FDA panel opposes pure hydrocodone painkiller

WASHINGTON (AP) — Government health experts overwhelmingly voted against a stronger version of hydrocodone on Friday, questioning the need for a new form of one of most widely abused prescription painkillers.

The Food and Drug Administration's panel of pain specialists voted 11-2 with one abstention against Zohydro for moderate to severe chronic pain. The drug was developed as a long-acting pain reliever by San Diego-based Zogenix Inc.

The FDA is not required to follow the group's recommendation, though it often does so.

The panelists acknowledged that the pill would likely reduce pain, but worried it would exacerbate the national epidemic of prescription painkiller abuse.

"I think the sponsor fulfilled the expectations of FDA, however I think the entire class is problematic in terms of abuse and safety issues," said professor James Ware of the Harvard School of Public Health.

If approved, Zohydro would be the first pure hydrocodone medication available in the U.S. Currently available products combine the drug with lower-grade painkillers such as acetaminophen.

Hydrocodone is prescribed to treat pain from injuries, surgery, arthritis, migraines and a variety of other ailments.

Hydrocodone-containing pills consistently rank as the first or second most-abused medicines in the U.S., according to the Drug Enforcement Administration.

The drug belongs to a family of medicines known as opiates or opioids because they are chemically similar to opium. They include morphine, heroin, oxycodone, codeine, methadone and hydromorphone.

Opiates block pain but also unleash intense feelings of well-being and can create physical dependence. Several panelists said the risks of fatal overdose with opioids swayed their vote against Zohydro.

"I have traveled around the country and I have seen the repercussions of opioids — they are a threat to public health," said consumer panelist, Rodney Mullins, of the Health Promotion and Advisory Council.

In 2011, the Centers for Disease Control estimated 14,800 deaths were related to opioids.

Zogenix has touted the benefits of its long-lasting pill, which only needs to be taken once every 12 hours, compared with every four to six hours for combination drugs like Vicodin. The company also notes that patients taking pure hydrocodone would not be at risk for acetaminophen-related liver side effects.

Panel Chairman Randall Flick of the Mayo Clinic abstained from voting, but suggested Zogenix might reformulate the drug to make it more difficult to abuse. Drug abusers often crush or dissolve pills in liquid to unlock their extended release mechanism and get an intense high.

"It is my view that tamper-resistant formulations are likely to reduce the incidence of morbidity and mortality associated with this class of drugs," Flick said.

In recent years the FDA has begun prodding drugmakers to develop more sophisticated pain relievers that are harder to abuse, but such measures are not a requirement.

Zogenix said it would focus sales on 15% of the 330,000 U.S. health professionals who prescribe high-strength prescription painkillers. The company said it would to monitor prescribing patterns and visit physicians who appear to be writing more prescriptions than normal.

Shares of San Diego-based Zogenix were halted ahead of the meeting and last traded at $2.36.

New Bath Salts Research Available to Coalitions

The National Institute on Drug Abuse, part of the National Institutes of Health, has released electronically-published research on “bath salts” applicable to coalition work.

“DrugFacts: Synthetic Cathinones (“Bath Salts”) details new research on what this emerging category of drugs does to the brain. The term “bath salts” refers to an emerging and dangerous family of drugs containing one or more synthetic chemicals related to cathinone, an amphetamine-like stimulant found naturally in the Khat plant. 

Dr. Michael Baumann, NIDA staff scientist and researcher, said the DrugFacts publication is part of the ongoing designer drug initiative with various federal partners including the Drug Enforcement Administration. 

To avoid confusion when describing the drug in coalition educational campaigns and advocacy work, Dr. Baumann recommends calling the drugs Synthetic Cathinones, also referred to as ‘bath salts,’ since the drugs are not pleasantly-scented bubble bath. 

Sold under such names as Ivory Wave, Red Dove, Bliss and Vanilla Sky, or referred to as innocuous, everyday items like ‘plant food,’ synthetic cathinones contain chemicals that can cause amphetamine like reactions such as hallucinations, paranoia, rapid and irregular heartbeats and suicidal thoughts. All of these names and seemingly infinite chemical alterations by mostly overseas synthetic chemists are to skirt regulatory control, they are not really something that one would want to put in their body, Dr. Baumann said. 

“As we continue to with the DEA, our piece is to determine the risk, pharmacology and toxicology. We know that these are synthetic stimulants, so we have been studying what are the drugs out there? What are these drugs actually doing? What’s the toxicology?” he said.

Dr. Baumann also notes that very little is known about how these substances interact with other drugs and alcohol.

“In the lab, we’re only beginning to unravel what these drugs are doing to the brain and the body,” he said. CADCA’s members have worked at the local, state and federal levels on policies that have identified retailers and contributed to banning the drugs’ use. Many contributed their recommendations to amend the Controlled Substances Act and designate certain synthetic substances as schedule I drugs. ‘Bath salts’ and a number of synthetic marijuana compounds will now be banned across the country. Internet sales have been problematic, however.

“There are individuals who actually document their trips online for others to learn from,” Dr. Baumann said. 

The 2012 Monitoring the Future survey on nation-wide teen drug use will include bath salts for the first time. Survey results will be released Dec. 19.

All over the mainstream news and on the sports TV channels, more and more athletes have admitted to using the prescription drug Adderall as a performance enhancer rather than as a medicine for those who genuinely need it.

Tampa Bay Buccaneers cornerback Eric Wright, who was suspended for four games by the National Football League for violating the league's policy on banned substances, is the second Tampa Bay starter this season who was disciplined for using Adderall. More than a dozen NFL players have either blamed their 2012 drug suspensions on Adderall or been connected to the stimulant by others.

In Major League Baseball, the percentage of players approved for Adderall runs above the national average, according to an article in USA Today.
The widespread use of Adderall in general highlights the complicated task the NFL — and Major League Baseball — face in regulating a powerful prescription drug that the leagues exempt as medicine for players who need it and classify as a performance-enhancer for those who don't.

Sound off. How do you feel about professional athletes abusing prescription drugs? Let the Marshall County Anti-Drug Coalition know on our Facebook page.

Coalitions in Action: Coalitions Educate Communities About Marijuana’s Harm

On Tuesday, voters in Washington state, Oregon and Colorado will decide if marijuana should be legal for recreational use, allowing adults to possess small amounts of pot under a regimen of state regulation and taxation. Under federal law, any marijuana use is still illegal. Six other states — Arkansas, Massachusetts, Illinois, New York, Pennsylvania, and Ohio— will decide whether to allow marijuana use for so-called medicinal reasons, as 17 states and Washington, D.C. have done previously. 

CADCA’s coalitions in these states have been working hard to educate the public about the harm of marijuana use, especially among youth, countering proponents who see the issue as “reefer reform.” 

“The Eagle River Youth Coalition in Edwards, Colo. hosted a successful event last week that educated community members about marijuana and youth. The presenters (renowned physician, law enforcement officer, and jail inmates) shared and offered resources on the negative impacts of marijuana use on the adolescent brain, addictive nature of the drug and likelihood of it being a “gateway drug”, and on local youth usage and perception data,” said Michelle Hartel Stecher, the coalition’s Executive Director. 

"Colorado is known for many great things — marijuana should not be one of them," Colorado’s Gov. John Hickenlooper said about Amendment 64. "Amendment 64 has the potential to increase the number of children using drugs and would detract from efforts to make Colorado the healthiest state in the nation. It sends the wrong message to kids that drugs are OK." 

CADCA members, the San Luis Valley Prevention Coalition, in Alamosa County, like other coalitions, have been educating their community by disseminating factual information and statistics about the measure and working on policies to increase barriers to accessing marijuana as well as tobacco and alcohol.
 
In Washington state, coalition leader Linda Thompson, where, according to public polls, their well-funded Initiative 502 is favored to pass, said community mobilization around marijuana legalization has occurred in every county in their state in a variety of ways. 

The coalitions that she is a part of, as Executive Director of the Greater Spokane Substance Abuse Council (GSSAC) and the Vice President and founding member of the state-wide Washington Association for Substance Abuse and Violence Prevention (WASAVP), have been countering the points of legalization proponents in a variety of venues, including with media editorial boards and with their partners in bordering Idaho and Oregon, where trafficking could occur. 

”We have great leaders all over the state who have been doing great things like conducting interviews, participating in debates, sending letters, and giving presentations, but we are up against a well-financed and professional legalization team. Despite this, we keep going on and will continue to educate about the harm of marijuana,” she said. 

Thompson said, although WASAP has taken a stance against Initiative 502, she knows some coalitions working on marijuana policy might not be able to devote a lot of time to advocacy or might not even think they can advocate or take a stance. 

“We can speak up with education. If you cannot advocate against legalization, prevention is prevention is prevention…We want our kids to make the choice not to use,” she said. 

Tom Parker, Lines for Life’s Strategic Development and communications Director, said Oregon’s marijuana legalization measure 80 has a faulty template and doesn’t seem likely to pass, but that hasn’t stopped the statewide non-profit organization committed to providing alcohol and drug prevention education and treatment referral from continuing their marijuana prevention work since medical marijuana was passed. 

“We have pointed out the flaws in measure 80 and spoken out against it. As marijuana attitudes have continued to soften, so-called “medical marijuana” sends a fuzzy message to our youth that if it’s OK to use as medicine, it’s OK to use it recreationally, it might be a benign drug, when we know it’s not,” Parker said. 

CADCA’s coalitions know that one of the best strategies in marijuana prevention has been sharing the facts, especially the science, how the drug affects the teen brain, and how prolonged use can reduce one’s IQ to the “lower third.” 

Kevin Sabet, Ph.D., Director of the Institute on Drug Policy at the University of Florida, Assistant Professor in the College of Medicine, Department of Psychiatry, joins both presidential candidates and the American Medical Association in opposing marijuana legalization. Read his opinion editorial here:http://www.usnews.com/debate-club/should-marijuana-use-be-legalized/there-are-smarter-ways-to-deal-with-marijuana-than-legalization. 

CADCA’s National Coalition Institute will host the webinar “Marijuana: Science and Strategies for Community Coalitions” from 3-4:30 p.m. EST Nov. 15 featuring Dr. Sabet, Dr. Susan Weiss, Acting Director of the Office of Science Policy and Communications at the National Institute on Drug Abuse (NIDA); Sue Thau, CADCA Public Policy Consultant; and Rhonda Ramsey Molina, Deputy Director of Dissemination and Coalition Relations for the CADCA Institute. Register here.

New Research Stresses Health Dangers of Bath Salts

National Institute on Drug Abuse research published in this week’s Neuropsychopharmacology shows that MDPV, a synthetic chemical commonly found in the drugs referred to as “bath salts,” is potentially more dangerous than cocaine when tested in rodents. In this study, MDPV prolonged the effects of two neurotransmitters, dopamine and norepinephrine (by blocking reuptake at brain nerve cells) and produced hyperactivity, rapid heart rate and increased blood pressure, which are highly dangerous symptoms.

Though this study was done in rodents, these results could explain why these substances are addictive and highly dangerous in humans, as indicated by reports that MDPV is the chief substance found in the blood and urine of emergency room patients who have overdosed on so-called “bath salts.”

For a copy of the study abstract, go towww.nature.com/npp/journal/vaop/ncurrent/abs/npp2012204a.html. 

To watch the recent CADCA TV show on this subject, “Designer Drugs: The New Frontier,” click here.

Red Ribbon Week is October 23 - 31

October is filled with many opportunities to promote healthy, drug-free living, including Red Ribbon Week (October 23-31).

As part of this important occasion, Red Ribbon week is used to emphasize the significance of students, educators and communities working together to prevent substance abuse.

The Red Ribbon Celebration was originally established as a national drug awareness campaign in 1988, after the death of Drug Enforcement Administration Agent Enrique “Kiki” Camarena. The Celebration was created to take a collective stand against underage use of alcohol, tobacco, and illegal drugs. The Red Ribbon Celebration is promoted to reach all audiences, but is particularly targeted toward elementary and middle school students to encourage them to make a commitment to a drug-free lifestyle.

Drug Free Action Alliance (DFAA) encourages schools and organizations to use this week as a springboard to other prevention observances throughout the year. Drug Free 24/7 is a program designed by DFAA to help communities galvanize their efforts into a consistent, year-long message. Check out how Drug Free 24/7 can be the tool to tie all of the important things you do in your community into an exciting and easily recognizable campaign.  Download the toolkit to get ideas for your Red Ribbon Week events or visit www.DrugFreeActionAlliance.org. 

White House Drug Policy Office Awards More Than $84 Million to Local Communities to Prevent Youth Substance Use

(Washington D.C.) – Today, Gil Kerlikowske, Director of National Drug Control Policy, announced $84.6 million in Drug-Free Communities Support Program (DFC) grants to 692 communities across the country.  These grants will provide local communities support to prevent youth substance use and reduce the demand for drug consumption in the United States.  Kerlikowske made the announcement during an address to the Council on Foreign Relations.

“America’s success in the 21st century depends in part on our ability to help young people make decisions that will keep them healthy and safe,” said Gil Kerlikowske, Director of National Drug Control Policy. “We commend the Drug-Free Communities Support Program grantees on their work to raise a generation of young people equipped to remain drug-free and ready to prosper in school, in their communities, and in the workplace.  While law enforcement efforts will always serve a vital role in keeping our communities safe, we know that stopping drug use before it ever begins is always the smartest and most cost-effective way to reduce drug use and its consequences.”

The Drug-Free Communities Support Program is directed by ONDCP, in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA).  The DFC Program provides grants of up to $625,000 over five years to community coalitions that facilitate youth and adult participation at the community level in local youth drug prevention efforts. Coalitions are comprised of community leaders, parents, youth, teachers, religious and fraternal organizations, healthcare and business professionals, law enforcement, and media.  The Marshall County Anti-Drug Coalition is receiving $125,000 in DFC Funding.

In April, the Obama Administration released the 2012 National Drug Control Strategy, the Obama Administration’s primary blueprint for drug policy in the United States.  The new Strategy is guided by three facts: addiction is a disease that can be prevented and treated; people with substance use disorders can recover; and innovative new criminal justice reforms can stop the revolving door of drug use, crime, incarceration, release, and re-arrest.

The rate of overall drug use in the United States has declined by roughly 30 percent since 1979. More recently, there has been a nearly 40 percent reduction in the number of current cocaine users and the number of current meth users has dropped by half.  To build on this progress and support a balance of public health and safety approaches to drug control outlined in the Strategy, the Obama Administration has committed over $10 billion for drug education programs and support for expanding access to drug treatment for people suffering from substance use disorders in FY 2012.  

For more information about the Administration efforts to reduce drug use and its consequences, or to learn more about the Drug Free Communities Support Program, visit: www.whitehouse.gov/ondcp

October is National Substance Abuse Prevention Month

The Marshall County Anti-Drug Coalition supports the Office of National Drug Control Policy’s second annual National Substance Abuse Prevention Month, which was launched by a Presidential Proclamation this week. You can read the proclamation here.  

In 2011, 20.6 million Americans were classified with substance dependence or abuse. National Substance Abuse Prevention Month is a prime opportunity to rally together and put the spotlight on substance abuse and those affected by this issue. It’s also a chance to recognize the organizations that provide substance abuse prevention services and to share resources that are available to prevent substance use problems before they start.

On Oct.18, the first-ever National Above the Influence Day will be celebrated in communities throughout the country. Coalitions will be able to hold events and activities that reinforce the Above the Influence campaign. 

Study Finds Alcohol and Drug Abuse Common in Fatal Crashes

The journal Addiction released results of a study this week that says more than half of U.S. drivers killed in car crashes had alcohol or drugs in their system at the time of the crash, Reuters reports. 

Using data from the National Highway Traffic Safety Administration (NHTSA) on road deaths in 14 states, researchers also found that men and people driving at night were the most likely to have alcohol, marijuana or other illicit or prescription drugs show up on a toxicology screen after the accident. 

"More than half of fatally injured drivers in the United States had been using alcohol or other drugs and approximately 20 percent had been using (two or more) drugs," wrote Joanne Brady of Columbia University and her colleagues. 

Alcohol was the most common drug, followed by marijuana and stimulants, including amphetamines. One in five had multiple drugs in their systems at the time of the fatal crashes, researchers found. 

Sixty percent of men killed while driving had drugs or alcohol in their system, compared to less than half of women. People who had an accident at night or on the weekend were also more likely to test positive than those driving on a weekday.

Mixing Alcohol and Drugs Account for 37 Percent of Substance Abuse Treatment Admissions

A new report shows that 37.2 percent of substance abuse treatment admissions involve both alcohol and drug abuse. According to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA), 23.1 percent of all admissions reported the abuse of alcohol and one other drug, and 14.1 percent reported the abuse of alcohol and two or more drugs. 

The report, “Nearly 40 percent of Substance Abuse Treatment Admissions Report Alcohol-Drug Combinations” is based on SAMHSA’s Treatment Episode Data Set (TEDS) received during 2009 and up through Nov. 3, 2010. TEDS is a compilation of data on the demographic characteristics and substance abuse problems of admission to substance abuse treatment facilities in the United States, primarily facilities that receive public funding. 

When alcohol is used with other drugs, it tends to be ingested in greater quantities than when used alone. Combining alcohol with other drugs can be dangerous. For example, taking benzodiazepines concurrently with alcohol increases the chances of serious injury or death. 

Professionals and individuals who need to identify appropriate drug and alcohol treatment services in their area can access SAMHSA’s online treatment locator at:http://findtreatment.samhsa.gov/TreatmentLocator/faces/quickSearch.jspx.

Synthetic Drug Industry Investigated by Nation-wide Law Enforcement Take Down

The DEA and other federal law-enforcement partners held a press conference today to present the results of Operation Log Jam, the first-ever nationwide law-enforcement action against the synthetic drug industry responsible for the production and sale of synthetic marijuana and other drugs that are often marketed as incense, bath salts or plant food. 

“Any drug that is marketed to young people is of great concern to us. So little is known about these substances, we don’t know what the long term results will be,” Michelle Leonhart, Drug Enforcement Administration (DEA) Administrator, said. “What really did it for DEA was the outpouring of requests for help from police and sheriffs as they were seeing this in their communities all over the country.” 

Leonhart and others who spoke to reporters at the press conference called synthetic drugs a “rapidly emerging threat” to people of all ages, especially youth. 

Operations occurred in 100 American cities and included raids in businesses such as head shops, gas stations, convenience stores, and smoke shops as well as manufacturing sites in warehouses and residences. 

Leonhart and her colleagues acknowledged the work conducted at the local and state level, with more than 30 states banning various compounds of synthetic drugs. Coalitions have been able to shut down some retailers selling synthetic drugs, but had been challenged by the more popular online sales. The law outlaws sales of synthetic drugs by both retail stores and online retailers. 

Earlier this month, President Obama signed into law new drug legislation that will permanently ban the deadly chemical compounds marketed and sold as bath salts and incense in the United States. It also outlaws similar compounds that may be produced in the future. The law bans the active ingredients of bath salts, mephedrone and methylenedioxypyrovalerone, by adding them to the Food and Drug Administration’s category of substances that cannot be sold under any circumstances and also cannot be prescribed for medical purposes. The law enumerates 31 compounds that are explicitly banned, giving the precise chemical name of each. Twenty from the list are synthetic marijuana varieties, and 10 are bath salts.

CADCA Joins Reps Keating, Bono Mack and Rahall in Support of Rx Abuse Deterrent Bill

Today, Congressman Bill Keating (D-MA) and Congresswoman Mary Bono Mack (R-CA) introduced the first federal legislation to require manufacturers to create tamper-resistant formulations for commonly-abused prescription painkillers. The bill was announced during a press conference in Washington, D.C., which featured remarks by CADCA’s Chairman and CEO Gen. Arthur T. Dean. Rep. Nick Rahall (D-WV), another supporter of the bill, also participated in the press conference.

The Stop the Tampering of Prescription Pills (STOPP) Act is key to preventing new users from abusing painkillers and safeguarding against overdoses. The bill would require any brand-name painkiller – whether immediate or extended release – that is currently on the market to use a tamper-resistant formulation, including generic medications. 

“Prescription drug abuse has cost our country conservatively $70 billion a year,” said Rep. Keating during the press conference. “This bill creates a clear pathway and establishes a process…to incentivize and mandate tamper-resistant formulations. It would help prevent injury and harm among the most vulnerable populations – particularly adolescents.”

Rep. Keating demonstrated the difference between a regular pill and a tamper-resistant one by attempting to crush both pills with a hammer. The regular pill crushed easily but the tamper-resistant pill stayed intact. 

Studies have shown that drug abusers tend to crush or otherwise break down time-released products into a form that can be snorted or injected for a more intense high. The STOPP Act is the first federal legislation that directs pharmaceutical manufacturers to invest in research and production to formulate tamper resistant drugs in order to compete with drugs of a similar nature that already employ tamper resistant technologies.
 
CADCA’s Gen. Dean noted that while the bill is not a “silver bullet” solution, it does create another obstacle that will deter some people from abusing prescription painkillers and is another tool in a comprehensive approach to reduce the prescription drug abuse epidemic.

“While coalitions are working hard to address prescription drug abuse in a holistic manner, their efforts alone will not solve the problem. It’s through a combination of efforts at the national, state and local levels that we can start to make a dent in this epidemic so I applaud Congressman Keating and Congresswoman Bono Mack for important bill,” Gen. Dean said. 

Rep. Bono Mack, who is a leading advocate in the area of substance abuse prevention and chairs the Congressional Caucus on Prescription Drug Abuse, said the legislation should be part of a comprehensive national strategy. “Prescription drug abuse is not just a public health epidemic – it’s a national tragedy,” she said.  “But through the increased use of tamper-resistant medicines, we may see hopelessness replaced by hope.  What’s needed now is a comprehensive national strategy for combating prescription drug abuse, especially when it comes to narcotic painkillers.  The STOPP Act should be part of that strategy.  More than 20,000 Americans a year are dying from prescription drug abuse – over 15,000 from painkillers alone.” Click here to view pictures.

For tools to help you address prescription drug abuse in your community, access CADCA's Rx Abuse Prevention Toolkit: From Awareness to Action, available at www.PreventRxAbuse.org

Summer‘s a Risky Time for Youth Drinking and Drug Abuse, Report Finds

More teens start drinking and smoking cigarettes and marijuana in June and July than in any other months, the U.S. Substance Abuse and Mental Health Services Administration said in a new report. 

The report states that on an average day in June and July, more than 11,000 teens ages 12 to 17 use alcohol for the first time – December is the only other month with comparable levels. Throughout the rest of the year, the daily average for first-time alcohol use ranges from 5,000 to 8,000 adolescents. 

Similarly in June and July, an average of 5,000 youth smoke cigarettes for the first time, as opposed to the daily average of about 3,000 to 4,000 during the rest of the year. The same pattern holds true for first time use of cigars and smokeless tobacco among youth. In terms of first-time use of marijuana, more than 4,500 youth start using it on an average day in June and July, as opposed to about 3,000 to 4,000 youth during the other months. 

“More free time and less adult supervision can make the summertime an exciting time for many young people, but it can also increase the likelihood of exposure to the dangers of substance abuse,” SAMHSA Administrator Pamela S. Hyde said in a news release. “That is why it is critically important to take every opportunity we can throughout the year to talk to our young people about the real risks of substance abuse and effective measures for avoiding it, so they will be informed and capable of making the right decisions on their own.” 

The report, “Monthly Variation in Substance Use Initiation among Adolescents,” is based on SAMHSA’s 2002 to 2010 National Survey on Drug Use and Health reports involving interviews with 231,500 adolescents between the ages of 12 to 17. 

At graduation and prom time, many coalitions host events to ensure teens celebrate these occasions and the summer, itself, safely, such as the Substance Abuse Prevention Coalition of Alexandria’s “All Night Drug and Alcohol Free Graduation Party” for high school seniors. Since their high school began the tradition in 1989, there have been no drug or alcohol-related graduation night fatalities, according to Noraine Buttar, SAPCA’s coordinator.

STATEMENT BY ONDCP DIRECTOR KERLIKOWSKE ON CONGRESS’ PASSAGE OF THE FOOD AND DRUG ADMINSTRATION SAFETY AND INNOVATION ACT (S. 3187)

The Office of National Drug Control Policy commends Congress for passing the Food and Drug Administration Safety and Innovation Act, S. 3187, which requires 26 synthetic chemicals, including those commonly found in products marketed as “K2” and “Spice,” to be considered Schedule I substances.  Schedule I substances are those with a high potential for abuse; have no medical use in treatment in the United States; and lack an accepted safety for use of the drug.

“I applaud Congress for coming together on this issue that is affecting so many of our young people. Research shows that parents are the most powerful force in the lives of young people,” said Director Kerlikowske.  “Synthetic drugs like ‘bath salts,’ Spice, and K2 are a serious threat to health and safety.  I urge families to take time today to learn what these drugs are and discuss the harms that all drugs pose to young people in America.”

As part of ongoing efforts to coordinate the Federal response to the drug threat, in February, the ONDCP joined The Partnership at Drugfree.org to introduce a kit for parents and adult influencers housing the tools they need to talk with their teens about this emerging threat and recognize the warning signs of use. The information kit includes a slidecast about synthetic drugs, a corresponding podcast and video, and a printable guide so parents can present details on what to look for, what the street names are and what the effects of these substances are to others in their community.  It is available at The Partnership at Drugfree.org website and is part of a "Parents360" community education program funded by the U.S. Department of Justice, Bureau of Justice Assistance.

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Supreme Court Upholds Healthcare Law

In a 5-4 ruling, the Supreme Court voted yesterday to uphold the Affordable Care Act (ACA). Prevention measures within the ACA, such as the Prevention and Public Health Fund and the National Prevention Strategy, will help create safe and drug free communities across the country. 

The ACA includes substance use disorders as one of the ten elements of essential health benefits. Health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults starting in 2014 must include services for substance use disorders. Within the ACA, more services will be available and become more affordable for individuals that have addiction disorders. These services include treatment for substance use disorder services, prescription drugs, rehabilitative, habilitative, and prevention and wellness services.

Prescription and Illicit Drug Abuse Increases for Baby Boomers, Senior Citizens

Data from national surveys reveal a trend for 50- to 59-year-olds: the number of those reporting past-month abuse of illicit drugs — including the non-medical use of prescription drugs — more than doubled from 2002 to 2010, going from 907,000 to 2,375,000, or from 2.7 to 5.8 percent in this population. 

Among those 65 and older, 414,000 used illicit drugs in 2010. A new topic, Prescription and Illicit Drug Abuse, available on NIHSeniorHealth.gov, describes this trend and the effects of medication and drug abuse on older adults. 

According to the National Institute on Drug Abuse (NIDA) at the National Institutes of Health, the numbers of older substance abusers could continue to rise, due to the aging of the baby boomers, which were more likely than previous generations to have used illicit drugs in their youth. 

Medications for a variety of conditions can help older adults maintain health and function, and most older adults take their medications as prescribed. At the same time, abuse of prescription medications — such as painkillers and depressants — and illicit drugs — such as marijuana and cocaine — can be especially harmful for older adults because aging changes how the body and brain handle these substances. 

"As people get older, it is more difficult for their bodies to absorb and break down medications and drugs," said Dr. Nora Volkow, director of NIDA. "Abusing these substances can worsen age-related health conditions, cause injuries and lead to addiction." 

Although substance abuse among older adults is preventable and treatable, many older adults may not get the help they need because some common warning signs of abuse, such as sleep problems, falls, and depression, can also be signs of other health conditions. 

What Are You Doing to Observe International Day Against Drug Abuse?

International Day Against Drug Abuse and Illicit Trafficking is observed by countries throughout the world each year on June 26. Established by the United Nations General Assembly in 1987, this day serves as a reminder of the goals agreed to by Member States of creating an international society free of drug abuse. 

As a Non-Government Organization that enjoys Special Consultative Status with the United Nations, CADCA helped shape the theme: “Global Action for Healthy Communities without Drugs,” which is meant to reinforce the role that communities play in addressing drug abuse. 

We encourage your coalition to get involved in this important observance! Here are just a few ways your community can get involved: 

• Launch a campaign to educate the community about the harmful effects of drug abuse using the materials available at http://www.unodc.org/drugs/en/campaign-tools/print.html. 

• Support or sponsor meetings in town halls, congregation places, sport centers and other communal places to raise awareness of the harmful effects of drug use and abuse and to promote healthy lifestyles
 
• Work with local media outlets to spread messages and distribute information
 
• “Like” the UN’s World Drug Campaign’s Facebook page. 

Let CADCA know how your coalition is observing International Day Against Drug Abuse by sending an e-mail to editor@cadca.org. 

Visit http://www.unodc.org/drugs/ for more information.

'Bath Salts': Use of Dangerous Drug Increasing Across U.S

A Delaware senator praised pending legislation proposing a nationwide ban on "bath salts," a dangerous synthetic drug that's on the rise in the United States and might have led to the recent attack in Miami where a man allegedly ate off 80 percent of a homeless man's face.

"Dangerous drugs like bath salts are terrorizing our communities and destroying lives," Democratic Sen. Chris Coons said in a statement Monday. "Stricter measures must be taken to stem the growing prevalence of bath salts and other new designer drugs."

The number of calls to poison centers concerning "bath salts" rose 6,138 in 2011 from 304 in 2010, according to the American Association of Poison Control Centers. More than 1,000 calls have been made so far this year.

These so-called bath salts, not to be confused with cleansing products, are an inexpensive, synthetic, super-charged form of speed. The drug consists of a potpourri of constantly changing chemicals, three of which -- mephedrone, MDPV and methylone -- were banned last year by the U.S. Drug Enforcement Agency.

Bath salts are still easily available online, though, and come in brand names such as "Purple Wave," "Zoom" or "Cloud Nine." A 50-milligram packet sells for $25 to $50.

The drugs create a condition police have come to call an "excited delirium" that makes users paranoid, violent and unpredictable. Miami police last month shot and killed a man who was allegedly feasting on the face of another homeless man in a daylight attack on a busy highway. Police are investigating whether the drugs found in bath salts were in the alleged attacker's system.

This case is not the first time police have had to respond to people high on the drug committing illegal acts or exhibiting dangerous behavior.

In July 2010, Carey Shane Padgett of Roanoke County, Va., allegedly beat his friend Cara Marie Holley to death. He later claims that he had ingested both bath salts and synthetic marijuana, or spice.

In April 2011, investigators determine that Army Sgt. David Stewart was under the influence of bath salts when he killed himself, his wife Kristy and their 5-year-old son in Spanaway, Wash.

Bay County Sheriff Frank McKeithen said he was disturbed by the affects that the drug had on the unidentified Florida teen who he witnessed high on bath salts in the back of a squad car.

"It's pretty devastating to think this kid was a normal kid walking around maybe the week before," McKeithen said.

In most cases, the active ingredient found in bath salts is a chemical known as metheylenedioxypyrovalerone, or MDPV for short. As far as the effects they have, bath salts are a central nervous system stimulant that acts something like a mix of methamphetamine and cocaine.

They dramatically increase the dopamine and norepinephrine levels in the human brain in two dangerous ways: by pouring more dopamine in as methamphetamine does, and at the same time, like cocaine, trapping both of these chemicals in the brain, so the user doesn't come down.

It's a dangerous situation, leading to a high that some drug abuse experts describe as up to 13 times more potent than cocaine. The altered mental status it brings can lead to panic attacks, agitation, paranoia, hallucinations and violent behavior.

"We certainly heard about people with extraordinary strength and you know we have seen that with PCP in the past," said Rusty Payne, spokesman for the U.S. Drug Enforcement Administration.

The combination can create desperation, and sometimes lead to naked ramblings and users hurting themselves, or others.

Louis J. De Felice, vice chairman of the Department of Physiology and Biophysics at Virginia Commonwealth University in Richmond, said, "I can easily imagine how this can lead to a sensation, many different sensations. One would be you would like to tear your skin out, or ripping your clothes."

The number of calls to poison centers concerning "bath salts" rose 6,138 in 2011 from 304 in 2010, according to the American Association of Poison Control Centers, More than 1,000 calls have been made so far this year.

The U.S. Drug Enforcement Agency says that the affects of the drug are unknown, and can be dangerous. In June 2011, the DEA arrested 10 members of an alleged bath salts ring in a sting in New York.

"This is so new to us," DEA spokesman Rusty Payne said after the major bust. "In the last year it's just taken off in the U.S. We've never seen anything like it."

The Senate passed legislation last month to make the sale of bath salts illegal, and Coons, a member of the Senate Judiciary Committee, urged "the House-Senate conference committee to preserve the measure during its negotiations this month."

How Do 'Bath Salts' Drive People Crazy?

By Natalie Wolchover | LiveScience.com

On Saturday in Miami, a naked, "zombielike" man viciously attacked a homeless man, biting off and eating much of his face. Police shot and killed the 31-year-old attacker, Rudy Eugene, who, according to some news outlets, may have been high on "bath salts" at the time of his cannibalistic attack.

These soothing-sounding substances are not what they seem. Manufactured in China and sold legally online and in drug paraphernalia stores under misleading brand names like "Ivory Wave," bath salts contain a bevy of newly concocted chemicals, such as methylenedioxypyrovalerone (MDPV), which aren't yet banned by the federal government. When snorted, injected or smoked, the synthetic powders can induce a state of paranoid delirium paired with abnormal strength, a combination that often leads to horrific acts of violence.

In short, "bath salts" actually do live up to the warnings of old-school anti-drug ads, which cautioned potential users of insanity, death and murder. The salts work by putting the brain's survival instincts into overdrive, essentially causing an extreme adrenaline rush that lasts for hours rather than moments.

MDPV, the active ingredient in "bath salts," increases the body's concentration of adrenalinelike hormones that prepare the heart, muscle tissue and the brain for the "fight or flight" response, explained Thomas Penders, an associate professor in the department of psychiatric medicine at East Carolina University. It does this by stopping neurons in the brain from reabsorbing the chemicals dopamine and norepinephrine immediately after secreting them, as would normally happen. This leads to a steady buildup of these neurochemicals, which trigger a person's primal survival behaviors, Penders told Life's Little Mysteries.

"One system of circuits in our brains are wired to detect and respond to threats. Overstimulation of this circuit leads to overestimation of actions by others as threatening. When the system becomes overwhelmed, as it does [from an overdose of] 'bath salts,' a condition develops known as 'excited delirium,'" he said. [Slideshow: Scientists Analyze Drawings by an Acid-Tripping Artist]

Crack cocaine, methamphetamine, ecstasy and PCP can also induce "excited delirium." It's a state of paranoid fearfulness and rage mixed with seemingly superhuman strength, as more oxygen is delivered to muscles, increasing their power. "This, to some extent, explains the bizarre aggressive behaviors we have seen during the recent rash of 'bath salt' cases," Penders said. "[However,] I cannot imagine what the individual in Miami was perceiving to fully explain the vicious attack described there."

Even if no one else gets hurt, sufferers of "excited delirium" can wind up dead or in the emergency room, with medical complications such as cardiac arrhythmias, a spike in body and brain temperature, muscle breakdown and kidney failure.

While overdoses of crack cocaine, methamphetamine, ecstasy and PCP can also induce "excited delirium," one particular danger of "bath salts" is that there's no way to gauge how large a dose will trigger the effects, despite the product's appearance of manufactured consistency. Because the substances are not made in the U.S. or regulated for consumption, studies have found varying concentrations of the active compounds from package to package, said Patrick Kyle, director of clinical chemistry and toxicology at the University of Mississippi Medical Center. This leads to unintended overdoses.

"The user assumes that since one dose of ‘XYZ’ brand gave him/her a ‘rush’ with the last use, one dose will give the same effect," Kyle wrote in an email. "The user may unknowingly overdose on the same amount of product from the same 'brand.'"