2024 September

by Lauraine Langreo, Writer,  Education Week

August 28, 2024

 

There have been “promising” declines in high school students’ overall use of illicit substances, concludes a report from the federal Centers for Disease Control and Prevention.

Since 2013, the percentage of students who reported drinking alcohol, using marijuana, or using select illicit drugs at any point has decreased. Since 2017 and 2019, respectively, the percentage of students who had ever misused or currently are misusing prescription opioids decreased, according to the CDC’s Youth Risk Behavior Survey.

That survey draws on data collected every two years among a nationally representative sample of U.S. high school students. The 2023 survey had more than 20,000 respondents and was conducted in the spring.

Still, many students continue to use substances and the lack of progress in some areas is concerning, according to the report.

The findings come as schools continue to face challenges in curbing students’ substance abuse, which could negatively affect learning, memory, and attention, according to experts. It could also be a sign of mental health challenges.

                                                                                                                   

 

While student substance abuse isn’t a new challenge for school districts, the substances that adolescents are experimenting with now are much more dangerous, said Darrell Sampson, the executive director of student services for the Arlington public schools in Virginia.

“It’s not necessarily that more kids are using substances than in prior years,” Sampson said. “It’s the lethality of the substance itself that has caused higher levels of concern.”

 

Research has shown rising overdose deaths among teens even as their substance use is declining. Those deaths have been linked to the increase in illicit fentanyl and other synthetic opioids. School districts have been pursuing several strands of legal action against companies that manufactured and marketed addictive opioids that have led to tens of thousands of deaths and countless more addiction struggles in the last two decades.

Beyond the legal actions, schools also continue to provide prevention and education programming for students and families, Sampson said. There’s “a glimmer of hope” that those measures are working, he said, based on the declines in the CDC data.

Experts recommend starting education about substance abuse as early as possible

In the Arlington, Va., district, students in grades 6 through 10 learn about substance abuse challenges as part of the health curriculum, Sampson said. The district has also slowly expanded that program to 5th and 4th grades and are looking into whether there’s capacity to start that education as early as 3rd grade.

“We know that the more we can at least open that conversation with our families and our students, the better off our students are going to be,” Sampson said. “It’s not just a message [they’re hearing] starting in middle school, but it’s a message [they’re hearing] over time.”

The district is expanding programming with 11th and 12th graders, too, because the information they got when they were in 10th grade could be outdated by then, Sampson said.

In addition, the district has substance abuse counselors who meet with students and try to explore the reasons they might be using substances, Sampson said.

Experts say it’s also important to think about how to incorporate student voice in any prevention or intervention programming.

Teens are more than twice as likely to go to their friends or peers for help or support when experiencing distress from their substance use than they are to go to a behavioral health provider or a family member, according to a survey from the Bipartisan Policy Center conducted in June among 932 teens (13- to 17-year-olds) and 1,062 young adults (18- to 26-year-olds). More than a quarter of teens said they didn’t go to anyone for help or support when they experienced distress from substance use.

Sophie Szew, a junior at Stanford University and the Bipartisan Policy Center’s mental health and substance use task force youth adviser, said those survey results “really underscore the importance of investing in those peer support networks and resources.”

DATA SOURCE: Bipartisan Policy Center

Source: https://www.edweek.org/leadership/teen-substance-use-is-declining-but-more-dangerous-drug-abuse-is-emerging/2024/08

Filed under: Drug use-various effects,Prevalence,USA,Youth :

by Perkins and Ranalli, ETR. Aug 28, 2024

ABOUT THE EXPERTS

Laura Perkins, MLS (she/her/hers) is a Product Editor at ETR and has over 20 years of experience in editorial content and health literacy.

Lauren Ranalli, MPH (she/her/hers) is the Director of Communications and Public Affairs at ETR and has over 20 years of experience in public health and adolescent health services.

Source: https://www.physiciansweekly.com/addressing-prescription-drug-misuse-among-adolescents/

Filed under: Drug use-various effects,Prescription Drugs,Prevention and Intervention,USA,Youth :

Photo: © Francis Odeyemi

Torrential rains last week caused a dam to collapse and flood north-east Nigeria, affecting more than four million people in 14 countries. Over 550,000 hectares of cropland were flooded, compounding an existing food security crisis.

“I have never in my life experienced a disaster as terrible as this,” writes Yakura*, a UN Office on Drugs and Crime (UNODC) Youth Peace Champion.  Youth Peace Champions are a network of young leaders dedicated to promoting prevention, rehabilitation and reintegration for children affected by adversity.

Yakura is one of tens of thousands of young people taking action in their communities, organizing rescue efforts and distributing essential food and water supplies.

“So many souls lost, so many properties destroyed. But one thing we still have is our resilience. Our resilience shines through even in the face of adversity,” she continues.

But where do resilience and adaptability come from? How can we unlock brain science to leverage the powers of youth creativity and cooperation and overcome the multiple crises faced by Yakura’s community and millions of other young people?

The European Brain Council and partner organizations, including UNICEF and UNODC, are joining forces to explore the ways in which brain health and brain science can reshape and improve policy and practice to support the advancement of humanity and the planet. The two entities are co-sponsoring a two-day summit, held from 19 to 20 September at the 79th UN General Assembly, on adolescent brain development and systemic policy change.

A series of UNODC-UNICEF papers being launched at the summit combine neuroscience and mental health research with data; exploration of community-driven innovations; and voices of youth such as Yakura’s from the frontline of climate change, violence and inequality. The papers highlight the potential that scientific understanding of the adolescent brain has for advancing policy change and protecting and uplifting vulnerable children and adolescents.

As Dr. Joanna Lai, Health Specialist at UNICEF explains: “Adolescents are full of potential but at the same time uniquely vulnerable, especially when faced with adverse experiences. To uplift them, we are advocating for policy and practice change across sectors that is based on a deep understanding of their development, ensuring timely, empathetic, and empowering intervention.”

Support in adversity

As noted by Alexandra Martins, Global Team Leader, END Violence Against Children at UNODC and co-panelist at the joint session, such research is needed now more than ever: “Hundreds of millions of children and adolescents are not able to grow up in an environment that supports healthy development and protection1. Every seven minutes, an adolescent dies as a result of violence. 15 to 19 year-olds are three times more likely to die violently than 10 to 14-year-olds. 15 million girls are victims of rape in their lifetime. At least 130 million adolescents, between the ages of 13 and 15, endure bullying in school. And we are not even accounting for the trauma being endured by young people affected by climate change and forced displacement.”

Chronic stress and violence can profoundly affect the development of the human brain, particularly during early childhood and teenage years. It may disrupt the developmental stages of neural networks; cause physical health degradation and brain aging; and modify learning and social connectedness. In the context of criminal justice and community safety, we know that children and adolescents who offend are disproportionately more likely to have experienced victimization and trauma.

But the adolescent brain, UNODC and UNICEF contend, is not only vulnerable to adversity and violence; it is also resilient, creative and flexible.

Adaptive and resilient – with the right support

As the UNODC-UNICEF papers highlight, adolescents’ brains are adaptive and young people are resilient problem-solvers when provided with the proper social support.Adolescents – be they survivors of adversity, violence or crime – can be co-authors and creative agents of policy change and innovation.

It is not only important to build awareness of the way in which adversity, violence and trauma negatively alter adolescent brain development but also to understand that the brain – especially the adolescent brain – is neither a static organ nor a fixed story. Science tells us that the adolescent brain has a unique and adaptive ability to rewire itself on the basis of its environment. A young person’s brain is particularly well-designed to rapidly forge new circuitry and behavioral pathways for resilience if health, education and justice systems provide the appropriate support.

Mohammed*, another Nigerian UNODC Youth Peace Champion, recently took part in an innovative peacebuilding training programme that combined neuroeducation with capacity building on the relationship between brain development, chronic stress, adversity and violence. “I was limited and could not see outside the box, but now I’m more open-minded and see things in better proportion,” he says. “I can now understand their [children’s] challenges and come up with a solution for them to be resilient and overcome their challenges and low self-esteem”.

“My rehabilitation and reintegration skills have been improved,” he continues. “I’m confident that within the context of insecurity, I can play a significant role in engaging with victims.”

 

Source: https://www.unodc.org/unodc/frontpage/2024/September/unlocking-the-science-of-adolescence-to-promote-effective-policy-and-practice.html

Filed under: Brain and Behaviour,Health,Mental Health,Others (International News),Youth :

Oct 29, 2014

The last week of October is Red Ribbon Week, celebrating a drug-free life (redribbon.org). It’s also the culmination of National Substance Abuse Prevention Month.

So why is substance abuse prevention important? According to the Office of National Drug Control Policy (ONDCP) Acting Director Michael Botticelli, “Preventing drug use before it begins – particularly among young people – is the most cost-effective way to reduce drug use and its consequences.” This matters to us as members of our community and our society.

But as parents, friends, family members – human beings – it’s not all about the money. Botticelli recognizes the cost of drug abuse is far-reaching beyond just our wallets. He goes on to say, “The best approach to reducing the tremendous toll substance abuse exacts from individuals, families and communities is to prevent the damage before it occurs.”

Parents want to help their kids avoid this “tremendous toll,” which could involve their health (physical or mental), family, other relationships, schooling, employment – the list goes on. Parents, however, often find themselves learning about a new drug trend and feel it’s just “one more thing to worry about.” One example would be the current heroin epidemic, especially among people who may have become addicted to prescription pain killers.

The good news is that parents don’t have to resort to worrying. Research has shown repeatedly that parents are a key factor in preventing drug abuse. When parents have open two-way communication with their kids and seek to provide accurate information, many are surprised to discover how much influence they can actually have. And young people are less likely to abuse drugs when they know their parents care, and that they have specific rules or expectations regarding drug use.

Some websites with helpful information on heroin and other drugs, as well as tips for talking to kids, include: www.fda.gov; www.cdc.gov; www.drugfree.org; teenshealth.org/teen; www.drugfreeactionalliance.org/know; combatheroin.ny.gov; and www.drugabuse.gov.

Even when there has been substance abuse with resultant problems, it’s never too late to seek help. People recover from addiction every day and lead healthy, productive lives.

HFM Prevention Council, Johnstown

Source: https://www.dailygazette.com/leader_herald/opinion/letters/prevention-is-important/article_c5769b46-83c7-5907-a49b-bb4cf191f7aa.html?=/&subcategory=640%7CConcert

Filed under: Drug use-various effects,Prevalence,Prevention and Intervention,USA :

Abstract

Background

Youth in disadvantaged socio-economic circumstances in South Africa face significant risks to their physical and mental well-being due to exposure to harmful behaviours. More than 50% of the global disease burden is attributed to non-communicable diseases linked to such behaviours. While interventions have been initiated to address these risks, the limited reduction in risky behaviour necessitates closer examination and the exploration of more targeted or innovative approaches for effective mitigation.

Objectives

To explore existing health risk behaviour prevention/intervention programmes targeting youth, focusing on decreasing risky behaviour engagement and to discuss the success of the intervention used.

Methods

Three electronic databases were searched from 2009 until November 2023. Studies specifically reported using an intervention programme in youth or adolescents aged 9 to 19 were included. Data extracted included age, grade, sample size, targeted risky behaviour, and outcome.

Results

A total of 1072 articles were screened across three major databases, and of the nine included studies, n = 7 yielded mild to moderate intervention success results. The use of incentives yielded unsuccessful results. The most successful intervention strategy identified was school-based intervention programmes targeting multiple risky behaviours.

Conclusion

School interventions combining counselling, electronic screening, and personalized feedback effectively modified behaviour, while incentive-based programs had minimal impact. This underscores the importance of targeted interventions to discourage risky behaviour among young people.

Clinical implications

Effective intervention and prevention programs targeting health risk behaviours in youth are essential in safeguarding their mental and physical well-being. A clear link between risky behaviour engagement and the potential development of non-communicable diseases or trauma should be emphasised.
The full article can be accessed by clicking on the Source link below:
Source: https://www.springermedizin.de/health-risk-behaviour-prevention-intervention-programmes-targete/27472880
Filed under: Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth,Mental Health,Others (International News),Prevention and Intervention,Youth :

By Sandee LaMotte, CNN  / Sat August 10, 2024

Using marijuana daily for years may raise the overall risk of head and neck cancers three- to five-fold, according to a new study that analyzed millions of medical records.

“Our research shows that people who use cannabis, particularly those with a cannabis use disorder, are significantly more likely to develop head and neck cancers compared to those who do not use cannabis,” said senior study author Dr. Niels Kokot, a professor of clinical otolaryngology-head and neck surgery at the Keck School of Medicine at the University of Southern California in Los Angeles.

Cannabis use disorder is diagnosed when a person has two or more of such symptoms as craving weed, becoming tolerant to its effects, using more than intended, using marijuana even though it causes problems in life, using it in high-risk situations, experiencing withdrawal and being unable to quit, according to the US Centers for Disease Control and Prevention.

“While our study did not differentiate between methods of cannabis consumption, cannabis is most commonly consumed by smoking,” Kokot said in an email. “The association we found likely pertains mainly to smoked cannabis.”

Some 69% of people with a diagnosis of oral or throat cancer will survive five years or longer after their diagnosis, according to the National Cancer Institute. If the cancer metastasizes, however, that rate drops to 14%. About 61% of people diagnosed with cancer of the larynx will be alive five years later — a rate that drops to 16% if the cancer spreads.

The study used insurance data to look at the association of cannabis use disorder with head and neck cancers, said Dr. Joseph Califano, the Iris and Matthew Strauss Chancellor’s Endowed Chair in Head and Neck Surgery at the University of California, San Diego. He was not involved in the study.

“The researchers used a huge, huge dataset, which is really extraordinary, and there is enormous power in looking at numbers this large when we typically only see small studies,” said Califano, who is also the director of UC San Diego’s Hanna and Mark Gleiberman Head and Neck Cancer Center.

“On average, people with cannabis use disorder smoke about a joint today and do so for at least a couple years, if not longer,” said Califano, who coauthored an editorial published Thursday in JAMA Otolaryngology–Head & Neck Surgery in conjunction with the new study.

However, he added, the study does not find an association between “the occasional recreational use of marijuana and head and neck cancer.”

Just like tobacco, smoking marijuana raise the risk of head and neck cancers, experts say.

Causes of head and neck cancers

In the United States, head and neck cancers make up 4% of all cancers, with more than 71,000 new cases and more than 16,000 deaths expected in 2024, according to the National Foundation for Cancer Research.

Tobacco use, which includes smoking cigarettes, cigars, pipes and smokeless tobacco, and the use of alcohol are the two most common causes of head and neck cancers, experts say. Other risk factors include poor oral hygiene;gastroesophageal reflux disease, or GERD; a weakened immune system; and a diet low in fruits and vegetables. Occupational risk factors include exposure to asbestos and wood dust.

A growing number of head and neck cancers are due to infection with the human papillomavirus or HPV, or the Epstein-Barr virus, or EBV, which are DNA viruses that affect genes, making them susceptible to malignancies.

Epstein-Barr virus is linked to infectious mononucleosis, also called the “kissing disease,” as well as various cancers. Researchers estimate that 90% of the world’s population is infected with EBV.  A vaccine is available for HPV, which is linked to a high risk of developing cervical cancer and some non-Hodgkin lymphomas.

It’s possible to be infected with both viruses at once, and that combination is responsible for 38% of all virus-associated cancers, according to research.

How might cannabis cause cancers?

The study, published Thursday in JAMA Otolaryngology–Head & Neck Surgery, analyzed a database of 4 million electronic health records and found more than 116,000 diagnoses of cannabis use disorder among people with head and neck cancers. Those men and women, whose average age was 46, were then matched with people who also had head and neck cancers but were not diagnosed with cannabis use disorder.

The analysis showed that people with cannabis use disorder were about 2.5 times more likely to develop an oral cancer; nearly five times more likely to develop oropharyngeal cancer, which is cancer of the soft palate, tonsils and back of the throat; and over eight times more likely to develop cancer of the larynx. The findings held true for all age groups, according to the study.

Smoke is one key reason for the association between smoking weed and head and neck cancers, experts say. Smoking tobacco doubles the risk of developing head and neck squamous cell carcinoma, which makes up 90% of all head and neck cancers.  Heavier tobacco use leads to even higher risk, and when alcohol is added, the risk is even greater.

Due to the way marijuana is smoked — unfiltered and breathed in deeply and held in the lungs and throat for a few seconds — the risk from cannabis smoke could be even greater, experts say.

Another key to the puzzle of how cannabis causes cancer: Research has found a link between various cannabinoids and tumor growth. There are more than 100 cannabinoids — biological compounds in the cannabis plant that bind to cannabinoid receptors in the human body, according to the National Center for Complementary and Integrative Health. All told, there are about 540 chemicals in each marijuana plant.

Tetrahydrocannabinol, or THC, is the substance that makes one euphoric, while cannabidiol, or CBD, has been shown to have medicinal uses for childhood seizures and epilepsy.

“Part of the research we have already published shows that THC or THC-like compounds can certainly accelerate tumor growth,” Califano said. “We also have some data to show that cannabinoids enhance the growth of HPV-related throat cancers.”

With the use of marijuana rising, there is concern that diagnoses of head and neck cancers could increase in coming years, Kokot said.

“Especially as (marijuana) becomes more widely legalized and socially accepted, we may see a corresponding rise in head and neck cancer cases if the association is confirmed,” he said.

“This underscores the importance to inform people about the potential risks and conduct further research to understand the long-term impacts of cannabis use on cancer development.”

Source:  https://edition.cnn.com/2024/08/08/health/marijuana-head-and-neck-cancer-wellness/index.html

 

Filed under: Cannabis/Marijuana,Drug use-various effects,Health,USA :

by Dan Krauth WABC logoabc Channel 7

Tuesday, August 13, 2024
Dan Krauth has the details on a new and potentially lethal narcotic that is creeping into the NYC area from Latin America.

NEW YORK (WABC) — There’s a new mystery drug that’s hitting the club scene in New York City and the ease of how it’s pouring into the area may surprise you.

It’s called pink cocaine.

While its bright color from food coloring stays the same, what’s inside can change from day to day and from dealer to dealer.

“You have no idea what you’re taking,” said NYC Special Narcotics Prosecutor Bridget Brennan. “I’ve never seen the drug supply as lethal as the one we’re in today.”

In cases the Special Narcotics Prosecutor and DEA have seen, when its lab tested, it actually has very little to no cocaine in it at all. Instead they’re finding cheaper manmade drugs from ketamine to ecstasy. It can be a dangerous and even deadly mixture of uppers and downers.

“When you see that mixture of your body being pulled in two directions, being amped up with a methamphetamine or cocaine and being sedated with something like ketamine, that’s a recipe for a terrible, terrible effect on the body,” said Brennan.

The Special Agent in Charge of the DEA in New York said in some cases the deadliest of drugs, fentanyl, is also getting mixed in, where even a tiny amount can be lethal.

“They’re mixing fentanyl in because they want to increase addiction, they want to increase their customer base they want more people to come back and buy their drug and it’s something every parent should be concerned about,” said Frank Tarentino, Special Agent in Charge of the Drug Enforcement Administration’s New York Division.

The drugs aren’t being sold in shady places or dark street corners as you might imagine. Prosecutors busted a New York City woman this summer for allegedly selling pink cocaine, and other drugs, over a messaging app on her cell phone. She’s accused of then shipping the drugs through the mail to customers. She has pleaded not guilty to the charges.

“You have this criminal underworld that has weaponized social media to push their poison to the far corners of the United States and across the world,” said Tarentino.

According to law enforcement sources, with the use of technology and social media, the mystery mixtures are easier to get than ever before and there are more drug overdose deaths reported than ever before. They say there’s no longer any such thing as safe experimentation, no matter how colorful the drug might be.

Pink cocaine also goes by the name Tusi.

Prosecutors say it’s a drug that’s difficult to track but was first spotted in the New York City area in January of 2023.

Source: https://abc7ny.com/post/pink-cocaine-nyc-new-mystery-drug-hitting-club-scene-new-york/15176935/

Filed under: Cocaine,Drug use-various effects,Fentanyl,USA :
Dr. Robert DuPont (NIDA, USA) shifted the paradigm from demonization to treatment of users.

Key points

  • In the 1970s, people addicted to opioids were demonized, considered hopeless. Some still believe this.
  • Setting high standards and following addicted patients for five years helps doctors know what treatments work.
  • Prevention is key to success in substance abuse, and it’s important to encourage non-use among teens.
In the United States, people addicted to opioids were once demonized as hopelessly bad, and treatment was virtually nonexistent. No one may have done more to change both matters than psychiatrist Robert DuPont, M.D, who, in 1969, during an unexplained surge in crime in the nation’s capital, was working with prisoners in the District of Columbia Department of Corrections. DuPont decided to test incoming inmates for drugs and was shocked to learn that nearly half (45%) were addicted to heroin. Desperate for heroin, they turned to crime for money.

At the behest of the district’s mayor, DuPont developed a D.C.-based clinic, the Narcotics Treatment Administration. It treated more than 15,000 heroin addicts over the next three years, and the D.C. crime rate plummeted by 50%, in a direct correlation.

Helping Medical Professionals Do Better

Robert L. “Bob” DuPont, born in 1936, graduated from Emory University and Harvard Medical School and completed his psychiatric training at the National Institutes of Health. He became the first director of the newly-created National Institute on Drug Abuse (NIDA), where he created a first-of-its-kind comprehensive training program for doctors, nurses, and counselors working in addiction treatment programs. Drug overdose deaths began declining, from from 6,413 to 2,492 by 1980.

In 1978, DuPont left government service to create the Institute for Behavior and Health (IBH), a think tank focusing on drug policy. Dupont has published more than 400 journal articles and 15 books, most recently Chemical Slavery: Understanding Addictions and Stopping the Drug Epidemic (2018).

The IBH conducted the first national study of doctors dependent on drugs and alcohol, their treatment, and five-year outcomes. “Physicians are given a comprehensive assessment by a team of professionals and get treatment for comorbidities, but the focus is on their addictions. They typically attend a month or more of residential treatment and, as outpatients, are monitored for five years with random drug and alcohol testing. If they miss a scheduled test or test positive for any drug, including alcohol, they are taken out of their practice again, assessed, and sent back to treatment.”

DuPont points out that many doctors who entered the program were initially resentful because they didn’t think there was anything wrong with them—typical of individuals with substance use disorder from all walks of life. Yet, most physicians greatly value their medical license, and the overwhelming majority cooperated because participation and success meant they could continue to practice medicine.

His study of nearly 1,000 drug-addicted physicians closely monitored for five years showed what is possible for the rest of the population. Seventy-eight percent never tested positive for drugs or alcohol, an excellent record. In addition, of those who did have a positive or missed drug test, nearly two-thirds never had a second positive test.

A follow-up study of physicians who successfully completed treatment and monitoring contracts five or more years ago showed that more than 95% were still in recovery. Physicians rated the treatment they had received as important to their recovery but said the most valued part of their care was involvement in the 12 steps.

Lessons Learned About Substance Abuse

DuPont says many people don’t realize that it’s rarely just one drug abused by most problematic substance users. And that is particularly true of individuals who die from drug overdoses, in whom two or more drugs are often identified post-mortem.

He also notes that many drugs used today are not in their natural forms but instead are ultra-potent synthetics, like fentanyl. In 2022, about 111,000 people died, and in 2023, about 108,300 people died of drug overdose. .

Early diagnosis and treatment is key

The earlier patients are diagnosed and treated, the better their chances of achieving and sustaining recovery, says DuPont. Many people can stop using substances for some period. However, the real problem is not drug withdrawal, as many people believe, but, instead, the repeated relapses. Yet he has known many individuals with seemingly hopeless drug or alcohol issues who emerged sober and productive. He largely credits organizations like Alcoholics Anonymous and Narcotics Anonymous.

Prevention is best

Whenever possible, prevention of drug use is best, particularly among young people. Not only is adolescence a time when most addictions begin, it’s also a time when the brain is uniquely vulnerable..

DuPont now focuses on youth substance-use prevention: no alcohol, nicotine, marijuana/THC, or other drugs by those under age 21. He notes that the percentage of 12th graders who report never using in their lifetime has increased from around 26% in 2018 to 32% in 2023. The trend is also evident in younger students. DuPont emphasizes, “This trend is key to reversing decades of pain, suffering, and addictions.“

At age 88, Robert DuPont, M.D., advocates for treatment research, long-term treatment with outcome reporting, mental health treatment parity (as important as physical health), and prevention. Recovery, he insists, is possible.

About the Author

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

Source: https://www.psychologytoday.com/gb/blog/addiction-outlook/202408/a-front-row-change-agent-of-the-drug-epidemic
Filed under: Addiction,Prevention and Intervention,Treatment and Addiction,USA :
Bethesda, Maryland  / Monday, August 19, 2024

The National Institutes of Health (NIH) has launched a programme that will support Native American communities to lead public health research to address overdose, substance use, and pain, including related factors such as mental health and wellness. Despite the inherent strengths in Tribal communities, and driven in part by social determinants of health, Native American communities face unique health disparities related to the opioid crisis. For instance, in recent years, overdose death rates have been highest among American Indian and Alaska Native people. Research prioritized by Native communities is essential for enhancing effective, culturally grounded public health interventions and promoting positive health outcomes.

“Elevating the knowledge, expertise, and inherent strengths of Native people in research is crucial for creating sustainable solutions that can effectively promote public health and health equity,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “As we look for ways to best respond to the overdose crisis across the country, it is crucial to recognize that Native American communities have the best perspective for developing prevention and therapeutic interventions consistent with their traditions and needs. This programme will facilitate research that is led by Native American communities, for Native American communities.”

Totaling approximately $268 million over seven years, pending the availability of funds, the Native Collective Research Effort to Enhance Wellness (N CREW) Programme will support research projects that are led directly by Tribes and organizations that serve Native American communities, and was established in direct response to priorities identified by Tribes and Native American communities.

Many Tribal Nations have developed and continue to develop innovative approaches and systems of care for community members with substance use and pain disorders. During NIH Tribal Consultations in 2018 and 2022, Tribal leaders categorized the opioid overdose crisis as one of their highest priority issues and called for research and support to respond. They shared that Native communities must lead the science and highlighted the need for research capacity building, useful real-time data, and approaches that rely on Indigenous Knowledge and community strengths to meet the needs of Native people.

The N CREW Programme focuses on: Supporting research prioritized by Native communities, including research elevating and integrating Indigenous Knowledge and culture; Enhancing capacity for research led by Tribes and Native American Serving Organizations by developing and providing novel, accessible, and culturally grounded technical assistance and training, resources, and tools; Improving access to, and quality of, data on substance use, pain, and related factors to maximize the potential for use of these data in local decision-making.

“Native American communities have been treating pain in their communities for centuries, and this programme will uplift that knowledge to support research that is built around cultural strengths and priorities,” said Walter Koroshetz, M.D., director of NIH’s National Institute of Neurological Disorders and Stroke (NINDS). “These projects will further our collective understanding of key programmes and initiatives that can effectively improve chronic pain management for Native American and other communities.”

The first phase of the programme will support projects to plan, develop, and pilot community-driven research and/or data improvement projects to address substance use and pain. In this phase, NIH will also support the development of a Native Research Resource Network to provide comprehensive training, resources, and real-time support to N CREW participants.

The second phase of the program, anticipated to begin in fall 2026, will build on the work conducted in the initial phase of the program to further capacity building efforts and implement community-driven research and/or data improvements projects. Additional activities that support the overarching goals of the N CREW Programme may also be identified as the program develops.

The N CREW Programme is led by the NIH’s NIDA, NINDS, and National Center for Advancing Translational Sciences (NCATS), with participation from numerous other NIH Institutes, Centers, and Offices. The N CREW Program is funded through the NIH Helping to End Addiction Long-term Initiative (or NIH HEAL Initiative), which is jointly managed by NIDA and NINDS. For the purposes of the N CREW Programme, Native Americans include American Indians, Alaska Natives, and Native Hawaiians. Projects will be awarded on a rolling basis and publicly listed.

This new programme is part of work to advance the Biden/Harris Administration’s Unity Agenda and the HHS Overdose Prevention Strategy.

Source: https://www.pharmabiz.com/NewsDetails.aspx?aid=171961&sid=2
Filed under: Addiction,Drug use-various effects,Mental Health,Prevention and Intervention,USA :

Course curriculum including testimonials from addicts, health workers and cops would bring big benefits for not very much cost

Author of the article:  Herbert Grubel, Special to Financial Post  (Canada) –  Published Aug 22, 2024

Last year British Columbia recorded 2,511 deaths suspected of being caused by illicit drugs, an average of nearly seven per day and an increase of five per cent from 2022. That’s a blemish on Canadian society and a cause of deep frustration: no matter how hard our governments and private charities have tried, we have not been able to end this carnage.

There has been no shortage of effort. To shrink the total number of users, we punish the possession, production, importation and dealing of drugs with fines and prison. To shrink the number of deaths caused by use of contaminated needles and drugs, we have provided safe injection sites and, in some provinces, free, safe opioids. To save users who have overdosed, we have made Naloxone readily available and put emergency medical teams on standby to take them to hospitals for treatment. To get users to give up their addiction, we offer them free mental health care and rehabilitation services.

What else can we do? We live in a free society. We cannot jail users or enrol them against their will in rehabilitation. We can always improve existing policies and apply more resources to them, but we may well have reached the limits of these policies in terms of financial commitment and political acceptability.

There is one policy, however, that has not been tried in Canada: Require all young Canadians to learn about the risk of death and other harms from using addictive recreational drugs and make them document their knowledge of these risks to receive their high-school graduation diploma.

This would not affect the current number of addicts but it should reduce the number of Canadians who become addicts in the future. Young people who understand the consequences of addiction will be better able to resist social pressures, sales pitches from drug dealers and the temptation to self-medicate the mental and emotional turmoil that afflicts many teenagers.

We know that providing the public with information about the consequences of personal actions is effective. That is why we have information campaigns about the effects of teen pregnancies, drunk driving and hiking in the back country without proper gear. Health Canada conducts regular campaigns informing the public about the risks of certain lifestyle choices and the failure to get vaccinated against the threat of infections.

Canada has many teachers, psychologists and media experts who could produce a curriculum that could effectively provide students with information about the consequences and risks of drug use. One does not have to be an expert to imagine the contents of such a curriculum.

One set of lectures would involve testimonials from addicts, whether in person or via video, about how hard it is to get a regular supply of drugs and find the money to pay for them, and how addiction led to homelessness and broken relationships with family and friends. They would discuss the trauma of seeing friends go into comas or die and discovering that their own mental acuity and health are diminishing.

Accounts by addicts of how they were induced to try their first dose would also be important, as well as testimony about the fleeting and decreasing pleasures they get from each successive hit.

The school curriculum might also include medical professionals talking about their experiences dealing with overdose victims, their inability to revive many of them and the persistent damage to users’ quality of life and mental and physical health.

Films could show parts of cities where addicts live in misery, inject drugs and sprawl motionlessly on the ground while under the influence. They could show medics attending to addicts in distress, with ambulance lights flashing in the dark background. They could show family members and friends attending funerals and mourning the death of overdose victims, or addicts being taken to jail in handcuffs by the police after committing crimes against property and persons.

No doubt there would be opposition to such a policy from Canadians who do not want to see time taken away from teaching traditional subjects or who are concerned that their children will be traumatized by the presentations or perhaps even encouraged to try drugs. These are legitimate concerns that need to be addressed in public discussions and ultimately government-arranged hearings about the benefits and costs of the proposed policy — as should be the practice with all government policies. But it seems to me the returns to the drug-abuse education are so high we should at least have public discussions about it.

Financial Post

Herbert Grubel is an emeritus professor of economics at Simon Fraser University.

Source:  https://financialpost.com/opinion/make-drug-awareness-requirement-graduate-high-school

Filed under: Canada,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Education,Youth :

Tricia Otto’s son, Calvin, will forever be 29 years old. That’s because he lost his life to fentanyl poisoning at age 29 in April of last year.

“He was funny. He had an amazing sense of humor. He was thoughtful. He was kind. He always worried about how other people were feeling. Um, he struggled with addiction for about 14 years, but he fought really hard against that,” Tricia Otto explains. “He always talked about wanting to be a fireman … And instead of fighting fires, my son spent his time fighting demons.”

In 2023 alone, there were over 1, 200 drug overdose deaths from fentanyl in Colorado.

That’s according to the Common Sense Institute. That equates to roughly three deaths per day on average. This upcoming Wednesday, August 21st, is National Fentanyl Prevention and Awareness Day. It was started by the nonprofit Facing Fentanyl. They’re organizing a takeover of Times Square in New York City this week.

Here in Colorado, there will be a Candlelight Vigil at the Denver City and County Building this Wednesday at 7 p. m. (flyer posted below).

Tricia Otto, in addition to being Calvin’s mom, is the Drug-Induced Homicide Foundation Colorado Chapter State Representative. She joined KGNU’s Jackie Sedley to discuss how important it is to talk about fentanyl poisoning, to use language that takes blame off of those with substance use disorder, and to hold those who sell illicit substances accountable.

“Referring fentanyl poisoning as an accidental overdose diminishes the calculated greed and disregard for human life that led to this tragic, tragic passing,” Otto says. “Those struggling with substance abuse disorder are targeted and exploited by drug dealers and others who stand to profit from their vulnerability. Calling it an accident ignores the deliberate actions of those that prey on the addicted, pushing dangerous substances for their own gain. This is not an unfortunate mishap. It’s a calculated act of malice that leads to the death and devastates families.”

Source: https://kgnu.org/fentanyl-overdose-prevention-awareness-triciaotto-calvinotto/

Filed under: Fentanyl,Mental Health,Prevention and Intervention,USA :
by Zachary Pottle |- Addiction Center

Remaining Sober In College

With August underway, many college students will be heading back to campuses across the country for another school year. For many, college is an exciting experience where young adults can learn, make friends, grow into their own, and of course attend the occasional party. However, for some students, returning to campus can present a host of challenges, especially those in recovery who may be worried about maintaining their sobriety.

It’s no secret college students experiment with substances. Now more than ever, college campuses are filled with drugs and alcohol. According to the 2023 National Survey on Drug Use and Health (NSDUH), 45.3% of male and 48.5% of female full-time college students ages 18 to 22 drank alcohol in the past month. Additionally, roughly 40% of both male and female college students said they had tried an illicit substance within the past year; with the most common being marijuana, cocaine, hallucinogens, and prescription drugs.

If you’re a student dealing with addiction, you might worry about being pressured to use drugs, attend parties where alcohol is prevalent, or spend time with people who engage in substance use. However, college doesn’t have to be overwhelming. By taking proactive steps to avoid substance use temptations, you can still enjoy your college experience.

Tips For Staying Sober On Campus

For students who are entering back into the college space after receiving treatment or in the earlier stages of recovery, campuses can be a stressful environment. Learning how to guard your sobriety while in environments ripe with drug and alcohol use can be hard, but fortunately many colleges have resources available to help keep you sober and engaged with your peers.

Avoid Popular “Party” Spots

While it likely goes without saying, avoiding places where drugs and alcohol are likely to be present is one of the best ways to stay sober in college. Many colleges have places that are synonymous with these types of activities; like popular local bars, fraternity or sorority houses, and other similar spaces. If you know that exposure to drugs or alcohol may trigger cravings or put your sobriety at risk, avoiding these spaces is key.

However, avoiding these places doesn’t mean that you have to have a “boring” college experience. For every bar or nightclub there’s an equal amount of spaces where social gatherings happen free of drugs and alcohol. Libraries, activity centers, sports facilities, and other places on campus are all great for avoiding triggers while also being a part of campus life.

Join A Club Or Campus Organization

While Greek life organizations are often associated with drug and alcohol use, many are involved in campus life and hold fundraisers, events, and other activities for all students on campus. Joining a fraternity or sorority can also be a great way to meet and connect with others, especially groups that focus on campus life and academic performance.

Many colleges also have a plethora of clubs and organizations for students to join. These include groups like student government, intramural sports, arts clubs, cultural clubs, and community service groups. Joining a group is a great way to stay involved with campus life while remaining sober.

Start An Exercise Routine

One of the most beneficial things you can do for your health is to exercise. Exercise can be especially helpful for those struggling with cravings or mental health conditions like anxiety or depression, both of which can be common for young adults struggling with their sobriety. Research shows that people who exercise regularly have better mental health and emotional wellbeing, and lower rates of mental illness.

Exercise doesn’t have to be strenuous or take a long time. Studies show low or moderate intensity exercise is enough to make a difference in terms of your mood and thinking patterns. The Centers for Disease Control and Prevention (CDC) recommends young adults aged 18-25 engage in 150 minutes of moderate-intensity physical activity a week. This can also be 75 minutes of vigorous-intensity or an equivalent combination of moderate- and vigorous-intensity physical activity. For additional benefits, the CDC recommends an extra two days of muscle-strengthening each week.

Utilize Campus Resources

Safeguarding your sobriety can be difficult, especially when your mental health is lacking. Without proper mental health care, depression, anxiety, stress or other mental health concerns can lead even the strongest of those in recovery into relapse. As our understanding of the importance of mental health has increased over the years, so too has our access to mental health care across the country.

Many colleges, especially larger state-sponsored schools with large student bodies, have counseling and other psychological services free of charge for enrolled students. Colleges that offer these types of services typically do so either online or in-person, and usually operate on a scheduling basis. If you’re unsure about whether or not your college offers counseling services, contact your admissions office or campus resource center to find out more.

Additional Resources For College Students In Recovery

While counseling services and campus organizations can both be beneficial to students in recovery, the reality is that many people experience relapses. Studies show that between 40 to 60 percent of individuals in treatment for substance abuse will relapse. It’s important to remember; however, that a relapse is not a sign of failure. Rather, relapses are a part of the recovery process.

Relapses can be a slight “bump in the road” for some, while for others relapses may require a bit of extra help to get them back on track. Treating chronic diseases requires changing long-established behaviors, and relapse doesn’t signify failure. When someone in recovery from addiction relapses, it’s a sign that they should consult their doctor to restart treatment, adjust it, or explore other options.

For students who may need extra resources, services like outpatient rehab may be a viable option to help keep you in school while also addressing relapse concerns. Outpatient programs provide young adults with the flexibility to receive treatment for part of the day while returning to campus each night. These programs vary, including day programs, intensive outpatient programs (IOP), and continued care. An addiction specialist can help determine which option best suits your needs.

Finding Help

Addiction is often seen by many as a lifelong disease; one that requires constant dedication, mindfulness, and strength. You should never be ashamed of needing support, regardless of how much or how frequent it is. If you’re struggling to stay sober, reaching out for help is always better than sacrificing your hard-earned sobriety. For additional resources and support, contact a treatment provider today to learn about your options.

Source: https://www.addictioncenter.com/community/stay-sober-college/

Filed under: Alcohol,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Education,Prevention and Intervention,USA,Youth :

Drug gangs recruiting hundreds of compatriots arriving across Channel to work for multimillion-pound operations

by Charles Hymas      Home Affairs Editor  – Daily Telegraph  (UK) – 28 September 2024 12:00pm

Albanian migrants are recruited as workers in illegal cannabis ‘farms’ set up in rented houses or disused industrial buildings.

Hundreds of Albanians who crossed the Channel on small boats have helped their drug gangs secure a stranglehold on Britain’s cannabis market.

They have been recruited as workers in illegal cannabis “farms” set up in rented houses or disused industrial buildings to produce crops worth up to £2 million a time and which can be grown and harvested in as little as 12 weeks.

The industrial scale of the cannabis production has been revealed by an undercover investigation into a secret channel on the encrypted messaging service Telegram. It is used by more than 700 Albanians to share intelligence on their cannabis operations.

Conversations between members of the group centre on the best chemicals for plant growth, the most effective way to harvest cannabis plants, the economics of securing properties for drug production and why crossbows are better than guns to defend their crops from rival gangs.

Members of the group recount robberies where cannabis “farm” workers have had their fingers cut off and landlords have demanded five-figure shares of the profits.

The National Crime Agency (NCA) said that the ruthless professionalism that the Albanians have brought to cannabis farming has enabled them to displace the Vietnamese as the main domestic providers of the drug in Britain.

Albanian gangs who previously specialised in cocaine moved into cannabis because it was “very, very low-risk”.

It turns a good profit because of high demand – Britons consume 240 tonnes of the drug, worth £2.4 billion, a year – and does not require risky cross-border transportation because it is homegrown, according to the NCA.

The surge in Albanians crossing the Channel in 2022, when 12,685 reached the UK in small boats, has provided the ready supply of illegal workers, skilled in the hydroponic technology required to grow the plants in the darkened rooms of houses where all the windows have been sealed.

It has led to increasing focus by police on the domestic production of cannabis. Some 29 Albanians were sentenced in July alone for illegally producing the drug. That was followed by a further 24 Albanians appearing before the courts in August. That represents nearly one a day.

Some 101 illegal Albanian migrants were sentenced to more than 300 years in jail in three months at the end of last year. Three-quarters of them were convicted of offences linked to cannabis production across England and Wales in indoor farms.

Many of the illegal migrants were recruited by the gangs after a government crackdown on black economy work made it difficult for them to find jobs.

Fines for bosses who employ illegal migrants have tripled to up to £60,000 per worker to make the practice so economically damaging that it could “put them out of business”. Police are concerned that Telegram has become a go-to platform for criminals. It has 900 million users but only about 100 employees. Pavel Durov, Telegram’s Russian-born founder, was detained in France this summer over its alleged failure to fight the use of the service for crime, including the spread of child sex abuse material.

The Albanians’ channel goes under the name Kusho, which means “cousin” and is the nickname Albanians use to address each other.

It currently has 703 members who share information about how to produce the maximum amount of cannabis from seed to full-grown plant.

Posts on the channel were collected by an Albanian reporter who infiltrated the group. “Everyone, you need to know how to grow ‘roses’,” said one of the organisers of the channel.

Another member listed the six key chemicals that had proved the most effective for fast, healthy growth.

One video demonstrated the best way to trim the dead leaves from a cannabis plant, while one member, using the pseudonym Bushi06, offered cannabis seedlings for £5 and boasted that he had sold 700 so far.

In discussions on how to protect the “farms”, one Albanian explained that it was better to spend £337 on a high-powered crossbow than a gun, because being caught in possession would carry a lesser sentence.

Some appeared less worried about police discovering their illegal operations than being attacked and robbed by rival gangs.

“Most robberies in the cannabis houses are happening in Leicester. They cut off the fingers of an Albanian worker,” said one member of the group.

“Police are not the big problem,” said a London-based Albanian using the pseudonym Deni. “The main problem is robbers who are now using drones to identify the houses. They detect the heat from the plants through the roofs of the houses.”

Others complained that landlords were overcharging them for the use of their properties or demanding a cut of the profits. “London landlords are charging £4,000 a month for a house. Not worth it at all,”  said one.

Another said: “So far I have invested £31,000 in a house including 12K for sealing it up, and 12K for the lights. Do not know if I will get my money back. The agency who rented me the house are asking for £9,000 when the product is ready for harvesting.”

Last summer, police launched Operation Mille to target cannabis farms in the UK. Among those jailed was Nard Nidri, 34, who entered the UK illegally in 2022 and lived in Birmingham, then moved to Swansea, where he worked at a car wash, before being recruited for a cannabis farm.

He was one of four “gardeners” jailed for a combined total of six years in August after police arrested them at a property in Neath, south Wales. Two rooms and the attic had been adapted and insulated to grow plants with a street value of £85,000.

Sentencing them, Judge Geraint Walters said cannabis farms being run by Albanian criminal gangs had reached “epidemic levels” and had, in his judgment, “become something of an industry”.

He suggested that authorities should look at the rental housing sector, noting that while so-called cannabis “farmers” often appeared in court, landlords and others receiving money from the rent of properties being used for the growing operations rarely did so.

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Source: https://www.telegraph.co.uk/news/2024/09/28/how-albanian-migrants-have-taken-over-uk-cannabis-market/

 

Filed under: Cannabis/Marijuana,Crime/Violence/Prison,Europe :

by    Youth Today magazine

Posted on 
The Centers for Disease Control and Prevention (CDC)

Summary

“The Youth Risk Behavior Survey Data Summary & Trends Report provides data on health behaviors and experiences of high school students in the United States. Data highlight students’ behaviors and experiences in 2023, changes from 2021 to 2023, and 10-year trends. The report focuses on six key areas:

  1. Sexual behavior
  2. Substance use
  3. Experiences of violence
  4. Mental health
  5. Suicidal thoughts and behaviors
  6. Other important issues, like social media use

Key Findings

  • In 2023, female students and LGBTQ+ students experienced more violence, signs of poor mental health, and suicidal thoughts and behaviors than their male and cisgender and heterosexual peers.
  • From 2021 to 2023, there were early signs that adolescent mental health is getting better. There were also concerning increases in students’ experiences of violence at school.
  • From 2013 to 2023, 10-year trends were similar to what data showed in 2021. There were decreases in students’ use of substances. There were increases in students’ experiences of violence, signs of poor mental health, and suicidal thoughts and behaviors. Students’ sexual activity decreased, but so did their protective sexual behaviors, like condom use.”

Read Full Report →

[Related report: 2024 U.S. national survey on the mental health of LGBTQ+ young people]

[Related: As more youth struggle with behavior and traditional supports fall short, clinicians are partnering with lawyers to help

Source: https://youthtoday.org/2024/08/youth-risk-behavior-survey-2013-2023/

Filed under: Brain and Behaviour,Crime/Violence/Prison,Drug use-various effects on foetus, babies, children and youth,Mental Health,Sexual Behaviour,USA :

Written by Ania Wellere, Master of Public Health Candidate, UNC Gillings School of Global Public Health.

As many know, drinking alcohol in a licensed premise under the age of 18 is against the law in the UK, however those aged 16 or 17 and accompanied by an adult can drink but not buy beer, wine, or cider with a meal. However, with relatively high alcohol use among children and young people in the UK, is the flexibility of this law one of many factors contributing to heavy episodic drinking among this population?

Youth drinking

According to Truque et al. (2023), 25% of adolescents in Europe begin to consume alcohol as early as the age of 13, and depending on region and gender, the prevalence of weekly alcohol consumption from adolescents is anywhere from 2%-33%. In 2021, NHS England found that the proportion of 15-year-olds who reported drinking at least once a month was 36%, with 14% saying at least weekly. Specifically in England, the World Health Organization found that the proportion of 13-year-olds who had consumed alcohol was far higher than the Health Behaviour in School-aged Children (HBSC) average – which covers 44 countries – and in Scotland and Wales.

Several factors influence children and young people’s alcohol use. One of the primary reasons young people give for why they drink at a young age is because of their peers. Drinking interest stems from failure to miss out, pressure to drink, and an attempt to improve their social status.

There are also some non-consensual factors, particularly outdoor advertising, but also advertising in magazines and television, that could be fuelling underage drinking because of its appeal to younger audiences. Children and young people do not ask to be exposed to these advertisements, and they cannot always filter the advertisements that they see through these mediums.

Despite regulatory efforts and codes that have been in place to protect children from alcohol marketing, researchers believe that attempts to protect children through the regulatory system and codes are failing. Several councils across the UK have taken the initiative to establish local policies that restrict advertisements of unhealthy commodities, including alcohol. If more local authorities follow suit in creating policies to restrict alcohol advertising, it would protect children and young people from exposure and potential alcohol-related harms.

Effect on the adolescent brain

Although youth drinking is slowly decreasing across the UK, heavy episodic drinking and its health impact is still a concern amongst adolescents, especially the effect alcohol has on the adolescent brain. Research on the effect alcohol has on the adolescent brain is limited. Research has typically focused on the impact alcohol has on the adult brain and the relationship between alcohol dependence and increased risk of dementia and other chronic diseases.

Before diving into the specific impact alcohol has on adolescent brains, it is important to lay out the process of how alcohol even travels through the body. So envision this: you take your first sip, and the alcohol makes its way through the stomach and into your bloodstream through the walls of your small intestine, where the blood will take the alcohol throughout the rest of your body. Alcohol then makes its way quickly to your brain, kidneys, lungs, and liver via the bloodstream. The way these parts of the body act is also contingent on the amount of alcohol that is in the bloodstream. For the brain, alcohol can impact your thought processes, emotions, memory, and coordination.

For an adolescent, alcohol moves through the body and breaks down slower than other age groups. The brains of adolescents have an increased likelihood of being negatively impacted compared to adult brains, according to the National Institute on Alcohol Abuse and Alcoholism. For young heavy episodic drinkers, brain development, structure, and function could possibly be altered compared to young non-heavy episodic drinkers, as seen through neuroimaging.

This impact on the brain has been noted to significantly affect the executive function of the adolescent brain. Executive function is defined as the mental processes that help an individual set and carry out their goals. Scientific evidence shows that weakened executive functions cause young people to make more errors and struggle with their shifting abilities (i.e., the ability to adapt). In the long run, this can follow young heavy episodic drinkers to adulthood.

In more technical terms, adolescent heavy episodic drinking is associated with a greater risk of reductions in grey matter during adolescence and disrupts white matter integrity, impacting neurocognitive functioning, according to Chikritzhs et al. (2024). In simple terms, the brain’s grey matter that helps individuals control movement, memory, and emotions is reduced, and white matter that allows the brain to exchange information and gives the ability to concentrate and learn is disrupted.

With these types of tissues being impacted by alcohol at a young age, there is research that has highlighted some of the risk factors that have come to disturb the lives of young heavy episodic drinkers when they become adults. A study including about 488,000 Swedish men found that heavy episodic drinking in adolescence was one of the strongest risk factors for developing early-onset dementia in adulthood.

As adolescence is a critical phase of development, more protective measures are put in place to reduce alcohol use among adolescents and, as a result, reduce alcohol-related harm to their brains. These protective measures usually include regulation of youth’s access to alcohol and alcohol advertising.

As we know, alcohol marketing is causally linked to young people drinking more and at an earlier age, and much of this marketing is non-consensual. To protect children’s rights, ‘the state must do all it can, through passing legislation and creating administrative systems, to promote and protect children’s rights’, according to the United Nations Convention on the Rights of the Child.

The brain is a vital organ to the body, and adolescent brain health is critical. With alcohol being accessible to children and young people in the UK, a ban on alcohol marketing should be taken into consideration. In addition, the normalisation of alcohol use among young people has to be put to an end, and that may start in the home with parents reshaping how they communicate alcohol use with their children and not encouraging drinking behaviour. Furthermore, future research should look at the differences between light to moderate and heavy drinking among adolescents to see if the effects on the brain are drastically different.

Source: https://www.ias.org.uk/2024/08/01/alcohol-and-its-impact-on-the-adolescent-brain/

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth,Europe,Prevalence,Youth :
Posted on 02/08/2024

Herschel Baker of Drug Free Australia has shared research references showing links between marijuana use and violence across the globe.

 

  1. A Review of Cases of Marijuana and Violence

The main scope of this paper was to inform the general public about the relationships between marijuana and violence in the general population and in individuals with mental illnesses, as recent findings do link marijuana with cases where psychosis was present. This article is a case review and not a research study; therefore, the chief limitations regard inferences that can be made from a case study. However, the findings suggest a further need for research on marijuana and violence. The authors of this paper did not intend to take sides regarding the legalization of marijuana. The focus was public health in regards to marijuana [2,11,14,18,36]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084484/

  1. The Relationship Between Marijuana Use and Intimate Partner Violence in a Nationally Representative, Longitudinal Sample   These findings have a number of implications for intimate partner violence prevention. First, given that any marijuana use appears to increase the risk for intimate partner violence, violence-prevention strategies should include early and continued marijuana prevention efforts in existing intimate partner violence treatment and prevention programming. Second, knowledge regarding the link between marijuana use and intimate partner violence could be used to inform domestic violence treatment providers of issues related to intimate partner violence recidivism. If early and continual marijuana treatment is emphasized as an important component of domestic violence treatment, then repeat occurrences of intimate partner violence among marijuana users may be reduced. Third, recognizing that there is a shared overlap between intimate partner violence perpetration and victimization and that marijuana use is a strong predictor for experiencing both outcomes, programs and policies that incorporate the complex relationship between marijuana and intimate partner violence could be developed to offer a more comprehensive treatment regimen. These holistic approaches are likely to be more beneficial than the current programs that are often “client specific” (e.g., they only serve drug users, or victims, or perpetrators; Karmen, 2007). Fourth, the finding that males are at increased risk for intimate partner vioence indicates that males should be included in intimate partner violence prevention programming, which has traditionally been reserved for women. Culturally specific programming may also be relevant, as different risk fac[1]tors may be present for Blacks compared with other groups, which may increase their risk for intimate partner violence. Future research is necessary to delineate these cultural-specific risk factors. Finally, the findings from this study may shed light on the potential harms of legislation legalizing marijuana use, as increased access to marijuana may increase use and, therefore, increase the harm associated with marijuana use (e.g., domestic violence, chronic diseases, and unintentional injuries). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782298/.

3, Association Between the Use of Cannabis and Physical Violence in Youths: A Meta-Analytical Investigation  https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.19101008These results demonstrate a moderate association between cannabis use and physical violence, which remained significant regardless of study design and adjustment for confounding factors (i.e., socioeconomic factors, other substance use). Cannabis use in this population is a risk factor for violence. A large study just published by a team from Montreal University in Canada has found that people who regularly smoke cannabis are almost three times more likely to commit a violent offence as those who abstain from the drug. The paper entitled “Association Between the Use of Cannabis and Physical Violence in Youths: A Meta-Analytical Investigation” and published in the American Psychiatric Association’s (APA) American Journal of Psychiatry did a meta-analysis of 30 studies which covered 296,815 people up to the age of 30. The study found that over time, prolonged cannabis use profoundly alters the brain, making the user less able to control their temper, and that addicts may also suffer from withdrawal symptoms, making them irritable and prone to lashing out. Psychiatrist Professor Sir Robin Murray, a world-leading expert on the neurological impact of the drug, was quoted in the media saying that the link between cannabis use and violence was a ‘neglected area’. The researchers say that while ‘the [scientific] literature has shown that cannabis use may lead to violent behaviours and aggression; however, this association has been inconsistent’ – with some studies showing a relationship and others not – their meta-analysis found users were more than twice as likely (2.15 times) to have committed a violent offence as non-users. Among ‘persistent heavy users’, the risk of violence was 2.81 times higher.

  1. Think Ya Know? Is Marijuana a Risk Factor for Violence? https://saynopetodope.org.nz/family-violence-child-abuse/
  1.  Association Between the Use of Cannabis and Physical Violence in Youths: A Meta-Analytical Investigationhttps://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.19101008These results demonstrate a moderate association between cannabis use and physical violence, which remained significant regardless of study design and adjustment for confounding factors (i.e., socioeconomic factors, other substance use). Cannabis use in this population is a risk factor for violence.
  2. Association of Cannabis Use With Self-harm and Mortality Risk Among Youths With Mood Disordershttps://jamanetwork.com/journals/jamapediatrics/article-abstract/2775255?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jamapediatrics.2020.5494 Cannabis use disorder is a common comorbidity and risk marker for self-harm, all-cause mortality, and death by unintentional overdose and homicide among youths with mood disorders. These findings should be considered as states contemplate legalizing medical and recreational marijuana, both of which are associated with increased CUD.
  3. Cannabis and Cannabinoids in Mood and Anxiety Disorders: Impact on Illness Onset and Course, and Assessment of Therapeutic Potentialhttps://pubmed.ncbi.nlm.nih.gov/31577377/ Forty-seven studies were included: 32 reported on illness onset, nine on illness course, and six on cannabinoid therapeutics. Cohort studies varied significantly in design and quality. The literature suggests that cannabis use is linked to the onset and poorer clinical course in bipolar disorder and PTSD, but this finding is not as clear in depression and anxiety disorders (ADs). There have been few high-quality studies of cannabinoid pharmaceuticals in clinical settings.
  4. Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood A Systematic Review and Meta-analysis https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2723657?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jamapsychiatry.2018.4500 Although individual-level risk remains moderate to low and results from this study should be confirmed in future adequately powered prospective studies, the high prevalence of adolescents consuming cannabis generates a large number of young people who could develop depression and suicidality attributable to cannabis. This is an important public health problem and concern, which should be properly addressed by health care policy.
  5. Young-adult compared to adolescent onset of regular cannabis use: A 20-year prospective cohort study of later consequenceshttps://pubmed.ncbi.nlm.nih.gov/33497516/ Initiation of regular cannabis use after high school strongly predicted smoking and illicit drug use in the mid-30s. This group also accounted for a higher proportion of illicit drug use and smoking in the cohort. Sensitivity analyses suggested that this association was at least partially causal. Given the legalisation of cannabis use in an increasing number of jurisdictions, we should increasingly expect harms from cannabis use to lie in those commencing use in young adulthood.

10  Association between Alcohol, Cannabis and Other Illicit Substance Abuse and Risk of Developing Schizophrenia: A Nationwide Population Based Register Study https://www.cambridge.org/core/journals/psychological-medicine/article/abs/association-between-alcohol-cannabis-and-other-illicit-substance-abuse-and-risk-of-developing-schizophrenia-a-nationwide-population-based-register-study/8914A1F1A0CBFBF17982720CBE2C2451 In conclusion, the consumption of substances is an extensive problem throughout the world and a current debate on legalizing cannabis in many countries has made uncovering the risk of abusing substances an important area of investigation (21,36). We found robust associations between a wide variety of substance abuse and an increased risk of developing schizophrenia. We are not aware of any other study focusing on the effect of such a wide variety of substance abuse and the interaction between the abuses as our study.

  1. Association of High-Potency Cannabis Use With Mental Health and Substance Use in Adolescence https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2765973 In conclusion, the consumption of substances is an extensive problem throughout the world and a current debate on legalizing cannabis in many countries has made uncovering the risk of abusing substances an important area of investigation (21,36). We found robust associations between a wide variety of substance abuse and an increased risk of developing schizophrenia. We are not aware of any other study focusing on the effect of such a wide variety of substance abuse and the interaction between the abuses as our study.
  1. Cannabis use and violence in patients with severe mental illnesses: A metanalytical investigation https://pubmed.ncbi.nlm.nih.gov/30780061/

With the upcoming policy changes on cannabis internationally such as the 2018 Canadian legalization of cannabis, it is of high importance to better investigate its potential harmful effects on violence mostly in more vulnerable psychiatric populations to devise effective interventions. Cannabis use should be considered in violence risk prevention and management.

  1. Professor Dame Carol Black Inquiry Violence Stories Violent deaths/injuries caused by cannabis users

https://www.cannabisskunksense.co.uk/uploads/site-files/Professor_Dame_Carol_Black_Inquiry_Cannabis_Violent_stories.pdfMales 53 Females 5 Methods: Stabbings: 19 Shootings: 21 Killing by hand: 4 (eg. Throttling, Beating, Battering, Jaw breaking) Axe: 1 Drowning: 1 Beheading: 2 Chased/run down by vehicle: 2 Bombings: 4 Victims: Relatives: 17 Strangers: 25 Friends: 6 Obama: 1 Mass killings 11 Possible Links with terrorists 6

  1. Attacker Smoked Cannabis: suicide and psychopathic violence in the UK and Ireland“Those whose minds are steeped in cannabis are capable of quite extraordinary criminality.” https://attackersmokedcannabis.com/
  1. Easton Woodhead suffering from marijuana-smoking psychosis in the lead-up to killing of homeless man Wayne Perry

https://www.theage.com.au/national/victoria/easton-woodhead-suffering-from-marijuanasmoking-psychosis-in-the-leadup-to-killing-of-homeless-man-wayne-perry-20150302-13shuy.html

  1. At Least Eleven Pot-Related Homicides Since Legalization, DA    George Brauchler    Sayshttps://www.westword.com/news/marijuana-related-homicides-in-colorado-since-legalization-9345285
  2. Marijuana Is More Dangerous Than You Think https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461328/

Some population-level data does exist, though. Research from Finland and Denmark, two countries that track mental illness more accurately, shows a significant increase in psychosis since 2000, following an increase in cannabis use. And last September, a large survey found a rise in serious mental illness in the U.S. too. In 2017, 7.5% of young adults met the criteria for serious mental illness, double the rate in 2008.

A 2012 paper in the Journal of Interpersonal Violence, examining a federal survey of more than 9,000 adolescents, found that marijuana use was associated with a doubling of domestic violence in the U.S. A 2017 paper in the journal Social Psychiatry and Psychiatric Epidemiology, examining drivers of violence among 6,000 British and Chinese men, found that drug use was linked to a fivefold increase in violence, and the drug used was nearly always cannabis.

Source: https://www.dbrecoveryresources.com/2024/08/marijuana-and-violence-2/

Filed under: Addiction,Australia,Cannabis/Marijuana,Crime/Violence/Prison,Youth :

Tuesday, July 30, 2024

Today, the U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of the 2023 National Survey on Drug Use and Health (NSDUH), which shows how people living in United States reported their experience with mental health conditions, substance use and pursuit of treatment. The 2023 NSDUH report includes selected estimates by race, ethnicity and age group. The report is accompanied by two infographics offering visually packaged highlight data as well as visual data by race and ethnicity.

“Each year, data from the annual NSDUH provides an opportunity to identify and address unmet healthcare needs across America. We’re pleased to see that more people received mental health treatment in 2023 than the previous year,” said Miriam E. Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “Also, to build upon increasing accessibility to data, this year’s release features two infographic reports: one focusing on race and ethnicity and one highlighting selected overall data.”

The 2023 NSDUH Report includes the following selected key findings.

Mental Health:

  • Among adults aged 18 or older in 2023, 22.8% (or 58.7 million people) had any mental illness (AMI) in the past year.
  • 4.5 million youth (ages 12 to 17) had a major depressive episode in the past year, of which nearly 1 in 5 also had a substance use disorder.
  • Among adults aged 18 or older in 2023, 5.0% (or 12.8 million people) had serious thoughts of suicide, 1.4% (or 3.7 million people) made a suicide plan, and 0.6% (or 1.5 million people) attempted suicide in the past year.
  • Multiracial adults aged 18 or older were more likely than adults in most other racial or ethnic groups to have AMI, serious mental illness (SMI), and serious thoughts of suicide.
  • Estimates of suicidal thoughts and behaviors among adults in 2023 were comparable to 2022 and 2021.

Substance Use:

  • In 2023, 3.1% of people (8.9 million) misused opioids in the past year, which is similar to 2022 and 2021 (3.2% and 8.9 million, 3.4% and 9.4 million respectively).
  • Among the 134.7 million people aged 12 or older who currently used alcohol in 2023, 61.4 million people (or 45.6%) had engaged in binge drinking in the past month.
  • Marijuana was the most commonly used illicit drug, with 21.8% of people aged 12 or older (or 61.8 million people) using it in the past year.
  • American Indian or Alaska Native and Multiracial people were more likely than most other racial or ethnic groups to have used substances or to have had an SUD in the past year.
  • In 2023, 9.4% of people aged 12 or older vaped nicotine in the past month, up from 8.3% in 2022.
    • In the past year, more people initiated vaping (5.9 million people) compared to any other substance.
    • Nicotine vaping estimates from 2021 are not comparable with estimates from 2022 and 2023.

Services and Recovery:

  • 31.9% of adolescents aged 12 to 17 (or 8.3 million people) received mental health treatment in the past year, an increase of more than 500,000 from 2022.
  • 23.0% of adults aged 18 or older (or 59.2 million people) received mental health treatment in the past year, an increase of 3.4 million from 2022.
  • Among people aged 12 or older in 2023 who were classified as needing substance use treatment in the past year, about 1 in 4 (23.6% or 12.8 million people) received substance use treatment in the past year. People were classified as needing substance use treatment in the past year if they had a substance use disorder (SUD) or received substance use treatment in the past year.
  • 30.5 million adults aged 18 or older (or 12.0%) perceived that they ever had a substance use problem. Among these adults, 73.1% (or 22.2 million people) considered themselves to be in recovery or to have recovered.
  • 64.4 million adults aged 18 or older (or 25.3%) perceived that they ever had a mental health issue. Among these adults, 66.6% (or 42.7 million people) considered themselves to be in recovery or to have recovered.
  • There were no racial ethnic differences among adults aged 18 or older in 2023 who perceived that they ever had a substance use problem or problem with their mental health who considered themselves to be in recovery or to have recovered from their drug or alcohol use problem or mental health issue.

About the National Survey on Drug Use and Health

Conducted by the federal government since 1971, the NSDUH is a primary source of statistical information on self-reported substance use and mental health of the U.S. civilian, noninstitutionalized population 12 or older. For the 2023 NSDUH national tables and some reports, statistical testing was conducted between estimates from different years (e.g., past month alcohol use in 2023 vs. the estimate in 2022). Where testing involved 3 years of comparable data for 2021 to 2023, pairwise testing was conducted between estimates in these years (i.e., 2021 vs. 2022, 2021 vs. 2023, and 2022 vs. 2023). Statistical tests for overall trends from the baseline year to the current year will not be conducted until four comparable NSDUH data points are available. The NSDUH measures include:

  • Use of illegal drugs, prescription drugs, alcohol, and tobacco,
  • Substance use disorder and substance use treatment,
  • Major depressive episodes, suicidal thoughts and behaviors, and other symptoms of mental illness, mental health care, and
  • Recovery from substance use and mental health disorders.

Addressing the nation’s mental health crisis and drug overdose epidemic is a top priority of the Biden-Harris Administration and are core pillars of the Administration’s Unity Agenda. The President’s Unity Agenda is operationalized through the HHS Overdose Prevention Strategy, the HHS Roadmap for Behavioral Health Integration, and the National Strategy for Suicide Prevention.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. To learn how to get support for mental health, drug or alcohol issues, visit FindSupport.gov. If ready to locate a treatment facility or provider, go directly to FindTreatment.gov or call 800-662-HELP (4357).

 

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

Last Updated:
Source: https://www.samhsa.gov/newsroom/press-announcements/20240730/samhsa-releases-annual-national-survey-drug-use-and-health
Filed under: Addiction,Alcohol,Cannabis/Marijuana,Cocaine,Heroin/Methadone,Mental Health,Treatment and Addiction,USA :

Background: Most violent crimes (52 %) are committed by adults aged 18-34, who account for 23 % of the US population and have the highest prevalence of cannabis use and cannabis use disorder (CUD). We examined whether and how associations of cannabis use, use frequency, and CUD with violent behavior (i.e., attacking someone with the intent to harm seriously) vary by sex in U.S. young adults.

Methods: Data were from 113,454 participants aged 18-34 in the 2015-2019 US National Surveys on Drug Use and Health, providing nationally representative data on cannabis use, CUD (using DSM-IV criteria), and violent behavior. Descriptive analyses and bivariate and multivariable logistic regression analyses were conducted.

Results: Among U.S. adults aged 18-34, 28.9 % (95 % CI = 28.5-29.2 %) reported past-year cannabis use (with/without CUD), including 20.5 % (95 % CI = 20.2-20.8 %) with non-daily cannabis without CUD, 4.7 % (95 % CI = 4.5-4.8 %) with daily cannabis use without CUD, 2.1 % (95 % CI = 1.9-2.2 %) with non-daily cannabis use and CUD, and 1.7 % (95 % CI = 1.5-1.8 %) with daily cannabis use and CUD. Past-year adjusted prevalence of violent behavior was higher among males with daily cannabis use but without CUD (2.9 %, 95 % CI = 2.4-2.7 %; adjusted prevalence ratio (PR) = 1.7, 95 % CI = 1.3-2.2) and males with daily cannabis use and CUD (3.1 %, 95 % CI = 2.3-4.0 %; adjusted PR = 1.8, 95 % CI = 1.3-2.4) than males without past-year cannabis use (1.7 %, 95 % CI = 1.6-1.9 %). Adjusted prevalence of violent behavior was higher among females with cannabis use regardless of daily cannabis use/CUD status (adjusted prevalence = 1.6-2.4 %, 95 % CIs = 0.9-3.2 %; adjusted PRs = 1.6-2.4, 95 % CI = 1.3-3.2) than females without past-year cannabis use (1.0 %, 95 % CI = 0.9-1.1 %).

Conclusions: Research is needed to ascertain the directionality of the associations between cannabis use and violent behavior and underlying sex-specific mechanism(s). Our results point to complex sex-specific relationships between cannabis use frequency, CUD, and violent behavior and highlight the importance of early screening for and treatment of CUD and of preventive interventions addressing cannabis misuse.

Keywords: Attacking someone with the intent to seriously hurt them; Cannabis use; Cannabis use disorder; Violent behavior.

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Source: https://pubmed.ncbi.nlm.nih.gov/38677161/
Filed under: Brain and Behaviour,Cannabis/Marijuana,Mental Health,Prevalence,USA,Youth :

As the population ages, we have to face a growing, generally overlooked crisis of drug abuse among seniors.

What once were considered problems for the younger generation are increasingly found in our older population. The reasons behind this troubling trend are complex and multifaceted, but understanding them holds the key to developing effective prevention strategies.

According to statistics from the United Nations Department of Economic and Social Affairs (2019), there are approximately 2.2 million people aged 60 years and above in Kenya.

Globally, one of the major reasons cited as being behind the increasing cases of drug abuse among elderly people is an increased incidence of chronic pain. As one grows older, the body becomes more prone to a whole range of problems, from arthritis to back issues.

Doctors prescribe very strong opioids for treating the related pain. Where they are highly effective in delivering relief, they come with the dangerous possibility of dependence. Too often, many of these seniors are caught in this vicious circle of addiction when all they were looking for was relief from physical suffering.

There is also the emotional wear and tear associated with growing older. This may be an empty feeling—lack of purpose and loss of social contacts—with retirement, even when well-planned.

A state of depression or anxiety can result from the death of the spouse or friend, or reduced mobility and increasing isolation. Some turn to alcohol or drugs, mistakenly seeking temporary relief from the pain of loneliness or fear of mortality.

Furthermore, stigma against mental health conditions in elderly persons often acts as a barrier to care. The vast majority were raised in an era where little, if any, emotional matters were discussed, and as such, self-medication was the rule rather than the presence of professionals. This lack of dealing directly with issues of mental health can perpetuate substance abuse problems.

It can also be a factor of financial stress. With fixed incomes and increasing healthcare costs, some seniors might turn to cheaper, illicit drugs to manage pain or emotional stress when they can no longer afford prescribed medications. Such substitution is dangerous and, therefore, leads to many other additional serious health and legal problems.

This means we must consider the intergenerational effects of attitudes in their relationships with drugs from one generation to the next.

The baby-boomer generation is entering old age now, but they were raised during times of increased experimentation with drugs. Some carry this behavior over into old age and may view recreational drug use as normal in life, rather than a potential danger. This is a complex issue that calls for a multi-faceted approach. First, there is a dire need to promote education and awareness of the dangers of drug abuse among seniors. This would involve not only the seniors themselves but also their families, caregivers, and even healthcare providers.

Substantial training should be provided to healthcare professionals regarding spotting the symptoms of substance abuse in older patients and looking for alternative methods for managing pain with lower addiction risks.

Steps could include physical therapy, acupuncture, or using pain relievers not having opioids. Regular medication review identifies potential drug interactions and minimises the risk of possible misuse in cases of accidental ingestion or use.

We have a lot of work to do in taking away the stigma associated with mental health treatment for older adults. Encourage seniors to seek counseling or support groups, giving them a healthy outlet to deal with life.

Community centers and senior living facilities can also play important roles in the creation of social connections and engaging activities to replace isolation and boredom. Underpin systems of financial support allow seniors to afford needed medication and treatments; otherwise, they may resort to dangerous alternatives. This could be done through Medicare coverage expansion or the creation of subsidies for essential prescriptions.

The need to educate family members and caregivers about the warning signs and symptoms of drug abuse among seniors is of the essence, and fostering an open, non-judgmental conversation regarding substance use is called for.

A supportive environment shall therefore have to be set up so that a senior feels comfortable discussing difficulties to be able to carry out early intervention effectively.

Such senior preventive programs should be designed and practiced universally. These can consist of workshops on healthy aging, handling stressful situations, and medication alternatives to alleviate pain. Peer support groups led by recovered senior addicts could serve as a powerful testimony and mentorship.

We have to change the attitude toward aging in our society. If we teach people that the later years of life can be the growth time, learning period, and the beginning of new experiences, then the older persons continue to feel a sense of purpose and identity in life. All this optimism can work very strongly against substance abuse.

Treatment of drug abuse in seniors is not just a public health imperative, it is also a moral one. A group of people who have contributed so much to our society all their lives deserve to enjoy their later years with dignity and support.

Understanding the roots of senior drug abuse and implementing comprehensive strategies of prevention can help ensure that our elders experience the quality of life they deserve.

Mr. Mwangi is Deputy Director, Corporate Communications, NACADA 

Source: Simon Mwangi 

Filed under: Drug use-various effects,Mental Health,Others (International News),Prevalence :

07/08/2024

Founded in 2015 by Christina von Sperling Afridi and her husband, Ambassador Tariq Khan Afridi, in the wake of their son’s death, the Karim Khan Afridi Welfare Foundation’s (KKAWF) mission is to raise awareness of the tragic consequences of drug addiction among Pakistani youth – The KKAWF is a member of the Dianova network – Image: young female student in Karachi (Pakistan), Photo by Muneer ahmed ok on Unsplash

In a significant move towards strengthening drug prevention initiatives in Pakistan, the First Meeting of the National Narcotics Control Committee (NNCC) witnessed notable mentions of the Karim Khan Afridi Welfare Foundation (KKAWF). Constituted under the National Anti-Narcotics Policy 2019 by the Ministry of Narcotics Control, the NNCC aims to consolidate and coordinate nationwide efforts against narcotics. The KKAWF’s impactful work in drug prevention and awareness among the youth has been prominently recognized, reflecting the foundation’s growing influence and contribution to this critical issue.A particularly commendable mention was made in a letter from the Ministry of Federal Education and Professional Training, highlighting the inclusion of KKAWF’s ‘Hum Sath Hain’ prevention program. This innovative initiative has already made substantial strides in combating drug abuse at the grassroots level. Over 300 teachers from public schools have been trained under this program, equipping them with the necessary skills and knowledge to educate and guide their students about the dangers of drug abuse. These trained educators are now actively implementing the ‘Hum Sath Hain’ program in their respective schools, directly impacting thousands of students and fostering a drug-free culture among the youth.

The Ministry’s letter, which was attached to the Minutes of the First Meeting of the NNCC, further highlighted the certification of three Master Trainers from the Federal Directorate of Education (FDE) by KKAWF. This certification is a testament to the foundation’s commitment to quality and sustainable training programs.

By empowering Master Trainers, KKAWF ensures that the knowledge and skills necessary for effective drug prevention are passed on, thereby creating a ripple effect that amplifies the program’s reach and impact.

The Foundation’s efforts were not only acknowledged through official documentation but also received commendation from key figures at the meeting. The Director General of Excise, Taxation and Narcotics Control Punjab, who was among the participants, praised KKAWF’s relentless efforts in drug prevention. This recognition from a high-ranking official underscores the importance and effectiveness of KKAWF’s initiatives.

KKAWF has consistently been at the forefront of drug prevention and awareness in Pakistan, focusing on educating young people about the dangers of drug use. The foundation’s programs are designed to address the root causes of drug abuse, providing youth with the tools and support they need to make informed choices. By collaborating with schools and educational institutions, KKAWF ensures that its messages reach young people in a structured and impactful manner.

The mention of KKAWF at the NNCC meeting signifies a broader acceptance and endorsement of its programs at the national level. Such recognition not only validates the foundation’s hard work but also provides it with a platform to expand its reach and influence. It opens doors for more collaborations with government bodies, educational institutions, and other stakeholders, thereby enhancing the collective efforts against drug abuse in the country.

In conclusion, the First Meeting of the National Narcotics Control Committee marked a significant milestone for the Karim Khan Afridi Welfare Foundation. The inclusion of their ‘Hum Sath Hain’ program in the official records, along with commendations from high-ranking officials, highlights the foundation’s vital role in drug prevention. As KKAWF continues to expand its initiatives and impact, it sets a commendable example for other organizations working towards a drug-free Pakistan.

Source: https://www.dianova.org/news/unite-for-a-drug-free-pakistan/

Filed under: Addiction,Others (International News),Prevalence,Prevention and Intervention :

Published: August 11, 2024

Abstract

Shivering is a frequently encountered perioperative complication in patients undergoing spinal anesthesia. Numerous different pharmacological agents have been employed to mitigate this issue. This scoping review aims to evaluate the efficacy of ketamine in mitigating the incidence of shivering. This review process utilized PubMed, JAMA, and Cochrane as primary databases. Searches were performed using combinations of key terms: “Ketamine,” “Shivering,” “Spinal Anesthesia,” and “Hypothermia.” Reviews of reference lists for additional pertinent data were performed. When ketamine was compared against a saline control, three out of five studies found ketamine to be more effective (p < 0.05, p < 0.001, p < 0.001) in the prevention of shivering. When compared with tramadol, two studies found ketamine to be more effective (p < 0.001, p < 0.001), one found no difference (p = 0.261), and one found tramadol to be more effective (p < 0.001). Two studies found dexmedetomidine more effective (p < 0.022, p < 0.027) than ketamine and tramadol. When comparing ketamine, ondansetron, and meperidine, all three were effective (p < 0.001) versus saline, with no significant difference between the three. Meperidine demonstrated more efficacy (p < 0.05) in reducing the intensity of shivering than ketamine. Ketamine’s effects on hemodynamics were shown to be equivocal or more favorable across several studies. While there is mixed evidence on whether it is better than other treatments, ketamine may have advantages from a hemodynamic standpoint. Dosages of 0.2-0.5 mg/kg with or without a subsequent infusion of 0.1 mg/kg per hour may aid in the prevention of perioperative shivering. Overall, ketamine is a safe and effective drug for the prevention of perioperative shivering. However, other drugs may be equally or more effective; therefore, patient population, hemodynamic status, patient preferences, and provider familiarity with different agents should be considered.

Introduction & Background

Shivering is an involuntary somatic muscle response typically triggered by prolonged exposure to cold environments or fever to raise body temperature by generating heat through repetitive contraction of skeletal muscles. Shivering is primarily controlled by the median preoptic nucleus (MnPO) in the anterior thalamus of the brain which contains the central efferent pathways for cold-defensive and febrile shivering. Some common causes of shivering include movement disorders, excitement, fear, stress, tremors, low blood sugar, anxiety, fever, cold exposure, postanesthetic shivering, and shivering with spinal anesthesia.

Patients frequently experience shivering following surgery with general or spinal anesthesia. This shivering may be due to a natural thermoregulatory response to central hypothermia or as a result of the release of cytokines throughout the surgical process [1]. This is unpleasant for the patient and occurs following surgery in 30-65% of patients who have received general anesthetics [1].

The exact mechanism underlying post-spinal anesthesia shivering is not fully understood but may involve thermoregulatory responses to hypothermia, affecting neurons in specific brain regions. Shivering with spinal anesthesia is an involuntary, oscillatory muscular activity that significantly increases metabolic heat production by up to 600% and increases oxygen consumption up to 400% [2]. This may lead to arterial hypoxia and is associated with an increased risk to patients with myocardial infarction [1]. These sequelae of shivering may prolong post-operative recovery time and contribute to poor patient outcomes.

A variety of medications have been studied to prevent or treat post-anesthesia shivering; recent studies indicate ketamine shows promise in controlling shivering. Ketamine is a competitive N-methyl-D-aspartate (NMDA) receptor antagonist and is involved in the regulation of heat. As a NMDA agonist, it increases the rate of neuronal discharge in the anterior hypothalamic preoptic region modulating serotonergic and noradrenergic neurons in the locus coeruleus [3]. The mechanism of action by which ketamine controls shivering has yet to be determined, but it is believed that it regulates shivering by producing non-vibration-induced heat, acting on the hypothalamus and beta-adrenergic effects.

As there is not yet a determined most effective agent this scoping review of current literature was conducted to determine the benefits of ketamine in the prevention of perioperative spinal anesthetic shivering. Hemodynamic effects of ketamine and other anesthetic agents were examined as a secondary objective.

The full article is available to read by clicking the source link below:

Source:  https://www.cureus.com/articles/277061-a-scoping-review-ketamine-for-the-prevention-of-perioperative-shivering-in-patients-undergoing-spinal-anesthesia#!/

Filed under: Drug use-various effects,Health,Ketamine :
12 Aug 2024

Substance abuse disorders are on the rise among young people. The American Addiction Center reports one in seven young adults are affected. Crisis coach Scott Silverman and youth drug prevention educator Rocky Herron joined the CBS 8 Morning Show with details.

Source: https://www.youtube.com/watch?v=K6BYoWOnAG8

Filed under: Addiction,Drug use-various effects on foetus, babies, children and youth,Prevention and Intervention,USA,Youth :

Children exposed to substances during pregnancy are at high risk of facing a range of negative health outcomes, including neonatal abstinence syndrome (NAS). This condition, where a baby is born experiencing withdrawal symptoms from drugs they were exposed to in utero, imposes a significant burden on the child, the family, and the healthcare system. In the United States, between 2009 and 2016, the costs associated with birth admissions for NAS tripled, jumping from $731.8 million to $2.5 billion.

A new study published in JAMA Pediatrics sheds light on the longitudinal impact of prenatal substance exposure. Researchers examined the relationship between maternal use of tobacco, alcohol, illicit drugs, and the misuse of prescription drugs during pregnancy, focusing on how these factors influence out-of-home care, hospital utilization, length of hospital stay, and healthcare costs from birth through young adulthood. By analyzing over 1.6 million healthcare records in New South Wales (NSW), the study found that prenatal substance use contributed to an excess of $84 million in hospital costs. These increased costs were driven by longer hospital stays, a greater need for special or intensive care, and later hospitalizations, commonly due to respiratory illnesses and mental health or behavioral disorders.

Tragically, this study found that children with prenatal substance exposure were more likely to be readmitted to the hospital by one year of age for reasons such as neglect, maltreatment, and misuse. Those born with NAS were particularly vulnerable, as they faced a two-fold higher risk of later hospitalization for mental health issues. Moreover, their hospital admission costs at birth were $12,000 higher compared to children without such exposure.

This study also highlighted that although one in four children with prenatal substance exposure entered out-of-home care by six months of age, this intervention reduced healthcare costs by $16 million and lowered the risk of hospital readmission for children with NAS by almost 30%. Out-of-home care, in this context, refers to the court-ordered placement of a child under 18 in foster care, relative care, adoption, or residential care due to safety risks in their biological home.

These findings underscore the importance of comprehensive drug policies that emphasize prevention and supportive services for pregnant mothers and families struggling with substance use. By intervening early and providing targeted support, we can mitigate the long-term effects of prenatal substance exposure, help keep families together, and reduce the burden on the healthcare system.

 

Source: https://www.saveoursociety.org/news-articles/breaking-the-cycle-the-impact-of-prenatal-substance-exposure-on-children-and-the-healthcare-system/

Filed under: Drug use-various effects on foetus, babies, children and youth,USA :

One of the most pressing issues for businesses in states where marijuana use is legal is determining employee impairment before taking any adverse action. Unlike alcohol, where a simple breathalyzer test can gauge impairment, marijuana’s effects vary significantly based on consumption method, strain, and user tolerance.

Studies have shown that THC—the psychoactive compound in cannabis—and its metabolites can linger in the body long after the “high” has worn off. Recognizing this, many states have enacted laws requiring employers to prove impairment, not just the presence of THC. Traditional drug tests like urinalysis, oral fluid tests, hair tests, and even emerging breath THC tests only indicate prior use, not current impairment.

This means that zero-tolerance policies based solely on the detection of THC metabolites are no longer viable in many states. Instead, employers must place more focus on assessing fitness for duty through reasonable suspicion training for supervisors and consider adopting impairment detection technology.

Given that measuring THC levels cannot be the sole indicator of impairment, new tools have emerged to detect impairment from drug and alcohol use. Advanced impairment detection technologies offer more accurate insights into an employee’s current state of impairment. These devices measure psychological and/or physical indicators, allowing employers to make informed decisions about workplace safety. Leading solutions are portable, scientifically defensible, and provide results within minutes.

However, these technologies alone are not enough. Supervisors play a crucial role in identifying and documenting impairment. Proper training in recognizing the signs of impairment and documenting these observations is essential. Supervisors must be equipped to take appropriate action based on their assessments, ensuring that safety and performance standards are upheld. We here at NDWA can help provide trainings for your supervisors – find out more here.

Employees must understand that they are not exempt from workplace safety regulations regardless of their state’s marijuana laws. Being under the influence at work can endanger themselves and their colleagues, and impact work quality and efficiency. It is the responsibility of employees to ensure their marijuana use doesn’t impair their fitness for duty. They must arrive at work sober and ready to perform.

Advanced impairment detection technology is promising, but isn’t a singular solution. By training supervisors to document regular behavior and performance, businesses can maintain safe and productive work environments.

 

Source:  NATIONAL DRUG-FREE WORKPLACE ALLIANCE

Filed under: Cannabis/Marijuana,Drug use-various effects,Prescription Drugs,Prevention and Intervention,USA,Workplace :

Effort aims to elevate Indigenous knowledge and culture in research, to respond to the overdose crisis and address related health disparities

The National Institutes of Health (NIH) has launched a program that will support Native American communities to lead public health research to address overdose, substance use, and pain, including related factors such as mental health and wellness. Despite the inherent strengths in Tribal communities, and driven in part by social determinants of health, Native American communities face unique health disparities related to the opioid crisis. For instance, in recent years, overdose death rates have been highest among American Indian and Alaska Native people. Research prioritized by Native communities is essential for enhancing effective, culturally grounded public health interventions and promoting positive health outcomes.

“Elevating the knowledge, expertise, and inherent strengths of Native people in research is crucial for creating sustainable solutions that can effectively promote public health and health equity,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “As we look for ways to best respond to the overdose crisis across the country, it is crucial to recognize that Native American communities have the best perspective for developing prevention and therapeutic interventions consistent with their traditions and needs. This program will facilitate research that is led by Native American communities, for Native American communities.”

Totaling approximately $268 million over seven years, pending the availability of funds, the Native Collective Research Effort to Enhance Wellness (N CREW) Program will support research projects that are led directly by Tribes and organizations that serve Native American communities, and was established in direct response to priorities identified by Tribes and Native American communities.

Many Tribal Nations have developed and continue to develop innovative approaches and systems of care for community members with substance use and pain disorders. During NIH Tribal Consultations in 2018 and 2022, Tribal leaders categorized the opioid overdose crisis as one of their highest priority issues and called for research and support to respond. They shared that Native communities must lead the science and highlighted the need for research capacity building, useful real-time data, and approaches that rely on Indigenous Knowledge and community strengths to meet the needs of Native people.

The N CREW Program focuses on:

  1. Supporting research prioritized by Native communities, including research elevating and integrating Indigenous Knowledge and culture
  2. Enhancing capacity for research led by Tribes and Native American Serving Organizations by developing and providing novel, accessible, and culturally grounded technical assistance and training, resources, and tools
  3. Improving access to, and quality of, data on substance use, pain, and related factors to maximize the potential for use of these data in local decision-making.

“Native American communities have been treating pain in their communities for centuries, and this program will uplift that knowledge to support research that is built around cultural strengths and priorities,” said Walter Koroshetz, M.D., director of NIH’s National Institute of Neurological Disorders and Stroke (NINDS). “These projects will further our collective understanding of key programs and initiatives that can effectively improve chronic pain management for Native American and other communities.”

The first phase of the program will support projects to plan, develop, and pilot community-driven research and/or data improvement projects to address substance use and pain. In this phase, NIH will also support the development of a Native Research Resource Network to provide comprehensive training, resources, and real-time support to N CREW participants.

The second phase of the program, anticipated to begin in fall 2026, will build on the work conducted in the initial phase of the program to further capacity building efforts and implement community-driven research and/or data improvements projects. Additional activities that support the overarching goals of the N CREW Program may also be identified as the program develops.

The N CREW Program is led by the NIH’s NIDA, NINDS, and National Center for Advancing Translational Sciences (NCATS), with participation from numerous other NIH Institutes, Centers, and Offices. The N CREW Program is funded through the NIH Helping to End Addiction Long-term Initiative (or NIH HEAL Initiative), which is jointly managed by NIDA and NINDS. For the purposes of the N CREW Program, Native Americans include American Indians, Alaska Natives, and Native Hawaiians. Projects will be awarded on a rolling basis and publicly listed.

This new program is part of work to advance the President’s Unity Agenda and the HHS Overdose Prevention Strategy.

Source:  https://nida.nih.gov/news-events/news-releases/2024/08/nih-launches-program-to-advance-research-led-by-native-american-communities-on-substance-use-and-pain

Filed under: Addiction,Education,Health,Prevention and Intervention,USA :

Dr. David R. Holtgrave, Ph.D., Joins the Department of Health as Senior Policy Advisor to the Commissioner to Enhance the Department’s Mission to End the Opioid Epidemic

ALBANY, N.Y. (August 15, 2024) – The New York State Department of Health is pleased to welcome nation-leading public health, prevention and substance use policy expert Dr. David R. Holtgrave, Ph.D., to the executive leadership team as Senior Policy Advisor to the Commissioner. Dr. Holtgrave joins the State Health Department with more than 35 years of public health experience, including serving in the White House Office of National Drug Control Policy from 2022-2024.

“Dr. Holtgrave is a national leader in drug prevention programs and a public health expert who comes to the State Health Department to help our fight against the overdose epidemic,” State Health Commissioner Dr. James McDonald said. “I’m thrilled to welcome Dr. Holtgrave to the executive leadership team, as we continue to rebuild the Department and hire experienced, compassionate public health experts.”

Dr. Holtgrave joins the Department with decades of experience addressing urgent public health issues, demonstrated by his development of an evidence-based national response plan to confront the emerging challenge of fentanyl combined with xylazine in the illegal drug supply, his rapid research to inform COVID-19 clinical decision making and his transitional work in addressing HIV-related health inequities in the U.S.

At the Department of Health, Dr. Holtgrave is charged with a range of activities all with the common theme of translating data into the best possible public health programs and policies for the residents of New York. In particular, he will focus on facilitating the substance use work in the Department to ensure that it is as coordinated, evidence-based and impactful as possible.

“I am honored and humbled by Commissioner McDonald’s invitation to join in the impactful work being done at the Department of Health,” Senior Policy Advisor to the Commissioner Dr. David Holtgrave said. “As the Department is committed to improving the health and well-being of all New Yorkers and building health equity across the State, I am delighted to be able to serve on this incredible team.”

Prior to his service in the White House Office of National Drug Control Policy, Dr. Holtgrave served as the Dean of the University at Albany School of Public Health and worked in close partnership with the New York State Department of Health.

From 2005 to 2018, he was the Chair of the Department of Health, Behavior, and Society at the Johns Hopkins Bloomberg School of Public Health, and served as a member and then Vice-Chair of the Presidential Advisory Council on HIV/AIDS (PACHA). His experience includes service as the Director of the Division of HIV/AIDS Prevention – Intervention Research & Support at the U.S. Federal Centers for Disease Control and Prevention (CDC); and as Professor and then Vice-Chair of the Department of Behavioral Sciences and Health Education at the Emory University Rollins School of Public Health.

A first-generation college student, Dr. Holtgrave earned his Ph.D. in 1988 from the University of Illinois at Urbana/Champaign in Quantitative Psychology and immediately thereafter held a post-doctoral research fellowship in the Interdisciplinary Programs in Health at the Harvard T.H. Chan School of Public Health.

Source: https://www.health.ny.gov/press/releases/2024/2024-08-15_executive_leadership.htm

Filed under: Addiction,Prevention and Intervention,USA :

School-based interventions hold the potential to save lives, researchers say.

Charlotte Waddell, Christine Schwartz, Jen Barican and Nicole Catherine 16 Aug 2024The ConversationCharlotte Waddell is a professor emerita of health sciences at Simon Fraser University, where Christine Schwartz is an adjunct professor and Nicole L.A. Catherine is a professor. Jen Barican is a senior research manager at SFU. This article was originally published by the Conversation.

Successful drug prevention programs delivered to middle-school students taught skills such as resisting peer pressure, managing stress and cultivating positive friendships. Illustration via Shutterstock.

Can a program for Grade 7 students help end the opioid crisis? The answer is yes, according to compelling research findings on school-based primary prevention interventions.

To address this crisis, many of Canada’s responses to the opioid crisis still focus downstream on adults, after problems have started or become entrenched.

In contrast, primary prevention operates upstream in childhood — before most young people start engaging in substance use, misuse or experimentation.

As researchers concerned with helping children avoid opioid misuse, we conducted a systematic review of prevention programs designed for this purpose.

Interventions that could save lives

The program Strengthening Families significantly reduced prescription opioid misuse among young people in Iowa and Pennsylvania, with benefits lasting up to 14 years after the program ended.

The impact was also large, reducing misuse by 65 per cent.

Project PATHS, the other successful program, which was delivered in Hong Kong, significantly reduced heroin use with benefits lasting up to two years later. And each time these programs prevented a young person from misusing opioids, they potentially saved a life.

Beyond intervening early, both of these successful programs shared other similarities. Children learned enduring skills such as resisting peer pressure, managing stress and cultivating positive friendships.

Teaching multiple skills that children could apply throughout their development likely played a role in the programs’ long-term success — and likely contributed to other positive outcomes including reducing cannabis and ecstasy use.

Both program evaluations also highlighted the ability to reach very large numbers of children, using school delivery. These numbers were about 12,000 for Strengthening Families and about 8,000 for Project PATHS.

These numbers suggest that new Canadian school-based prevention efforts could potentially reach thousands of young people. With such a substantial population impact, these programs hold great promise to reduce many harms associated with the opioid crisis — including not only deaths but also criminal activity and distress for individuals misusing opioids and their families.

These two school-based programs have another significant feature adding to their appeal for delivery in Canada. Training for facilitators is very brief — only two days for Strengthening Families and three days for Project PATHS.

The short training time also helps reduce delivery costs, further increasing the appeal for policymakers and school administrators.

In Canada, we need such programs. And evaluations

Yet program benefits do not always translate between countries. So Canadian evaluations would be an important component to accompany implementation of either or both programs.

PreVenture, a school-based program developed by a clinical psychologist and researcher at the University of Montreal, is a good example of expanding both prevention and evaluation efforts.

Researchers from across Canada are currently assessing whether this program can avert opioid use with youth in British Columbia, Ontario and Nova Scotia — building on its success with decreasing alcohol problems as well as the number of drugs that youth used in an RCT in the United Kingdom.

If successful, PreVenture could also be expanded so that fewer Canadian children experience the devastating effects of the opioid crisis.

Research has highlighted important gains that Canadians can achieve by investing in school-based prevention programs.

To realize these benefits, however, leadership is needed at the provincial and territorial levels given that schools fall within these jurisdictions.

Yet the federal government can also take strong leadership, for example, encouraging these types of primary prevention efforts across the country — as they have done with previous important child health problems.

Prevention needs to be central to the approach

The federal government has committed more than a billion dollars since 2017 to address the toxic drug problem — paralleled by provincial and territorial funding.

But a policy shift towards meaningful prevention also requires tackling the realities of current Canadian health spending priorities. While last November, the federal government called for proposals for “projects aimed at helping prevent and decrease substance use-related harms among young people,” such efforts need to be backed by rigorous evaluation methods such as RCTs.

And the programs we describe above have RCT support — suggesting that these are a place to start.

Devastation from the opioid crisis is obviously continuing. Efforts to respond to the acute crisis must therefore also continue — including ensuring access to effective treatments for all in need and curtailing the supply of toxic substances.

But primary prevention also needs to be central in the public health responses, given that continuing increases in treatment spending have not been enough and will likely never be enough on their own. Primary prevention is a crucial but underused component of a comprehensive public health approach.

Most importantly, new primary prevention efforts can increase the chances of more young people experiencing the healthy development that they deserve, in turn precluding much suffering and many costs later in life — while meeting the collective duty of care that all Canadians share for all children.The Conversation

Source: https://www.thetyee.ca/Analysis/2024/08/16/Programs-Youth-Toxic-Drug-Deaths/

Filed under: Canada,Drug use-various effects on foetus, babies, children and youth,Education,Prevention and Intervention,Youth :
  • Written by Aisha Ashley Aine & TIMOTHY NSUBUGA

Back in 2016 when radio personality Ann Ssebunya started the Drugs Hapana Initiative (DHA), the aim was to create awareness and prevention of drugs and substance abuse in her community.

Over the years, DHA has grown to cover the nation. Last weekend, it went a notch higher to create the National Prefects Conference, a forum where Ssebunya and other experts mentored young people to realize their full potential and empower them to act as change agents, write ASHLEY AINE and TIMOTHY NSUBUGA.

More than 200 prefects from various schools from the north, east, south, west, and central teamed up at Nile hall Hotel Africana for the National Prefects Conference.

A team of mental health specialists from Butabika hospital led by the executive director Dr David Basangwa, Dr Kenneth Ayesiga and Dr Eric Kwebiiha, among others, together with a well-prepared group of facilitators, took to the floor to explain the situation of global and national drug use among the youth and the causes and effects of drug abuse on mental health amongst the youth of this nation.

The use of alcohol and drugs during adolescence and early adulthood has become a serious public health problem in Uganda. The World Health Organisation global status report 2024 stated that Uganda has one of the highest alcohol and substance abuse rates in the world.

In another study done on drug and substance abuse in the schools of Kampala and Wakiso, it was found that 60% to 71% of the students used illicit drugs, with alcohol and cannabis taking the biggest percentages. These facts were presented by the head girl of Nabisunsa Girls School in her articulate speech, backed by research she carried out with a team of nine from her prefectorial body.

The global situation on drug use today, according to the World Drug Report research, shows a higher increase in the abuse of drugs by young people in this generation than has ever been recorded in history. Thirty-five million people have suffered and are suffering from drug use disorders, and the majority of people under rehabilitation in Africa are under 35 years of age.

As per the drug abuse state in Uganda, with evidence from hospitals, schools, community surveys and police, it has been found that the country is now a consumer Uganda with alcohol use as high as 12.21pp and a heavy use of hard drugs, that is, hallucinogens like marijuana, mushrooms, phencyclidine/angel dust (smoked or snorted), ketamine, lysergic acid diethylamide (LSD), also known as CIA truth serum, aviation fuel, codeine (cough syrups), cocaine, khat (mairungi), herion, kuber and ice, among many others.

Dr Basangwa, in his well-detailed PowerPoint presentation, showed what the drugs looked like and their names. He stated that although there might be some who think he is enabling and triggering curiosity for people to use drugs, he noted that while handling cases of drug abusers, they had all regretted not knowing the effects of what they were taking and wished they had known.

So, his purpose today was to inform the youth of the various drugs and the effects they can have on a person, and to raise awareness among the youth.

“We cannot fight what we do not know, as drugs come in many forms,” he said.

The head teacher of Kitintale Progressive School revealed in an interview that he once found one of his students with a watch that emits flavoured tobacco smoke, or, in simple terms, a vape watch. Another speaker told of how a vape fell from the belongings of a girl walking with her mother at school, and the poor woman picked it up, not knowing what it was.

He continued by giving an example of the alcohol and drug unit in Butabika, which is mostly filled with young people—people who have dropped out of school, while those still studying are also brought by their parents for rehabilitation. The theme of the conference called for the discussion of psychoactive drugs and their abuse.

These are the types of drugs that usually work on the brain to cause mood changes, but the catch is their addictive effect if abused. Questions arose from the audience to the doctors panel: does it feel good to do drugs? Why does a person get addicted to drugs? and why would anyone opt for drugs? What would encourage someone to try these dangerous substances?

EXPERT TAKE

The panel of mental health doctors took turns answering, explaining first that addiction comes about because drugs have the capacity to change the way the brain functions; it changes the functionality of the brain that makes it need the drug on a daily basis, which is what we call addiction.

There are various inexhaustible factors—environmental, social, and economic—that bring or cause people to try drugs. A perfect example of an environmental factor is the recent global pandemic that brought a high rise in drug abuse in our country. The pandemic saw the use of narcotic drugs as recreational means, and as the youth had too much time on their hands, they turned to drug use.

Others do drugs for experimental purposes or, rather, out of curiosity. The speaker, reminiscing about his days in school, tells of how they had students in school who were known smokers of marijuana, and the whole time, out of curiosity, he had wanted to try it, but when he did, he didn’t like the feeling, and that was the end of it.

But there are some unlucky ones that will try it and like the feeling, and they will go back again to get that feeling. Aggrey Kibenge, the permanent secretary of the ministry of Gender, Labour and Social Development, said the major factors causing the youth to engage in drug use are peer pressure, family history or exposure to drugs, the feel-good feeling, loneliness, depression, the issue of abuse at home that cripples the mental states of children as they grow, the absence of parents during childhood,

As the speakers told of the effects of the drugs on the young leaders, one of the prefects voiced her concerns about who is qualified to advise or counsel drug users— someone who has gone through the same ordeal.

ENTER CHANDIRU

Ssebunya, the organiser, scheduled Jackie Chandiru, someone with firsthand experience in addiction and recovery, to facilitate a 20-minute session with the young leaders. She walked through the conference hall as she told and showed the story and scars from her addiction.
Chandiru had certainly been blessed by God; as she testifies, it was He who pulled her back.

She had had an accident and had a back injury that required surgery. This injury caused her a lot of pain, and it was then that the doctors prescribed her a painkiller called pethidine. She used it too much and got addicted to the point where she did the injections herself.

She told the prefects that if she falls sick and needs an IV, the only place it would be put is in her neck, as the veins in her arms or limbs are dead. She lost her husband, and her music career was almost failing because she had lost the morale of going to the studio and writing songs; all she wanted was pethidine.

She mentioned a person who helped her through these trying times was the MC for the event, Paul Waluya, a clinic therapist and mental health specialist.

The event ended quite successfully as the theme was discussed fully, not to forget the memorable ice breakers, particularly the one that had the whole hall acting like a banana plantation in a windy situation with Waluya blowing air into the microphone for the wind sound effect.

Source: https://www.observer.ug/index.php/education/82054-experts-turn-to-school-leaders-in-fight-against-drug-abuse

Filed under: Addiction,Drug use-various effects,Others (International News),Prescription Drugs,Youth :

BY JULIA MARNIN –  AUGUST 02, 2024

 

A New Jersey man caused the diversion of a flight due to his dangerous behavior and was arrested when the plane landed, feds say. Jan Rosolino via Unsplash An American Airlines passenger forced a Dallas-bound flight to land in a different city because of his “violent” and dangerous behavior, including repeated attempts to open the plane’s doors and his assault on a flight attendant, federal prosecutors said. The flight crew and passengers had to restrain Eric Nicholas Gapco’s hands and feet with flexible restraints until the flight from Seattle landed in Salt Lake City on July 18, according to the U.S. Attorney’s Office for the District of Utah. Gapco, 26, of Delanco, New Jersey, was arrested when the flight landed, according to prosecutors. Gapco continued “to engage in violent and erratic behavior” at the Salt Lake City International Airport, where he smashed the glass door of a holding cell, court documents say. He denied consuming illegal drugs or prescription medication, but later told his arresting officers he ate “approximately ten marijuana edibles,” according to a motion for his detention. Gapco said he didn’t know how much THC, a psychoactive component of the cannabis plant, was in each edible, the motion says. Gapco was indicted July 31 on charges of interference with a flight crew and attempted damage to an aircraft, the U.S. Attorney’s office said in a news release. His federal public defender didn’t immediately respond to McClatchy News’ request for comment on Aug. 1. On the July 18 flight, prosecutors said Gapco wouldn’t stay in his seat, tried to take a flight attendant’s seat, “propositioned a flight attendant for sex,” was loud, yelling, vaping and disrupting others. He also locked himself in a plane bathroom, went on to try to open the flight’s doors and is accused of trying to hand another passenger a bag of pills, according to prosecutors. Gapco “assaulted and intimated a flight attendant and aircraft crew members,” prosecutors said. “The safety and security of our customers and team members is our top priority,” American Airlines told McClatchy News in a statement on Aug. 1. “We thank our team members for their professionalism and our customers for their understanding.” American Airlines didn’t immediately respond to McClatchy News’ request for comment on Aug. 1. After Gapco broke a glass door at the Salt Lake City airport following his arrest, Gapco was taken to a hospital to be medically evaluated, according to prosecutors. “He continued to be belligerent” and “combative with medical staff and the police,” prosecutors wrote in the motion for his detention. “At one point, he spat on an officer.” Galco’s temporary detention was granted on July 23, court records show. He is due to appear for his initial appearance in court the afternoon of Aug. 1, prosecutors said.

Source: https://www.sacbee.com/news/nation-world/national/article290654789.html

 

Filed under: Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,USA :

Suicide rate among Native American population is second-highest in the state

By  | byarbrough@scng.com | San Bernardino Sun
UPDATED: 

In 2020, Assemblymember James C. Ramos, D-San Bernardino, celebrated the creation of the state’s new Office of Suicide Prevention.

Four years later, more work remains to be done, he and other Native American leaders say.

Despite making up only 3.6% of Californians in 2020, American Indians or Alaskan Natives made up 9.8% of those who killed themselves that same year, according to the California Department of Public Health. Nationally, Native American populations are more than twice as likely as Black or White populations to die due to deaths of “despair” — suicide, drug overdoses and alcoholic liver disease — according to a UCLA Health survey released in April.

On Wednesday, July 17, Ramos — author of  Assembly Bill 2112, which created the Office of Suicide Prevention — gathered with representatives of Inland Empire tribes at the Morongo Band of Mission Indians’ Tribal Council Chambers in a roundtable to discuss the need for more help preventing suicide among Native Americans.

“We’ve had incidents where young members have taken their lives,” said Soboba Band of Luiseno Indians Chairperson Isaiah Vivanco. “Life is so precious, and when we have young ones taking their own lives, it has to be (a warning), it has to be an issue.”

Tribal leaders said that, too often, health professionals don’t understand native culture, and end up pushing those who need help away.

“Culture is healing as well,” said Soboba tribal secretary Monica Herrera. “Sometimes (mental health) facilities don’t recognize that (patients) are Native American and that sweat lodge or praying or some type of cultural healing is not encouraged. ‘We can’t take you to the sweat lodge; it’s against our policies.’ “

California health officials vowed to do better at the meeting.“Our traditional behavioral health system has woefully failed Native American populations,” California Health and Human Services Deputy Secretary of Behavioral Health Stephanie Welch told the tribal leaders. “There are high rates of suicide, there are high rates of self-harm as I have heard in the room, and there are high rates of drug misuse and overdose.”

Native communities aren’t using existing mental and behavioral health resources, state officials reported.

“When I see statistics around low utilization of behavioral health services, that’s on us,” Welch said. “Behavioral health services has not traditionally reflected the acceptance of (the) cultural, linguistic and geographical diversity that’s needed to address the needs of Native Americans communities.”

The department knows that it isn’t reaching many groups that need its mental health services and has embarked on a new initiative, “Mental Healthcare for All,” she said.

“And that truly means all of us and it needs to be inclusive of California Native Americans,” Welch said. “Everybody should have access to affordable, equitable, and most importantly, culturally responsive mental health and substance use disorder (treatment).”

As part of the effort, the state is investing in mobile clinics to bring services directly to tribal communities.

Within five years, Welch said, her agency hopes to have culturally appropriate mental health counselors available on mental health crisis lines in the state. In the meantime, her team is examining gaps in existing services when it comes to meeting the needs of California’s Native American population, along with identifying barriers that prevent the community from accessing healthcare options.

More mental health resources should be on the way.

Voters approved Proposition 1 in the March 5 primary election this year, authorizing a nearly $6.4 billion bond for facilities for mental health or substance abuse treatment.

“We want to make sure that California’s first people are not left out of that equation,” Ramos said.

Source: https://www.eastbaytimes.com/2024/08/04/california-needs-to-do-more-to-prevent-suicide-among-native-americans-tribal-leaders-say/

Filed under: Addiction,Brain and Behaviour,Drug use-various effects,Prevalence,USA :

August 4, 2024

Conferences|ASPC: American Society for Preventive Cardiology

Lifestyle changes—including eating fruits, vegetables, and whole grains—can help patients, especially those with diabetes or hypertension, improve outcomes.

Robert Ostfeld, MD, ScM, director of preventive cardiology at Montefiore Health System and professor of medicine at Albert Einstein College of Medicine in New York sat down with Drug Topics ahead of the American Society for Preventive Cardiology Congress on CVD Prevention to discuss the role that dietary patterns and nutrition decisions play in living a healthful lifestyle.

Drug Topics: What specific nutrients or dietary patterns have been shown to benefit patients with hypertension and diabetes, and how can this information be incorporated into patient counseling?

Robert Ostfeld, MD, ScM: That’s a very important question. A healthful diet, of course, can very positively impact cardiometabolic health—including blood pressure, diabetes, [and] lipids—and cardiovascular health and overall health in general.

Reassuringly, there is broad [alignment] in terms of what defines a healthful dietary pattern. For example, multiple medical societies—like the American Heart Association, the American College of Cardiology, the American Society for Preventive Cardiology, the Canadian Cardiovascular Society, the European Society of Cardiology—are all broadly aligned; consuming more plant-based nutrition, less ultra-processed foods, less red and processed meats, is helpful both cardiometabolically and [for] cardiovascular health overall.

Unfortunately, that recommendation hasn’t necessarily percolated down well, at least into the US. There was an interesting recent analysis where from the NHANES database—the National Health and Nutrition Examination Survey database—published in 2021, where they looked at a little over 11,000 people…where they used 5 elements to define diet. One element was consuming at least 4 and a half servings of fruits and vegetables a day, at least 3 servings of whole grains each day, low sugar or sweetened beverage consumption, low salt consumption, and 2 servings of fatty fish each week. If you had 0 or 1 of those, then they felt you had a poor diet; 2 or 3 an intermediate [diet], and 4 or 5, an ideal dietary pattern. About 75% of the US has a poor, 0 to 1 of those [elements] dietary pattern; 25% [have] intermediate, and 0.7% of the US has an ideal dietary pattern.

READ MORE: Food Is Medicine: Pharmacists Can Advance Policies for Healthier Communities

There’s a huge gap between where we are and where we could. You could ask, “Does it even really matter?” Of course it does. In this study, they modeled if everyone adopted an ideal dietary pattern—so 4 or 5 of those 5 elements—for 1 year, what would happen? Well, it was estimated that cardiovascular event rates would fall by about 42%. The gap matters. There’s randomized prospective cohort data that eating a healthful dietary pattern, more plant based [and] aligned with American College of Cardiology and American Heart Association recommendations, can also be helpful for high blood pressure, particularly the DASH [Dietary Approaches to Stop Hypertension] dietary pattern for high cholesterol, the dietary portfolio pattern, which is a high fiber plant based diet, and also, similar recommendations broadly for diabetes.

What I should reinforce is, it’s not really that there’s 1 diet for high blood pressure, high cholesterol, and diabetes. They’re really broadly aligned that consuming more healthful, plant-based foods—fruits, vegetables, whole grains, beans, lentils—less ultra-processed foods and less red and processed meats, is helpful for all of the above: cardiovascular health and cardiometabolic health.

Drug Topics: How can patients be supported in overcoming common barriers to healthy eating, such as budget constraints and limited access to nutritious foods, in the management of hypertension and diabetes?

Ostfeld: Helping the individual patient in the office embrace a more healthful diet can be a challenge. Society does not make…it easy for the healthy choice to be the easy choice. And behavior change, getting someone to change how they eat, how they live, can be very, very difficult. These are big hurdles that we face.

As an individual practitioner, it can be overwhelming to overcome some of these things; at least we can try and start. As an individual [health care provider], you’ll have your team around you who can support you and reinforce your message. Nurses, support staff, and registered dietitians can be incredibly helpful to reinforce and educate about this topic.

In the clinic specifically, I will try to find a specific reason that the patient may be interested in living more healthfully. Maybe they want to lose weight or improve their skin complexion, maybe they want to lower their blood pressure, lower their cholesterol, come off a medication… Whatever the case may be, I try to highlight how consistently eating more healthfully can address that particular issue. I will give them some very specific steps—some simple specific steps, because everyone’s busy and there’s so much information to take in—that they can hopefully do when they get home to live more healthily. I have a handout that I give them that I try to keep very simple.

Sometimes in clinic, because we’re all so busy, I’ll just say, “Let’s just start with 222.” [That’s] 2 servings of green leafy vegetables a day, 2 servings of fruit each day, 2 servings of other vegetables each day: 222. I’ll do that a little bit weirdly, deliberately, so they’ll remember it. Then when they go home, depending on where they live, there may be more or [fewer] access or cost issues. [I’ll explain that] for ease, [they] could cook in bulk; we certainly don’t have to buy, you know, organic green juices. You can get frozen vegetables, frozen fruits, big sacks of potatoes, oatmeal, and beans, and those things can be much less expensive and more doable.

Another way to help patients adopt a more healthful lifestyle is—there may be the hurdle of costs here—but there are services that can deliver meals, healthful meals, to patients; they may be able to access registered dieticians, and of course there are multiple online resources that are free for patients. The Physicians Committee for Responsible Medicine has a 21-day kickstart for more plant-based nutrition should, the [health care provider] feel that that’s appropriate for the patient. There are a variety of resources that people can have access to; some may cost a little bit more, but some are also free. The American College of Lifestyle Medicine also has multiple online resources.

Source: https://www.drugtopics.com/view/q-a-examining-the-key-drivers-of-a-healthful-lifestyle

Filed under: Education,Health,Prevention (Papers),Prevention and Intervention,USA :

BMC Public Health volume 24, Article number: 2103 (2024) Cite this article

Abstract

Background

Black individuals in the U.S. face increasing racial disparities in drug overdose related to social determinants of health, including place-based features. Mobile outreach efforts work to mitigate social determinants by servicing geographic areas with low drug treatment and overdose prevention access but are often limited by convenience-based targets. Geographic information systems (GIS) are often used to characterize and visualize the overdose crisis and could be translated to community to guide mobile outreach services. The current study examines the initial acceptability and appropriateness of GIS to facilitate data-driven outreach for reducing overdose inequities facing Black individuals.

Methods

We convened a focus group of stakeholders (N = 8) in leadership roles at organizations conducting mobile outreach in predominantly Black neighborhoods of St. Louis, MO. Organizations represented provided adult mental health and substance use treatment or harm reduction services. Participants were prompted to discuss current outreach strategies and provided feedback on preliminary GIS-derived maps displaying regional overdose epidemiology. A reflexive approach to thematic analysis was used to extract themes.

Results

Four themes were identified that contextualize the acceptability and utility of an overdose visualization tool to mobile service providers in Black communities. They were: 1) importance of considering broader community context; 2) potential for awareness, engagement, and community collaboration; 3) ensuring data relevance to the affected community; and 4) data manipulation and validity concerns.

Conclusions

There are several perceived benefits of using GIS to map overdose among mobile providers serving Black communities that are overburdened by the overdose crisis but under resourced. Perceived potential benefits included informing location-based targets for services as well as improving awareness of the overdose crisis and facilitating collaboration, advocacy, and resource allocation. However, as GIS-enabled visualization of drug overdose grows in science, public health, and community settings, stakeholders must consider concerns undermining community trust and benefits, particularly for Black communities facing historical inequities and ongoing disparities.

Peer Review reports

Background

The overdose crisis poses an unrelenting public health threat in the U.S. with fatal drug overdoses reaching a record high of over 100,000 in 2021 [1]. Record highs are especially prominent for Black individuals, who outpaced other racial/ethnic groups in rates of fatal drug overdose during the first two decades of the 2000s [2, 3] experiencing the highest increase in rate of overdose death from 2015–2020 [4]. Relative to White individuals, these disparities have continued to widen since the COVID-19 pandemic. American Indian/Alaska Native and Black populations have faced the highest rates of fatal drug overdose of all U.S. racial/ethnic groups since 2021 [5]. Disproportionate increases in fatal drug overdose rates among Black individuals coincide with the introduction of illicitly manufactured fentanyl and its analogues to the drug supply [2, 3] though fatal overdoses involving heroin and cocaine have also disproportionately increased among this group [6, 7]. Although racial disparities in fatal overdose are driven by the increasingly adulterated drug supply, they are exacerbated by social determinants of health (SDOH), including drug criminalization and inequitable enforcement by law enforcement [8, 9], racial residential segregation that contributes to Black neighborhood disinvestment [10], racialized service access that limits treatment options for Black individuals [11, 12], and inequitable availability of overdose prevention (e.g., naloxone) [13]. Indeed, fentanyl-related overdose deaths tend to cluster in low treatment-density, high-deprivation neighborhoods where residents are predominantly Black [14,15,16], emphasizing the impact of place-based SDOH on increasing racial inequities in the overdose crisis.

Racial inequities in overdose are generally attributed to SDOH, including features of one’s geographic location or built environment that impact well-being, such as aspects of neighborhood deprivation [17]. Black people in the United States are more likely than their White counterparts to live in neighborhoods that face high deprivation, including socioeconomic (e.g., high rates of poverty and unemployment) and physical deprivation (e.g., the deterioration of building structures and vacancies) due to policies that contribute to residential segregation and neighborhood disinvestment [18]. Both socioeconomic and physical deprivation are associated with fentanyl availability, drug overdose [11, 14, 19], and lower access to treatment and overdose prevention [13, 20, 21]. Predominantly Black neighborhoods are particularly vulnerable to overdose in the face of deprivation [11] with higher racial residential segregation (i.e., higher Black-to-White resident ratios) also predicting fatal overdose [15]. These racialized neighborhood-level inequities are not only associated with overdose, but also substance use treatment access. As the proportion of Black residents in an area increases, the proportion of substance use treatment facilities decreases [22], especially those providing medications for opioid use disorder (MOUD) [23,24,25].

To mitigate the impacts of racialized SDOH on drug overdose in Black neighborhoods, community-based efforts have used mobile outreach to service areas with low treatment access. Often these efforts dispatch peers, community health workers, and/or other lay advocates to provide harm reduction tools, overdose education, and service linkage [26,27,28,29]. Outreach services provided by peers and lay health workers with similar lived experiences (i.e., racial and/or drug use) not only address geographic barriers to treatment access, but also mitigate justifiable mistrust of systems that Black individuals in disinvested communities develop as a function of their experience with persistent systemic disinvestment [30,31,32]. Accordingly, drug-related outreach efforts have shown promising rates of engagement and follow-up with Black individuals in particular [26, 28, 29]. For example, one study found that a mobile unit providing MOUD enrolled a greater proportion of Black individuals relative to fixed-site clinics [33].

Overdose prevention outreach is typically limited by convenience- or funding-based location targets, rather than data-driven targets [26, 29]. This is despite extensive research using maps produced with geographic information systems (GIS) to characterize and visualize the epidemiology of drug overdose–with over 181 articles published on this topic since 2017 [34]. Indeed, GIS has been used to identify target populations and neighborhoods for health and social services [35,36,37], identify naloxone-distributing pharmacies that require improved pharmacist education [38], and inform location targets for overdose prevention services [39, 40]. However, few of these studies discuss implications for outreach or address how spatial data visualization (i.e., via maps) translates to organizations and individuals conducting outreach.

The present study takes the first step toward addressing the gap between research and community praxis by examining the acceptability and appropriateness of GIS to facilitate data-driven outreach for reducing overdose inequities facing Black individuals. We convened a focus group of community stakeholders leading overdose prevention outreach programs in Black communities in St. Louis, MO to assess how GIS tools can best characterize and visualize overdose to reflect practitioner needs. This formative study leveraged existing community partnerships to inform both the aims and recruitment with the goal of conducting a focus group that would guide the development of future community-engaged research adopting GIS in outreach settings. The aims were to 1) examine systemic and cultural barriers to implementing a GIS-facilitated overdose visualization tool among outreaching health workers and 2) understand the extent to which outreaching health workers would find such a tool acceptable and appropriate for overdose prevention.

Methods

Setting

Participants were stakeholders invited to participate due to their leadership role in organizations that conducted outreach in the neighborhoods of St. Louis, MO, locally referred to as “North City.” North City refers to the area of St. Louis City bordered by St. Louis County to the West, the Mississippi river to the East and North, and the east–west Delmar Blvd to the south. The latter is infamously called the “Delmar Divide” as it divides St. Louis City not only racially and socioeconomically but also in terms of health, with those neighborhoods north of the Divide having a higher concentration of Black residents and poverty, but a significantly lower life expectancy than those south of it [41]. St. Louis’s current racial and socioeconomic segregation is an enduring product of redlining and other segregationist policies of the mid-twentieth century [42], that contribute not only to economic and health inequities but also specifically to overdose inequities [43]. For example, from 2015 to 2021, drug-involved deaths among Black residents of St. Louis City and County increased at a rate eight times that of White residents, with overdoses among both races increasingly clustering in North City Black neighborhoods [43, 44]. Like others across the country, social service nonprofits and grassroots community organizations in and around North City St. Louis responded by launching or expanding existing services to include overdose prevention outreach.

Participants and procedures

Participants were recruited from partner agencies known to the research team funded by the Missouri Department of Mental Health’s State Opioid Response (Missouri SOR) to provide substance use services via outreach in North St. Louis neighborhoods. In 2021–2022, several agencies and funders inquired about the potential to visualize substance use/harm reduction service access (e.g., via Google Maps) and overdose risk (e.g., zip code-based heat maps) via mapping. However, some community partners and research staff were concerned that making these data public may attract bad actors and disproportionately negatively impact Black communities. These conversations led to the current research questions.

Using purposive convenience sampling, 17 potential participants from 11 organizations were emailed to provide a description of the study and invited to participate. Six of these organizations were current collaborators on other academic-community initiatives emerging in response to increasing overdose in North St. Louis, and thus also engaged with the research team on various other activities, including providing harm reduction resources and education, sharing data, conducting program evaluation, and co-engaging in legislative, funding, and media advocacy. The five other agencies were known entities in the community funded to provide substance-related services in predominantly Black neighborhoods, but not currently engaged with the research team. All potential participants were contacted over email with standardized information about the study; those who did not respond were followed up with by phone.

Enrolled participants (N = 8) were predominantly Black (88%); 50% were women and 50% were men (n = 4 each). Participants represented 7 organizations ranging from grassroots neighborhood nonprofits to large, regional social service and treatment agencies; 4 agencies were connected with the research team in other capacities and 3 agencies were new connections. All participants had an operational or supervisory role in their organization’s adult substance use treatment or harm reduction programming. People with these roles were sampled to speak to the acceptability and appropriateness of a GIS tool in the context of current organizational and program barriers and decision-making processes; however, all were experienced conducting street outreach.

Before the focus group, two staff met individually with each participant to obtain informed consent. The focus group was conducted in-person at a local university by MP, who was assisted by a notetaker and observer. It lasted approximately 120 min and was audio recorded. The focus group protocol was developed for the current study based on questions that emerged internally among the research team during initial work creating preliminary maps and a review of the available literature. The protocol included a semi-structured discussion of current outreach efforts to address overdose and attitudes toward mapping efforts in St. Louis [See Supplemental Materials: Appendix A]. Participants also provided feedback to preliminary maps created in Esri’s ArcGIS Online, including an overdose heat map by census tract, a substance use treatment and service map, and a map demonstrating individual overdose locations that could be filtered by race and other overdose characteristics (see Fig. 1). Participants responded to prompts focused on accessibility of the spatial information and usability to their work. Participants were provided $50 in compensation. This study was approved by the Institutional Review Board.

The focus group was transcribed verbatim by a professional transcription service. Three members of the research team (DEB, MP, and RG) read the transcript and notes taken by an observer and met several times to generate organizing codes that represented recurring concepts arising from different participants. Using an inductive reflexive approach to thematic analysis [45] informed by contextualism (a relativist perspective) [46], two coders independently coded the transcript semantically (MP, RG) in ATLAS.ti and met with the first author (DEB) to address any discrepancies, reaching consensus on 13 codes. Finally, MP organized codes into 4 preliminary themes by creating a visual table; themes were based on keyness (the ability of the theme to answer the research question) and meaningfulness (themes that identify underlying conceptualizations, not simply topical descriptions). The coding team met to review themes for internal homogeneity and external heterogeneity and check coherence with data before drafting the following results.

Results

We identified four themes that contextualize the acceptability and utility of an overdose visualization tool among community stakeholders providing services in Black communities. They were 1) importance of considering broader community context; 2) data manipulation and validity concerns; 3) potential for awareness, engagement, and community collaboration; and 4) ensuring data relevance to the affected community. Each is described below with illustrative quotes from respondents (expanded in Table 1).

Importance of broader community context

Although the researchers’ intent was to discuss a mapping tool, participant conversations frequently emphasized the context underlying racism-related SDOH in St. Louis’s Black neighborhoods. Specifically, participants discussed how current and historic policies have detrimentally impacted Black communities in the region, leading to striking disparities between White and Black communities in St. Louis with the latter seen as “depletion zones.” Participants highlighted the difference between White-majority communities that have “access to everything within five minutes” (Participant #1) including education, healthcare, and opportunities for physical activities and Black-majority communities, in which “weeds is high, vacant buildings” (Participant #2) and “you got to drive five miles to pick up lunch” (Participant #3). As one participant stated about the condition of Black neighborhoods: “That’s enough to make a person not see a future” (#2).

Participants reinforced an increasing need for substance use intervention in Black-majority communities due to the high community-level access to drugs paired with the unpredictable drug supply following the rise of synthetic opioids. They noted that open air-drug markets are disproportionately located in Black neighborhoods in St. Louis due to persistent neighborhood deprivation. Thus, illicit fentanyl can freely flow into North St. Louis while other resources such as nutritious food are unavailable. However, participants felt that overdose is just one manifestation of the impact of systemic racism on health:

In our community, it’s not just drugs, it’s not just bullets. From the day you’re born, you are faced with reasons and that manifests in so many things. It’s a struggle, honestly is a struggle to be Black in America. (Participant #4)

Ultimately, participants felt that until the disparities in SDOH related to systemic racism are more directly addressed, advocates such as themselves could never “get to the core or root of the problem [of overdose in] low-income minority communities” (#1).

This theme derived in part from participants’ previous experiences with initiatives that used mapping to visualize other health disparities (e.g., sexually transmitted infections [STIs]) that ended up stalling or having limited impact on the community due to SDOH-related barriers that made it difficult to implement change or access services. Thus, participants emphasized that a mapping tool must not only show overdose, but also the SDOH that must be mitigated to effectively redress overdose, such as “the lack of quality services” (#4) ranging from addiction treatment to public transportation. Emphasizing specific SDOH that would put overdoses in Black neighborhoods in context, one participant stated, “Are there banks nearby? Are there businesses nearby? Are there grocery stores? Are there restaurants? Are there schools?” (#3).

Data manipulation and validity concerns

Decades of disinvestment and gentrification in St. Louis’s Black communities, led to concerns that organizations from outside of these communities may perpetuate similar harms. This included some skepticism about an overdose visualization tool created by an academic institution. Participants were concerned that a map highlighting a majority-Black area as a “high crime, high overdose neighborhood” may lead to further disinvestment and increased law enforcement presence. They described how a map could be used to justify and encourage gentrification and the displacement of Black residents rather than improving their circumstances, citing previous instances of entities using spatial data to do just that:

I lived for 30 years in the central corridor in the 17th ward…once [a local university] wanted our neighborhood, it was over with. We had really high rates of everything you can think of. And the population was 70:30, 70 African American, 30 White. Now it’s flipped. And what happened was [the university] wrote a bunch of grants showing that the demographics needed this money[, then] used that money to wipe that demographic out. (Participant #5)

Participants were also apprehensive about the validity of the overdose data that the visualization tool would display. They doubted whether the data would accurately represent the Black people who use drugs they work with, many of whom are unhoused and face other structural barriers that may leave them “invisible to the system.” One participant stated, “Usually with overdoses, people go to the hospital. African American brothers do not go to the hospital” (Participant #6), emphasizing the perception that many Black people die alone and are thus, not accurately represented in overdose surveillance. Thus, it was important for participants to understand who compiled overdose data and how it was gathered as they tended to trust first-hand experiences and local anecdotal information over overdose data. One participant shared, “I see 200 people a week and that number isn’t going down. If anything, it’s going up. So even if you brought me all kinds of statistics that said [drug overdose] was decreasing … I’m still seeing the same or more.” Despite this, they still saw an overdose visualization tool as something they could use to supplement first-hand experience:

It’s helpful in the sense that I can go now, myself, and see if [the data are] true. So, I don’t just take it at its face value, I go now to experience it for myself…The numbers showed us that these were the places that we needed to be for a lot of reasons. But I don’t just take a map at face value like, “Okay, that’s the way it is, let’s go see parts of it,” but let me check that, check that skepticism, take that and go learn from there. (#3)

Awareness, engagement, and community collaboration

Despite concerns about displaying overdose data using GIS, participants endorsed potential compatibility of an overdose visualization tool with current service and community needs, describing its appropriateness for supplementing their own service provision as well as for advocacy toward greater resources and systems change. Participants noted ways in which an overdose visualization tool could be appropriate for guiding their overall service provision, targeting specific overdose prevention resources, and collaborating with agencies that provided complementary resources (e.g., social services). A map would help them choose places to conduct outreach based on “where the most overdoses were taking place in these communities (#3). Mapping could help target specific resources, for example, to people who use stimulants, who several participants noted were “getting pushed to the side” (#6) in the context of a worsening opioid crisis.

However, participants most strongly viewed an overdose visualization tool as an advocacy tool at individual, organizational, and policy levels. At the individual level, they imagined using the tool to increase general awareness of overdose within the neighborhoods they work. They did not imagine the mapping tool as one they would use in the office, but instead in the community doing street outreach and engaging with community members (e.g., on a mobile phone or tablet). They cited drug stigma and a lack of knowledge within North St. Louis as a barrier to providing needed resources. Specifically, participants described how many community members they interacted with seemed to ignore or deny drug-related deaths in their own neighborhoods. Some attributed this to “old school…generations” who “don’t talk about stuff” (#6) like drug use and the overdose crisis, and thus, were unwilling to support the needed harm reduction services participants’ organizations provided. One participant was particularly frustrated with community members’ rejection of their harm reduction outreach services, stating, “You might choose to put your nose up to it, or blind yourself to it, but it’s real” (#3). Thus, this participant valued the potential of a map displaying fatal overdose to help increase understanding about the impact of the overdose crisis on the Black community and to generate collective action toward mitigating it:

There’s situations where we pull up in a place and they’re like, “we don’t want you here.” Well okay, but let me show you why I’m here. I can use that map to show there’s a reason why. “I came because look at these numbers right here”… Now I can get the whole community involved, in a way that I couldn’t before … because the communities we go to right now don’t acknowledge that there’s an [overdose] issue in their community. (#3)

In their positions as not only service providers, but also advocates for a severely under-resourced community, participants hoped an overdose visualization tool could increase community awareness of available services since they found residents and providers often unaware of them. Participants felt strongly that outreach efforts must connect residents affected by drug use to resources beyond treatment services to address the full range of health and social consequences of neighborhood deprivation. Thus, they saw potential for improved collaboration and referral across organizations and discussed how an overdose visualization tool could be used for community advocacy, problem solving, and planning across organizations:

With the mapping… [local government could] utilize the community organizations within those zip codes to be at the table to resolve problems in that zip code versus making their own plan of what they think is going to work … bring those people to the table, because those are the people that see and know that community. (#1)

At the policy level, an overdose mapping tool was also seen as a strategy to advocate for increased funding within their communities and for their organizations specifically. For example, they described how GIS data visualizations could be incorporated into grant applications to demonstrate the need for the services their organizations provide. They also hoped a mapping tool could help facilitate overall increased investment in North St. Louis, including for additional outpatient and inpatient treatment options, affordable housing development, and HIV/STI clinics.

Ensuring data relevance to the community

Participants stressed the importance of including people with lived experience in the development of any overdose mapping tool. People who use drugs and providers who serve them in communities targeted by the tool should be consulted during its development. Although participants valued spatial data, they believed that it should be paired with narrative data and storytelling. Focus group participants generated ideas such as including stories of how the overdose crisis has affected community members or testimonials of people who achieved recovery within the tool, emphasizing that “maps without a story are meaningless to the community” (#3). They also saw this mixed methods strategy as vital for framing the maps so that they do not perpetuate stigma toward people who use drugs or serve as a rationale for bad actors to further disinvest in Black-majority areas with high overdose rates.

Participants also reinforced that each neighborhood they work within is unique with different community assets, challenges, and histories. Regional, county, and city-level maps had much less perceived utility to this group than a tool that could examine neighborhood-level geography:

Each community has its own different thing that’s going to work. Baden, what works in Baden ain’t going to work in Hyde Park. Two totally different communities, even though they may be structured similar, … same thing is not going to work in those communities. (#1)

Discussion

The current qualitative study examined the acceptability and potential utility of using GIS to facilitate data-driven mobile outreach services for overdose prevention. Participants from organizations providing outreach services in predominantly Black neighborhoods pointed to the potential for a GIS tool displaying locations of drug overdose to inform their service provision and referrals, improve awareness of the Black overdose crisis among both community members and funder-stakeholders, and facilitate collaboration among service providers. Participants’ ability to resist a conversation focused solely on the GIS tool resulted in one that highlighted the importance of understanding the context of opioid use in St. Louis’s Black neighborhoods and the need to elevate community voice, both in features of and in the use of the tool.

Citing manifestations of systemic racism that have led to neighborhood-level inequities in SDOH–and in turn, drug overdose–findings also highlight that such a tool could be limited by data validity and misrepresentation. Participant recommendations for mitigating these concerns included making a mapping tool more relevant to Black communities by including qualitative data, such as storytelling, and involving stakeholders from those communities to incorporate hyper-local knowledge. Participants also noted ways that the GIS tool could be used to communicate with government officials and across community organizations, increase advocacy, and gain resource investments that mitigate SDOH contributing to overdose rates.

Our findings are aligned with previous research demonstrating that community organizations conducting overdose prevention via outreach see the benefit of mapping to inform linkages to treatment and related resources [39, 40]. Although previous research has pointed to the utility of GIS data for agencies conducting outreach to “underserved communities with high overdose burdens” (40 p. 1761), this study included voices from grassroots organizations with lived experience working in those communities. A unique contribution of including voices was discussion of how GIS could be used not only for targeted tertiary prevention, but also for more advocacy to address what participants saw as the “root cause” of the Black overdose crisis: racism related SDOH. As such, participants suggested GIS tools include historical and current characteristics associated with systemic racism and racialized neighborhood segregation (e.g., food deserts, vacancies, and limited access to health services). GIS is already used to identify environmental manifestations of racism impacting social, mental, and physical health disparities. Research has demonstrated how racialized health disparities derive from economic SDOH like poverty and unemployment, environmental SDOH like noise pollution and poor walkability, and historical SDOH like redlining [47, 48]. Using GIS to visualize manifestations of racism may be a promising strategy for educating the public about the source of health disparities and advocating for equity-focused funding and intervention [49].

Participants also suggested that GIS can be used to directly mitigate overdose by improving community awareness of the opioid crisis, helping to reduce stigma and empower residents in areas with high overdose burdens to recognize and respond to overdose. This may be particularly useful in racially minoritized communities who have been impacted by the false racialization of substance use or “double stigma” at the intersection of racial and drug-related discrimination [50, 51]. For example, in New Mexico, ethnically and culturally matched community health workers are dispatched to Latinx communities to provide overdose education, but also to reduce mental health and substance use related stigma, incorporating culturally-relevant concepts such as whole person health [52]. Such interventions provided by culturally congruent lay health workers and peers could be supplemented by local data visualization using GIS in Black communities overburdened by overdose.

Despite identified benefits of GIS, findings suggest community ambivalence about mapping. Previous research among research and clinician stakeholders have pointed to the potential for big data related to overdose to be framed or used to perpetuate inequities, including socioeconomic disinvestment [53, 54]. Like previous research, the result of this ambivalence tended to skew towards potential benefits rather than concerns [54]. Specifically, the devastation of the overdose crisis was perceived to be so severe that it was better to use the data in the hopes of attracting more awareness and resources:

We’ve got to recognize that [bad actors are] an inherent risk and roll with it, but there’s also so many benefits. We’ve all talked about all the different ways we can use this [mapping tool] and we’ve got to think about those more than we think about the harmful. (#3)

However, given the stigmatization of those affected by overdose, future spatial epidemiology and surveillance of the problem must consider integrating qualitative data and citizen science. Community-engaged approaches that incorporate the perspectives of people with lived experience with drug use and/or racism can highlight cultural strengths of underserved communities, mitigate racialized stigma, and provide practical recommendations to avoid data being used to perpetuate the deficit narrative. In the context of technology like GIS, one promising approach is digital storytelling, a researcher-facilitated process of capturing lived experience in multimedia formats often used for health promotion in marginalized groups [55, 56]. Digital storytelling has been integrated with GIS, exemplified by ArcGIS’s own “Story Maps” tool, but has been little used in geospatial science and drug surveillance. Integrating big data via GIS and qualitative lived experience via digital storytelling may help scientists, public health officials, and community members better understand and solution social and economic inequities driving the drug overdose crisis in Black communities [57].

Although not mentioned by those participating in the focus group, the inclusion of community voice might also enhance community trust of researchers and research institutions through the experience of authentic inclusion and elevation of community voice [54]. Community-engaged and GIS methods have been combined to identify areas for public health intervention for problems including chronic disease and nutrition [53, 58]. These participatory mapping approaches incorporate local knowledge into geospatial indices that may predict health outcomes and identify SDOH beyond those traditionally discussed [59, 60]. Thus, in addition to building trust toward and engagement with opioid big data, community-engaged approaches to opioid surveillance in Black communities may also improve scientific and applied outcomes, contributing to increased health equity.

Given increasing use of GIS in drug overdose epidemiology and research by local public health agencies, community organizations, and researchers alike, future GIS research should increase its public health application. The current study raises several implementation questions for future research. For example, participants suggested that a mobile tool could help supplement overdose education during outreach whereas a tool displaying drug trends (e.g., stimulant versus opioid-involved death) could help them target specific harm reduction resources. Thus, research involving the adoption of a GIS tool into outreach and other community-based interventions could examine the feasibility of mobile tools and the fidelity of community-based organizations to providing resources aligned with the drug trends observed. Consistent with participant recommendations from this project, adoption of GIS tools should include the ability to examine data at smaller levels of analysis (i.e., at the address level) to identify neighborhood-level gaps in overdose prevention and related services [61]. Future research should extend findings on acceptability of overdose mapping tools by evaluating the effectiveness of such maps for outreach. Although several studies have used GIS as a tool to evaluate the impact and effectiveness of outreach services, very few studies have evaluated how GIS tools can be used to improve such services. One recent study evaluated the implementation of GIS tools to target outreach services for opportunity youth (i.e., youth not engaged in school or work) in the Phoenix, AZ area [36]. The authors describe how three GIS-derived maps increased agency referrals and led to the opening of satellite centers to increase access in high need areas. Next steps include examining whether GIS can similarly facilitate the needed increase in resources, collaboration, and awareness to address the opioid crisis in Black communities.

This report must be considered given its limitations. The most significant limitation is that results are based on one focus group as the study was practically limited by the limited number of organizations conducting outreach in North St. Louis and recruitment challenges. These challenges included generating interest in research participation among potential participants and coordinating schedules for focus groups due to lack of capacity for staff coverage within many of the organizations. Although the group was homogenous given participants’ similar roles, conducting only one group certainly limited variability in perspectives as well as in thematic analysis. As participants were recruited from known partners, many were familiar with the focus group facilitator (MP). This may have enriched the conversation due to increased trust and rapport with the facilitator, but also could have biased the conversation toward participants who were more familiar with her. We also must acknowledge that the research team are culturally distinct from participants and hold relatively privileged social locations, despite some investigators sharing characteristics like racial and regional origin. Although our analysis approach was inductive, the current interpretation is limited as we are not members of the affected community of Black people who use drugs. Results also have limited transferability to other communities given the focus on the needs of North St. Louis. However, racialized neighborhood disinvestment is common in many cities and concerns about using big overdose data to perpetuate racist policies has been documented in previous research [54, 62]. Thus, the current study may inform future GIS-related research and practice focused on racial disparities in drug overdose.

Conclusions

The current study highlighted the potential utility of GIS to facilitate data-driven outreach for drug overdose prevention in underserved Black neighborhoods. As data visualization of overdose explodes in science, public health, and community settings, stakeholders must consider validity concerns that may undermine benefits and limit community trust. Those using GIS to illuminate service inequities and gaps in overdose among marginalized groups must consider the historical community context, minimize opportunities for data manipulation and misinterpretation, and seek to garner the knowledge and trust of affected communities.

Availability of data and materials

The data generated and analyzed during the current study are not publicly available as they reasonably be shared without compromising the privacy and confidentiality of participants. However, certain sections of the data are available from the corresponding author upon reasonable request.

Source: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19541-3

Filed under: Addiction,Drug use-various effects,USA :

In 2023, 1.5 million adolescents aged 12 to 17 initiated nicotine vaping in the past year.

The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of its annual National Survey on Drug Use and Health (NSDUH), which shows how people living in America reported about their experience with mental health conditions, substance use, mental health and pursuit of treatment in 2023. The report includes selected estimates by race, ethnicity, and age group. The 2023 sample size was 67,679 and used varied collection methods in gathering data from respondents who are noninstitutionalized and age 12 or older.

Key findings of people aged 12 or older who used tobacco products or vaped nicotine in the past month:

  • Among people aged 12 or older- 22.7 % (or 64.4 million people) was highest among young adults aged 18 to 25 – 30.0 % or 10.2 million people
  • Adults aged 26 or older -23.4% or 52.3 million people
  • Adolescents aged 12 to 17 – 7.4% or 1.9 million people
  • Higher among American Indian or Alaska Native (34 %) or Multiracial people (30.6 %) than among White (24.7%), Black (24.2%), Hispanic (17.9%), or Asian people (10.3%)
  • The percentage of people who vaped nicotine was higher among young adults aged 18 to 25 (24.1% or 8.2 million people) than among adults aged 26 or older (7.4% or 16.6 million people) or adolescents aged 12 to 17 (6.8% or 1.8 million people)

Legislation in December 2019 raised the federal minimum age for sale of tobacco products (along with e-cigarettes) from 18 to 21 years.25 All 50 states and the District of Columbia prohibit the sale of tobacco products to people younger than 21.

  • In 2023, 1.5 million adolescents aged 12 to 17, 1.4 million young adults aged 18 to 25, and 3.1 million adults aged 26 or older initiated nicotine vaping in the past year.
  • About two thirds (62.5%) of the 5.9 million people in 2023 who initiated nicotine vaping in the past year did so at age 21 or older (3.7 million people) compared with 37.5 percent (or 2.2 million people) who did so before age 21.

It is evident that several safety and mental health concerns have arisen due to the growing popularity of e-cigarettes. E-cigarettes heat liquids known as vape juices or e-liquids and transform them into an inhalable vapor containing nicotine and other hazardous compounds. It has been purported by the National Institute on Drug Abuse (NIDA), that Vaping, which was originally marketed to quit smoking, has become a problematic behavior in itself. Vaping can be harmful to a person’s physical and mental health, self-control, mindfulness, and other interventions can help people resist the lure of vaping.

Vaping can be especially dangerous for young people because their brains are still developing. Nicotine is highly addictive and can harm brain development until around age 25 and can negatively impact a developing brain in terms of mood/impulse control disorders, interference with memory and attention processing and negatively affect planning and decision-making.

Find out what’s happening in Glen Covewith free, real-time updates from Patch.

As individuals, being mindful, prevention education and making health choices and cultivating self-control can play an important role safeguarding our well-being. At the societal level, grassroot efforts for increased regulation over entities seeking to profit from harmful products and promote interventions that are accessible and beneficial to all is most effective. There is a large body of research that tackling nicotine dependence with vaping with the same vigor as combustibles is a growing need.

According to SAFE, the best method of protecting is prevention education and encouraging a goal to “Live SAFE” and substance free and changing the societal norms regarding these products to help curb youth initiation and a lifelong nicotine addiction.

For information on how to quit smoking or vaping tobacco or nicotine, the NYS Smoker’ provides free and confidential services that include information, tools, quit coaching, and support in both English and Spanish. Services are available by calling 1-866-NY-QUITS (1-866-697-8487), texting (716) 309-4688, or visiting www.nysmokefree.com, for information, to chat online with a Quit Coach, or to sign up for Learn2QuitNY, a six-week, step-by-step text messaging program to build the skills you need to quit any tobacco product. Individuals aged 13 to 24 can text “DropTheVape” to 88709 to receive age-appropriate quit assistance.

SAFE, Inc. is the only alcohol and substance abuse prevention, intervention, and education agency in the City of Glen Cove. The Coalition is concerned about all combustible and electronic products with marijuana and tobacco. The Agency is employing environmental strategies to educate and update the community regarding the negative consequences in collaboration with Carol Meschkow, Manager- Tobacco Action Coalition of Long Island. To learn more about the SAFE Glen Cove Coalition please follow www.facebook.com/safeglencove or to learn more about electronic products visit the Vaping Facts and Myths Page of SAFE’s website to learn more about how vaping is detrimental to your health www.safeglencove.org.

Filed under: Addiction,Drug use-various effects,Education,Health,Prevalence,USA,Youth :

Aug 5 2024

Drug-involved overdose deaths increased by over 500 percent in 2022 according to a study at Columbia University Mailman School of Public Health, with trends attributed to synthetic opioids. National data shows that fentanyl and heroin in particular attributed substantially to the rise particularly since 2014. However, the study also reports that income protection policies, can have a supportive role in preventing fatal drug overdoses. The findings are reported in the International Journal of Drug Policy.

Over 73,000 people died from an overdose in 2020, which subsequently increased to 106,699 people in 2021, a record for the highest number of overdose deaths in one year.

And in fact, more recently, we entered a fourth wave of the overdose crisis, characterized by fatal overdoses in the context of polysubstance use.”

Silvia Martins, MD, PhD, Professor of Epidemiology at Columbia Public Health

The COVID-19 pandemic exacerbated economic hardship; and as a result, the U.S, government enacted income protection programs in conjunction with existing unemployment insurance (UI) to dampen COVID-19-related economic consequences.

“In the context of financial and economic stressors which are known to increase overdose risk we hypothesized that we would observe lower levels of overall overdose and opioid deaths given that robust unemployment insurance benefits could be a buffer,” said Martins., who is also director of the Substance Use Epidemiology Unit of the Department of Epidemiology at Columbia.

The researchers used data based on responses of 89,914 individuals 18 years of age or older from the pooled 2014 – 2020 Detailed Restricted Mortality files for all counties from the Centers for Disease Control and Prevention, aggregating at the county-quarter level. Included were deaths from any drug overdose, any opioid overdose, and any stimulant overdose. Data on unemployment insurance were obtained from the U.S. Department of Labor as well as statutes by the individual states.

Data from 30 states collected by the CDC indicate rates were persistently stable or even increasing, suggesting that increases in overdose deaths observed after the start of the pandemic show minimal signs of abating. “In fact, treatment disruptions and closures of harm reduction organizations in compliance with social distancing ordinances may have also contributed to worsening substance use morbidity and mortality during this period,” noted Martins.

“We also theorized that states and counties with limited safety net policies may increase an individual’s social, psychological, and biological vulnerability to develop a drug use disorder, including opioid and stimulant use disorders. Such policies likely play a significant role in substance use initiation and subsequent development of substance use disorders as well as treatment access for such disorders,” Martins noted.

An earlier study that examined the relationship between state-level UI robustness and fatal opioid overdoses from 1999 to 2012 support the current findings although the research used data from earlier in the overdose epidemic and also different methods were used.

“While their earlier analysis shows that, between 1999 to 2012, UI was associated with lower rates of opioid overdoses, our study builds and expands on findings from that research, as we examined the relationship between UI and any drug-involved mortality — including all other drug overdoses and stimulant overdoses — during the 4th wave of the epidemic intertwined with the COVID-19 period,” observed Martins. In addition, the earlier study only examined fatal overdoses among “prime-age” people aged 25-54, whereas Martins and her team expanded our inclusion criteria to include everyone ages 18 and older.

“Our results therefore reinforce the notion in a call for a broader discussion on the protective role of the safety net programs to buffer drug-related harms,” stated Martins.

Co-authors are Luis E. Segura, Megan E. Marziali, Emilie Bruzelius,Natalie S. Levy, Sarah Gutkind, and Kristen Santarin, Columbia Mailman School of Public Health; Katherine Sacks, Milken Institute; and Ashley Fox, University at Albany, SUNY.

The study was funded by the Columbia University Mailman School of Public Health Calderone Health Equity Award and NIH-NIDA grants R01DA059376 and T32DA031099.

Source: https://www.news-medical.net/news/20240805/Study-Drug-involved-overdose-deaths-increased-by-over-50025-in-2022.aspx

Filed under: Drug use-various effects,Prevalence,USA :

As the new school year starts, officials are alerting parents to be vigilant of innovative ways kids might conceal drugs, such as in candy boxes and soda cans

Published August 12, 2024

With the onset of the new school year, there’s a growing concern among school officials about the creative methods some students might use to conceal drugs. Parents are being asked to stay alert to the possibility of everyday items being used for these purposes.

Creative Concealments

During a recent awareness campaign, officials highlighted how items that appear mundane, like candy boxes, soda cans, and water bottles, can actually be specialized containers designed to hide drugs. “At first glance, these items might look like ordinary snacks or drinks, but they’re increasingly being used to conceal substances,” noted a spokesperson from the organization SCAN, which is dedicated to substance abuse prevention.

Types of Disguised Containers

The variety of containers mentioned includes those designed to look like everyday objects. Water bottles, soda containers, and even chip bags can be modified with hidden compartments. These products are often marketed discreetly and can be easily overlooked by the untrained eye.

Signs of Substance Abuse

In addition to being aware of potential hidden containers, officials are advising parents to watch for changes in their child’s behavior which may indicate substance abuse. “Changes in attitude, energy, and social circles can be red flags,” the spokesperson added, emphasizing the importance of open communication and observation.

Community and School Involvement

Schools are working closely with local law enforcement and organizations like SCAN to provide resources and education to parents. Workshops, informational meetings, and resource materials are being offered to help parents and guardians recognize both the signs of drug use and the unlikely places drugs might be hidden.

Call to Action

Parents and guardians are encouraged to engage with their children about the dangers of drugs and the pressures they may face. By maintaining an open dialogue and staying informed about the latest drug concealment methods, parents can play a crucial role in preventing drug abuse.

For more tips on how to detect hidden drug containers and support children in staying drug-free, stay with Fox News Rio Grande Valley and follow us on your favorite social network.

Source: https://foxrgv.tv/hidden-in-plain-sight-officials-warn-parents-of-disguised-drug-containers/

Filed under: Drug use-various effects,Education,Others (International News),Prevalence,USA,Youth :
Harm reduction encompasses interventions, programmes and policies that seek to reduce the health, social and economic harms of drug use to individuals, communities and societies. On this page, you can find the latest analysis of harm reduction interventions in Europe, including key data on opioid agonist treatment, naloxone programmes, drug consumption rooms and more. 

This page is part of the European Drug Report 2024, the EMCDDA’s annual overview of the drug situation in Europe.

Evolving drug problems pose a broader set of challenges for harm reduction

The use of illicit drugs is a recognised contributor to the global burden of disease. Interventions designed to reduce this burden include prevention activities, intended to reduce or slow the rate at which drug use may be initiated, and the offer of treatment to those who have developed drug problems. A complementary set of approaches goes under the general heading of harm reduction. Here the emphasis is on working non-judgementally with people who use drugs in order to reduce the risks associated with behaviours that are mostly associated with adverse health outcomes, and more generally to promote health and well-being. Probably the best known of these is the provision of sterile injecting equipment to people who inject drugs, with the aim of reducing the risk of contracting an infectious disease. Over time these sorts of approaches appear to have contributed to the relatively low rate, by international standards, of new HIV infections now associated with injecting drug use in Europe. Over the last decade, as patterns of drug use have changed and the characteristics of those who use drugs have also evolved, to some extent, harm reduction interventions have also needed to adapt to address a broader set of health outcomes and risk behaviours. Prominent among these are reducing the risk of drug overdose and addressing the often-considerable and complex health and social problems faced by people who use drugs in more marginalised and socially excluded populations.

A spectrum of responses is needed to reduce changing drug-related harms

Chronic and acute health problems are associated with the use of illicit drugs, and these can be compounded by factors such as the properties of the substances, the route of administration, individual vulnerability and the social context in which drugs are consumed. Chronic problems include dependence and drug-related infectious disease, while there is a range of acute harms, of which drug overdose is perhaps the best documented. Although relatively rare at the population level, the use of opioids still accounts for much of the morbidity and mortality associated with drug use. Injecting drug use also increases risks. Correspondingly, working with opioid users and those who inject drugs has been historically an important target for harm reduction interventions and also the area where service delivery models are most developed and evaluated.

Reflecting this, some harm reduction services have become increasingly integrated into the mainstream of healthcare provision for people who use drugs in Europe over the last three decades. Initially, the focus was on expanding access to opioid agonist treatment and needle and syringe programmes as a part of the response to high-risk drug use, primarily targeting injecting use of heroin and the HIV/AIDS epidemic. Recent joint EMCDDA-ECDC guidance on the prevention and control of infectious diseases among people who inject drugs recommends providing opioid agonist treatment to prevent hepatitis C and HIV, as well as to reduce injecting risk behaviours and injecting frequency, in both the community and prison settings. The guidelines also recommend the provision of sterile injecting equipment alongside opioid agonist treatment to maximise the coverage and effectiveness of the interventions among people who inject opioids.

 

To access the full report, please click on the link below:

Source: https://www.euda.europa.eu/publications/european-drug-report/2024/harm-reduction_en

Filed under: Drug use-various effects,Europe,Prevention and Intervention,Treatment and Addiction :

The European Drug Report 2024: Trends and Developments presents the EMCDDA’s latest analysis of the drug situation in Europe. Focusing on illicit drug use, related harms and drug supply, the report provides a comprehensive set of national data across these themes, as well as on specialist drug treatment and key harm reduction interventions.

This report is based on information provided to the EMCDDA by the EU Member States, the candidate country Türkiye, and Norway, in an annual reporting process.

The purpose of the current report is to provide an overview and summary of the European drug situation up to the end of 2023. All grouping, aggregates and labels therefore reflect the situation based on the available data in 2023 in respect to the composition of the European Union and the countries participating in EMCDDA reporting exercises. However, not all data will cover the full period. Due to the time needed to compile and submit data, many of the annual national data sets included here are from the reference year January to December 2022. Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour such as drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Although considerable improvements can be noted, both nationally and in respect to what is possible to achieve in a European-level analysis, the methodological difficulties in this area must be acknowledged. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Caveats relating to the data are to be found in the online Statistical Bulletin 2024, which contains detailed information on methodology, qualifications on analysis and comments on the limitations in the information set available. Information is also available there on the methods and data used for European-level estimates, where interpolation may be used.

Content

The drug situation in Europe up to 2024

This page draws on the latest data available to provide an overview of the current situation and emerging drug issues affecting Europe, with a focus on the year up to the end of 2023. The analysis presented here highlights some developments that may have important implications for drug policy and practitioners in Europe.
Understanding Europe’s drug situation in 2024 – key developments

Drug supply, production and precursors

Analysis of the supply-related indicators for commonly used illicit drugs in the European Union suggests that availability remains high across all substance types. On this page, you can find an overview of drug supply in Europe based on the latest data, supported by the latest time trends in drug seizures and drug law offences, together with 2022 data on drug production and precursor seizures.
Drug supply, production and precursors – the current situation in Europe 

Cannabis

Cannabis remains by far the most commonly consumed illicit drug in Europe. On this page, you can find the latest analysis of the drug situation for cannabis in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more.
Cannabis – the current situation in Europe 

Cocaine

Cocaine is, after cannabis, the second most commonly used illicit drug in Europe, although prevalence levels and patterns of use differ considerably between countries. On this page, you can find the latest analysis of the drug situation for cocaine in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more.
Cocaine – the current situation in Europe 

Synthetic stimulants

Amphetamine, methamphetamine and, more recently, synthetic cathinones are all synthetic central nervous system stimulants available on the drug market in Europe. On this page, you can find the latest analysis of the drug situation for synthetic stimulants in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more
Synthetic stimulants – the current situation in Europe 

MDMA

MDMA is a synthetic drug chemically related to the amphetamines, but with somewhat different effects. In Europe, MDMA use has generally been associated with episodic patterns of consumption in the context of nightlife and entertainment settings. On this page, you can find the latest analysis of the drug situation for MDMA in Europe, including prevalence of use, seizures, price and purity and more.
MDMA – the current situation in Europe 

Heroin and other opioids

Heroin remains Europe’s most commonly used illicit opioid and is responsible for a large share of the health burden attributed to illicit drug consumption. Europe’s opioid problem, however, continues to evolve in ways that are likely to have important implications for how we address issues in this area. On this page, you can find the latest analysis of the drug situation for heroin and other opioids in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more.
Heroin and other opioids – the current situation in Europe 

New psychoactive substances

The market for new psychoactive substances is characterised by the large number of substances that have emerged, with new ones being detected each year. On this page, you can find an overview of the drug situation for new psychoactive substances in Europe, supported by information from the EU Early Warning System on seizures and substances detected for the first time in Europe. New substances covered include synthetic and semi-synthetic cannabinoids, synthetic cathinones, new synthetic opioids and nitazenes.
New psychoactive substances – the current situation in Europe 

Other drugs

Alongside the more well-known substances available on illicit drug markets, a number of other substances with hallucinogenic, anaesthetic, dissociative or depressant properties are used in Europe: these include LSD, hallucinogenic mushrooms, ketamine, GHB and nitrous oxide. On this page, you can find the latest analysis of the situation regarding these substances in Europe, including seizures, prevalence and patterns of use, treatment entry, harms and more.
Other drugs – the current situation in Europe 

Injecting drug use

Despite a continued decline in injecting drug use over the past decade in the European Union, this behaviour is still responsible for a disproportionate level of both acute and chronic health harms associated with the consumption of illicit drugs. On this page, you can find the latest analysis of injecting drug use in Europe, including key data on prevalence at national level and among clients entering specialist treatment, as well as insights from studies on syringe residue analysis and more.
Injecting drug use – the current situation in Europe 

Drug-related infectious diseases

People who inject drugs are at risk of contracting infections through the sharing of drug use paraphernalia. On this page, you can find the latest analysis of drug-related infectious diseases in Europe, including key data on infections with HIV and hepatitis B and C viruses.
Drug-related infectious diseases – the current situation in Europe 

Drug-induced deaths

Estimating the mortality attributable to drug use is critical for understanding the public health impact of drug use and how this may be changing over time. On this page, you can find the latest analysis of drug-induced deaths in Europe, including key data on overdose deaths, substances implicated and more.
Drug-induced deaths – the current situation in Europe 

Opioid agonist treatment

Opioid users represent the largest group undergoing specialised drug treatment, mainly in the form of opioid agonist treatment. On this page, you can find the latest analysis of the provision of opioid agonist treatment in Europe, including key data on coverage, the number of people in treatment, pathways to treatment and more.
Opioid agonist treatment – the current situation in Europe 

Harm reduction

Harm reduction encompasses interventions, programmes and policies that seek to reduce the health, social and economic harms of drug use to individuals, communities and societies. On this page, you can find the latest analysis of harm reduction interventions in Europe, including key data on opioid agonist treatment, naloxone programmes, drug consumption rooms and more.
Harm reduction – the current situation in Europe 

PDF version of full report

The European Drug Report 2024 was designed as a digital-first product, structured by modules, and optimised for online reading. Within each chapter, you may download a PDF version of the page. We are also making available here  a PDF version of the full report (all modules and annex tables combined). Please note that some errors may have occurred during the transformation process and that it is possible that this version does not contain all corrections made since the report was first published (please check the last updated date).

Download full PDF version of the European Drug Report 2024 (16 MB, last updated 14.06.2024)

Source: https://www.euda.europa.eu/publications/european-drug-report/2024_en

Filed under: Drug use-various effects,Europe,Prevention and Intervention,Treatment and Addiction :

As marijuana policies change across the nation, the conversation around its impact often centers on human health. However, it is critical to consider the impact on animals as a new study published in the Journal of the American Veterinarian Medical Association sheds light on the concern of marijuana toxicity in dogs.

Currently, the gold standard confirmatory testing for THC toxicity in dogs is costly, not easily accessible, and takes time to receive results. Thus, veterinarians often use the human urine multidrug test (HUMT) for point-of-care testing, which is unfortunately, unreliable in dogs. To rule out serious and severe conditions, HUMT is done in conjunction with additional tests such as bloodwork and advanced imaging.

To understand the history, physical, neurological, and clinical-pathological findings associated with marijuana toxicity in dogs, this study analyzed the medical records of 223 dogs diagnosed with THC toxicity between January 2017 and July 2021 from a university teaching hospital.

Key findings include:

  • Demographics: The median age of the exposed dogs was 1 year, and the breeds varied, with mixed breeds being the most common.
  • Owner Denial: Most dog owners denied the possibility of marijuana ingestion. Common stories reported were that their dog began “acting abnormal after going outside or to a public space” and when asked about marijuana being in the home, 55.6% claimed “absolutely no marijuana is in the house”.
  • Clinical Signs: Most dogs developed clinical signs of toxicity within four hours of ingestion. Common clinical signs included ataxia (88.3%), hyperesthesia (75.3%), lethargy (62.8%), urinary incontinence (45.7%), and vomiting (26%). The majority (70.4%) experienced both ataxia (abnormal movement/lack of coordination) and hyperesthesia (increased sensitivity).
  • Vitals and Bloodwork: While most dogs had normal vitals like heart rate, respiratory rate, and body temperature, common abnormalities included systemic hypertension (60.7%), tachycardia (37%), and hyperthermia (22.6%). Common electrolyte abnormalities included mild hyperkalemia (51.3%) and mild hypercalcemia (79.1%), with the researchers noting that this study was the first to report such abnormalities in dogs.
  • Prognosis: Fortunately, all dogs survived; however, 22% were hospitalized.

The denial of dog owners in disclosing the possibility of marijuana exposure can lead to delays in diagnosis and treatment, resulting in needless testing, increased costs, and undue stress. Educating pet owners on the risks and signs of marijuana exposure and ensuring veterinarians are equipped with the tools and resources to diagnosis marijuana toxicity, are critically needed. These findings underscore the need for policies to prioritize the health and safety of pets, especially considering that many of these cases occurred within the same year as legalization in the area where the university hospital is located, as the researchers point out.

Source: Save Our Society From Drugs | 333 3rd Ave N Suite 200 | St. Petersburg, FL 33701 US

 

Filed under: Animals,Cannabis/Marijuana,Drug use-various effects,USA :

The implications of these findings on the propagation of cannabis genotoxicity and epigenotoxicity to the next generation extremely significant.

Prior to this research, the field was aware of the effects in the male but the work in females is more recent.

 

To access the full document:

  1. Click on the link below.
  2. An image  – the front page of the full document will appear.
  3. Click on the image to open the full document.

 

HUMAN REPRO AND GENOTOXICITY ARTICLE

Filed under: Drug use-various effects on foetus, babies, children and youth,Genes,Health,USA :
A recent poll, conducted by Gallup, found that there has been a shift in public opinion regarding marijuana.

This is SAM’s  The Drug Report’s Friday Fact report
 

The first asked the question, “What effect do you think the use of marijuana has on most people who use it – very positive, somewhat positive, somewhat negative or very negative?” Gallup focused on several demographic subgroups and found that all of them were less likely in 2024 than in 2022 to say that marijuana had a positive effect on users. Here’s a breakdown for each subgroup:
This poll revealed a 12% drop among Independents, a 7% drop among young adults,  and a 13% drop among nonreligious people. Likewise, as the percentage of Americans that say marijuana has a positive effect on most people who use it has declined, there has been an increase in the percentage that say it has a negative effect on them. This increased from 45% in 2022 to 51% in 2024, with the remainder answering that they had “no opinion.” A majority of Americans now recognize that marijuana has harmful effects on users, which include cannabis use disorder, depression, anxiety, and impairment, among others.

 

A second question asked, “What effect do you think the use of marijuana has on society – very positive, somewhat positive, somewhat negative or very negative?” It found that the percentage of Americans that thought it was “very negative” or “somewhat negative” increased from 50% in 2022 to 54% in 2024, as the percentage that thought it had a “very positive” or “somewhat positive” effect declined from 49% to 41%.

 

More and more Americans are waking up to the harmful effects of marijuana. Now a majority of Americans believe that marijuana is harmful for both users and society. Public opinion is clearly shifting as more families have seen first-hand the results of marijuana use.

Source: Smart Approaches to Marijuana (SAM) – Friday Fact – Fri 30/08/2024
Filed under: Cannabis/Marijuana,Drug use-various effects,Prevalence,USA :

With the increasing legalization of recreational marijuana across various states, employers need to proactively prepare for the changes and their implications on the workplace. As more states allow adults to legally purchase and possess marijuana, it’s essential for employers to review and update their workplace policies to ensure compliance and maintain a safe work environment.

Despite legalization, employers can still prohibit marijuana use that leads to impairment at work, akin to alcohol restrictions. Recent legal decisions, such as White v. Timken Gears & Servs., Inc. in Illinois, reinforce that a positive drug test for marijuana while working, even if used recreationally off-duty, can justify termination if it violates a reasonable and consistently applied workplace policy. This underscores the importance of clear, fair, and legally sound drug and alcohol policies to ensure workplace safety.

  • The first step is to re-evaluate your drug testing protocols. Ensure they align with both state and federal regulations, particularly if your industry is governed by specific mandates, such as those from the Department of Transportation. Consider your agreements with insurance carriers, as marijuana testing might be a condition of coverage or discounts.
  • Testing for marijuana presents unique challenges due to the limitations of current testing methods. Talk with your testing laboratory to understand the differences between qualitative and quantitative tests and determine which best supports your workplace policies.
  • Evaluate whether to implement second chance agreements for employees who test positive for marijuana. Additionally, consider providing access to substance abuse programs. These measures can help manage employees who might struggle with marijuana use while offering them a chance to comply with workplace policies.
  • Update your policies in your employee handbook, workers’ compensation policies, and other relevant documents to clearly state that while marijuana may be legal, it is prohibited in the workplace. Clearly outline that possession or use of marijuana at the worksite is forbidden and that employees are not permitted to use marijuana during lunch or other breaks. Specify the consequences of violating these policies to ensure there are no ambiguities.
  • Hold meetings to communicate the company’s stance and expectations regarding marijuana use to all employees. Transparency is key; ensure employees understand the policies, the reasons behind them, and the consequences of non-compliance. Clear communication helps in setting the right expectations and reduces misunderstandings.
  • Conduct comprehensive training sessions for HR professionals, managers, and supervisors on the company’s policies regarding marijuana use. Ensure that all managerial staff understand the testing protocols and disciplinary policies. Training should also cover how to handle conversations with employees about marijuana use, ensuring consistency and sensitivity. Equip your managers with the skills to recognize signs of impairment at work. Understanding how to identify and address employees who might be under the influence of marijuana is crucial for maintaining workplace safety. Provide clear guidelines on the steps to take if impairment is suspected. Check out our trainings here!

The increasing state legalization of recreational marijuana marks a significant change for employers. By proactively updating your drug testing protocols, policies, training programs, and communication strategies, you can effectively manage the impact of this new legislation on your workplace. Staying informed and prepared will help you navigate this evolving landscape while ensuring a safe and compliant work environment.

Source: 

  • Drug Free Foundation AMERICA, Inc.
  • National Drug-Free Workplace Alliance
Filed under: Cannabis/Marijuana,Economic,Legal Sector,USA,Workplace :

Vaping among younger adults and binge drinking among mid-life adults also maintained historically high levels, NIH-supported study shows

August 29, 2024

 

Past-year use of cannabis and hallucinogens stayed at historically high levels in 2023 among adults aged 19 to 30 and 35 to 50, according to the latest findings from the Monitoring the Future survey. In contrast, past-year use of cigarettes remained at historically low levels in both adult groups. Past-month and daily alcohol use continued a decade-long decline among those 19 to 30 years old, with binge drinking reaching all-time lows. However, among 35- to 50-year-olds, the prevalence of binge drinking in 2023 increased from five and 10 years ago. The Monitoring the Future study is conducted by scientists at the University of Michigan’s Institute for Social Research, Ann Arbor, and is funded by the National Institutes of Health.

Reports of vaping nicotine or vaping cannabis in the past year among adults 19 to 30 rose over five years, and both trends remained at record highs in 2023. Among adults 35 to 50, the prevalences of nicotine vaping and of cannabis vaping stayed steady from the year before, with long-term (five and 10 year) trends not yet observable in this age group as this question was added to the survey for this age group in 2019.

For the first time in 2023, 19- to 30-year-old female respondents reported a higher prevalence of past-year cannabis use than male respondents in the same age group, reflecting a reversal of the gap between sexes. Conversely, male respondents 35 to 50 years old maintained a higher prevalence of past-year cannabis use than female respondents of the same age group, consistent with what’s been observed for the past decade.

“We have seen that people at different stages of adulthood are trending toward use of drugs like cannabis and psychedelics and away from tobacco cigarettes,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “These findings underscore the urgent need for rigorous research on the potential risks and benefits of cannabis and hallucinogens – especially as new products continue to emerge.”

Since 1975, the Monitoring the Future study has annually surveyed substance use behaviors and attitudes among a nationally representative sample of teens. A longitudinal panel study component of Monitoring the Future conducts follow-up surveys on a subset of these participants (now totaling approximately 20,000 people per year), collecting data from individuals every other year from ages 19 to 30 and every five years after the participants turn 30 to track their drug use through adulthood. Participants self-report their drug use behaviors across various time periods, including lifetime, past year (12 months), past month (30 days), and other use frequencies depending on the substance type. Data for the 2023 panel study were collected via online and paper surveys from April 2023 through October 2023.

Full data summaries and data tables showing the trends below, including breakdowns by substance, are available in the report. Key findings include:

Cannabis use in the past year and past month remained at historically high levels for both adult age groups in 2023. Among adults 19 to 30 years old, approximately 42% reported cannabis use in the past year, 29% in the past month, and 10% daily use (use on 20 or more occasions in the past 30 days). Among adults 35 to 50, reports of use reached 29%, 19%, and 8%, respectively. While these 2023 estimates are not statistically different from those of 2022, they do reflect five- and 10-year increases for both age groups.

Cannabis vaping in the past year and past month was reported by 22% and 14% of adults 19 to 30, respectively, and by 9% and 6% of adults 35 to 50 in 2023. For the younger group, these numbers represent all-time study highs and an increase from five years ago.

Nicotine vaping among adults 19 to 30 maintained historic highs in 2023. Reports of past-year and past-month vaping of nicotine reached 25% and 19%, respectively. These percentages represent an increase from five years ago, but not from one year ago. For adults 35 to 50, the prevalence of vaping nicotine remained steady from the year before (2022), with 7% and 5% reporting past-year and past-month use.

Hallucinogen use in the past year continued a five-year steep incline for both adult groups, reaching 9% for adults 19 to 30 and 4% for adults 35 to 50 in 2023. Types of hallucinogens reported by participants included LSD, mescaline, peyote, shrooms or psilocybin, and PCP.

Alcohol remains the most used substance reported among adults in the study. Past-year alcohol use among adults 19 to 30 has showed a slight upward trend over the past five years, with 84% reporting use in 2023. However, past month drinking (65%), daily drinking (4%), and binge drinking (27%) all remained at study lows in 2023 among adults 19 to 30. These numbers have decreased from 10 years ago. Past-month drinking and binge drinking (having five or more drinks in a row in the past two week period) decreased significantly from the year before for this age group (down from 68% for past month and 31% for binge drinking reported in 2022).

Around 84% of adults 35 to 50 reported past-year alcohol use in 2023, which has not significantly changed from the year before or the past five or 10 years. Past-month alcohol use and binge drinking have slightly increased over the past 10 years for this age group; in 2023, past-month alcohol use was at 69% and binge drinking was at 27%. Daily drinking has decreased in this group over the past five years and was at its lowest level ever recorded in 2023 (8%).

Additional data: In 2023, past-month cigarette smoking, past-year nonmedical use of prescription drugs, and past-year use of opioid medications (surveyed as “narcotics other than heroin”) maintained five- and 10-year declines for both adult groups. Among adults 19 to 30 years old, past-year use of stimulants (surveyed as “amphetamines”) has decreased for the past decade, whereas for adults 35 to 50, past-year stimulant use has been modestly increasing over 10 years. Additional data include drug use reported by college/non-college young adults and among various demographic subgroups, including sex and gender and race and ethnicity.

The 2023 survey year was the first time a cohort from the Monitoring the Future study reached 65 years of age; therefore, trends for the 55- to 65-year-old age group are not yet available.

“The data from 2023 did not show us many significant changes from the year before, but the power of surveys such as Monitoring the Future is to see the ebb and flow of various substance use trends over the longer term,” said Megan Patrick, Ph.D., of the University of Michigan and principal investigator of the Monitoring the Future panel study. “As more and more of our original cohorts – first recruited as teens – now enter later adulthood, we will be able to examine the patterns and effects of drug use throughout the life course. In the coming years, this study will provide crucial data on substance use trends and health consequences among older populations, when people may be entering retirement and other new chapters of their lives.”

View more information on data collection methods for the Monitoring the Future panel study and how the survey adjusts for the effects of potential exclusions in the report. Results from the related 2023 Monitoring the Future study of substance use behaviors and related attitudes among teens in the United States were released in December 2023, and 2024 results are upcoming in December 2024.

 

Source:  https://nida.nih.gov/news-events/news-releases

Filed under: Cannabis/Marijuana,Methamphetamine/GHB/Hallucinogens/Oxycodone,Prevalence,USA :

By Dr. Liji Thomas, MDReviewed by Benedette Cuffari, M.Sc.  Aug 28 2024

How can modern psychedelic research and traditional approaches integrate to address substance use disorders and mental health challenges?

A recent study published in the Journal of Studies on Alcohol and Drugs discusses the history and current state of psychedelic research for the treatment of substance abuse disorders (SUDs).

Psychedelics

Psychedelics are consciousness-altering drugs, some of which include lysergic acid diethylamide (LSD), dimethyltryptamine (DMT), psilocybin, and mescaline. Methylenedioxymethamphetamine (MDMA) and ketamine are also considered psychedelics; however, these drugs have different mechanisms of action.

Although psychedelics have been exploited for centuries to induce altered states of consciousness, their use, as opposed to their abuse, has largely been unexplored in modern medicine. In fact, several studies have indicated the potential utility of psychedelics for individuals who have mental illness due to traumatic experiences, false beliefs, and unhealthy behavioral patterns, such as posttraumatic stress disorder (PTSD) and depression.

The recent coronavirus disease 2019 (COVID-19) pandemic led to global changes in the use of methamphetamine, alcohol, and cannabis, as well as a significant increase in opioid overdoses in the United States. Thus, another promising application of psychedelics is their potential use for treating SUDs.

However, restrictive policies, poor funding, lack of equitable and diverse recruitment and access, as well as the multiplicity of small-scale psychedelic research programs have prevented researchers from effectively investigating the effects of psychedelics in the treatment of SUDs.

Overview

Over the past seven decades, researchers have become increasingly interested in examining the potential use of psychedelics in traditional medicine. Despite federal policies banning recreational drug use, researchers have elucidated some of the biological effects of psychedelics on the central nervous system (CNS) and their potential role in the treatment of SUDs. Nevertheless, there remains a lack of well-controlled multi-center trials and systematic reviews in this area.

As researchers continue to examine the pharmacological potential of these drugs, it is crucial to address their addiction and abuse potential, the legalization of recreational drugs, and the attempts of pharmaceutical companies to introduce high-selling psychedelics as therapies for mental illness.

History and current use of psychedelics

Psychedelics like ayahuasca, Peyote, and psilocybin-containing mushrooms have been used throughout history by traditional healers and indigenous communities for both spiritual and health purposes. By recognizing these contributions, researchers can benefit from the potential benefits of traditional usage patterns while investigating the use of these drugs for treating SUDs and other mental health disorders.

For example, a hybridized SUD therapy program in Peru utilizes ayahuasca to treat alcohol and drug use. At one year following treatment, reduced depression and anxiety, higher quality of life, and reduced severity of addiction have been reported.

One notable contribution is the acknowledgment that key experiences of treatment participants might provide more insight than the search for putative “active ingredients” of interventions as complex as psychedelic-assisted treatment.”

Purging in psychedelic treatment

Psychedelic use, specifically ayahuasca use, is closely linked to vomiting as a means of purging the body. This is reported to have spiritual, Amazonian, and clinical benefits.

Conclusions

The optimal approach to psychedelic-assisted treatment involves mutual respect for and recognition of the value of both traditional and modern applications. Thus, mixed-methods research is crucial, as traditional approaches may help identify a better therapeutic agent or program than traditional approaches to identifying and isolating active ingredients.

However, it is essential to evaluate and quantify the success rates of traditional approaches to psychedelic use, as well as elucidate the biological mechanisms that may contribute to their therapeutic effects. Researchers must recognize and credit traditional history and practices throughout these efforts to protect these cultures from being exploited, ignored, and suppressed by pharmaceutical industries.

The rush to patent processes in psychedelic treatments of addiction and other psychiatric conditions reflects the enormous greed of private commercial entities to benefit financially from vulnerable patients in need of effective therapies.

Thus, regulatory control of psychedelic therapies is vital to establish rigorous research standards that can lead to the generation of sufficient evidence in this area. Without this type of overview, private corporate interests may seek to exploit governmental support for crucial research needed to address these mental health issues.

Source:  https://www.news-medical.net/news/20240828/Psychedelics-A-new-hope-for-substance-abuse-treatment.aspx

Filed under: Brain and Behaviour,Drug use-various effects,Health,Methamphetamine/GHB/Hallucinogens/Oxycodone,Prevention and Intervention,Psychiatric drugs,USA :

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