"Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it is the only thing that ever has." - Margaret Mead

Monday, August 26, 2013

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.

Tuesday, August 20, 2013

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.

Friday, August 9, 2013

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.