanent total deafness.

New research released this week by the Kaiser Family Foundation indicates that people are receiving important health information from prime-time television shows. Although the study looked at the storyline of another medical drama and not "House, M.D.," the important finding is that 45.6 percent of the audience surveyed remembered the key medical information six weeks later.

Click here to continue reading article at ABC News

Accuracy, Efficacy And Ethics Of Abstinence-only Programs Questioned By Public Health Experts

ScienceDaily (Sep. 19, 2008) — Studies published in a special issue of the online journal Sexuality Research and Social Policy by the University of California Press reveal that abstinence-only-until-marriage sex education programs fail to change sexual behavior in teenagers, provide inaccurate information about condoms, and violate human rights principles.

Edited by John S. Santelli, MD, MPH, professor and chair of the Heilbrunn Department of Family and Population Health and Leslie M. Kantor, MPH, assistant professor of clinical Population and Family Health at the Columbia University Mailman School of Public Health, the theme issue examines scientific and ethical implications of federal abstinence-only policies and programs.

In sum, the articles show that abstinence-only programs contain medical inaccuracies, fail to help young people to change behavior, and conflict with ethical standards. Abstinence-only programs violate young people's right to accurate information—and also teachers' and health educators' rights to answer questions and provide medically accurate information. Many states have now refused to participate in the federal program (25 states as of August 2008) citing concerns about efficacy and accuracy of abstinence-only programs. The federal program provides funding for abstinence-only education and restricts information about contraception and other aspects of human sexuality.

"Abstinence-only programs have a broad variety of problems with accuracy, efficacy, and ethics," Dr. Santelli. "These studies clearly demonstrate that federal promotion of abstinence has failed in its primary goal of helping young people delay initiation of sex, and actually, withholds life-saving information from young people."

Click here to continue reading article at Science Daily

Potential New Drug For Cocaine Addiction And Overdose

ScienceDaily (Sep. 16, 2008) — Chemists are reporting development of what they term the most powerful substance ever discovered for eliminating cocaine from the body, an advance that could lead to the world's first effective medicine for fighting overdoses and addictions of the illicit drug.

Their findings are scheduled for the Sept. 24 issue of the Journal of the American Chemical Society, a weekly publication.

In the new study, Chang-Guo Zhan and colleagues point out no effective anti-cocaine medication currently exists for cocaine abuse. One of the most promising approaches focuses on substances that mimic butyrylcholinesterase (BChE), a natural blood protein that helps break down and inactivate the drug, researchers say. However, natural BChE is too weak and ineffective for medical use, the researchers note.

The researchers describe design and produce the most potent, stable BChE structure ever produced. In lab studies, that form of BChE broke down, or metabolized, cocaine 2,000 times faster than the body's natural version of BChE, the scientists say, noting that reducing levels of the drug in the blood is a key to fighting overdose in humans. The substance also prevented convulsions and death when injected into mice that were given overdoses of cocaine, they note.

Tuesday, September 23, 2008

In Tangle of Young Lips, a Sex Rebellion in Chile

Below is part of a NY Tizmes article addressing sexual behavoir among teenagers in Chile. Harm Reduction would be valuable and necessary in this case, where the abstinence-only approach has clearly been tossed out, and the kids are going do what they will.


Published: September 12, 2008

SANTIAGO, Chile — It is just after 5 p.m. in what was once one of Latin America’s most sexually conservative countries, and the youth of Chile are bumping and grinding to a reggaet├│n beat. At the Bar Urbano disco, boys and girls ages 14 to 18 are stripping off their shirts, revealing bras, tattoos and nipple rings.

The place is a tangle of lips and tongues and hands, all groping and exploring. About 800 teenagers sway and bounce to lyrics imploring them to “Poncea! Poncea!”: make out with as many people as they can.

And make out they do — with stranger after stranger, vying for the honor of being known as the “ponceo,” the one who pairs up the most.

Chile, long considered to have among the most traditional social mores in South America, is crashing headlong into that reputation with its precocious teenagers. Chile’s youths are living in a period of sexual exploration that, academics and government officials say, is like nothing the country has witnessed before.

“Chile’s youth are clearly having sex earlier and testing the borderlines with their sexual conduct,” said Dr. Ramiro Molina, director of the University of Chile’s Center for Adolescent Reproductive Medicine and Development.

The sexual awakening is happening through a booming industry for 18-and-under parties, an explosion of Internet connectivity and through Web sites like Fotolog, where young people trade suggestive photos of each other and organize weekend parties, some of which have drawn more than 4,500 teenagers. The online networks have emboldened teenagers to express themselves in ways that were never customary in Chile’s conservative society.

Click here to continue reading the article at the New York Times

Friday, September 12, 2008

Hurdles Keep Street Drugs Out of Medicine Chest

From Marijuana to Ecstasy, Scientists Fight to Study Illicit Drugs' Medical Properties

Sept. 11, 2008

The patients at Dr. Michael Mithoefer's clinic in South Carolina all suffer from post-traumatic stress disorder. Some are the victims of rape and child sexual abuse, others -- veterans returning home from Iraq -- bear the psychic scars of war.

They have tried other therapies before but here, under the watchful eye of Mithoefer and his staff, they're trying something new -- MDMA, better known as ecstasy, a drug that if bought on a street corner would land these patients in jail.

The results of the Mithoefer study -- the first Food and Drug Administration-approved Phase 2 trial of MDMA to treat post-traumatic stress -- will not be known until it concludes later this month. But the treatment already shows promise, the doctor says.

"We have had some very dramatic results," Mithoefer said. "We have examples of people on disability for years who have now returned to work. The treatment has had a profound effect on a number of people whose symptoms are now much better. It hasn't been that way for everybody but, overall, this seems to be much more effective than what is currently out there."

Like an ex-con trying to clean up his act and leave behind his criminal past, illicit drugs have a hard time shaking off their bad reputations. Many illegal drugs such as MDMA and marijuana could have pharmacological futures. Others such morphine and cocaine were initially developed for medicinal purposes, and some can be found in your medicine cabinet masquerading under assumed names. But scientists looking to do new research say it is difficult to get funding or approval for studies on drugs with rap sheets.

Click here to continue reading article at ABC Health News

Wednesday, September 10, 2008

Children of Alcoholics Forced Into Adulthood

Studies Show Children of Alcoholics Suffer Lifelong Effects but Can Bounce Back

Sept. 10, 2008

"What is your emergency?" asked the 911 operator. The little boy replied, "My mom is making me blow air into her interlock."

The Albuquerque, N.M., youngster was asked to help his mother break the law and blow into her ignition interlock device to start the car. Police responded to the call this week and charged 30-year-old Genevieve Sullivan with violating her probation for drunken driving.

The 11-year-old walked a fine emotional line: He told operators he was afraid his mother would hear him and he'd get in trouble. But he was even more afraid of the consequences should his mother drive drunk.

Experts say children of alcoholics bear a heavy psychological burden for the sins of their parents. They are forced into adulthood early and spend much of their growing up years protecting themselves and their families.

"He knew at 11," said New York state psychologist Pat O'Gorman, who isn't involved with the New Mexico case. "He knew his mother was in trouble. He knew she needed help, and he knew he could provide that help."

According to the National Council on Alcoholism and Drug Dependence, nearly 14 million Americans are considered problem drinkers and 76 million are exposed to alcoholism in family settings.

Studies suggest about one in four children in the United States is exposed to alcohol abuse or dependence sometime before the age of 18, according to the Children of Alcoholics Foundation.

Click here to continue reading article at ABC Health News

Tuesday, September 9, 2008

Popularity of a Hallucinogen May Thwart Its Medical Uses

DALLAS — With a friend videotaping, 27-year-old Christopher Lenzini of Dallas took a hit of Salvia divinorum, regarded as the world’s most potent hallucinogenic herb, and soon began to imagine, he said, that he was in a boat with little green men. Mr. Lenzini quickly collapsed to the floor and dissolved into convulsive laughter.

When he posted the video on YouTube this summer, friends could not get enough. “It’s just funny to see a friend act like a total idiot,” he said, “so everybody loved it.”

Until a decade ago, the use of salvia was largely limited to those seeking revelation under the tutelage of Mazatec shamans in its native Oaxaca, Mexico.

Today, this mind-altering member of the mint family is broadly available for lawful sale online and in head shops across the United States.

Though older Americans typically have never heard of salvia, the psychoactive sage has become something of a phenomenon among this country’s thrill-seeking youth.

More than 5,000 YouTube videos — equal parts “Jackass” and “Up in Smoke” — document their journeys into rubber-legged incoherence.

Some of the videos have been viewed half a million times.

Yet these very images that have helped popularize salvia may also hasten its demise and undermine the promising research into its possible medical uses.

Pharmacologists who believe salvia could open new frontiers for the treatment of addiction, depression and pain fear that its criminalization would make it burdensome to obtain and store the plant, and difficult to gain government permission for tests on human subjects. In state after state, however, including here in Texas, the YouTube videos have become Exhibit A in legislative efforts to regulate salvia. This year, Florida made possession or sale a felony punishable by 15 years in prison. California took a gentler approach by making it a misdemeanor to sell or distribute to minors.

Click here to continue reading article at the New York Times

Tuesday, September 2, 2008

Methadone works in American prisoners who are addicted

A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release. Gordon MS, Kinlock TW, Schwartz RP, O'Grady KE. Addiction 2008 103;8:1333-1342

Dear Colleagues,

These researchers found, predictably, that offering methadone treatment to prisoners with a history of opiate addiction was feasible, safe and effective, just like it is in the community generally when done according to established guidelines. They compared counselling with/without MMT, finding less heroin use and less criminal activity at 6 months after release in those offered MMT. Treatment retention was also higher.

This is yet another example of American research which is decades behind other countries. And this is despite heroin addiction has been accepted as a brain disease’ by the White House and methadone and similar registered treatments are proven effective approaches. However, for those in the US prison system these maxims do not apply for some reason. Note that this study was not published in an American journal.

Almost uniquely, in New South Wales, prisoners have had access to methadone treatment for over 20 years. It was initially introduced as a pre-release measure to address the high rate of overdoses in those recently released. There is now a copious literature on the subject, largely very positive. Methadone has now been introduced in many other jurisdictions, although rarely ‘across the board’ as occurs in New South Wales.

Thus a trial which gave some subjects no access to such treatment would be unethical, unnecessary and cruel in a normal country. Yet in America, despite a large drug budget and constitutional protection s, denying prisoners appropriate treatment seems to be ‘business as usual’, like Guantanamo Bay and capital punishment. These researchers say that there is an “urgent treatment need” yet it is unlikely anything will be done in a hurry in the USA, despite persuasive research like this.

Comments by Andrew Byrne