Supreme Court Upholds Healthcare Law

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How Do 'Bath Salts' Drive People Crazy?

By Natalie Wolchover | LiveScience.com

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

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

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

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

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

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

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

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

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