GOVERNOR TOMBLIN SIGNS SUBSTANCE ABUSE BILL

Governor travels the state to announce his response to drug crisis
CHARLESTON, W.Va. - Today Gov. Earl Ray Tomblin visited Prestera Center in Huntington, Bond's Pharmacy in Lubeck and Patterson's Drug Store in Martinsburg to discuss his groundbreaking new substance abuse legislation."Prescription drug abuse in our state is a pervasive problem with tragic consequences," said Gov. Tomblin. "We have lost far too many of our fellow West Virginians to drug overdoses, and drug addiction leads to other crimes like robberies and home invasions. That's why I fought so hard for this new law. It cracks down hard on the underlying causes of our state's drug crisis. I'm proud that we're tackling this problem head-on, and I'm confident that this legislation will save lives."Senate Bill 437 includes the following critical reforms:
New prescriptions will be recorded in a statewide database within 24 hours of being dropped off, to stop patients from collecting duplicate prescriptions from different doctors;
West Virginia will impose the nation's strictest yearly purchasing limit for pseudoephedrine, the key ingredient in meth;

Consumer protections against illegitimate online pharmacies will be strengthened.

Dangerous Teen Craze Whip-its Making a Comeback?

ABC News- There is growing concern among health professionals that Whip-Its -- small canisters filled with nitrous oxide that can be used as a recreational drug and were reportedly used by actress Demi Moore shortly before she was rushed to the hospital in January -- are making a comeback among teenagers and young adults across the country.

"What makes them really popular is they're easily accessible," said William Oswald, founder of the Summit Malibu drug treatment center. "You can get them at a head shop, you can get it out of a whipped cream bottle."

The most recent figures show that Whip-Its have become the most popular recreational inhalant of choice, with over 12 million users in the U.S. who have tried it at least once, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Inhaling the compressed gas, either from the Whip-It chargers, a whipped cream canister, or a nitrous tank, is purported to result in a fleeting high, lasting anywhere from a few seconds to several minutes.

And while some states have passed laws attempting to stop the inhalation of nitrous, experts say the use of Whip-Its is mostly ignored by authorities and left unregulated.

"It's non-detectable," said Oswald. "So when they're testing people, it doesn't show."

An ABC News investigation airing tonight on "Nightline" found that multiple online retailers allowed large purchases of the Whip-Its, with no questions asked about age or what they would be used for. A tobacco shop selling the canisters alongside cigars and rolling papers insisted they were cooking supplies, but then immediately removed all boxes from the shelves when confronted with ABC News cameras.

But while a growing collection of user videos on YouTube portray doing Whip-Its, or "Noz" as it's sometimes called, as a harmless, laughter-inducing activity, it can be deadly.

Illinois college student Benjamin Collen, 19, died from asphyxiation from nitrous oxide. He was found dead in a fraternity house surround by Whip-Its chargers in 2008.

Melyssa Gastelum was an 18 year-old aspiring fashion model and National Honors Society student when she went to an all-ages party in Phoenix last May where she inhaled Whip-Its and ingesting a small amount of ecstasy. She died later at the hospital and the medical examiner ruled that nitrous oxide was a contributing factor in her death.

"I wish I could wake up from this nightmare," said her mother, Christy Gastelum. "I ask myself, 'Why do bad things happen to good people? Why?'"

Experts told ABC News it's not clear why sniffing death occurs in some people and not others, which adds to the hidden danger of using inhalants such as Whip-Its.

Dr. Westley Clark, director of the Center for Substance Abuse Treatment at SAMHSA, said inhaling nitrous oxide, or huffing as it's sometimes called, can cut off oxygen to the brain and result in severe effects on the body's cardiovascular system.

"What you're concerned about is heart effects, effects on their peripheral nervous system, effects on their organ system," said Clark.

Debbie Goldman knows that all too well. She said she started using Whip-Its in college and through her years at one of the country's leading law firms, going through 10 boxes of the tiny chargers every night, 24 to a box.

"My whole body would go numb, and I would just fall asleep," Goldman said. "My neurologist told me I was very lucky that I didn't die from it or have brain damage."

When she woke up one morning and couldn't walk, she said she required intense physical therapy for six months. Then she entered rehab and got sober. Now, Goldman said she wants young people to know how addictive and dangerous Whip-Its can be, and she wants officials to take notice.

"They should not be accessible like they are," she said.

The grieving family of Melyssa Gastelum are also now committed to raising awareness about the dangers of nitrous oxide inhalation.

"Our parents did talk to us about marijuana, heroine, drinking and driving," said Melyssa's older sister, Alyssa Gastelum. "But there's so many things that you just don't know about… And it's not just teaching your kids right and wrong. It's teaching them about what can happen to them. How one decision can change their lives and their family's lives forever."

Appalachia Addresses Appalling Abuse of Prescription Drugs

While prescription drug abuse affects all walks of life— urban, suburban, and rural— residents of rural counties are nearly twice as likely to overdose on painkillers as people in larger cities. And this fact rings true in Appalachia.

Coalitions throughout Appalachia have been working on strategies to solve the epidemic. For example, a state-wide conference “The Different Faces of Substance Abuse” took place recently in Kentucky. Catherine Brunson, a CADCA trainer, conducted a training on CADCA’s Rx Abuse Prevention Toolkit.

And the federal government is taking notice of the problem. Recently Gil Kerlikowske, Director of National Drug Control Policy at the Office of National Drug Control Policy, met with seven governors who are members of the Appalachian Regional Commission (Alabama, Kentucky, Mississippi, North Carolina, Pennsylvania, Tennessee, and West Virginia) to discuss the serious threat of prescription drug abuse to Appalachian communities and the Obama administration’s efforts to reduce drug use and its consequences through a public health and safety approach. During the meeting, Alabama governor Robert Bentley, Kentucky governor Steven Beshear, Mississippi governor Phil Bryant, North Carolina governor Beverly Perdue, Pennsylvania governor Tom Corbett, Tennessee governor Bill Haslam, and West Virginia governor Earl Ray Tomblin discussed the toll that prescription drug abuse has taken on Appalachian communities and actions state leaders are taking to prevent abuse and trafficking through education, information-sharing, interstate task force cooperation to crack down on “pill mills,” and treatment programs.

“The devastation wrought by prescription drug abuse on Appalachian communities is simply heartbreaking,” Kerlikowske told the group. “Prescription drug abuse is claiming too many lives, threatening public safety, and placing unnecessary obstacles in the way of economic prosperity in Appalachia. While we must ensure that Americans have legitimate access to lifesaving prescription medications, the Obama administration also remains laser focused on addressing this epidemic through a comprehensive public health and safety approach. All of us have a role to play in this effort, and I commend Governors from Appalachia for leading the way in recognizing the severity of this challenge and implementing evidence-based reforms to protect their communities from the misery caused by this epidemic.”

CADCA’s Chairman and CEO, Gen. Arthur Dean, will be addressing public and private stakeholders from across the country in sessions that highlight prevention, education, treatment and law enforcement efforts in addressing the prescription drug epidemic, particularly hard-hit Appalachia, at the inaugural National Rx Drug Abuse Summit. Organized by CADCA member Operation UNITE, headquartered in Kentucky. The Summit will take place April 10-12 in Florida. Other headliners include Florida Attorney General Pam Bondi, Director Kerlikowske and the Surgeon General Dr. Regina Benjamin.

According to the Centers for Disease Control and Prevention, deaths from prescription painkillers have reached epidemic levels in the past decade and now exceed deaths from heroin and cocaine combined. Prescription painkiller overdoses killed nearly 15,000 people in the U.S. in 2008—a rate of 4.8 deaths per 100,000 population. This rate is nearly four times the rate for 1999.

There is still a lot of work to do, but Bondi told attendees at the “Faces” conference that the "pill pipeline" between her state and Kentucky has been significantly reduced thanks to tougher regulations and the launch of a prescription monitoring program.

Kentucky Attorney General Jack Conway also spoke at the conference. He announced that he and House Speaker Greg Stumbo are close to finalizing a broad legislative package focused on pain management clinics and KASPER, the state's electronic prescription monitoring program, including: requiring prescribers who write scripts for certain controlled drugs to be registered; requiring KASPER reports be run on patients before pills are given out in emergency rooms; strengthening mandatory penalties for doctors who over-prescribe pills; and expediting the process of reviewing doctors who over-prescribe.

“It was amazing to have the attorney generals from both Kentucky and Florida at our conference,” said Sheila D. Barnard, Director of CADCA-member coalition Ohio County Together We Care in Beaver Dam, Ky. “As part of the planning committee for the conference, I thought it was important to have them there, as the Rx pipeline goes straight from Kentucky to Florida.”

Barnard said that 60 percent of the pills on the street in her state come from Florida.

The Food and Drug Administration provides guidelines for the proper disposal of unused or expired medicines, and ONDCP encourages the proper disposal of prescription drugs in an effort to reduce diversion. On April 28, the Drug Enforcement Administration will host another National Prescription Drug Take-Back Day. At last fall’s Take-Back Day, Barnard’s coalition collected 183 pounds of unused medications. She plans to participate in the event next month. The coalition is also close to securing a permanent drop box in their community. Barnard worked in a pharmacy before she worked in a coalition and saw some of the worst prescribing behavior, but now sees some of the best.

At the sold-out conference, Barnard said there were representatives from all aspects of their Rx abuse problem: public health, coalitions, University of Kentucky, clinicians, law enforcement and pharmacists.

“I do think physicians and hospitals are stopping the unnecessary prescriptions. A lot of education needs to get into the right hands and the coalitions are doing that. We’re all (going to) have to work together to combat this, though. It’s not just a Kentucky or Florida problem. It’s an interstate problem,” Barnard said.

To participate in a take-back event, visit www.DEA.gov.

Research Reveals New Information about “Bath Salts”

Drugs known as “bath salts” are one of a growing list of synthetic and unevenly regulated narcotics that are found across the United States and on the Internet. New research on this potent drug paints an alarming picture, revealing that bath salts pack a powerful double punch, producing combined effects similar to both methamphetamine and cocaine, Medical News Today reports.

"This combination of effects is particularly novel and unexpected," said Louis J. De Felice of Virginia Commonwealth University's School of Medicine in Richmond, Va. "Methamphetamine and cocaine operate in the brain in completely opposite ways. It would be atypical that both drugs would be taken together, but that's the effect that occurs with bath salts."

De Felice and his colleagues presented their research this week at the 56th Annual Meeting of the Biophysical Society in San Diego, Calif.

The team's research reveals that bath salts contain two structurally similar chemicals that produce quite dissimilar effects on the brain's dopamine transport system. Dopamine is a neurotransmitter that plays an important role in the brain's pleasure and reward centers. Though bath salts' chemicals are structurally similar, both acting as potent psycho-stimulants, they use completely opposite mechanisms in the brain.

The first component is a dopamine-releasing agent known as mephedrone, which, like meth, causes the brain to release more dopamine. The other chemical is methylenedioxypyrovalerone, which, like cocaine, is a dopamine reuptake inhibitor. Both compounds increase dopamine availability to receptors, and both, through different mechanisms, produce feelings of euphoria.

The surprising finding is that rather than canceling each other out, as would be anticipated, the chemicals combine to enhance the effects of the other.

"The two drugs have different kinetics, so rather than cancel each other they exacerbate the effect of either drug applied alone," De Felice told Medical News Today.

The researchers began this particular project as part of a larger study on how amphetamine and meth affect the human dopamine transporter molecule. They made the novel finding that both chemicals create long-lasting effects that endure 30 minutes or more after the drugs are removed. This initial research continued with cathinone, which is a naturally occurring compound found in the khat shrub (Catha edulis). The drugs found in bath salts are synthetic derivatives of cathinone.

"The stimulant and blocker features of these drugs have been studied previously," De Felice said, "but the evidence for long-lasting stimulation by MEPH and inhibition by MDPV is novel. It also is in some sense unexpected that two structurally similar agents could act oppositely at the dopamine transporter."

The researchers do not yet know why these drugs have a persistent effect. They also don't understand the fundamental reason why two structurally similar drugs act oppositely on the dopamine transporter.

"There also are many questions on the meaning of these findings for the dozens of other illicit synthetic drugs that have found their way to the street," concludes De Felice. "We do suspect, however, that the combination that is found in bath salts could be behind its powerful physiological and neurological effect on users."

CADCA and the DEA recently produced a CADCA TV show on this topic highlighting the success of our coalitions on reducing bath salts in their communities. Watch the show anytime at http://www.cadca.org/cadca_tv/designer-drugs-new-frontier.