2011 February

Irreversible harm… a scan of the brain of a healthy six-week old (left) next to a scan of the brain of a baby of the same age who is suffering from foetal alcohol syndrome.

Photo: National Drug Research Institute

AUSTRALIA has fallen behind in recognising and diagnosing ”completely preventable” foetal alcohol syndrome and wider spectrum disorders, researchers warn.

The federal government has so far failed to respond more than a year after a monograph – an extensive gathering of available studies – was submitted to the Health Minister, Nicola Roxon, recommending favourable treatments.

There are a growing number of intervention treatments for children born with the illnesses and researchers advocate a renewed effort to help pregnant women who suffer chronic alcohol dependence.

Foetal alcohol syndrome causes serious primary structural brain damage, sometimes shown at birth in facial deformities such as a small head, flat mid-face, underdeveloped jaw and a short nose with a low bridge, but just as often in learning and behavioural problems.

More broadly, foetal alcohol spectrum disorder occurs in up to 1 per cent of live births and includes foetal alcohol syndrome and other central nervous system birth defects attributable to alcohol consumption by the mother. US research suggests sufferers are disproportionately likely to face the juvenile justice system.

Early intervention can help but ”Australia is well behind other countries in recognising or diagnosing” the disorders, says Nyanda McBride, a researcher with the National Drug Research Institute at Curtin University.

If no alcohol is consumed during pregnancy – and, some suggest, during preconception and breastfeeding – there is no risk of the ”completely preventable” disorders, Dr McBride said.

Women with chronic alcohol abuse problems needed ”much more treatment and care”, said Lucy Burns, a senior lecturer with the National Drug and Alcohol Research Centre at the University of NSW.

”We have virtually no treatments available for alcohol dependence in pregnant women,” Dr Burns said.

Although the National Health and Medical Research Council guidelines recommend women abstain from alcohol during pregnancy, ”we still don’t know the cut-off point at which alcohol starts to have this problematic effect”.

She said she had no date for the release of the monograph.

Elizabeth Elliott, a paediatrics researcher at Sydney University, said the monograph was submitted ”a long time ago”. The conditions had been under-recognised ”partly because health professionals are unsure about how to make the diagnosis”.

A spokeswoman for Ms Roxon said the Australian Health Ministers Conference would respond later this year. The issues were a ”priority” and the government had funded research for screening and diagnosis.

Source: www.smh.com.au July 21, 2010

Filed under: Australia :

(St. Petersburg, FL) The Field Research Corporation just released the results of their latest Field Poll evaluating the support/opposition to California’s ballot initiative, Proposition 19. This initiative to tax and legalize use, cultivation and distribution of marijuana is opposed by 48% of the voters, while only 44% support it.

Demographically, the poll reports an overwhelming opposition by double-digit margins from minority California voters. According to Bishop Ron Allen, head of the International Faith Based Coalition and an anti-drug advocate in Sacramento, “The results of this poll show that the African American and Hispanic communities are fed up with drugs being pushed onto their children and into their neighborhoods. People understand that this is a serious public health and safety issue. As an African American I am concerned that the legalization of such poison would bring more drug dealers, increased use, and other negative consequences to our communities!”

Bishop Allen has also been outspoken against the California NAACP’s position that this is a civil right’s issue. Allen refutes, “Contrary to what is claimed, Proposition 19 will not change the prison statistics for drug possession crimes by minorities. Under current California law, there is no mechanism that allows for the arrest of anyone for possession of less than one ounce of marijuana. Proposition 19 would not change that situation but would certainly send the wrong message to our children, make marijuana, and probably other drugs, more readily available thereby driving drug use up. We could expect more drug impaired individuals on our highways, in our workplaces and in our schools!”

Calvina Fay, executive director of Drug Free America Foundation said, “The outcome of this poll is evidence that as the public has become more educated about the dangers of drug legalization and the flaws of this Proposition, they have more readily rejected it.” Fay continued, “This initiative is not a solution to California’s economic problems. In fact, this Proposition, according to L.A. District Attorney Steve Cooley, does not allow the state to generate any revenue because one section of the act prohibits any marijuana-specific state tax. Additionally, there is considerable uncertainty about its potential impact. No government has ever legalized the production and distribution of marijuana for general use, so there is virtually no evidence on which to base predictions or to gamble with the outcomes of such a dangerous experiment with the future of our children!”

“Based on The Field Poll results, the public doesn’t want marijuana legalized,” added John Redman, Director of Community Alliances for Drug Free Youth and a San Diego resident. “California voters would have to agree that it’s acceptable for pseudo-legal drug dealers to profit from the slavery of addiction. Many experts agree that the cost from addiction and usage associated illnesses far outweighs the amount of any revenue claimed to be generated – something the state of California cannot afford,” concluded Redman.

If you would like to set up an interview about this issue with Bishop Allen, John Redman, Calvina Fay or other policy experts, please contact Lana Beck at (727) 828-0211 or (727) 403-7571.

Source: http://www.cadfy.org.php July 9, 2010

Filed under: USA :

The policy of the Government brought changes in the views, attitudes and directions, comparing to the previous years. The new drug strategy is part of these changes. It is based on prevention, strengthening the families, school education, and reconstruction of the rank of teachers, supporting young people, offering help for those, who got into trouble and on a strong law interdiction against drug dealers. These will form the basis of a new drug strategy, to be elaborated by the end of 2011, together with an action plan.

During the past 8 years new drugs emerged in the illegal marketplace and new forms of drug trafficking and distribution among young people were domesticated. Hungary having been a transit country of drug trafficking became a target country. The children and young people can access drugs and mind altering substances much easier than earlier. Drug liberalization came into the forefront and nothing happened to stop these negative trends. The drug strategy implemented by now had failed, as it was not capable to prevent or reduce the increasing drug problem. Those, who induced this situation, would not be able to create and implement an appropriate new drug strategy.

The drug strategy of the past years, which placed the emphasis on drug liberalization and harm reduction, cannot be continued any more. This policy benefited those, who preferred drug liberalization. Trafficking of yet non-scheduled, harmful substances became profitable, similarly to distribution of illicit drugs.

The task of the state is the protection of society, especially those groups who are the most deprived and endangered, against those, who want to gain profit by damaging them. In the focus of the Government stands now the strengthening of families, raising awareness of parents about their responsibilities and improving the societal solidarity. These goals are met by the measures of Government taken now, e.g. the family tax benefit, earlier retirement of women, sanctioning of avoiding school for more than 50 hours by pupils, stricter penalization of shoplifting. Positive effects of these measures have become visible in a short term.

Source: World Federation Against Drugs Jan. 2011

Filed under: Europe :

Every medical professional witnesses the effects of addiction on patients. Many agonize how addiction destroys families, fuels crime, changes neighborhoods and imperils our youth.

Many professionals are discovering a way to make a difference. The grassroots Reality Tour Drug Prevention Program has been growing county by county since 2004, aided by healthcare volunteers. The consequence-driven, parent/child program started in Butler 2003. It organizes existing community resources to present the real story of addiction.

Neil Capretto, D.O., Medical Director at Gateway Rehabilitation Center in Beaver County, recognizes the collaborative benefits, “One of the many strengths of Reality Tour is that it brings together drug and alcohol treatment providers, schools, churches, businesses, hospitals, police and the legal system. They network through this program to improve the life and health of youth.”

Reality Tour opens with brief dramatic scenes narrated by a ‘teen on drugs’ that involve the audience. Q & A sessions with police and a recovering addict offer insight. The tempo changes as parent/child learn coping skills and experience a revealing self-discipline test. Adults rate it as ‘priceless’ and a follow-up study shows 80% of youth are still working on prevention goals after three months.
CANDLE, Inc., is the Butler non-profit that oversees Reality Tour. Executive Director and developer Norma Norris recalls that, “The program took off by itself in 2003. We quickly had a 2-month waiting list. Soon other communities wanted to replicate it. Parents everywhere are eager to protect their children. Now over 25 communities are licensed.”

Healthcare professionals are key players according to Norris, “Dr. Jeffrey David and his wife Jan played the role of grieving parents for years. Butler Ambulance provided ER props and sends EMT’s monthly. Butler Memorial Hospital and Highmark were supportive.” Over 5,000 Butler residents have attended and all eight county school districts are involved.

Volunteers like VA Pharmacist Tiffany Kimmerle continue to step forward, “I truly feel Reality Tour can change a teenager’s mind about using drugs. Helping a program that has the ability to change lives, and probably save lives is most rewarding.”

County by county replications continued. Armstrong County Memorial Hospital joined with ARC Manor and District Attorney Scott Andreassi in 2005. Originally, six programs per year were planned but demand requires a monthly frequency.
In Westmoreland County, Excela Health plays a primary role. R.N. Tina Bobnar and her family manage the ER scene along with Scot Ritenour. Nurse Educator Sheri Walker recalls, “Excela Health sent an e-mail requesting volunteers. I was interested because I have seen the devastating effects of addiction when I worked in Labor and Delivery. The numbers of addicted moms was on the rise.” Her daughter Liza, who lost a classmate to an overdose, volunteered too declaring, “Mom, we have to do this!”

The parent/child approach appeals to Walker, “What impressed me the most and still does, is the focus on communication between parent and child. The program is not, “just say no,” but is more about, “these are some ideas for how to say no. Reaching children before they start experimenting with drugs is why I believe in this program. Youth who attend have a chance to make an informed decision.”
Research by the University of Pittsburgh’s School of Pharmacy shows the Reality Tour does increase parent/child communication. Youth also report an increase in their perception of harm associated with drugs.

Norris underscores that, “The program is for the general public. Prevention has the best outcome when introduced early. A MetLife study shows a marked increase nationally for youth in grades 9-12, with 38% reporting past 30 day drug/alcohol use.”

While Western PA leads the state with 13 Reality Tour sites, Eastern PA healthcare providers are taking notice. Geisinger Medical Center, Wayne Memorial Hospital and the Child Death Review Team in Pike County are involved. Norris hopes to organize the whole state and has sights on Allegheny County next. Oregon, New York, New Jersey and Vermont will also start programs in 2010.
Any community is just 90 days away from a Reality Tour. Training is facilitated with the aid of CANDLE’s detailed manual and volunteer workshop on DVD. More information and newsletter signup is available at

www.RealityTour.org

E-mail :NormaNorris@candleinc.org t

Source: www.behavioralhealthcentral.com 21.June 2010

Filed under: USA :

When Patrick Sayers received a 30-year sentence for killing Michael Mickelson, it was held up as proof that the system is finally taking driving under the influence seriously.

Thirty years is the maximum sentence for vehicular homicide while under the influence. In seeking it, Deputy Missoula County Attorney Kirsten Pabst LaCroix reviewed the facts:

The Hamilton man put his three toddlers in the back seat of his 1-ton Chevy pickup and then partied with a friend as he drove north along U.S. Highway 93 in 2007. The truck was going 50 mph when it swerved into Mickelson’s car near Miller Creek Road.

“A lethal, loaded weapon,” LaCroix called Sayers’ truck.

Sayers, too, was loaded that day. But not with booze. He was stoned.

Sayers, who smoked two bowls of pot in the truck with his friend that day, is among an increasing number of drivers nationwide who had drugs in their system when they were involved in fatal wrecks, according to federal statistics. A study released a few weeks ago by the National Highway Traffic Safety Administration shows the number going up every year since 2005.

Those statistics showed that in 2009, Montana ranked second in the nation, after Alaska, for marijuana involvement in fatal crashes, according to the report “Killer on the Highway,” compiled by Rebecca Sturdevant, who became an anti-DUI activist after a drunken driver killed her son, Highway Patrol Trooper Evan Schneider, in 2008. Some 13 percent of the Montana motorists in the deadly crashes had used marijuana, compared to 4 percent nationwide.
Both the highway agency and Sturdevant cautioned that record-keeping varies widely among states. Nor do those statistics mean that marijuana use caused the crashes.

Still, the study confirmed what Kurt Sager sees on the highways.

While the number of fatal crashes involving booze still ranks high – Montana routinely stands among the worst in the nation – “the rate of increase of drugs is climbing more steadily than alcohol,” said Sager, traffic safety resource officer for the Montana Highway Patrol. “Alcohol-impaired fatalities were down in 2010, but the drug-related fatalities were up. So, we’re winning one battle but losing another.”

DUI has become so synonymous with drunken driving that it’s easy to forget that “under the influence” covers a multitude of substances. (Conditions, too. New Jersey has a law against driving drowsy.)

But even as reports increase, courts and law enforcement struggle with the issue of how to judge impairment when a driver has been using something other than – or, as is frequently the case, along with – alcohol.

Travis Vandersloot, who killed Montana Highway Patrol Trooper Michael Haynes in a head-on crash in 2009, had a blood-alcohol level of 0.18 and also had been smoking marijuana.

David Bugni, the Butte man convicted in the 2009 crash that killed Missoula prosecutor Judy Wang, had been drinking and smoking dope, although his blood alcohol concentration was 0.04 percent, below the legal cutoff of 0.08 percent.

And Daniel Alvin Prindle, a Billings man who pulled his vehicle into the path of an oncoming car in 2008, seriously injuring two people and hurting a third, had marijuana, cocaine and barbiturates in his system. Last week, a judge ordered him to pay $700,000 in restitution.

But only Vandersloot, who’d downed 13 drinks in the hours before he killed Haynes, was charged with being under the influence. That’s because there’s nothing comparable to the 0.08 blood alcohol level when it comes to pot, prescription drugs, cocaine, meth or other drugs.

“You can get a level in their system, but there’s nothing to relate that to that proves they’re impaired,” said Missoula County Sheriff’s Capt. Brad Giffin. “The only way is a circumstantial case that proves they are impaired to a point where they can’t function properly.”

The Highway Patrol’s Sager trains law enforcement around the state as drug recognition experts, applying standardized field sobriety tests as a way to check for impairment, no matter the cause. By spring, he said, some 70 law enforcement officers around the state – there are 12 among the 100 members of the Missoula police force – will be trained. The demand for their services is great.

Missoula Police Sgt. Ed McLean said police have made DUI arrests “strictly for cannabis, strictly for meth … for combinations of alcohol and narcotics, for analgesics combined with depressants. We have made arrests on every drug for DUI.”

Rebecca Sturdevant said she’s seen good progress on raising awareness of the problem of drunken driving. Now she wants to see that same awareness of all types of impaired driving.

She supports a bill sponsored by state Rep. Ken Peterson, R-Billings, that would tweak the drug provisions of the state’s DUI law.

Peterson’s proposal specifies that “driving with any amount of a dangerous drug or its metabolite in a person’s body is a violation,” although it exempts prescription drugs.

“The basic concept,” said Sturdevant, “is that we need to be able to keep people who are smoking and driving off the highway.”

But some substances can be detected in a person’s system long after their effect is gone. That’s true of THC, the main ingredient in marijuana.

“It’s absurd to test for marijuana metabolites that might be present for marijuana usage days ago or weeks ago,” said John Masterson, head of Montana NORML (National Organization for the Legalization of Marijuana Laws). “People shouldn’t be charged for DUI for something that they did weeks ago.”
NORML stresses that “people should not be under the influence of anything while they are driving a motor vehicle,” Masterson said.

He favors the system of drug recognition experts, saying that “when you test for impairment, rather than chemical quantity, so long as it’s a qualified expert you can test for alcohol, potentially marijuana, potentially prescription painkillers, potentially sleep deprivation … all of the sorts of reasons people should not be on the highway endangering our friends and families.”

The voter initiative that legalized medical marijuana in Montana in 2004 specifically states that the law doesn’t permit “any person to operate, navigate, or be in actual physical control of any motor vehicle, aircraft, or motorboat while under the influence of marijuana.”

The number of people legally smoking marijuana in Montana has nearly tripled in the 15 months since the declaration by the U.S. Department of Justice that it would no longer raid medical marijuana distributors. Some 27,292 Montanans held “green cards” as of December.

McLean said officers making traffic stops “tend to get the greatest resistance from people who think that, ‘OK, because I have a medical marijuana card, it’s legal for me to smoke.’ Or, their doctor is prescribing pain medication and then they get behind the wheel of a car and become a danger to themselves and others. That’s the education curve we need to overcome.”

No matter what the substance, said Deputy Missoula County Attorney Jen Clark, the key word is impaired.

“It’s kind of analogous to alcohol,” said Clark. “You can have it, but it doesn’t make it OK to drive if you’re impaired.”

Source: www. missoulian.com 16th Jan. 2011

Filed under: USA :

Up to 40 per cent of those presenting with psychiatric disorders are also abusing substances, and that figure rises to 60 per cent in the case of those who have committed suicide.

And doctors treating substance abuse addicts at Dublin’s Rutland centre have discovered that those presenting for treatment for addiction are also experiencing depression, anxiety, and other mental health challenges.

This, according to the Rutland’s Centre’s newly appointed clinical director, Dr Fiona Weldon, is “a reflection of the changing landscape in the use of mood-altering substances that have an impact on mental health, such as cocaine, hash and head-shop substances”.

The Rutland Centre has also seen an increase in those presenting with co-existing mental health issues and eating disorders. As a result, Dr Weldon has launched two new programmes to meet the growing demand for services to deal with issues in the area of addiction and eating disorders.

The first of these, which starts this month, is the Dual Diagnosis Outpatient Programme, an evidence-based intervention utilising Dialectical Behaviour Therapy responding to those experiencing difficulties with mental health and addiction. It aims to break the cycle of addiction and respond to other co-existing issues.

An Eating Disorder Programme will deal with compulsive overeating and an obsessional relationship with food leading to many other health-threatening issues.

Other eating disorders, also on the increase, particularly bulimia and anorexia, are also dealt with in a highly specialised group therapy and psycho-educational programme on a residential basis as well as in a new outpatient group targeting stabilisation of eating and increasing skills to manage psychological distress. Visit www.rutlandcentre.ie for more information.

Source: www.independent.ie Sunday July 11 2010

Filed under: Europe :

ALMOST a third of prisoners who die from drugs after being released from jail die within a week. Research shows nearly half of this group die within a month including eight out of 10 who are on temporary, or early, release. The report from the Health Research Board (HRB) comes as separate figures show almost 1,000 convicted criminals are on temporary release as the prison overcrowding crisis deepens.

The HRB report — the first of its type in Ireland — said many of the deaths are preventable through inexpensive action such as better links between prisons and treatment services and training to prevent overdoses. The report said there were 130 recorded drug deaths among prisoners and ex-prisoners between 1998 and 2005, but said this was likely to be an underestimate.

The HRB authors, lead by Suzi Lyons, said the 130 represented 5% of the 2,442 people on the National Drug-Related Deaths Index, a “much higher” proportion than for the general population. It said 105 of the 130 had left prison: 93 after completing their sentence and 12 on temporary (or early) release. Of the 105, 25 (or 28%) died within a week of release and a further 17 (19%) within a month. The mortality rate was the worst among the 12 people on temporary release, 10 of whom died within the first month. The research found exact dates of release for 89 individuals.

The results show of 105 drug deaths of ex-prisoners:

*89% were male, 62% were aged 20 to 29 and 84% were unemployed.

*20% were living in unstable accommodation and 10% were homeless.

*97% had a history of drug misuse, 61% had a history of drug injecting use and 34% were reported to be injecting at the time of their death.

*30% were on the methadone treatment register at the time.

*67% of deaths were due to poisonings.

*63% of deaths by poisoning within a month of release were due to two or more drugs.

* Heroin or methadone was involved in 79% of single drug deaths and 96% of polydrug deaths.

Campaigners have said that simple and inexpensive measures could cut the high number of prisoners who are dying. These include better communication between prisons and outside drug services, and more training for users, their families and drug workers on how to prevent overdoses.

Researchers said this number was “much higher” than for the general population and added the figure of 130 was likely to be an underestimate.

The report, Drug-Related Deaths Among Recently Released Prisoners in Ireland, was published in the International Journal of Prisoner Health. It concluded: “The increased proportions of individuals who die so soon after release from prison highlights the need for preventative measures for this at-risk group.

“Such measures include ensuring the release of drug-dependant prisoners in a planned manner, providing continuity of methadone and other forms of drug treatment, and providing accommodation and support to enter education or employment on release.”

It called for improved communication between prison services and addiction treatment and reintegration services.

Source: www. IrishExaminer.com 14th July 2010

Filed under: Europe :

HONOLULU — The founder and director of The Hawaii Cannabis Ministry and 13 associates are facing federal marijuana charges. Federal authorities told a news conference Friday that Roger Christie led a major marijuana growing, processing and distribution ring. Christie says he uses marijuana as a sacrament. But authorities say neither his ministry nor state medical marijuana laws protect him from federal prosecution. Federal officials seized 3,000 plants, with a retail value of $4.8 million. Four Big island residences are facing forfeiture. The defendants were arrested Thursday and flown to Honolulu. Authorities say six were released on bond. Christie and seven others remain in custody pending detention hearings next week.

Source: The Associated Press. 9th July 2010

Filed under: USA :

Special Report

The young wrestler was sitting on the kitchen floor, his bloody face illuminated by the early-morning light that streamed through a nearby window. In other parts of the world, the shadow of the moon was edging across the rising sun, marking the beginning of a dramatic and well-publicized total eclipse. Will Hollingsworth had talked of little else for the past four days: the last eclipse of the millennium and the apocalypse some believed would follow. He had not slept in more than 100 hours, holed up in his room, paging restlessly through a Bible, his television tuned to news of the eclipse. It was a peculiar obsession for a 20-year-old college student who spent most of his time training to be a world-class athlete. Will didn’t appear intoxicated. To the contrary, he was alert, engaging and philosophical, though strangely fixated on current events.

Now this.

On any other day, he would have been out the door — running for miles along eastern Hillsborough County’s busiest roads, pumping iron at the gym, working out with his old high school wrestling team.

But on this August morning in 1999, there was only the inexplicable blood and the vacant stare that greeted me when I came to make breakfast. “What happened?” I asked my only son. “I’ve been fighting demons,” he replied.

Demons?

“It’s true,” he insisted, gesturing to his bloody face and filthy shirt. “I’ve been fighting demons all night. And I won.”

I followed his gaze through the window into the back yard. There, the torn sod and blood-stained patio marked the spot where he had pounded his face into the ground as his father and I slept, oblivious to the war we were about to wage with an invisible enemy. Will would battle his demons for the next three years. But he would never exorcise them. GHB already had laid claim to his sanity, and there was no one who could tell us how to retrieve it.

Dying To Win

Trinka Porrata is all too familiar with the phenomenon of young men who speak of mortal conflict with demons — men who pound their heads on concrete as they experience the unique and little-known psychosis that accompanies GHB withdrawal. “I can’t tell you how many times I’ve heard about that,” said the retired Los Angeles narcotics detective. “Some of them try to put their heads through plate-glass windows.” Some succeed.

Porrata, founder of Project GHB, has spent seven years throwing a lifeline into cyberspace for addicts desperate to escape the grip of a nutritional supplement promoted as a safe, non-habit-forming sleep aid that claimed to build lean muscle mass. Most have been athletes or bodybuilders, but GHB use cuts across all demographics. “It’s the most unique drug,” she said. “We have a lot of senior citizens hooked on it thinking it’s antiaging. It’s big in the gay community, big in the gym scene, big in the club scene. Yet it’s invisible.”

Porrata said she has had more than 1,800 inquiries from GHB users and their family members since Project GHB went online in December 1999. “We were getting: ‘I thought I was the only person in the world with this problem,’” she said.

Before the debut of Project GHB, anyone looking for information on the chemical discovered a nest of Internet sites featuring glowing testimonials, mail-order supplies and recipes for cooking it at home. Central Florida, with its fitness culture, was a watershed for the craze during the 1990s, before GHB-related products were outlawed.

Tampa had its own cottage industry in the form of Body Life Sciences, a now-defunct company that produced and marketed the supplement under the brand names Revivarant and Revivarant G. GHB seemed to offer something for everyone, depending on the dosage: sedation, exhilaration, sexual stimulation, weight loss and the unsubstantiated promise of massive muscles. It was readily available at health food stores and gyms, where it entered the marketplace as an ostensibly safe, legal alternative to steroids.

In recent years, its ability to induce mild euphoria and amnesia attracted a new kind of customer who employed it as a party drug associated with overdoses and sexual assaults. GHB’s link to “date rapes” and all-night raves quickly overshadowed its widespread use in the athletic community. Yet it is the athletes and bodybuilders, who incorporate it into a daily regimen, who are most at risk of becoming addicted.

“It’s really the frequency of the dose as opposed to the amount of the dose that leads to this very striking psychosis,” said David Kershaw, a psychologist for Hillsborough County’s Mobile Crisis Unit. Kershaw has seen his share of GHB addicts in withdrawal — beginning in late 1999, when the county’s mental health center saw a rash of cases involving muscular young men suffering from hallucinations and paranoia.

One believed he had an invisible tape recorder fastened to his leg. Another saw a swarm of flies covering his body. All were regular users of GHB. “The irony is that despite the fact that they wouldn’t deliberately pollute their bodies like that, they get sucked into using it,” Kershaw said. “The people I see are all athletes, all concerned with being as healthy as they can be.”

One of them was Will.

The Runner Stumbles

Will’s descent into madness was swift and seemingly irreversible.

The first sign that something was amiss came one night in the spring of 1999, when he called to ask his father to come help him change a flat tire. It turned out the tire was flat because Will had drifted off an exit ramp on Interstate 75 and into a tree. Weeks later, another late-night call — this one from an ex-girlfriend, who said she had received an urgent message from Will asking her to pick him up at a gas station near the University of South Florida.

When she arrived, she found the car, with the engine still running, the driver’s door ajar, but no sign of Will. He turned up at another nearby gas station — incoherent, with no memory of how he got there. His father and I were mystified. Will seemed as bewildered as we were. “I keep making mistakes, and I don’t know why,” he said.

He never made the connection between the potion he bought at the local health food store and the bizarre things that happened when he stopped using it. We didn’t know he was using GHB. There were a lot of things we didn’t know.

The Will we knew was exceptionally bright, responsible, hardworking and honest. A good student, a loyal friend and — most striking — a gifted athlete with a passionate dream to be the best of the best — at something.

He was, at one time, the fastest boy in Hillsborough County — sprinting and jumping his way through a medley of track-and-field titles during his middle school years. There was a charisma about the sturdy blond boy whose blistering speed brought stadium crowds to their feet as he entered the homestretch.

When he earned a place on the Brandon High School wrestling team — one of the premiere prep athletic programs in the nation — he told a sports reporter what it meant to soar with the Eagles. “I feel there is no limit to where I can go,” he said in a 1997 newspaper interview. “It is a great team and I don’t think my life will ever be the same.”

Death And Detox

About the time the young wrestler was beginning to unravel in Florida, bodybuilder Mike Scarcella, a former Mr. America, was arrested in Texas, charged with felony possession with intent to distribute GHB.

The U.S. Food and Drug Administration had banned the supplement in 1990 but left loopholes that allowed its analogues — chemical cousins that turn into GHB after ingestion — to be sold for another decade. By all accounts, including his own, Scarcella had been using the supplement for years — first as a muscle-building nightcap, then as a morning pick-me-up. Eventually he was sipping capfuls throughout the day, a classic pattern among athletic users that can lead to physical dependence in a matter of weeks or months. Scarcella was hooked. His May 1999 arrest, which resulted in 10 years’ probation, was not enough to pry him from the grip of GHB.

The 1992 Mr. America continued to use and sell the drug, even as he tried to kick the habit — first on his own, then in hospitals, where doctors had no experience with the bizarre hallucinations and raging psychosis of GHB withdrawal.

Even with a doctor’s help, withdrawal can be deadly. Stroke, heart attack and suicide are among the consequences for addicts in withdrawal, which can start within one to three hours of a missed dose.

Anxiety, restlessness and insomnia can quickly progress to delirium, muscle tremors and delusions.

“They think they’re on fire. They’re moving, thrashing, screaming,” said Karen Miotto, a University of California-Los Angeles addiction psychiatrist who helped develop a GHB detox protocol. “I think GHB is probably harder to get addicted to than some other drugs,” she added. “But once people get addicted, it is far harder to get off than any drug I’ve seen.”

Scarcella’s battle ended in August 2003, when the 39-year-old bodybuilder was admitted to a Texas hospital feeling the first effects of GHB withdrawal. By the 10th day, he had become delusional and suffered what the medical examiner termed “sudden cardiac death.”

Doctors and psychiatrists have been slow to recognize GHB withdrawal. Most know little beyond its reputation as a date-rape or club drug with the potential to deliver a swift, deadly knockout punch. Emergency room physicians have become familiar with the unconscious overdose patients — generally youthful partiers — who are often treated and released.

But they rarely consider GHB use in the muscular, hallucinating patients who are delivered in four-point restraints. “ER doctors don’t really know what to look for,” Kershaw said. Most physicians and mental health professionals also fail to recognize the early stages of withdrawal, when careful detoxification using the right medications might head off a spiral into psychosis. “It really means that the only time they’re going to get help is when they’ve reached the state of hallucinating,” said San Francisco addiction specialist Alex Stalcup. By then, their condition may be far less treatable.
“It’s just heartbreaking.”

Jesus’ Son

The angels appeared in September 1999, shortly after the eclipse that marked the end of life as we knew it.
These were not benevolent guardians, but mute, shadowy creatures only Will could see. What was their purpose? I asked him. “They’re here to watch us,” he said. Not as protectors but observers. They were neither dangerous nor benign. They just WERE, he said. Six weeks had passed since the morning of Will’s bloody battle with the backyard demons.

His father and I had spent the first week taking turns staying home from work with him as he slept round-the-clock, sedated by a physician.

The sleep deprivation that preceded the incident was enough to cause hallucinations, according to a psychologist friend. Perhaps sleep would bring him out of it, she suggested. We knew by this time that GHB had played some role. Will had acknowledged taking the supplement in the week before the eclipse. But he had stopped about three days before, he insisted. When Will finally woke up by week’s end, the crisis seemed to have passed.

He returned to his part-time job as a waiter at a Brandon restaurant and began his junior year at USF. With his sights set on the Olympics since high school, he resumed his regular workouts — and, according to his off-campus roommates, resumed his GHB use. “It takes you to a place you never want to come back from,” Will said.

On Labor Day, he was back home, reading the Bible around the clock. He stopped attending classes, didn’t report for work and did not return to the apartment he shared with three other students. He had stopped taking GHB.
He also had ceased his workouts and stopped eating. He claimed he was going to fast for two weeks — “like Jesus.”

Once again, his father and I took turns working from home, watching, waiting. He was, by law, an adult and could not be forced into an evaluation unless he proved to be a danger to himself or others. He didn’t meet that criterion — not yet. His father took his car keys, just in case. Sept. 17, 1999. It was my turn to watch over Will.

I worked on a news story from my laptop on the dining room table, just outside his bedroom. Each time I checked on him, he was sitting on his couch, reading his Bible. He had not eaten since Sept. 6. Shortly before 6 p.m., Will wandered out of his room and pulled up a chair across from me. My fingers froze on the keyboard as I met his gaze. “What are you working on?” he asked. I knew he couldn’t possibly be interested, but it was the first time in weeks he had made any effort to engage in conversation. I began to explain the story I was writing. Then I saw it, so plainly that for a moment I thought I was the one losing touch with reality.

Will’s gray-green eyes, the windows to his troubled soul, suddenly transformed into black pools of blazing madness. And for the first time, I understood the concept of possession. I was still answering his question when he cut me off in midsentence. “You don’t know who you’re dealing with, do you?” hissed the suddenly dark, dangerous creature.

“No,” I replied, cautiously. “Who AM I dealing with?” He rose from his chair and took a step toward me, his fist clenched, his face contorted with rage. “I am the Lord Jesus Christ, and I want my car keys.” I glanced at the clock. His father was due home any time now.

Will’s lips smiled, but his eyes still glittered with that dark madness. “He’s not going to save you,” he said, as though he had read my mind. The phone rang. Will answered. “Yeah, Dad. She’s right here,” he said, handing me the phone, still smiling that frightening smile. Whatever I had seen in Will’s eyes, his father heard in his voice. “Can you talk?” he asked me. “No.”

“Something is wrong?”

“Yes.”

“Get out of the house,” Will’s father told me. “Get out NOW.” Clearly the time for watching and waiting was over. His father dialed 9-1-1.

That night, the angels made their first appearance as Kershaw and his mobile crisis unit came to commit Will for 72 hours of psychiatric observation under Florida’s Baker Act — the first of nearly a dozen hospitalizations over the next 30 months. It wasn’t a tough call. Will was in “florid psychosis” and claimed alternately to be God, Jesus and Jesus’ son.

Then there were the angels, who would, in time, become Will’s constant companions. Kershaw was among the few professionals we encountered over three years who took serious note when we told him of the GHB link.

“Will’s case prompted me to educate myself on this,” he said. “If I have someone who’s got psychotic symptoms, and they’ve got a history of being a fairly well-functioning athlete with no history of mental illness, one of the first things I think of now is GHB.”

Spontaneous Combustion

GHB was the last thing David Johnson thought of as he searched the Internet for information about “Enliven,” a supplement his 28-year-old son, Tyler, purchased at a health food store near his home in Beebe, Ark.

Tyler, who had graduated weeks before from the University of Arkansas, became restless and “fidgety” on the night of July 15, 2000. His pulse raced, and he began to say things that didn’t make sense, Johnson said. Unknown to Johnson, the young bodybuilder had been taking Enliven for about a year. Now, engaged to be married and about to begin law school, Tyler had decided to stop taking it. That night, he showed his father a bottle of the supplement, labeled as a “100% Pure Cellular Recovery System” that “Renews the Body Naturally.”

What it didn’t say was the active ingredient — 1,4 butanediol, better known as BD — is a solvent that converts into GHB once ingested.

GETTING OFF ‘G’

Withdrawal from GHB is among the most prolonged and severe of any drug and should not be undertaken without medical supervision.

Cardiovascular distress is significant, posing the risk of stroke or heart attack. Spikes in blood pressure from repeated bouts of withdrawal can result in arterial damage and an enlarged heart. Withdrawal grows more severe with each subsequent attempt, “kindling” the nervous system to the point of inducing delirium or seizures.

Patients treated before they reach this stage stand a better chance of successful recovery. Detox begun in early stages of withdrawal, with onset of restlessness and anxiety, works best. Detox generally takes at least two weeks, often requiring heavy doses of sedatives, accompanied by monitoring of blood oxygen levels. David Johnson didn’t know it, but Tyler was in GHB withdrawal.

“I wanted to take him to the hospital, but he told me he was all right and he went to bed,” Johnson said.

The next morning, shortly after dawn, a neighbor discovered Tyler’s body on the Johnsons’ front lawn. He had shot himself in the head. Suicide is an all-too-common outcome in cases of GHB addiction, though the true numbers will never be known. Porrata has seen it over and over.

“It’s like spontaneous combustion, not like they pondered it. They just shoot themselves in the head,” she said.
Detox from GHB can take at least two weeks.

“I think one of the most dangerous periods is after detox, where they are suffering depression, anxiety, and it becomes this protracted withdrawal state,” Miotto said. GHB anxiety is malignant — the frightening dreams at night, the terror during the day as the central nervous system tries to deal with the legacy of a little-understood chemical assault on the brain, Stalcup said. “If I had to go through what I see people going through, I don’t know if I could do it,” he said.

Perhaps the harshest irony, Porrata said, is the people who become addicted to GHB in the pursuit of health and fitness and end up turning to street drugs to counter the effects of withdrawal. Black-market Xanax, Valium and similar drugs tend to be the ones of choice. Alcohol, cocaine, Ecstasy and even crystal methamphetamine aren’t far behind.

Of Dreams And Nightmares

In the weeks and months that followed Will’s first Baker Act, life took on a rhythm of sorts — but not the sort we envisioned.

By day, Will continued to run, lift weights, wrestle and pursue his athletic dreams. By night, he battled the demons that invaded his sleep. The boy who once was a designated driver for friends retreated to his room, alone, to drown the delusions in rum and vodka.His circle of friends shifted from students and athletes to dropouts and drug dealers who could ensure a steady supply of sedatives and anything else that might quiet the voices and visions.

I purchased a dreamcatcher and hung it beside his bed, hoping the mystical Indian legend would offer some comfort.

But nothing could banish the nightmarish images that appeared when he closed his eyes. “You can’t imagine what is happening in the world,” he told me. “Yes, I can.” I had to look no further than the gaping hole in his soul.

Laced with antipsychotics prescribed by his doctors, supplemented by a pharmacopia of his own invention, Will struggled to hold down a job and tried, unsuccessfully, to complete his junior year.

He teetered for months on the brink of madness, alternately stabilizing, then disintegrating into a series of forced hospital stays. We didn’t know whether he continued to use GHB or whether the drug had permanently rewired his brain.

“With Will, when I saw him again and again, I wasn’t sure if the GHB had triggered more of a chronic process with him,” Kershaw said. Each time Will was committed, we asked the nurses and doctors to flag his chart to reflect his GHB use — a request that often was received with blank stares and dismissive waves. Will continued to slip from our grasp, trapped in a world inhabited by demons and angels, a world defined by the absence of light or joy.

We wondered how long he could survive in such a dark and hopeless place. It didn’t help that he had come to believe he possessed the gift of prophesy and claimed to have seen his own death many times. He wouldn’t tell us when this was to occur. All he would say was that it involved fire.

Drowning In Cases

In the beginning, the addicts who flocked to Project GHB for help tended to be young men in their late teens and early 20s. Today, Porrata is seeing older men who have been using for five to 10 years. Most are 30 to 55 years old.
“It’s not the party kids,” she said. “It’s the man in midlife crisis who starts going to the gym and wants to lose a few pounds, look a little better, rekindle things — and someone introduces him to ‘G.’”

But still it is the athletes who concern her the most. “Any place you see steroids, GHB is right in the shadows,” she said. “The sports world won’t admit this drug. It’s like their secret drug, and they won’t give it up.”

Unlike steroids, there is no evidence GHB enhances physique or performance. Still, users subscribe to the myth.

“What makes GHB so attractive to athletes is it’s very difficult to detect. They pass all the routine urine drug screens that you do,” said Tampa addiction specialist David Myers.

One of Myers’ patients — a Major League Baseball player — sipped GHB from a small mouthwash bottle during his games. He told Myers and his team managers that GHB use was widespread in pro sports, including among his teammates.

“He relapsed,” Myers said. “There was no support from team management, and it was clear they were not interested in tackling GHB issues.”

There is some speculation that stepped-up enforcement has limited the drug’s availability. But despite a major Drug Enforcement Administration sting that netted 115 Internet distributors in 84 North American cities in 2002, followed by a $7 million bust this year in Scotland, there is plenty of GHB to go around. With Project GHB and other Internet sources supplying information that wasn’t available to addicts six years ago, many users are taking matters into their own hands, Porrata said. “They’ll die from other drugs,” she said. “And we’ve had so many suicides — so many.”

The Three Demons

Will’s final Baker Act took place Jan. 18, 2002. His slide into psychosis began as it always did: He stopped eating.

This time he said he planned to fast until Easter. When he entered Memorial Hospital’s psychiatric unit that day, he had been fasting for two weeks and had lost nearly 30 pounds. A public defender assigned to Will’s case blocked every effort to give him intravenous fluids and nutrients. If he wanted to starve himself, it wasn’t our business, or his doctor’s, she said. By February, Will was still fasting and began walking into walls. He fell and hit his head.

Then something remarkable happened: After three years of inexplicable madness, someone finally decided to take a look at Will’s brain. A nurse requested a CT scan. It was then that we finally met his demons. There were three of them: inoperable brain lesions whose nature and origin doctor’s couldn’t even guess at. Will was transferred to the medical floor, and for the first time in nearly two months, he received IV fluids and nutrients. Too late.

The neurological collapse began with involuntary flickering of his eyelids, which grew more pronounced each day. His hearing began to fail. He started to lose the use of the right side of his body. Still he would not eat. “Don’t worry,” he said. “I’ll be fine.” “All you have to do is start eating, and they’ll let you out of here,” I pleaded. “Isn’t there someplace you’d rather be?” “Heaven,” he said. On Easter, Will broke his fast with a Cadbury egg. He was transferred to a physical therapy unit, then sent home.

The brain scan was sent to Johns Hopkins University in an attempt to identify the lesions. The young wrestler, once the fastest boy in Hillsborough County, could not get from the bedroom to the bathroom without a walker. His balance was gone, his hearing severely impaired. And his flickering eyes couldn’t focus on a television screen, much less a Bible.
But he could kneel, and he could pray. And that is what Will did each day. “Everything will be fine,” he kept saying. “I’ve seen the future, and I’ll be wrestling.”

One of the saddest things about GHB, Miotto said, is the way the drug affects the mind. “They don’t grasp the level of their impairment,” she said. But the saddest thing about Will’s experience was his ability to grasp just that.

Despite his irretrievably broken mind, he knew what he had lost. He knew it all along. Will had always felt a particular affinity for the homeless. In the years he struggled with GHB psychosis, he actively sought them out to give them money as they picked through garbage bins. “That could be me someday,” he said. Despite his intermittent delusions of grandeur, his goals were humble. “What do you want from life?” I asked him shortly before that last Baker Act.

“I just want to be able to take care of myself,” he said. “To drive a car. To have a place of my own.”
Weeks after Will’s release from the hospital, his doctor evaluated him. He checked his eyes, his ears, his balance. This, he told him, was as good as it was going to get. As for the three still-unidentified brain lesions — things could get worse, he added.

Four days later, on June 3, 2002, my son took a gas can from the garage to the back yard. He doused himself and lit a match. A young man approached me after the memorial service. He said his name was Brandon and that Will had persuaded him to seek treatment for cocaine addiction.

“I’m two years clean and sober now,” he said. “Will saved my life, and I just wanted you to know.”

Source: Researcher Mike Messano contributed to this project. Reporter Jan Hollingsworth can be reached at (813) 865-4436 or jhollingsworth@tampatrib.com.

PRODUCT NAMES

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Remforce
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Enliven
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Flower Power
Dream On
Weight Belt Cleaner

By JAN HOLLINGSWORTH The Tampa Tribune
Published: Nov. 12, 2006

Source: Project GHB

A DECISION by the Dutch government to decriminalise the smuggling of hard drugs could leave Britain vulnerable to a flood of cheap cocaine.

Customs officers are allowing traffickers caught at Schiphol airport, Amsterdam, with less than 3kg of cocaine to go free. The only penalty they face is the confiscation of their drugs.
In the first phase of a policy that could soon be extended to other hard drugs, the liberal measures are being applied to 35 so-called “cocaine flights” a week from the Caribbean.
Last year police caught 2,176 smugglers from the region and seized six tons of the drug. But from now on, traffickers no longer have to worry about hefty prison terms or even arrest.
The policy may prove even more controversial than Holland’s infamous “coffee shops”, where soft drugs such as cannabis have been sold openly for decades.

The Dutch authorities claim the measure will allow them to divert money spent prosecuting offenders into drug seizures. However, critics in neighbouring countries, including Britain, fear it will lead to a boom in the number of people ready to act as “mules” for drug cartels.
The National Drug Prevention Alliance in Britain has warned that the policy amounts to a capitulation by the police with consequences that could spin out of control.

“This won’t just hit the UK badly. It will affect the whole of Europe,” said David Raynes, a former chief narcotics investigator for Customs and Excise. “Holland is the drugs warehouse of Europe and by not controlling its problem it’s creating an infection that will spread to all the countries around.”

In Germany the street value of cocaine has already fallen from €150 (£102) a gram to just €50 (£34), raising the prospect of a sharp rise in the number of addicts. The Dutch government has ignored a plea from Otto Schily, the German interior minister, to toughen rather than weaken its deterrent.

However, Ivo Hommes, a spokesman for the Dutch justice ministry, said the initiative could save millions spent on prosecuting and jailing offenders, allowing more funds to go into the detection and confiscation of drugs. “Locking up thousands of smugglers doesn’t solve the problem. There will always be more of them,” he said. “We’ve been honest enough to admit that we only manage to stop 15% of the drugs coming in, so we are trying something new.”
A leaked ministry memorandum, however, has suggested that the policy was adopted because the prosecution service was overburdened. It emphasised that drug-related arrests should not be permitted to “block the justice system”.

Britain’s National Criminal Intelligence Service is said to be eyeing the policy “warily”.
Source: Sunday Times 1.02.04

Filed under: Europe :

By Mary Brett, BSc.

Today’s cannabis is much stronger
In 1971 drugs were classified in the UK,and cannabis was placed into the B category. Since then it has changed out of all recognition. The THC (tetrahydrocannabinol, the psychoactive ingredient) content at that time was under 1%. This rose in 2002 to more than 7%. Specially cultivated varieties like skunk and nederweed can have THC contents of more than 30%.

Even more alarming is the fact that the class A cannabis oils with up to 60% THC are now also downgraded to class C. Although rare in Britain, these powerful mind bending drugs should stay where they were, in their proper place, alongside cocaine and heroin.

Persistence in the cells
THC is rapidly absorbed into the blood and then sequestered into fatty tissue in the body, especially the cell membranes of the brain. Release of THC back into the blood is very slow. Fifty per cent will still be there after a week and 10% a month later. The prolonged presence of the drug in our brain cells, results in the disruption and impairment of the chemical communication system, the neurotransmitters between the cells, for some considerable time.

Dependence and addiction
Because THC mimics and so replaces one of the neurotransmitters, anandamide, it has its own receptor sites. These occur in many different areas of the brain so many systems are affected. These include concentration, memory, learning, motor skills, judgment, reasoning, planning, logical thoughts, reward, pain, sound and colour perception. Tolerance and physical addiction occur and withdrawal symptoms are common when use of the drug ceases, though not so severe as the “cold turkey” of heroin withdrawal due to its persistence in the body.7 The earlier the child starts to use cannabis, the greater the escalation of use. In September 2002, out of 6 million drug addicts in the USA, two thirds were cannabis dependent. More were being treated for cannabis than for alcohol addiction. Psychological addiction has been recognized for many years and is very difficult to treat.

Driving and flying hazards
Psycho-motor skills are affected so cannabis intoxication is a driving hazard In some American studies, cannabis has been implicated as many times as alcohol in accidents, although 10 times as many people drink. In Norway, 56% of drug-impaired drivers who tested negative for alcohol tested positive for THC.12 It has been estimated that in 2001, out of 4 million high school seniors in the US, approximately one sixth admitted to driving under the influence of cannabis. Of these, 38,000 reported crashing as a result. Alcohol was blamed for 46,000 accidents. Airline pilots on flight simulators could not land their planes properly even 24 hours after a joint and had no idea they had a problem. Someone having a joint today should not be driving tomorrow.

Psychiatric risks/schizophrenia/psychosis
Mental illness and cannabis have been linked for a long time15 but 3 papers in the BMJ in November 2002 brought the subject sharply into focus.16 Studies from New Zealand, Australia and Sweden found strong links with a variety of mental disorders including schizophrenia, psychosis, depression and anxiety. A separate Dutch study noted that 50% of psychiatric cases were due to cannabis. Professor Robin Murray of The Institute of Psychiatry has been widely quoted recently in the press, saying that cannabis is the “number one problem facing mental health services in inner cities”. A colleague, Dr Paddy Powers said that cannabis is a factor in 70 to 80% of all psychosis cases. Over 2000 cases of cannabis psychosis in a 2-year period caused an experiment in decriminalization in Alaska to be terminated by public referendum in 1991.

THC increases the amount of the neurotransmitter dopamine released in the brain. The psychiatric symptoms of schizophrenia are mediated by dopamine. This may prove to be the link. A Swedish scientist, Jan Ramstrom, said in 1989, “Cannabis is one of the most psychopathogenic narcotic preparations. It is worth mentioning that the opiates (heroin etc), apart from the development of dependence itself, produce far fewer toxically precipitated psychiatric complications than do cannabis preparations”

Violence
One of the cries of the liberalisers of this drug is, “Better for kids to sit around stoned and peaceful rather than be drunk and violent”. Not so! A New Zealand paper in 2002 showed young male users to be 5 times more likely to be violent than their non-using peers.

Overdosing?
Maybe you can’t overdose on cannabis; tobacco smokers don’t overdose either; in US records for 1999, of 664 marijuana related deaths, 187 of them involved only marijuana. Mentions of marijuana use in emergency room visits has risen in the United States by 176% since 1994, surpassing those of heroin. 110,000 such visits were recorded in 2001.

Personality changes
Even on one joint a month, a “cannabis personality” develops within a year or so. Users become inflexible, can’t plan their days properly, can’t take criticism or criticise themselves. At the same time they feel lonely and misunderstood. Trying to talk sense to them becomes a futile exercise.26 They are more likely to drop out of school, steal, become violent, run away from home or contemplate suicide.27 Adolescents with their immature brains are particularly vulnerable to mind-altering drugs. Personal and emotional development can be severely compromised.28

Cognitive impairment/school performance
Teachers will tell you that school performance begins to decline with those using cannabis. An American paper showed that youths with an average grade D or below, were more than 4 times as likely to have used cannabis in the past year as those with an average grade A. Australian researcher, Dr Nadia Solowij, said, “Use more often than twice a week for even a short period of time, or use for 5 years or more at a level of even once a month, may each lead to a compromised ability to function to their full mental capacity, and could possibly result in lasting impairments”.

A study of municipal workers found those using cannabis on or off the job reported more “withdrawal behaviours”, leaving work without permission, daydreaming, shirking tasks and spending work time on personal matters. All practices that adversely affect productivity and morale, not only for the users but also their colleagues.

Lung disease – emphysema/ bronchitis/cancer
Cannabis smoke contains between 50 and 70% more of the carcinogens found in unfiltered tobacco smoke.32 The amount of tar and levels of carbon monoxide absorbed are 3 to 5 times more than for the same amount of tobacco.33 Pre-cancerous changes have been seen in the airways of 20 to 30 year olds,34 and rare head and neck cancers, formerly only seen in older tobacco smokers are now being seen in young cannabis users. A case of emphysema showing a pair of lungs shot through with holes from cannabis use is yet another item in this sorry saga.

Effects on the reproductive system and children
Cannabis can suppress ovulation in women and if they smoke when pregnant, the baby will be lighter and have a smaller head circumference. A long running study of children in Canada by Peter Fried has discovered deficits in their cognitive functioning at 9. One form of leukaemia is 10 times more common in these offspring.

A reduction in sperm count and the presence of abnormal sperm has been documented for years. Some men complain of impotence. Cannabis smoking in the previous hour has been associated with a fivefold increased risk of heart attack in middle-aged people.

The gateway effect
Australian researchers found that weekly users were 60 times more likely to move on to other drugs, the strongest association being in 14 to 15 year olds. A possible genetic link was dismissed by a study of 300 pairs of same-sex twins in New Zealand. Use of cannabis by one of them before the age of 17 meant that he or she was 2 to 5 times more likely to have drug problems and dependency later in life, than their sibling. Professor Denise Kandel and her team in the USA have researched this topic for the past 20 years or so. They have consistently found that level of usage is a major factor.

Medical Use
Pure synthetic THC, Nabilone, is already available in the UK for the nausea of chemotherapy and the stimulation of the appetite in AIDS patients.51 No-one should have a problem with extracts of cannabis being purified and tested, as they are now in Britain, if, according to the EU rules for medicines they prove to be efficacious, but cannabis, per se, with its 400 chemicals would never pass the tests. Nabilone anyway is by no means the first choice of doctors because of its side effects.54 The warning on it reads, “THC encourages both physical and psychological dependence and is highly abusable. It causes mood changes, loss of memory, psychosis, impairment of coordination and perception, and complicates pregnancy”.

Keith Stroup, an American pot-using lawyer said in 1979, “We will use the medical marijuana argument as a red herring to give pot a good name”.

In conclusion
For a UK government which banned beef-on-the-bone with its infinitesimal risk of transmitting CJD, it is astonishing that they should relax the law on a drug which has been proved to be so damaging.

*************************

This digest is an extract of a much longer paper prepared by Mary Brett, BSc., Head of Personal, Social and Health Education at Dr Challoner’s Grammar School in Amersham, Buckinghamshire, England, and a former Executive Councillor of the National Drug Prevention Alliance. The full paper runs to 9 pages, including 54 technical references. The full paper may be requested from Mrs Brett by emailing her on mary.brett@dsl.pipex.com

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For further extensive references and research digests on cannabis and other drugs, access the NDPA website on www.drugprevent.org.uk – and see also its links to several other sites in a range of countries.

Individual health risks
The assessment of individual health risks includes consideration of mephedrone’s acute and chronic toxicity, its dependence potential, and similarities and differences to other reference stimulants.

Systematic data are not routinely collected in Europe on acute toxicity related to mephedrone or closely comparable recreational drugs. Therefore, information on these effects of mephedrone is limited to user reports and clinical data on individuals presenting with acute problems. The reported short-term effects of mephedrone use have much in common with those of other stimulants. Some self-reports from users favourably compare mephedrone’s effects, saying the high can be both better and longer lasting than cocaine.

The main routes of administration for mephedrone are reported as snorting (nasal
insufflation) and swallowing (oral ingestion), sometimes after dissolving with water. As mephedrone is primarily available in powder form, injecting use is reported but appears to be rare.

Adverse effects reported by users include sweating, headaches, tachycardia, palpitations, nausea, chest pain, bruxism (teeth grinding), agitation/aggression and paranoia. In addition, nasal insufflation of mephedrone is reported to be associated with significant nasal irritation and pain which has led to some users switching to oral use of mephedrone. Users report increased sexual arousal but there is insufficient information to detect whether this is associated with highrisk sexual behaviour.
Some detailed information on the patterns of acute mephedrone toxicity is available from clinical case series from poisons information services and specialist hospitals in the United Kingdom and Sweden, including one series of analytically confirmed acute mephedrone toxicity from the United Kingdom. In this data, patients typically present with sympathomimetic features (dilated pupils, agitation, tachycardia, hypertension); severe clinical features such as chest pain, significant hypertension, arrhythmias and seizures have been reported in a small number of cases to date. Similar to other stimulant drugs, it is likely that the risk of toxicity is related to the dose of mephedrone used; however there is insufficient information available from toxicity
reports to determine a ‘dose threshold’ and/or whether particular routes of use are more likely to be associated with toxicity. It is possible that certain rare, but clinically significant, severe effects are associated with mephedrone use. However, as experience of the toxicological profile of the drug is currently limited to a few hundred cases it is difficult to be sure.

Data from individuals presenting with acute mephedrone toxicity suggest that the majority of individuals have used at least one other substance together with mephedrone. However there are analytically confirmed cases of lone mephedrone toxicity. This is similar to individuals presenting with acute toxicity related to other stimulant drugs. There are two reported fatalities in which mephedrone appears to be the sole cause of death (one in Sweden and one in the United Kingdom). In addition to these cases, there are at least another 37 deaths in the United Kingdom and Ireland in which mephedrone has been detected in post-mortem blood and/or urine toxicology screening. In some of these cases it is likely that other drugs and/or other medical conditions or trauma may have contributed to or been responsible for death. The inquests into the deaths are pending for the majority of these cases
therefore it is not possible at this time to determine the contribution of mephedrone.

Strong craving for the substance is reported by some users’ self-reports, sometimes rated higher than that experienced with other stimulant drugs. This is cited as a main reason for using more mephedrone than intended, and for using for longer periods than planned. Withdrawal symptoms do not appear to be significant for most users with the primary symptoms of nasal congestion and fatigue most probably related to route of use and lack of sleep secondary to staying up late. However the other reported findings, in heavier users, would be consistent with a stimulant withdrawal syndrome. There is some evidence that the drug has a high abuse liability with over 30 % of the UK telephone survey sample reporting three or more DSM criteria
of dependence and being classified as dependent. Tolerance, loss of control, a strong urge to use and using despite problems predominate. In addition, there are reports from the United Kingdom of mephedrone dependence being reported to drug treatment services that suggest psychological rather than physical dependency similar to other stimulant drugs.
No studies have been published investigating the potential for chronic mephedrone toxicity associated with mephedrone use, including reproductive toxicity, genotoxicity and carcinogenic potential. Reports suggest mephedrone may be used as an alternative to illicit stimulants. The reasons given for using mephedrone include: value for money, product purity and consistency as well as the poor availability or low quality of other stimulants (cocaine, ecstasy/MDMA). Some users
noted a preference for mephedrone over other stimulant drugs with data from the UK clubbers rating mephedrone above ecstasy and cocaine for strength and pleasurable high. Mephedrone users in the UK telephone survey reported on the considerable impact mephedrone had on their consumption of cocaine and ecstasy, with approximately two thirds of the sample reporting that they now took less MDMA, and a third reporting that they now consumed less cocaine. Just under half of the group reported they would choose mephedrone over cocaine and only a quarter said that they would take mephedrone over ecstasy
.
The physical effects reported by mephedrone users are typical of other stimulants and may be particularly similar to MDMA. However, mephedrone’s relatively short duration of action, leading to repeat dosing, is more analogous to cocaine.
In summary, from the data sources available, it appears that the effect profile and clinical presentations of mephedrone intoxications share some features seen with MDMA and some features seen with cocaine. Additionally, there are very limited reports of fatalities directly related to mephedrone. Some users have reported negative effects and in some cases these have required medical attention. Similar to other stimulant drugs, the extent to which users experience problems requires further investigation. Data also suggest that mephedrone has a potential to cause dependency. However, more in-depth studies would be required to explore in
detail the dependence potential of this drug.

Source: excerpt from DEA report 2010

A promising new cognitive therapy, or brain training, approach to drug addiction was published in the recent issue of Biological Psychiatry.
Drug addiction is considered a brain disease, according to the National Institute on Drug Abuse, because the abuse of drugs leads to changes in the structure and function of the brain. Drug prevention, education, and awareness programs seem to be quite effective for some individuals because they realize the long term repercussions of abusing substances. For those that are vulnerable to addictions, these measures often fall short. One theory for this may be the “delayed discounting” sometimes present in those who are vulnerable to addictions.
Addicts tend to exhibit a trait called “delay discounting”, or the tendency to devalue rewards and punishments that occur in the future. Addicts may at the same time have a predisposition towards “reward myopia” which is the tendency towards the immediate gratification that drugs can provide with addictions.
Dr. Warren Bickel, from the Center for Addiction Research in Little Rock, Arkansas, and his colleagues borrowed a rehabilitation approach used successfully with patients suffering from stroke, or traumatic brain injury.
The therapy approach utilized working memory training. Subjects addicted to stimulants were given brain exercises that focused on strengthening the areas of the brain associated with storing and managing information reasoning to guide behavior. Dr. Bickel’s team had stimulant abusers repeatedly perform a working memory task and found that by strengthening the brain circuitry, they also reduced the addicts devaluation of longer term rewards.
Dr. John Krystal, Editor of Biological Psychiatry comments on the article:
“The legal punishments and medical damages associated with the consumption of drugs of abuse may be meaningless to the addict in the moment when they have to choose whether or not to take their drug. Their mind is filled with the imagination of the pleasure to follow. We now see evidence that this myopic view of immediate pleasures and delayed punishments is not a fixed feature of addiction. Perhaps cognitive training is one tool that clinicians may employ to end the hijacking of imagination by drugs of abuse.”
“Dr. Bickel says, “Although this research will need to be replicated and extended, we hope that it will provide a new target for treatment and a new method to intervene on the problem of addiction.”
Source Published in Biological Psychiatry reported in e-max health.com 27th Jan 2011

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