World No Tobacco Day Highlights the Industry’s “Interference”

World No Tobacco Day will be observed this year on Thursday, May 31st. Hosted by the World Health Organization (WHO), the theme is "tobacco industry interference.” 

Tobacco Industry Interference was selected as this year’s theme for The World Health Organization (WHO) World No Tobacco Day. World No Tobacco Day is meant to encourage a 24-hour period of abstinence from all forms of tobacco consumption across the globe. The day is further intended to draw global attention to the widespread prevalence of tobacco use and to negative health effects. This year’s campaign will focus on the need to expose and counter the tobacco industry’s brazen and increasingly aggressive attempts to undermine the WHO Framework Convention on Tobacco Control (FCTC) because of the serious danger they pose to public health. 

WHO states that: The tobacco industry has historically employed a multitude of tactics to shape and influence tobacco control policy. The tobacco industry has used its economic power, lobbying and marketing machinery, and manipulation of the media to discredit scientific research and influence governments in order to propagate the sale and distribution of its deadly product. Furthermore, the tobacco industry continues to inject large philanthropic contributions into social programs worldwide to create a positive public image under the guise of corporate social responsibility.
 
Tobacco use remains the leading cause of preventable death in the United States, causing approximately 443,000 deaths each year. 

For more information on World No Tobacco Day, visit http://www.who.int/tobacco/en/. To view CADCA’s tobacco resources, visit http://www.cadca.org/ctg. Know someone who wants to quit smoking and tobacco use altogether? Free help is available by calling the Tobacco Quit Line at 1-800-QUIT-NOW.

Limit Prescriptions For Painkiller Drugs

As much as one-third of the painkiller drugs abused in the United States come from hospital emergency rooms, a national study indicates. That ought to be all the impetus East Ohio hospitals need to go along with voluntary guidelines recommended to curb the problem.

Ohio Gov. John Kasich announced the guidelines this week, after consulting with state health care associations. Emergency rooms are "one of the largest access points for opiate painkillers. We hope that will be reduced to a trickle," the governor explained.

Kasich's guidelines include a variety of steps to reduce the flow of painkillers into the hands of those who abuse them and/or provide them to others for improper use. Doctors would limit both the number and duration of painkiller prescriptions. Emergency room staffers would insist on identification from those seeking painkillers - and would check them against a computerized database.

Drug overdoses have become the leading cause of accidental death in Ohio. In 2010, overdoses killed 1,544 Buckeye State residents - including 19 people in Belmont, Jefferson and Harrison counties.

Clearly, implementing the governor's guidelines would help health care professionals comply with their primary credo, "do no harm." Again, East Ohio hospitals should embrace and enforce the limits as soon as possible.

Number of US newborns with drug withdrawal triples

CHICAGO (AP) — Less than a month old, Savannah Dannelleyscrunches her tiny face into a scowl as a nurse gently squirts a dose of methadone into her mouth.

The infant is going through drug withdrawal and is being treated with the same narcotic prescribed for her mother to fight addiction to powerful prescription painkillers.

Disturbing new research says the number of U.S. babies born with signs of opiate drug withdrawal has tripled in a decade because of a surge in pregnant women's use of legal and illegal narcotics, including Vicodin, OxyContin and heroin, researchers say. It is the first national study of the problem.

The number of newborns with withdrawal symptoms increased from a little more than 1 per 1,000 babies sent home from the hospital in 2000 to more than 3 per 1,000 in 2009, the study found. More than 13,000 U.S. infants were affected in 2009, the researchers estimated.

The newborns include babies like Savannah, whose mother stopped abusing painkillers and switched to prescription methadone early in pregnancy, and those whose mothers are still abusing legal or illegal drugs.

Weaning infants from these drugs can take weeks or months and often requires a lengthy stay in intensive care units. Hospital charges for treating these newborns soared from $190 million to $720 million between 2000 and 2009, the study found.

The study was released online Monday in the Journal of the American Medical Association.

Savannah is hooked up to heart and oxygen monitors in an Oak Lawn, Ill., newborn intensive care unit. In a pink crib, she sleeps fitfully, sometimes cries all night, and has had diarrhea and trouble feeding — typical signs of withdrawal. Some affected babies also have breathing problems, low birth weights and seizures.

It nearly breaks her young mother's heart.

"It's really hard, every day, emotionally and physically," said Aileen Dannelley, 25. "It's really hard when your daughter is born addicted."

Doctors say newborns aren't really addicted — which connotes drug-seeking behavior that babies aren't capable of — but their bodies are dependent on methadone or other opiates because of their mothers' use during pregnancy. Small methadone doses to wean them off these drugs is safer than cutting them off altogether, which can cause dangerous seizures and even death, said Dr. Mark Brown, chief of pediatrics at Eastern Maine Medical Center.

Newborn drug withdrawal is rampant in Maine, Florida, West Virginia, parts of the Midwest and other sections of the country.

Dr. Stephen Patrick, the lead author of the study and a newborn specialist at the University of Michigan health system in Ann Arbor, called the problem a "public health epidemic" that demands attention from policymakers, as well as from researchers to clarify what long-term problems these infants may face.

University of Maine scientist Marie Hayes said her research suggests some affected infants suffer developmental delays in early childhood, but whether those problems persist is uncertain.

It's the 21st century version of what was known as the "crack baby" epidemic of the 1980s. Some experts say that epidemic was overblown and that infants born to mothers using crack cocaine face no serious long-term health problems.

Some think the current problem is being overblown, too.

Carl Hart, an assistant psychiatry professor at Columbia University and a substance abuse researcher at the New York Psychiatric Institute, noted that only a tiny portion of the estimated 4 million U.S. infants born each year are affected.

Hart also said the study probably includes women who weren't abusing drugs during pregnancy, but were taking prescribed painkillers for legitimate reasons. He said he worries that the study will unfairly stigmatize pregnant women who are "doing the right thing" by taking methadone to fight their addiction.

Doctors pushing powerful painkillers "like candy" contribute to the problem, said Arturo Valdez, who runs the Chicago substance abuse program that Aileen Dannelley attends. Patients at his West Side clinic include men and women who are prescribed opiate painkillers for legitimate reasons, such as car accident injuries, and find themselves addicted when the prescriptions runs out. Some turn to street drugs, which can be cheaper and easier to obtain, Valdez said.

In some states, mothers of newborns with drug withdrawal are arrested and jailed, but Valdez said addiction is a brain disease that should be treated like other illnesses, not stigmatized.

Aileen Dannelley said she started abusing drugs after an adult neighbor introduced her to crack when she was 14. She said she would "never have touched it" if she had known how addictive drugs can be.

She said she has abused Vicodin, which a doctor gave her to treat back pain from sitting all day at an office job, as well as other prescription painkillers and heroin.

Dannelley was still abusing drugs early in her pregnancy but decided in December to quit, vowing: "I'm not going to go back to that lifestyle. There's a baby inside me."

Now she is trying to get her life back on track. Estranged from her husband, she is living with her parents and just signed up for nursing classes at a local junior college. She visits Savannah every day. The baby has been in the hospital since she was born in early April, and her mother hopes to take her home soon.

"I am doing so good for the first time in my life," Dannelley said.

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National Survey Shows Friends and Family Are Primary Sources of Abused Painkillers

The Office of National Drug Control Policy (ONDCP) released a new analysis of data from the 2009 and 2010 National Survey on Drug Use and Health (NSDUH) revealing that the majority of new or occasional nonmedical users of pain relievers obtained the drug from family or friends for free or took them without asking. In contrast, frequent or chronic users (those who used pain relievers non-medically once a week or more on average in the past year) were more likely to obtain the drug from doctors or by buying them than were less frequent users.

“These data confirm that properly disposing of expired or unneeded medications is one of the most important actions Americans can take to address our Nation’s prescription drug abuse epidemic,” said Gil Kerlikowske, Director of National Drug Control Policy. “We will continue our unprecedented and comprehensive efforts to address this threat, but at the end of the day, our strongest tool is vigilance among everyone with access to a medicine cabinet.” 

ONDCP findings from the Substance Abuse and Mental Health Service Administration’s NSDUH averaged for 2009 and 2010 show that over half (55 percent) of persons who used pain relievers non-medically obtained the pain relievers from a friend or relative for free, another 11 percent bought them from a friend or relative, and 5 percent got them from a friend or relative without asking – adding up to 71 percent obtaining their most recently used pain relievers in some fashion from friends and family. Additionally, the more frequently prescription pain relievers are used, the more likely these pain relievers were obtained from doctors or purchased, rather than by getting them for free. 

Some key findings from this analysis: 

• Among new abusers of pain relievers, 68 percent of new users (those who began misuse of pain relievers in the past year) obtained their abused pills from a friend or relative for free or took them without asking, 17 percent were prescribed by one or more doctors, and 9 percent were purchased from a friend, dealer, or the Internet.

• Among occasional abusers of pain relievers (less than once a week on average in the past year), 66 percent obtained the pills for free from a friend or relative or took them without asking, 17 percent were prescribed from one or more doctors, and 13 percent were purchased from a friend or relative, dealer, or the Internet. 

• Among chronic abusers of pain relievers only 41 percent obtained the pills for free or without asking from a friend or relative, 26 percent were prescribed from one or more doctors, and 28 percent were purchased from a friend or relative, dealer or the internet. 

To help Americans address this threat, the Drug Enforcement Administration will host its fourth National Take Back Day on Saturday at more than 5,000 collection sites across the United States. Last October, 377,080 pounds—188.5 tons—of prescription drugs at over 5,300 sites operated by the DEA and state and local law enforcement partners were collected. In its three previous Take Back events, DEA and its partners took in almost a million pounds—nearly 500 tons—of pills. 

A full copy of the ONDCP's analysis, "Epidemic: Responding to America's Prescription Drug Abuse Crisis," is available here. 

Visit www.DEA.gov to find a location taking back medications near you on Saturday.

Coalitions in Action: Brazilian Coalition Trained by CADCA has Lowest Rates of Alcohol Sales to Minors in the Country

Over the past four years, CADCA has provided training and technical assistance to various communities in Brazil, South America’s largest country. Evidence is now emerging about the impact of a coalition CADCA helped form in the city of Pindamonhangaba (“Pinda”), a city of 150,000 inhabitants, in São Paulo State.

During a recent visit by CADCA’s Vice-President for International Programs, Dr. Eduardo Hernández-Alarcón, to community groups in the city of São Paulo, one of Brazil’s leading researchers praised the Pinda coaition’s work to improve its alcohol environment. While selling to minors under the age of 18 years old is illegal in Brazil, the law is generally ignored and there is virtually no enforcement.

The researcher, Dr. Ronaldo Laranjeira of the Federal University of São Paulo, observed that his studies show that the average percentage of outlets that sell to minors in his country is a startling 85 percent. However, he noted, because of the work of the community coalition, Pinda’s rate was only 56 percent, the lowest in Brazil.

Eliane Prado Marcondes, President of the Pinda coalition, noted that they utilized evidence-based strategies which their members learned at CADCA trainings to address the issue of sales of minors.

“We used multiple strategies to address this serious issue” Marcondes stated. “For example, we got the city to place signs in all outlets with the notice that federal law prohibits the sale to minors. We also requested that the local police increase monitoring of all of these establishments. Local church leaders distributed information to their members about the necessity of enforcing the alcohol laws in their neighborhoods and encouraged residents to report violations to the police. Finally, we worked closely with the local business association and municipal authorities to visit all outlets to make them aware of the law and its consequences.”

Pinda coalition Vice President, Father José Júlio Azarito, observed that while he is pleased with the progress Pinda has made to protect its youth, much more needs to be done.

CADCA is currently providing training and technical assistance to several communities in São Paulo state. Dr. Hernández and CADCA trainer Juliana Badaró Langille, herself a native Brazilian, recently completed a week-long visit to Brazil where they provided training to groups in the cities of Tremebé, Taubaté, and Redenção da Serra. Langille, who is the Executive Director of the Community Connections of Brockton coalition in Massachussetts, also conducted two half day trainings for youth.

CADCA’s International Program is supported by the Bureau of International Narcotics and Law Enforcement Agency of the U.S. State Department.