New Study Finds States with Stronger Alcohol Policies Have Less Binge Drinking

According to a new study, a novel composite measure consisting of 29 alcohol policies demonstrates that a strong alcohol policy environment is a protective factor against binge drinking in the U.S. The study was led by researchers at the Boston University Schools of Medicine (BUSM) and Public Health and Boston Medical Center (BMC), and is published in the current issue of the American Journal of Preventive Medicine.

Binge drinking is a common and risky pattern of alcohol consumption that is responsible for more than half of the 80,000 alcohol-attributable deaths that occur each year in the United States. "If alcohol policies were a newly discovered gene, pill or vaccine, we'd be investing billions of dollars to bring them to market," said Tim Naimi, MD, MPH, senior author of the study, and associate professor of medicine at BUSM and attending physician at BMC. 

While previous research demonstrates that individual alcohol policies can reduce risky drinking and alcohol-related harms, this is the first study to characterize the effect of the overall alcohol policy environment. States with stronger policy scores had lower rates of binge drinking, and states with larger increases in policies had larger decreases in binge drinking over time. Specifically, compared with states with weaker policy environments, states with stronger policy environments had only one-fourth of the likelihood of having binge drinking rates in the top 25% of states, even after accounting for a variety of factors associated with alcohol consumption such as age, sex, race, religious composition, income, geographic region, urban-rural differences, and levels of police and alcohol enforcement personnel. 

Alcohol policy environments differed considerably between states, with policy scores varying up to threefold between them. Among all states and Washington D.C., almost half had a rating of less than 50 percent of the maximum possible score in any particular year from 2000-2010, and states in the bottom quartile of policy strength had binge drinking rates that were 33 percent higher than those in the top quartile. "Unfortunately, most states have not taken advantage of these policies to help drinkers consume responsibly, and to protect innocent citizens from the devastating second-hand effects and economic costs from excessive drinking," added Naimi. 

Overall, analyses showed that the policy environment was largely responsible for state-level differences in binge drinking. "The bottom line is that this study adds an important dimension to a large body of research demonstrating that alcohol policies matter -- and matter a great deal – for reducing and preventing the fundamental building block of alcohol-related problems," said Naimi.

Visit www.cadca.org/niaaa to access videos and publications that address binge drinking on college campuses.

Coalition Launches Program to Prevent Doctor Shopping

While nearly every state (49) has a Prescription Drug Monitoring Program to help identify "doctor shoppers," problem prescribers and individuals in need of treatment, these programs vary dramatically in funding, use and capabilities. In the latest addition to CADCA’s Coalition Ideas Exchange, the Weymouth Youth Coalition Substance Abuse Prevention Team discusses how it launched the Preventing Doctor Shopping and Pharmacy Hopping campaign to help local pharmacists and physicians reduce misuse and access to prescription drugs.

After experiencing growing rates of non-medical prescription drug use, hospitalization and overdose in Weymouth, Mass., key informant interviews revealed that incidents of doctor shopping and pharmacy hopping significantly contributed to the problem. In response to the issue, the coalition led a collaborative effort to increase local pharmacists’ use of the state’s Prescription Monitoring Program (PMP). The program creates barriers for individuals looking to access large amounts of prescription medications for non-medical purposes. The Preventing Doctor Shopping and Pharmacy Hopping Campaign, led by the coalition, included educating and enrolling pharmacists in the PMP, as well as supporting statewide legislation to ensure proper prescription monitoring practices among Massachusetts physicians.

CADCA’s Coalition Ideas Exchange provides coalitions access the latest information from other organizations across the country that are implementing innovative strategies and interventions to address substance abuse in their communities. The information comes directly from coalitions with the goal of providing resources, actionable steps and recommendations for applying these ideas to work in other communities. To learn more about the Weymouth Youth Coalition Substance Abuse Prevention Team and the Coalition Ideas Exchange, visit www.cadca.org/ideasexchange.

Study Examines Teen Attitudes About Drug Use

High school seniors who frown upon the use of drugs are most likely to be female, nonsmokers or hold strong religious beliefs, according to a study by Joseph Palamar of New York University. The study examines how teenagers’ attitudes toward marijuana influenced their thoughts on the further use of other illicit drugs. The work appears online in the journal Prevention Science, published by Springer.

Although previous research has shown that people who disapprove of a particular drug will in all likelihood not use it, little is known about how the use of one drug affects people’s attitudes toward using other drugs. 

Palamar examined how demographics and a lifetime use of various drugs – marijuana use in particular – can predict if a person will become partial to using “harder” and more dangerous drugs, such as powder cocaine, crack, LSD, heroin, amphetamine and ecstasy, also known as “Molly.” Data was obtained from 29,054 high school seniors who took part in the Monitoring the Future annual cross-sectional survey of approximately 130 public and private schools in 48 states between 2007 and 2011.

Palamar found that youths who smoked cigarettes or used more than one “hard” drug were consistently less critical of other drug use. The lifetime use of alcohol had no impact on people’s attitudes. Those who used only marijuana tended to be less judgmental of further using such so-called “socially acceptable” drugs as LSD, amphetamine and ecstasy. They did not approve of cocaine, crack or heroin, however, most likely because of their perceived dangers and addictive qualities.

Unsurprisingly, female high school seniors consistently disapproved of using cocaine, crack, LSD and ecstasy. Compared to their male counterparts, females are generally less likely to use most drugs. Palamar was also not surprised by the finding that religiosity robustly increased attitudes against drug use, as it is a major force in societal values.

Youths from more advantaged socio-economic backgrounds with highly educated parents as well as those living in urban areas were much less disapproving of the use of the so-called “less dangerous” drugs. Palamar believes that the higher prevalence of illicit drug use in urban areas may be helping to normalize drug use in cities.

“Public health and policy experts need to ensure that the use of other drugs does not increase in light of the growing prevalence of marijuana use and more lenient policies surrounding it,” Palamar explains. 
 

U.S. Attorneys General Urge FDA to Regulate E-cigarettes

Reuters reports that top U.S. law enforcement officials urged the Food and Drug Administration this week to quickly issue a promised set of rules governing the sale of e-cigarettes.

In 2009, the FDA was given authority to regulate cigarettes, cigarette tobacco and roll-your-own tobacco, although not pipe tobacco, cigars or e-cigarettes. The law allows the FDA to expand its authority over all tobacco products, but it must first issue new regulations. The FDA has said they are in development.

In a letter to FDA Commissioner Margaret Hamburg, Attorneys General from 41 states asked the agency to "take all available measures" to issue the rules by the end of October.

"We ask the FDA to move quickly to ensure that all tobacco products are tested and regulated to ensure that companies do not continue to sell or advertise to our nation's youth," they wrote.

The FDA did not immediately respond to a request for comment.

The letter comes less than a week after the American Academy of Pediatrics and 14 other public health organizations, including the American Lung Association and American Heart Association, sent a letter to President Barack Obama asking him to pressure the FDA into issuing the rules.

In July, the FDA said it might place restrictions on menthol cigarettes following a review that showed the products are likely to be more addictive than regular cigarettes. The agency is seeking public comment.

In their letter, the Attorneys General noted that sales of e-cigarettes have doubled every year since 2008 and are projected to reach $1.7 billion in 2013. The cost, meanwhile, has fallen, making them more affordable and attractive to youth, they said.

Moreover, there are no restrictions on advertising e-cigarettes.

"Consumers are led to believe that e-cigarettes are a safe alternative to cigarettes, despite the fact that they are addictive, and there is no regulatory oversight ensuring the safety of the ingredients in e-cigarettes."

To learn more about e-cigarettes, read CADCA’s latest blog post about how some jails are using e-cigarettes as a way to raise funds for their facilities regardless of the health consequences. CADCA also published a blog post in July about e-cigarettes, entitled “E-cigarettes: Do I Smell a Rat?” which you can find on CADCA’s website.

Health Insurance Marketplace Opens on Oct. 1st

Sep 26, 2013

Did you know that the Affordable Care Act (ACA) health insurance marketplace will open on Oct. 1? The health insurance marketplace will provide opportunities for the uninsured, and those seeking a better healthcare plan, to access quality, affordable healthcare. Community coalitions can play a role in reducing the number of uninsured Americans by helping to raise awareness of these new insurance opportunities.

SAMHSA has created valuable resources for multiple audiences, and has engaged a number of national partners, including CADCA, in the development of materials.  The goal is to help you learn more about a role your local organization can play in the new healthcare marketplace.  Your community coalition may be well-positioned to reach special populations of uninsured individuals for enrollment, partner with federally qualified health care providers or engage in improving systems as this new marketplace moves forward. 

To learn more about the health insurance marketplace and to access a toolkit developed for community organizations, visit: 
http://beta.samhsa.gov/health-reform/samhsa-health-reform-efforts/enrollment-coalitions-initiative.Note that the initial open enrollment period ends on March 31, 2014 so it’s important to act now.

Coalitions should scroll down and click on the “Community-Based Prevention Organizations Toolkit.”  CADCA asks all interested coalitions to review the SAMSHA materials and we welcome your feedback on these resources.  Please email your questions or comments to Mary Elliott at melliott@cadca.org and be sure to write “enrollment coalitions” in the email subject line.  

Coalitions can also access CADCA’s publication, Coalitions and Community Health: Integration of Behavioral Health and Primary Care, which outlines specific action steps for coalitions to educate their community about some of the key provisions of the ACA that are already being implemented, as well those taking effect in January 2014 and beyond. It also offers suggestions for how coalitions can get at the table with community stakeholders that are involved in planning and implementing integration efforts. The publication was developed in partnership with the SAMHSA-HRSA Center for Integrated Health Solutions.

Raise Awareness of the Dangers of Prescription and Over-the-Counter Medicine Abuse this October

You may be aware that prescription drug abuse is at epidemic proportions in our nation, but did you know that roughly one in three teens knows someone who has abused over-the-counter cough medicine to get high? Help educate your community about the dangers of medicine abuse by participating in theCADCA 50 Challenge this October.

The CADCA 50 Challenge is an attempt to get prescription and over-the-counter medicine abuse on the radar screens of families across America. To participate, simply host an educational event on medicine abuse during National Medicine Abuse Awareness Month this October. 

To register for the CADCA 50 Challenge, visit www.PreventRxAbuse.org. By registering, you're automatically entered in a drawing for a free iPad!
The website also includes a host of helpful tools to assist you in the planning of your event, including a new Grassroots Media Kit. The Grassroots Media Kit includes several resources to help you plan and promote your National Medicine Abuse Awareness Month event so that your message reaches a broader audience. You’ll also find other useful tools, such as PowerPoint presentations, videos and our Rx Abuse Prevention Toolkit: From Awareness to Action.  

For more information, visit www.preventrxabuse.org or contact Natalia Martinez Duncan atnmartinez@cadca.org.

More Than 100,000 Americans Quit Smoking Due to National Media Campaign

An estimated 1.6 million smokers attempted to quit smoking because of the Centers for Disease Control and Prevention’s “Tips From Former Smokers” national ad campaign, according to a study released by the CDC. As a result of the 2012 campaign, more than 200,000 Americans had quit smoking immediately following the three-month campaign, of which researchers estimated that more than 100,000 will likely quit smoking permanently.

The study surveyed thousands of adult smokers and nonsmokers before and after the campaign. Findings showed that, by quitting, former smokers added more than a third of a million years of life to the U.S. population. 

The Tips campaign, which aired from March 19 to June 10, 2012, was the first time a federal agency had developed and placed paid advertisements for a national tobacco education campaign. Ads featured emotionally powerful stories of former smokers living with smoking-related diseases and disabilities. The
campaign encouraged people to call 1-800-QUIT-NOW, a toll-free number to access quit support across the country, or visit a quit-assistance website. 

The study on the campaign’s impact is published this week by a medical
journal, The Lancet. 

“This is exciting news. Quitting can be hard and I congratulate and celebrate with former smokers - this is the most important step you can take to a longer, healthier life,” said CDC Director Tom Frieden, M.D., M.P.H. “I encourage anyone who tried to quit to keep trying – it may take several attempts to succeed.’’

According to the CDC study:
•    Millions of nonsmokers reported talking to friends and family about the dangers of smoking and referring smokers to quit services. 
•    Almost 80 percent of smokers and almost 75 percent of nonsmokers recalled seeing at least one of the ads during the three-month campaign.
•    Calls to the quitline more than doubled during the campaign and visits to the website were more than five times higher than for the same 12-week period in 2011.

Visit http://www.cdc.gov/tobacco/campaign/tips/ to view ads in the “Tips from Former Smokers Campaign”. 

In June, Tiffany Roberson, one of the individuals featured in the CDC campaign, wrote a guest post on CADCA’s Blog. Click here to read her post.

E-cigarette Use More Than Doubles among U.S. Middle and High School Students

The percentage of U.S. middle and high school students who use electronic cigarettes, or e-cigarettes, more than doubled from 2011 to 2012, according to new data published by the Centers for Disease Control and Prevention (CDC).

The findings from the National Youth Tobacco Survey, in this week’s Morbidity and Mortality Weekly Report, show that the percentage of high school students who reported ever using an e-cigarette rose from 4.7 percent in 2011 to 10.0 percent in 2012. In the same time period, high school students using e-cigarettes within the past 30 days rose from 1.5 percent to 2.8 percent. Use also doubled among middle school students. Altogether, in 2012 more than 1.78 million middle and high school students nationwide had tried e-cigarettes.

"The increased use of e-cigarettes by teens is deeply troubling," said CDC Director Tom Frieden, M.D., M.P.H. "Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes."

The study also found that 76.3 percent of middle and high school students who used e-cigarettes within the past 30 days also smoked conventional cigarettes in the same period. In addition, 1 in 5 middle school students who reported ever using e-cigarettes say they have never tried conventional cigarettes. This raises concern that there may be young people for whom e-cigarettes could be an entry point to use of conventional tobacco products, including cigarettes.

“About 90 percent of all smokers begin smoking as teenagers,” said Tim McAfee, M.D., M.P.H., director of the CDC Office on Smoking and Health. “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical.”

Electronic cigarettes, or e-cigarettes, are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol. E-cigarettes not marketed for therapeutic purposes are currently unregulated by the Food and Drug Administration. The FDA Center for Tobacco Products has announced that it intends to expand its jurisdiction over tobacco products to include e-cigarettes, but has not yet issued regulatory rules. Because e-cigarettes are largely unregulated, the agency does not have good information about them, such as the amounts and types of components and potentially harmful constituents.

Click here to read a recent blog CADCA published about e-cigarettes.

People Who Abuse Prescription Painkillers 19 Times More Likely to Use Heroin

A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that people aged 12 to 49 who had abused prescription pain relievers were 19 times more likely to have initiated heroin use recently (within the past 12 months of being interviewed) than others in that age group (0.39 percent  versus 0.02 percent). The report also shows that four out of five recent heroin initiates (79.5 percent) had previously abused prescription pain relievers.

While the report shows that people abusing prescription painkillers were at greater risk of later starting heroin, it also shows that the vast majority of people using prescription pain relievers nonmedically did not start using heroin. In fact, only 3.6 percent of the people who initiated the nonmedical use pain relievers went on to use heroin within five years.

“Prescription pain relievers when used properly for their intended purpose can be of enormous benefit to patients, but their nonmedical use can lead to addiction, serious physical harm and even death,” said Dr. Peter Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “This report shows that it can also greatly increase an individual’s risk of turning to heroin use – thus adding a new dimension of potential harm.”

The report’s examination of the association between the nonmedical use of prescription pain relievers and the initiation of heroin use is part of SAMHSA’s efforts to identify some of the factors which may explain the rise in the rates of heroin use, dependence and initiation that have occurred in the past few years.

The number of people reporting that they have used heroin in the past 12 months rose from 373,000 people in 2007 to 620,000 people in 2011. Similarly, the number of people dependent on heroin in the past 12 months climbed from 179,000 people in 2007 to 369,000 people in 2011. The number of people starting to use heroin the first time in the past 12 months also increased from 106,000 people to 178,000 people during the same period.  

The report also found significant shift between 2008 and 2011 in heroin initiation levels and patterns. For example, although overall heroin initiation rose among all 12 to 49 year olds, these increases were only seen among adults aged 18 to 25 and 26 to 49, with no change in the rate among youths aged 12 to 17.  Heroin initiation among people with annual incomes less than $20,000 or $20,000-$49,999 also increased during this time period. 

Past-year heroin initiation rates went up sharply in all regions of the nation during this period except the South where the rate stayed lowest in country. Heroin initiation rates were also lower among Blacks than among other racial and ethnic groups.  

The report, Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States, is based on data from SAMHSA’s National Survey on Drug Use and Health (NSDUH), covering the period of 2002 to 2011. NSDUH is a national survey of over 67,500 people age 12 and older.

NIAAA Offers Online Course to Help Healthcare Professionals Screen Youth for Alcohol Problems

A new online training course will help health care professionals conduct fast, evidence-based alcohol screening and brief intervention with youth. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) produced the course jointly with Medscape, a leading provider of online continuing medical education. 

"Just in time for back-to-school physicals, physicians, physician assistants, and nurses can learn how to use a simple youth alcohol screening tool and earn up to 2.5 continuing education credits or contact hours," said Kenneth R. Warren, Ph.D., acting director of NIAAA.  "This new course joins NIAAA's family of evidence-based, user-friendly products to help clinicians identify patients of all ages who are at risk for alcohol-related problems, and to intervene early, when we have the best chance to prevent problems."

The course presents three engaging case scenarios of youth at different levels of risk for alcohol-related harm. The scenarios illustrate a streamlined, 4-step clinical process outlined in Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide. NIAAA produced the guide in 2011 in collaboration with the American Academy of Pediatrics (AAP), which recommends screening all adolescents regarding alcohol use. 

Underage drinking is widespread and a major public health problem. Over the course of adolescence, the proportion of youth who drink more than a few sips escalates from 7 percent of 12-year-olds to nearly 70 percent of 18-year-olds. Heavy drinking is common. Having five or more drinks on one occasion is reported by half of 12 to 15-year-olds who drink and two-thirds of 16-20-year olds who drink. 

Course participants will learn how to use a quick and powerful two-question screening tool. One question asks about the drinking habits of an adolescent's friends and the other question asks about the adolescent's own drinking frequency. The course also offers an innovative risk estimator and teaches how to conduct different levels of intervention for lower, moderate, and highest risk patients. Participants will also receive an overview of brief motivational interviewing, an interactive, youth-friendly intervention considered to have the best potential effectiveness for the adolescent population. 

Access to the CME course requires a username and password, which users can set up for free here.

National Evaluation Finds DFC Coalitions Effective at Reducing Drug Use

The latest results from the National Evaluation of the Drug Free Communities Support Program (DFC) found that coalitions funded by the DFC program have been successful at reducing drug and alcohol use in their communities.

The evaluation found that rates of past 30-day use declined significantly across all substances (alcohol, tobacco, marijuana) and school levels (middle and high school) between all DFC grantees ever funded across in the program.

Among current DFC grantees, prevalence of past 30-day use declined significantly for alcohol and tobacco at each school level (middle and high school) between first and most recent data reports. Past 30-day use of marijuana also declined significantly among middle school youth for this group.

In addition, prevalence of past 30-day use was significantly lower for DFC high school students as compared to a nationally-representative sample of high school students taking the Youth Risk Behavior Survey (YRBS). Differences in prevalence of 30-day use between DFC and YRBS were statistically significant for alcohol in 2003, 2005, 2007, 2009, and 2011. Differences in prevalence of 30-day use were statistically significant for marijuana in 2003, 2005, 2007, and 2009, but not in 2011.

However, similar to what other national studies are finding, marijuana use increased slightly in DFC communities. Among DFC grantees that reported data from 2011, prevalence of marijuana use among both middle school and high school youth increased significantly (+0.7 and +1.3 percentage points respectively) from their next most recent report. During this same time frame, there was a significant decline in perception of risk for using marijuana among middle school and high school youth in these DFC communities. The recent trend in increased prevalence of marijuana use is similar to the results from the National Survey of Drug Use and Health which reported that 30-day use of marijuana increased by 0.6 percentage points among 13 year olds and by 1.0 percentage points among 18 year olds between 2010 and 2011. 

The work of DFC grantees represents a comprehensive, multi-faceted approach focusing on the reduction of youth substance use that reaches communities containing more than one third of the Nation’s population. 

Visit the DFC website to read the full 2012 National Evaluation Interim Report.

Although the President’s FY 2014 Budget Request contained a $6.3 million cut to the Drug Free Communities (DFC) program, due to the collective advocacy of CADCA and the substance abuse prevention field, both the House and the Senate Appropriations Committees have recommended funding levels above the President’s Budget Request. 

Today, the full Senate Appropriations Committee marked up its version of the Financial Services and General Government Appropriations Bill, which contains funding for the DFC program. This bill funds the DFC program at a level of $92 million, which is level funding when compared to the FY 2013 level before sequestration. The full House Appropriations Committee has also marked up its version of this bill, and funded the program at a level of $88 million. 

While this is great news, the appropriations process is not yet complete, as the bill still has to go to conference. Typically, the House and Senate split the difference between their two bills. Therefore, in order to ensure that the DFC program receives the highest possible funding level in the final bill, it is imperative that the field responds en masse when CADCA issues the next Legislative Alert.

If you're not currently signed up to receive CADCA's Legislative Alerts, click here to sign up today!

Targeting Impulsive Adolescents May Reduce Problem Drinking

A study reported by Medical News Today showed that young people with impulsive tendencies are more prone to drinking heavily at an early age. The study was conducted by scientists at the University of Liverpool.

The research suggests that targeting personality traits, such as impulsivity, could potentially be a successful intervention in preventing adolescent drinking from developing into problems with alcohol in later life. 

"Our results show that more impulsive individuals are more likely to start drinking heavily in the future compared to less impulsive individuals. The next steps are to take these results and apply them to prevention interventions that are tailored to individual characteristics, such as impulsivity,” said Professor Matt Field, from the University of Liverpool's Institute of Psychology Health and Society.

Previous research has suggested that impulsive behavior is linked with adolescent drinking, but it is unclear whether young people who are impulsive tend to drink more, or whether drinking while the brain is still developing is particularly harmful and can lead to the progression of impulsive behaviors. 

The team used computer tests that measured inhibitory control, the ability to delay gratification, and risk-taking. More than 280 young people who were aged 12 or 13 at the beginning of the study took part in the study. The participants repeated the computer tests every six months over the two years of the study. 

Results showed that those participants who were more impulsive in the tests went on to drink more heavily or have problems with alcohol at a later time. The study did not, however, show that alcohol consumption led to increased impulsive behavior on the computer tests. This suggests that there is a link between impulsivity and adolescent drinking, but that alcohol may not necessarily lead to increased impulsive behavior in the short-term.

Opiate overdose deaths 'skyrocketed' in women, CDC finds

The Centers for Disease Control and Prevention are urging health care professionals to cut back on the amount of painkillers they prescribe, particularly to women, as new research has found women are becoming addicted at alarming rates. NBC’s Tom Costello reports and Dr. Nancy Snyderman comments on the dangers of prescription drugs.

More men still die after overdosing on prescription painkillers in the U.S. each year, but women are catching up fast, according to a grim new report from government health researchers.

Opiate pain reliever deaths among women spiked five-fold in the decade from 1999 to 2010, climbing to 6,631, up from 1,287, according to an analysis by the Centers for Disease Control and Prevention. During that same period, prescription painkiller deaths among men jumped 3.6 times, to 10,020.

That means 17,000 people die each year from opiate overdoses, more than quadruple the number of a decade ago.

"Prescription painkiller deaths have skyrocketed in women," said CDC director Dr. Tom Frieden. "Stopping this epidemic in women -- and in men -- is everyone's business. Doctors need to be cautious about prescribing and patients about using these drugs."

About 42 women die each day in the U.S. from drug overdose, including 18 a day who die from prescription painkillers, the CDC found.

It’s part of a worsening problem that saw some 943,365 women head to U.S. emergency departments in 2010 because of drug misuse or abuse, according to the study that analyzed data from the National Vital Statistics System and the Drug Abuse Warning Network, or DAWN. Top causes included heroin and cocaine, the psychoactive drugs called benzodiazepines – and opiate pain relievers.

Men used to be twice as likely as women to die from drug overdoses, most of which are unintended, researchers said. Now, the ratio is about 1.55 times. Overall, drug overdose deaths now claim more than 38,000 people in the U.S. each year.

Women are joining the boys’ club of opiate overdoses for several reasons, experts say. Unlike illicit drugs like heroin and cocaine, prescription painkillers such as hydrocodone, oxycodone and fentanyl have a patina of legitimacy, said Dr. David Sack, an addiction psychiatrist with Promises Treatment Center in Malibu, Calif.

“People assume that because it’s prescribed by a doctor, it’s safe,” Sack said.

There’s less stigma surrounding prescription pills than drugs such as heroin or cocaine, said Daniel Raymond, public policy director for the Harm Reduction Coalition, an advocacy group.

“There doesn’t seem to be the same level of punitive social attitudes,” he said.

Lucas Jackson / Reuters

More women are dying after overdosing on prescription painkillers, a new study finds. Deaths spiked among women in the decade from 1999 to 2010.

In addition, women are more likely than men to be prescribed prescription painkillers, to get higher doses of the drugs and to use them chronically. Some research has suggested that the most common forms of pain -- including back pain, abdominal pain, migraines and pain from cancer -- may be more prevalent in women, and that women may be more sensitive to pain.

Women also weigh less than men, so they may be more susceptible to the effects of prescription painkillers.

At the same time, women are more likely to have multiple prescriptions from different providers, including drugs to combat anxiety and depression.

“Most of the fatalities aren’t on a single medicine. It’s a mix of medicines,” Sack noted. “And why you mix alcohol and opiate drugs, it’s a deadly combination.”

The unique stresses that women face may factor into the spike in prescription opiate use, said Dr. Leigh Vinocur, an emergency medical physician in Baltimore and Shreveport, La., and a spokeswoman for the American College of Emergency Physicians.

Many women who become addicted to prescription opiates have histories of sexual abuse or other trauma, experts said.

The bulk of the deaths from prescription opioids was in middle-aged women, with 1,515 deaths in 2010 in women aged 35 to 44 and 2,239 deaths in women from 45 to 54, the new study showed.

“Think of all the pressures on women to look good and to be perfect,” Vinocur said. “I think that’s why we’re seeing it.”

Opiate abuse is a special problem for pregnant women, who commonly give birth to children who are addicted to the same substances, said David Craig, a clinical pharmacist at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla.

Incidences of neonatal abstinence syndrome, or NAS, tripled between 2000 and 2009, according to a study last year in the Journal of the American Medical Association.

Solving the problem may be difficult, despite efforts to crack down on so-called “pill mills” and to make doctors more aware of appropriate prescribing, said Raymond, of the Harm Reduction Coalition. It can be difficult for women to find treatment or to seek treatment, often because they worry about the effect on their children.

“I think it’s a good wake-up call that we need to make sure we take gender-sensitive approaches, whether that’s tailoring treatment access or recognizing some of the underlying causes of the histories of abuse,” Raymond said. “Nobody’s immune from this.”

Drug type: Prescription Drug, Synthetic Drugs

While use of traditional illicit drugs, such as cocaine and heroin, has remained stable, the use of new psychoactive substances (NPS), such as synthetic marijuana, and MDPV or “bath salts”, increased dramatically throughout the world, according to the 2013 World Drug Report. The report was released on World Drug Day this week by the United Nations Office on Drugs and Crime (UNODC).

The report found that the number of NPS reported by Member States to UNODC rose from 166 at the end of 2009 to 251 by mid-2012, an increase of more than 50 percent. 

“Over the past few years, we’ve heard from CADCA members about the negative impact these drugs are having in communities across the United States. Many young people are using these drugs under the mistaken belief that because they are not illegal and sold in stores they must be safe. However, synthetic marijuana, also referred to as ‘spice’ or ‘K2’, and ‘bath salts’ have proven to be anything but – leading to strong hallucinations, violent behavior and even suicides,” said CADCA Chairman and CEO Gen. Arthur T. Dean in a statement.  

The report noted the unique challenge that these substances pose.  

“Given the almost infinite scope to alter the chemical structure of NPS, new formulations are outpacing efforts to impose international control. While law enforcement lags behind, criminals have been quick to tap into this lucrative market,” the UNODC stated in their press release, adding that in response to the proliferation of NPS, UNODC has launched an early warning system which will allow the global community to monitor the emergence and take appropriate actions.

The World Drug Report also noted that prescription opiate use remains high and polydrug use, especially the combination of prescription drugs and illicit substances, continues to be a concern, especially the misuse of sedatives and tranquillizers – with more than 60 per cent of the countries covered in the report ranking such substances as among the first three misused types of substances.

To download the 2013 World Drug Report, visit: http://www.unodc.org/wdr/. Click here to read CADCA’s media statement on the report.

PTSD: Not Just a Military Problem

Posttraumatic Stress Disorder (PTSD) is a mental health condition that affects millions of individuals worldwide. While it is often closely associated with combat veterans and other members of the military, the fact is PTSD can affect anyone who experiences a traumatic event. 

June is PTSD Awareness Month, and next Thursday, June 20 is PTSD Screening Day. 

The first step in getting help for PTSD is recognizing the symptoms. Service members, college students and members of the public can take a free, anonymous self-assessment for PTSD and other related conditions at www.PTSDscreening.org. While the assessment does not provide a definitive diagnosis, it will provide information on how to seek help if you are experiencing PTSD symptoms. 

During the past year, many communities across the U.S. have experienced devastating tragedies. Hurricane Sandy, the shootings in Newtown, the Boston Marathon bombings, and most recently, cases of severe weather in the Plains states have left many individuals, families and communities reeling. While most people are amazingly resilient following trauma, for some, the emotional toll these events cause can last much longer. 

About 60 percent of men and 50 percent of women will experience at least one traumatic event in their lifetime, according to the National Center for PTSD, U.S. Department of Veteran Affairs. Overall, about 8 percent of men and 20 percent of women will develop PTSD. While traumatic events such as natural disasters, fires or acts of violence can affect an entire community, other instances like a terrifying car accident can affect a single individual. 

Most people will have stress-related reactions following a traumatic event, yet only some will develop PTSD. If these reactions do not begin to go away over time or get worse, or impact day to day life, it may be PTSD. PTSD symptoms often include: 

* Reliving the event through nightmares and flashbacks 

* Avoiding situations that remind you of the event, such as large crowds or driving a car 

* Negative changes in beliefs and feelings. This can include feelings of guilt, fear or shame. 

* Feeling keyed up or jittery

“PTSD is a condition that many people believe only affects members of the military and veterans, but that simply is not the case,” says Dr. Douglas G. Jacobs, founder and medical director of Screening for Mental Health, Inc. “While combat veterans do have a high rate of PTSD, we also see PTSD in members of the public, especially among first responders, victims of violence or those affected by natural disasters.” 

It is recommended that anyone who was been exposed to a traumatic event over a month ago and is experiencing symptoms of PTSD take an anonymous PTSD assessment at www.PTSDscreening.org. By simply answering a series of basic questions, people can determine if they are showing symptoms of PTSD, and if so, where to find the help they need. While these screenings are not diagnostic, the results will indicate whether further assessment by a clinician is advisable. The screening website, provided by the nonprofit Screening for Mental Health, is accessible year-round to the public. 

CDC Releases New Report on Indoor Secondhand Smoke Exposure

Four out of five U.S. adults report having voluntary smoke-free rules in their homes and three out of four report having voluntary smoke-free rules in their vehicles, according to a study published in the journal Preventing Chronic Disease, a publication of the Centers for Disease Control and Prevention (CDC). The study, entitled “Smoke-Free Rules and Secondhand Smoke Exposure in Homes and Vehicles among US Adults, 2009–2010” is the first to present estimates of smoke-free rules and secondhand smoke exposure in vehicles among U.S. adults. 

The National Adult Tobacco Survey respondents were classified as having smoke-free rules if they never allow smoking inside their homes or vehicles. Despite the high prevalence of voluntary smoke-free rules in homes and vehicles, the study found that almost 11 million non-smoking adults continue to be exposed to secondhand smoke in their home, and almost 17 million non-smoking adults continue to be exposed to secondhand smoke in a vehicle. The study also contains state-by-state data showing that the highest prevalence of smoke-free rules in homes and vehicles occurred in many states with comprehensive smoke-free laws and longstanding tobacco control programs. 

“We have made tremendous progress in the last 15 years protecting people in public spaces from secondhand smoke,” said Tim McAfee, M.D., M.P.H., director of the Office on Smoking and Health at CDC, in a news release. “The good news is that people are applying the same protection in their homes and vehicles. However, millions of non-smokers, many of whom are children, remain exposed to secondhand smoke in these environments.” 

Exposure to secondhand smoke causes heart disease and lung cancer in adult non-smokers. In children, secondhand smoke exposure causes more severe and frequent asthma attacks, acute respiratory infections, ear infections and sudden infant death syndrome (SIDS). Secondhand smoke exposure is responsible for an estimated 50,000 deaths each year in the United States. The Surgeon General has concluded there is no safe level of exposure to secondhand smoke, and that only 100 percent smoke-free policies can protect non-smokers from the dangers of secondhand smoke. Opening a window does not work, nor does any other ventilation system. 

The online version of the article is available at http://www.cdc.gov/pcd/.

Study Finds Early Alcohol Use Increases Alcohol Abuse Later in Life

The earlier the age at which youth take their first alcoholic drink, the greater the risk of developing alcohol problems, Medical News Today reported.

A new study that will be published in the October issue of Alcoholism: Clinical & Experimental Research shows that individuals who have their first drink during puberty subsequently have higher drinking levels than do individuals with a post-pubertal drinking onset.

"Most teenagers have their first alcoholic drink during puberty, however, most research on the risks of early-onset alcohol use up to now has not focused on the pubertal stage during which the first alcoholic drink is consumed," said Miriam Schneider, leader of the Research Group Developmental Neuropsychopharmacology at the Central Institute of Mental Health, University of Heidelberg, as well as corresponding author for the study.

"Common thinking in alcohol research was that the earlier adolescents begin, the more deleterious become their drinking habits. However, a closer look at the statistics revealed a peak risk of alcohol use disorders for those beginning at 12 to 14 years of age, while even earlier beginners seemed to have a slightly lower risk. Since timing of puberty is not a simple function of chronological age, and also greatly differs between the sexes, the pubertal phase at first drink may therefore represent a stronger and better indicator for subsequent alcohol-related problems than simply the age."

The longitudinal epidemiological study involved Schneider and her colleagues determining pubertal age at first drink in 283 young adults (152 females, 131 males) that were part of a larger epidemiological study. In addition, the participants' drinking behavior - number of drinking days, amount of alcohol consumed, and hazardous drinking - was assessed at ages 19, 22, and 23 years via interviews and questionnaires. Furthermore, a rodent study concurrently examined the effects of mid-puberty or adult alcohol exposure on voluntary alcohol consumption in later life by 20 male rats.

Both studies revealed that those individuals that initiated alcohol consumption during puberty tended to drink more and also more frequently than those starting after puberty, Schneider wrote in the study.

Researchers noted the influence of a high degree of brain development that occurs during puberty.

"In summary, puberty is a very critical developmental period due to ongoing neurodevelopmental processes in the brain. It is exactly during puberty that substances like drugs of abuse - alcohol, cannabis, etc. - may induce the most destructive and also persistent effects on the still developing brain, which may in some cases even result in neuropsychiatric disorders, such as schizophrenia or addictive disorders. Prevention work therefore needs to increase awareness of specific risks and vulnerability related to puberty,” Schneider told Medical News Today.

Teen Smokers May Be At Greater Risk Of Marijuana Addiction

New research presented at the Pediatric Academic Societies annual meeting in Washington, D.C., supports the theory that cigarettes are a gateway drug to marijuana.

"Contrary to what we would expect, we also found that students who smoked both tobacco and marijuana were more likely to smoke more tobacco than those who smoked only tobacco," said study author Megan Moreno, MD, MSEd, MPH, FAAP, an investigator at Seattle Children's Research Institute and associate professor of pediatrics at the University of Washington, in a news release printed in Medical News Today.

Dr. Moreno and her colleagues randomly selected incoming college students from two universities - one in the Northwest and one in the Midwest - to participate in the longitudinal study. Students were interviewed prior to entering college and again at the end of their freshman year regarding their attitudes, intentions and experiences with substances.

Specifically, students were asked if they had used tobacco or marijuana ever in their lives and in the past 28 days. Researchers also assessed the quantity and frequency of marijuana and tobacco use in the past 28 days.

Results showed that prior to entering college, 33 percent of the 315 participants reported lifetime tobacco use, and 43 percent of lifetime users were current users. In addition, tobacco users were more likely to have used marijuana than those who did not use tobacco.

By the end of their freshman year, 66 percent of participants who reported tobacco use prior to entering college remained current users with an average of 34 tobacco episodes per month. Of these, 53 percent reported concurrent marijuana use. Overall, users of both substances averaged significantly more tobacco episodes per month than current users of tobacco only.

"These findings are significant because in the past year we have seen legislation passed that legalizes marijuana in two states," Dr. Moreno said. "While the impact of these laws on marijuana use is a critical issue, our findings suggest that we should also consider whether increased marijuana use will impact tobacco use among older adolescents."

Research Shows Early Dialogue Between Parents and Children Most Effective In Deterring Teen Tobacco, Alcohol Use

Early, substantive dialogue between parents and their grade-school age children about the ills of tobacco and alcohol use can be more powerful in shaping teen behavior than advertising, marketing or peer pressure, a University of Texas at Arlington marketing researcher has shown.

The findings of Zhiyong Yang, an associate professor of marketing in the UT Arlington College of Business, are published in a recent edition of the Journal of Business Research. Similar findings were part of a 2010 study he published in the Journal of Public Policy & Marketing of the American Marketing Association.
Yang's current work, "Demarketing teen tobacco and alcohol use: Negative peer influence and longitudinal roles of parenting and self-esteem," argues that parental influence is a powerful tool in dissuading children from smoking and drinking in their later teen years.

His 2010 article, "The Impact of Parenting Strategies on Child Smoking Behavior: The Role of Child Self-Esteem Trajectory," shows that dialogue between parents and teens is effective in combating risky behavior, such as tobacco and alcohol use, and that parental influences buffer the impact of other external factors such as social media and peer pressure.

"First, our conclusion is that parenting styles can be changed, and that's good news for the parents and the teens," Yang said, in a news release. "Second, our study shows that parental influence is not only profound in its magnitude, but also persistent and long-lasting over the course of a child's entire life. Effective parenting plays the critical role as a transition belt to pass normative values of society from one generation to another."

Rachel Croson, Dean of the UT Arlington College of Business, said Yang's research sheds important light on what drives behaviors and misbehaviors.

"Marketers often study how to sell more products," Croson said. "Dr. Yang's work answers some important and thorny questions about how to sell less, and what parents may be able to do to help improve their children's health and well-being."

Binge Drinking in College Can Lead to Heart Disease Later in Life

Frequent binge drinking in college can cause immediate changes in circulation that increase an otherwise healthy young adult's risk of developing cardiovascular disease later in life, according to research published this week in the Journal of the American College of Cardiology.

"Regular binge drinking is one of the most serious public health problems confronting our college campuses, and drinking on college campuses has become more pervasive and destructive," said Shane A. Phillips, PT, Ph.D, senior author and associate professor and associate head of physical therapy at the University of Illinois at Chicago. "Binge drinking is neurotoxic and our data support that there may be serious cardiovascular consequences in young adults."

College students age 18 to 25 years old have the highest rates of binge drinking episodes, with more than half engaging in binge drinking on a regular basis. Prior studies have found that binge drinking among adults age 40 to 60 years old is associated with an increase in risk for stroke, sudden cardiac death and heart attack, but the effect on younger adults has not been studied.

Researchers looked at two groups of healthy nonsmoking college students: those who had a history of binge drinking and those who abstained from alcohol. Binge drinking was defined as consuming five or more standard size drinks (12 ounces of beer, 5 ounces of wine, 1.5 ounces of 80 proof spirits or 8-9 ounces of malt liquor) in a two-hour period for males and four or more standard size drinks in a two-hour period for females. On average, the students who binge drink had six such episodes each month over four years. Abstainers were defined as having consumed no more than five drinks in the prior year. Students were also questioned about their medical history, diet, history of family alcohol abuse and frequency of binge drinking. 

The study found that the binge drinkers had impaired function in the two main cell types (endothelium and smooth muscle) that control blood flow. These vascular changes were equivalent to impairment found in individuals with a lifetime history of daily heavy alcohol consumption and can be a precursor for developing atherosclerosis, or hardening of the arteries, and other cardiovascular diseases such as heart attack and stroke.

Binge drinkers were not found to have increased blood pressure or cholesterol, which are well-established risk factors for heart disease; however, both high blood pressure and cholesterol cause changes in vascular function similar to what the students demonstrated.

Visit www.CardioSmart.org for more information on the harmful effects of heavy alcohol use on heart health or for information on teen alcohol abuse.

Visit www.cadca.org/niaaa to access a new video and publication, entitled College and Drinking: A Risky Curriculum, which highlight research on binge and heavy drinking among college-age youth.

Alcohol, Drug Use A Greater Risk for Children of Deployed Parents

A new University of Iowa study suggests that military deployment of a parent puts children at an increased risk for drinking alcohol and using drugs. 

Using data from a statewide survey of sixth, eighth, and 11th-grade students in Iowa, the researchers found an increase in 30-day alcohol use, binge drinking, using marijuana and other illegal drugs, and misusing prescription drugs among children of deployed or recently returned military parents compared to children in nonmilitary families. The increased risk was consistent across all age groups. The findings are published online in the journal Addiction. 

"We worry a lot about the service men and women and we sometimes forget that they are not the only ones put into harm's way by deployment - their families are affected, too," says Stephan Arndt, Ph.D., UI professor of psychiatry in biostatistics and senior study author. "Our findings suggest we need to provide these families with more community support." 

In 2010, almost 2 million American children had at least one parent in active military duty, according to the Department of Defense. 

A second unexpected finding was the relationship between parental deployment, disruption of children's living arrangements, and increased risk of substance use. 

"When at least one parent is deployed, there are a measurable percentage of children who are not living with their natural parents," Arndt told Medical News Today. "Some of these children go to live with a relative, but some go outside of the family, and that change in these children's living arrangements grossly affected their risk of binge drinking and marijuana use." 

The study found that for children who were not living with a parent or relative, those with a deployed parent had a risk of binge drinking that was 42 percentage points higher than a student from a nonmilitary family. In comparison, children with a deployed parent who still were living with a parent had a risk of binge drinking that was about 8 percentage points higher than children of nonmilitary families who were living with a parent. 

Because the study surveyed only Iowa children, the nature of Iowa's military population may also affect the results, Arndt notes. In Iowa, along with Vermont, Wisconsin, and Minnesota, the largest portion of military personnel serve with the Reserve or the National Guard. These groups of military personnel live in civilian communities rather than on military bases and may have limited access to support services and resources designed to help military families. 

Although the study findings may be specific to families of National Guardsmen and women, Arndt said that the results agree with previous research that focused on risky behavior for children of deployed military men and women in Washington state, which unlike Iowa has a large active duty population. 

Does your coalition want to address substance abuse and quality of life issues with the veterans and their families in your community? The VetCorps project is being conducted by CADCA in partnership with the National Guard Bureau’s Prevention, Treatment and Outreach (PTO) Program with funding assistance from the Corporation for National and Community Service (CNCS). CADCA is recruiting AmeriCorps and VISTA members, and placing them in one of CADCA’s community coalitions located throughout the country to provide support to Veterans and Military Families (VMF) with a special emphasis on serving the needs of National Guard and Reserve VMF. 

Learn more about CADCA’s VetCorps project at http://www.cadca.org/VetCorps.