Internet

Press Release: Ambassador Linda Thomas-Greenfield Launches Alliance to Prevent Drug Harms in Collaboration with United Nations and Tech Industry

Today, Ambassador Linda Thomas-Greenfield, Representative of the United States to the United Nations, launched the Alliance to Prevent Drug Harms (Prevent Alliance), alongside representatives from the United Nations and the tech industry, including Meta, Snap Inc., and X Corp.

“Two out of every five Americans know someone who has died of an opioid overdose…in every corner of the world…we’re seeing a rapid rise in synthetic drug use, dependence, and overdose death,” said the Ambassador. “This is an international crisis…we’ve seen the criminal groups that produce these drugs adapt quickly.”

That adaptation includes the use of technology platforms, including social media, to promote the illicit use of non-medical synthetic drugs.

“This alliance between the United States, the United Nations, and our partners in the private sector, holds immense potential to make a meaningful difference. To disrupt this crisis, both here in the United States and all across the globe, and adapt with the same agility, the same resourcefulness, of those we’re up against. This is a good step, but we all know much more needs to be done to address this problem.” Ambassador Thomas-Greenfield continued.

The Prevent Alliance, a public-private partnership effort, is committed to ending the use of online platforms to aid the flow of illicit substances. Through a framework for cross-industry cooperation, the Prevent Alliance will work to disrupt the availability of synthetic drugs online, promote drug-prevention content across platforms, and enables cross-sector communication establishing the best evidence-based practices for drug-prevention campaigns.

The alliance builds upon the work of the Global Coalition to Address Synthetic Drug Threats, a multilateral effort to combat the threats posed by synthetic drugs launched by Secretary Blinken last year, and the U.S.-led adoption of new controls targeting the synthetic drug manufacturing process at the UN Commission on Narcotic Drugs earlier this year.

Maggie Nardi, the Deputy Assistant Secretary of State of the Bureau for International Narcotics and Law Enforcement Affairs (INL), said, “Governments alone cannot shield people from the dangers of synthetic drug misuse; we must forge stronger alliances with public health, civil society, affected communities, academics, and industry to combat their illicit manufacture, distribution, and promotion.”

Under the Biden Administration, the United States is dedicating more resources to tackle the demand for drugs, including more resources for public awareness, health interventions and services to prevent and reduce the implications of drug use, as well as measures to prevent, detect, and stop the illicit manufacturing and trafficking of drugs. These efforts include support for the UN Office on Drugs and Crime (UNODC) and Commission on Narcotic Drugs, as well as U.S. leadership in rallying countries around the Global Coalition to Address Synthetic Drug Threats.

“Evidence-based prevention is key to respond to the drug use situation globally, especially in a rapidly digitalized world. Social media nowadays carries an important influence on the individual. To harness this influence positively, science can help,” said Delphine Schantz, director of UNODC’s New York office. “UNODC together with WHO reflected on that science through the International Standards on Drug Use Prevention. This science aims at creating a healthy and safe environment for children and youth, fostering resilient generations against drugs and any risky social and health behaviors. Working through this science, social media could be one of those added layers of prevention.”

“Families and communities around the world are struggling with the opioid crisis,” said Nell McCarthy, Vice President of Trust and Safety at Meta. “From governments to the private sector, and health care systems to civil society organizations, we must all do our part to combat this crisis, which is why Meta is proud to be part of the Prevent Alliance.”

Source: https://usun.usmission.gov/ambassador-linda-thomas-greenfield-launches-alliance-to-prevent-drug-harms-in-collaboration-with-united-nations-and-tech-industry/ July 2024

This is the Executive Summary of the DEA’s 2024 National Drug Threat Assessment 

Fentanyl is the deadliest drug threat the United States has ever faced, killing nearly 38,000 Americans in the first six months of 2023 alone. Fentanyl and other synthetic drugs, like methamphetamine, are responsible for nearly all of the fatal drug overdoses and poisonings in our country. In pill form, fentanyl is made to resemble a genuine prescription drug tablet, with potentially fatal outcomes for users who take a pill from someone other than a doctor or pharmacist. Users of other illegal drugs risk taking already dangerous drugs like cocaine, heroin, or methamphetamine laced or replaced with powder fentanyl. Synthetic drugs have transformed not only the drug landscape in the United States, with deadly consequences to public health and safety; synthetic drugs have also transformed the criminal landscape in the United States, as the drug cartels who make these drugs reap huge profits from their sale.
Mexican cartels profit by producing synthetic drugs, such as fentanyl (a synthetic opioid) and methamphetamine (a synthetic stimulant), that are not subject to the same production challenges as traditional plant-based drugs like cocaine and heroin – such as weather, crop cycles, or government eradication efforts. Synthetic drugs pose an increasing threat to U.S. communities because they can be made anywhere, at any time, given the required chemicals and equipment and basic know-how. Health officials, regulators, and law enforcement are constantly challenged to quickly identify and act against the fentanyl threat, and the threat of new synthetic drugs appearing on the market. The deadly reach of the Mexican Sinaloa and Jalisco cartels into U.S. communities is extended by the wholesale-level traffickers and street dealers bringing the cartels’ drugs to market, sometimes creating their own deadly drug mixtures, and exploiting social media and messaging applications to advertise and sell to customers.
The Sinaloa Cartel and the Cartel Jalisco Nueva Generación (also known as CJNG or the Jalisco Cartel) are the main criminal organizations in Mexico, and the most dangerous. They control clandestine drug production sites and transportation routes inside Mexico and smuggling corridors into the United States and maintain large network “hubs” in U.S. cities along the Southwest Border and other key locations across the United States. The Sinaloa and Jalisco cartels are called “transnational criminal organizations” because they are not just drug manufacturers and traffickers; they are organized crime groups, involved in arms trafficking, money laundering, migrant smuggling, sex trafficking, bribery, extortion, and a host of other crimes – and have a global reach extending into strategic transportation zones and profitable drug markets in Europe, Africa, Asia, and Oceania.

Source: https://www.dea.gov/sites/default/files/2024-05/NDTA_2024.pdf May 2024

The International Narcotics Control Board (INCB) study recommends responding with the same methods, running counter-narcotics campaigns offering advice that can be trusted on popular online platforms.

“We can see that drug trafficking is not just carried out on the dark web. Legitimate e-commerce platforms are being exploited by criminals too,” said Jallal Toufiq, INCB President.

Criminal gangs take advantage of the chance to reach large global audiences on social media channels by turning them into marketplaces and posting inappropriate, misleading and algorithm-targeted content that is widely accessible to children and adolescents, the board noted.

Poppy cull

The authors of the report observed a significant decline in opium poppy cultivation and heroin production in Afghanistan following the Taliban’s ban on drugs. But, South Asia’s methamphetamine trafficking boomis linked to its manufacture in Afghanistan with outlets in Europe and Oceania.

In Colombia and Peru, there has been a notable increase in illicit coca bush cultivation, rising by 13 per cent and 18 per cent respectively in 2022.

Cocaine seizures also reached a record level in 2021 in West and Central Africa, a major transit region.

And Pacific island States have transitioned from being solely transit sites along drug trafficking routes to becoming destination markets for synthetic drugs.

In North America, the opioid crisis persists, with the number of deaths involving synthetic opioids other than methadone surpassing 70,000 in 2021. In Europe, several countries are pursuing a regulated market for cannabis for non-medical purposes, which, the INCB experts believe, may be inconsistent with drug control.

Soundcloud

Real-world dangers online

Other trends linked to drug dealing today include the use of encryption methods in communications and transactions, anonymous browsing on the darknet and payments in hard-to trace cryptocurrencies, which increase challenges for prosecutors.

The INCB report also highlighted how criminals relocate their operations to regions with less stringent law enforcement or lighter sanctions, often choosing countries where extradition can be evaded.

The latest data also emphasizes the heightened risk of deadly overdoses linked to the online availability of fentanyl – many times more potent than heroin – and other synthetic opioids.

Another area of concern is telemedicine and online pharmacies. While such services have the potential to enhance healthcare access and simplify the prescription and delivery of lifesaving medicines, illegal internet outlets that sell drugs without a prescription directly to consumers are a very real health risk.

The global trade in illicit pharmaceuticals is estimated at $4.4 billion.

In many cases, it is impossible for consumers to know whether the drugs or medicines they are buying are counterfeit, banned or illegal.

To combat the online threat, the report’s authors insist that internet platforms should be used to raise awareness about drug misuse and support public health campaigns, especially targeting young people.

Given the global nature of the challenge, countries should cooperate to identify and respond to new threats, said INCB, whose 13 members are elected by the UN’s Economic and Social Council (ECOSOC).

Source: https://news.un.org/en/story/2024/03/1147252

US DRUG CZAR EXPLAINS CAUSES AND RSDT TOOL TO PREVENT TEEN DRUG USE AND OVERDOSE DEATH INTERVIEW WITH U.S. DRUG CZAR JOHN WALTERS

Introduction:  In response to recent news of a huge increase in drug overdose deaths and arrests for drug trafficking among Fairfax County youths, Fox News TV5 reporter Sherri Ly interviewed U.S. Drug Czar John Walters for his expert views on the cause and potential cure for these horrific family tragedies.  Following is a transcript of that half-hour interview with minor editing for clarity and emphasis added.  The full original interview is available through the 11/26/08 Fox5 News broadcast video available at link:

WALTERS:  Well, as this case shows, while we’ve had overall drug use go down, we still have too many young people losing their lives to drugs, either through overdoses, or addiction getting their lives off track.  So there’s a danger.  We’ve made progress, and we have tools in place that can help us make more progress, but we have to use them

Q 1:  You meet with some of these parents whose children have overdosed.  What do they tell you, and what do you tell them?

WALTERS:  It’s the hardest part of my job; meeting with parents who’ve lost a child.  Obviously they would give anything to go back, and have a chance to pull that child back from the dangerous path they were on.  There are no words that can ease their grief.  That’s something you just pray that God can give them comfort.  But the most striking thing they say to me though is they want other parents to know, to actAnd I think this is a common thing that these terrible lessons should teach us.

Many times, unfortunately, parents see signs: a change in friends, sometimes they find drugs; sometimes they see their child must be intoxicated in some way or the other.  Because it’s so frightening, because sometimes they’re ashamed – they hope it’s a phase, they hope it goes away – they try to take some half measures.  Sometimes they confront their child, and their child tells them – as believably as they ever can – that it’s the first time.  I think what we need help with is to tell people; one, it’s never the first time.  The probability is low that parents would actually recognize these signs – even when it gets visible enough to them – because children that get involved in drugs do everything they can to hide it.  It’s never the first time.  It’s never the second time.  Parents need to act, and they need to act quickly.  And the sorrow of these grieving parents is, if anything, most frequently focused on telling other parents, “Don’t wait: do anything to get your child back from the drugs.”

Secondly, I think it’s important to remember that one of the forces that are at play here is that it’s their friends.  It’s not some dark, off-putting stranger – it’s boyfriends, girlfriends.  I think that was probably a factor in this case.  And it’s also the power and addictive properties of the drug.  So your love is now being tested, and the things you’ve given your child to live by are being pulled away from them on the basis of young love and some of the most addictive substances on earth.  That’s why you have to act more strongly.  You can’t count on the old forces to bring them back to safety and health.

Q 2:  When we talk about heroin – which is what we saw in this Fairfax County drug ring, alleged drug ring – what are the risks, as far as heroin’s concerned?  I understand it can be more lethal, because a lot of people don’t know what they’re dealing with?

WALTERS:  Well it’s also more lethal because one, the drug obviously can produce cardiac and respiratory arrest.  It’s a toxic substance that is very dangerous.  It’s also the case that narcotics, like heroin – even painkillers like OxyContin, hydrocodone, which have also been a problem – are something that the human body gets used to.  So what you can frequently get on the street is a purity that is really blended for people who are addicted and have been long time addicted.  So a person who is a new user or a naïve user can more easily be overdosed, because the quantities are made for people whose bodies have adjusted to higher purities, and are seeking that effect that only the higher purity will give them in this circumstance.  So it’s particularly dangerous for new users.  But we also have to remember, it almost never starts with heroin.  Heroin is the culmination here.  I think some of the – and I’ve only seen press stories on this — some of these young people may have gotten involved as early as middle school.

We have tools so that we don’t have to lose another young woman like this– or young men.  We now have the ability to use Random Student Drug Testing (RSDT) because the Supreme Court has, in the last five years, made a decision that says it can’t be used to punish.  It’s used confidentially with parents.  We have thousands of schools now doing it since the president announced the federal government’s willingness to fund these programs in 2004.  And many schools are doing it on their own.  Random testing can do for our children what it’s done in the military, what it’s done in the transportation safety industry– significantly reduce drug use.

First, it is a powerful reason not to start.  “I get tested, I don’t have to start.”  We have to remember, it’s for prevention and not a “gotcha!”  But it’s a powerful reason for kids to say, even when a boyfriend or girlfriend says come and do this with me, “I can’t do it, I get tested.  I still like you, I still want to be your friend; I still want you to like me, but I just can’t do this,” which is very, very powerful and important.  And second, if drug use is detected the child can be referred to treatment if needed.

Q 3:  Is the peer pressure just that much that without having an excuse, that kids are using drugs and getting hooked?

WALTERS:  Well one of the other unpleasant parts of my job is I visit a lot of young people in treatment; teenagers, sometimes as young as 14, 15, but also 16, 17, 18.  It is not uncommon for me to hear from them, “I came from a good family.  My parents and my school made clear what the dangers were of drugs.  I was stupid.  I was with my boyfriend (or girlfriend) and somebody said hey, let’s go do this.  And I started, and before I knew it, I was more susceptible.

We have to also understand the science, which has told us that adolescents continue to have brain development up through age 20-25.  And their brains are more susceptible to changes that we can now image from these drugs.  So it’s not like they’re mini-adults.  They’re not mini-adults.  They’re the particularly fragile and susceptible age group, because they don’t have either the experience or the mental development of adults.  That’s why they get into trouble, that’s why it happens so fast to them, that’s why it’s so hard for them to see the ramifications.

So what does RSDT do?  It finds kids early–­ if prevention fails.  And it allows us to intervene, and it doesn’t make the parent alone in the process.  Sometimes parents don’t confront kids because kids blackmail them and say “I’m going to do it anyway, I’m going to run away from home.”  The testing brings the community together and says we’re not going to lose another child.  We’re going to do the testing in high school – if necessary, in middle school.  We’re going to wrap our community arms around that family, and get those children help.  We’re going to keep them in school, not wait for them to drop out.  And we’re certainly not going to allow this to progress until they die.

Q 4:  And in a sense, if you catch somebody early, since you’re saying the way teenagers seem to get into drug use is a friend introduces it to a friend, and then next thing you know, you have a whole circle of friends doing it.  Are you essentially drying that up at the beginning, before it gets out of hand?

WALTERS:  That is the very critical point.  It’s not only helping every child that gets tested be safer, it means that the number of young people in the peer group, in the school, in the community that can transfer this dangerous behavior to their friends shrinks.  This is communicated like a disease, except it’s not a germ or a bacillus.  It’s one child who’s doing this giving it behaviorally to their friends, and using their friendship as the poison carrier here.  It’s like they’re the apple and the poison is inside the apple.  And they trade on their friendship to get them to use.  They trade on the fact that people want acceptance, especially at the age of adolescence.  So what you do is you break that down, and you make those relationships less prone to have the poison of drugs or even underage drinking linked to them.  And of course we also lose a lot of kids because of impaired driving.

Q 5:  And how does the drug testing program work, then, in schools– the schools that do have it.  Is it completely confidential?  Are you going to call the police the minute you find a student who’s tested positive for heroin or marijuana or any other illicit drug?

WALTERS:  That’s what is great about having a Supreme Court decision.  It is settled – random testing programs cannot be used to punish, to call law enforcement; they have to be confidential.  So we have a uniform law across the land.  And what the schools that are doing RSDT are seeing is that it’s an enormous benefit to schools for a relatively small cost.  Depending on where you are in the country, the screening test is $10-40.  It’s less than what you’re going to pay for music downloads in one month for most teenage kids in most parents’ lives.  And it protects them from some of the worst things that can happen to them during adolescence.  Not only dying behind the wheel, but overdose death and addiction.

 Schools that have done RSDT have faced some controversy; so you have to sit down and talk to people; parents, the media, young people.  You have to engage the community resources.  You’re going to find some kids and families that do have treatment needs.  But with RSDT you bring the needed treatment to the kids.

I tell, a lot of times, community leaders – mayors and superintendents, school board members – that if you want to send less kids into the criminal justice system and the juvenile justice system, drug test — whether you’re in a suburban area or in an urban area.

What does the testing do?  It takes away what we know is an accelerant to self-destructive behavior: crime, fighting in school, bringing a weapon, joining a gang.  We have all kinds of irrefutable evidence now – multiple studies showing drugs and drinking at a young age accelerate those things, make them worse, make them more violent, as well as increasing their risks of overdose deaths and driving under the influence.  So drug testing makes all those things get better.  And it’s a small investment to make everything else we do work better.

Again, drug testing is not a substitute for drug education or good parenting or paying attention to healthy options for your kid.  It just makes all those things work better.

Q 6:  And I know you’ve heard this argument before, but isn’t that big brother?  Aren’t there parents out there who say to you, “I’m the parent: why are you going to test my child for drugs in school; that’s my job?” 

WALTERS:  I think that is the critical misunderstanding that we are slowly beginning to change by the science that tells us substance abuse is a disease.  It’s a disease that gets started by using the drug, and then it becomes a thing that rewires our brain and makes us dependent.  So instead of thinking of this as something that is a moral failing, we have to understand that this is a disease that we can use the kind of tools for public health – screening and interventions – to help reduce it.

Look, let me give you the counter example.  It’s really not big brother.  It’s more like tuberculosis.  Schools in our area require children to be tested for tuberculosis before they come to school.  Why do they do that?  Because we know one, they will get sicker if they have tuberculosis and it’s not treated.  And we can treat them, and we want to treat them.  And two, they will spread that disease to other children because of the nature of the contact they will have with them and spreading the infectious agent.  The same thing happens with substance abuse.  Young people get sicker if they continue to use.  And they spread this to their peers.  They’re not secretive among their peers about it; they encourage them to use them with them.  Again, it’s not spread by a bacillus, but it’s spread by behavior.

If we take seriously the fact that this is a disease and stop thinking of it as something big brother does because it’s a moral decision that somebody else is making, we can save more lives.  And I think the science is slowly telling us that we need to be able to treat this in our families, for adults and young people.  We have public health tools that we’ve used for other diseases that are very powerful here, like screening – and that’s really what the random testing is.  We’re trying to get more screening in the health care system.  So when you get a check up, when you bring your child to a pediatrician, we screen for substance abuse and underage drinking.  Because we know we can treat this, and we know that we can make the whole problem smaller when we do. 

Q 7:  You have said there were about 4,000 schools across the country now that are doing this random drug testing.  What can we see in the numbers since the Supreme Court ruling in 2002, as far as drug use in those schools, and drug use in the general population?

WALTERS:  Well, what a number of those schools have had is of course a look at the harm from student drug and alcohol use.  Some of them have put screening into place, random testing, because they’ve had a terrible accident; an overdose death; death behind the wheel.  What’s great is when school districts do this, or individual schools do this, without having to have a tragedy that triggers it.  But if you have a tragedy, I like to tell people, you don’t have to have another one.  The horrible thing about a tragic event is that most people realize those are not the only kids that are at risk.

There are more kids at risk, obviously, in our communities in the Washington, DC area where this young woman died.  We know there’s obviously more children who are at risk of using in middle school and high school.  The fact is those children don’t have to die.  We cannot bring this young lady back.  Everybody knows that.  But we can make sure others don’t follow her.  And the way we can do that is to find, through screening, who’s really using.  And then let’s get them to stop – let’s work with their families, and let’s make sure we don’t start another generation of death.  So what you see in these areas is an opportunity to really change the dynamic for the better.

Q 8:  Now, although nationally drug use among our youth is going down – what does it say to you – when I look at the numbers specific to Virginia, the most recent that I could find tells me that 3% of 12th graders, over their lifetime, have used a drug like heroin?  What does it say to you?  To me, that sounds like a lot.

WALTERS:  Yeah, and it’s absolutely true.  I think the problem here is that when you tell people we are taking efforts that are making progress nationwide, they jump to the conclusion that that means that we don’t have a problem anymore.  We need to continue to make this disease smaller.  It afflicts our young people.  It obviously also afflicts adults, but this is a problem that starts during adolescence — and pre-adolescence in some cases — in the United States.  We can make this smaller.  We not only have the tools of better prevention but also better awareness and more recognition of addiction as a disease.  We need to make that still broader.  We need to use random testing.  If we want to continue to make this smaller, and make it smaller in a permanent way, random testing is the most powerful tool we can use in schools.

We want screening in the health care system.  We have more of that going on through both insurance company reimbursement and public reimbursement through Medicare and Medicaid for those who come into the public pay system.  That needs to grow.  It needs to grow into Virginia, it’s already being looked at in DC; it needs to grow into Maryland and the other states that don’t have it.  We are pushing that, and it’s relatively new, but it’s consistent with what we’re seeing – the science and the power of screening across the board.

We need to continue to look at this problem in terms of also continuing to push on supply.  We’re working to reduce the poisons coming into our communities, which is not the opposite of demand; that we have to choose one or the other.  They work together.  Keeping kids away from drugs and keeping drugs away from kids work together.  And where we see that working more effectively, we’ll save more lives.  So again, we’ve seen that a balanced approached works, real efforts work, but we need to follow through.  And the fact that you still have too many kids at risk is an urgent need.  Today, you have kids that could be, again, victims that you have to unfortunately tell about on tonight’s news, that we can save.  It’s not a matter we don’t know how to do this.  It’s a matter of we need to take what we know and make it reality as rapidly as possible.

Q 9:  Where are these drugs coming from?  Where’s the heroin that these kids allegedly got coming from?

WALTERS:  We do testing about the drugs to figure out sources for drugs like heroin.  Principally, the heroin in the United States today has come from two sources.  Less of it’s coming out of Colombia.  Colombia used to be a source of supply on the East Coast, but the Colombian government, as a part of our engagement with them on drugs, has radically reduced the cultivation of poppy and the output of heroin.  There still is some, but it’s dramatically down from what it was even about five years ago.  Most of the rest of the heroin in the United States comes from Mexico.  And the Mexican government, of course, is engaged in a historic effort to attack the cartels.  You see this in the violence the cartels have had as a reaction.  So we have promising signs.  There are dangerous and difficult tasks ahead, but we can follow through on that as well.

Most of the heroin in the world comes from Afghanistan; 90% of it.  And we are working there, of course, as a part of our effort against the Taliban and the forces of terror and Al Qaeda, to shrink that.  The good news is that last year we had a 20% decline in cultivation and a 30% decline in output there.  Most of that does not come here, fortunately.  But it has been funding the terrorists.  It’s been drained out of most of the north and the east of the country.  It’s focused on the area where we have the greatest violence today, in the southwest.  We’re working now – you see Secretary Gates talking to the NATO allies about bringing the counter-insurgency effort together with the counter-narcotics effort to attack both of these cancers in Afghanistan.  We have a chance to change heroin availability in the world in a durable way by being successful in Afghanistan.  We’ve started that path in a positive way.  Again, it’s a matter of following through as rapidly as possible.

Q 10:  Greg Lannes, the father of the girl in Fairfax County who died, told me that one of his main efforts, as you imagined, was to let people know that those drugs, they’re coming from where it is produced, outside our country; that they’re getting all the way down to the street level and into our neighborhoods– something that people don’t realize.  So when you hear that they busted a ring of essentially teenagers who have been dealing, using and buying heroin, what does that say to you as the man in charge of combating drugs in our country?

WALTERS:  Well again, we have tools that can make this smaller.  But we have to use those tools.  And we have multiple participants here.  Yes we need to educate.  And we need to make sure that parents know they need to talk to their children, even when their children look healthy and have come from a great home.  Drugs – we’ve learned, I think, over the last 25 years or more, drugs affect everybody; rich or poor, middle class, lower class or upper class.  Every family’s been touched by this, in my experience, by alcohol or drugs.  They know that reality– we don’t need to teach them that.

What we need to teach them is the tools that we have that they can help accelerate use of.  Again, I think – there is no question in my mind that had this young woman been in a school, middle school or high school that had random testing – since that’s where this apparently started, based on the information I’ve seen in the press – she would not be dead today.  So again, we can’t go back and bring her to life.  But we can put into place the kind of screening that makes the good will and obvious love that she got from her parents, the obvious good intentions that I can’t help but believe were a part of what happened in the school, the opportunities that the community has to have a lot of resources that she didn’t get when she needed them.  And now she’s dead.  Again, we can stop this: we just have to make sure we implement that knowledge in the reality of more of our kids as fast as possible.

Q 11:  Should anyone be surprised by this case?  And that such a hardcore drug like heroin is being used by young people?

WALTERS:  We should never stop being surprised when a young person dies.  They shouldn’t die.  They shouldn’t die at that young age, and we should always demand of ourselves, even while we know that’s sometimes going to happen today, that every death is a death too many.  I think that it is very important not to say we’re going to accept a certain level.  Never accept this.  Never!  That’s my attitude, and I know that’s the president’s  attitude as well here.  Never accept that heroin’s going to get into the lives of our teenagers.  Never accept that our children are going to be able to use and not be protected.  It’s our job to protect themThey have a role, also, obviously in helping to protect themselves.  But we need to give them the tools that will help protect them.

When I talk to children and young adults in high school or college, they know what’s going on among their peers.  And in some ways, when you get them alone and they feel they can talk candidly, they tell us they don’t understand why we, as adults who say this is serious, don’t act.  They know that we see children who are intoxicated; they know that we must see signs of this, because as kid’s lives get more out of control, they show signs of it.  They want to know why we don’t act.

We can use the tools of screening, and we can use the occasion of a horrible event like this to bring the community together and say it’s time for us to use the shock and the sorrow for something positive in the future.  I haven’t met a parent of a child who’s been lost who doesn’t say I just want to use this now for something positive.  And that’s understandable, and I think we ought to honor that wish.

Q 12:  Well, I guess I’m not asking should we accept that this is in our schools, but is it naïve for people not to understand or realize that these hardcore drugs are in our schools, and in our communities, and in our neighborhoods. 

WALTERS:  Yeah.  Where it is naïve, I think, is to not recognize the extent and access that young people have to drugs and alcohol.  I think we sometimes think that because they come from a home where this isn’t a part of their lives now, that it’s not ever going to be part of their lives.  Look, your viewers should go on the computer.  Type marijuana into the Google search engine and see how many sites encourage them to use marijuana, how to get marijuana, how to grow marijuana, the great fun of marijuana.  Go on YouTube and type in marijuana, and see how many videos come up using marijuana, joking around about marijuana.  And then when you start showing one, of course the system is designed to show you similar things.  Type in heroin.  See what kind of sites come up, and see what kind of videos come up on these sites.  Young people spend more time on these sites than they do, frequently, watching television.  Remember, there is somebody telling your children things about drugs.  And if it’s not you, the chances are they’re telling them things that are false and dangerous.  So there is a kind of naiveté about what the young peoples’ world, as it presents itself to them, tells them about these substances.  It minimizes the danger, it suggests that it’s something that you can do to be more independent, not be a kid anymore. 

We, from my generation — because I’m a baby boomer — unfortunately have had an association of growing up in America with the rebellion that’s been associated with drug use.  That’s been very dangerous, and we’ve lost a lot of lives.  We have to remember that it’s alive and well, and has become part of the technological sources of information that young people have.  I also see young people in treatment centers who got in a chat room and somebody offered them drugs or offered them to come and buy them alcohol and flattered them, and got them involved in incredibly self-destructive behavior.  The computer brings every predator and every dangerous influence into your own child’s home – into their bedroom in some cases, if that’s where that computer exists.  You wouldn’t let your kids go out and play in the park with drug dealers.  If you have a computer and it’s not supervised, those drug dealers are in that computer.  Remember that.  And they’re only a couple of keystrokes away from your child.

Q 13:  And you talk about the YouTube and the computers and all those things.  What about just the overall societal image?  Because we have this whole image with heroin, of heroin chic.  How much does that contribute to the drug use, and how difficult does it make your job, when a drug is being made out to be cool in society by famous people?

WALTERS:  There are still some elements of that.  It was more prominent a number of years ago.  I would say you see less of that now glamorized in the entertainment industry, or among people who are celebrities in and out of entertainment.  You see more cases of real harm.  But it’s still out there.  The one place that I think is replacing that, just to get people ahead of the game here, is prescription pharmaceuticals.  Those have been marketed to kids on the internet as a safe high.  They falsely suggest that you can overcome the danger of an overdose because you can predict precisely the dosage of OxyContin, hydrocodone, Vicodin.  And there are sites that suggest what combination of drugs to use.  We’ve seen prescription drug use as the one counter example of a category of drug use going up among teens.  We’re trying to work on that as well, but that’s something that’s in your own home, because many people get these substances for legitimate medical care.  Young people are going to the medicine cabinet of family or friends, taking a few pills out and using those.  And those are as powerful as heroin, they’re synthetic opioids, and they have been a source of overdose deaths. 

So let’s not forget – while this Fairfax example reminds us of the issues of heroin chic and of the heroin that’s in our communities, the new large problem today is a similar dangerous substance in pill form in our own medicine cabinets.  Barrier to access is zero.  They don’t have to find a drug dealer; they just go find the medicine cabinet.  They don’t have to pay a dime for it because they just take it and they share that with their friends.  We need to remember, that’s another dimension here.  Keep these substances out of reach – under our control when we have them in our home.  Throw them away when we’re done with them.  Make sure we talk to kids about pills.  Because people, again, are telling them that’s the place to go to avoid overdose death, is to take a pill.

Q 14:  When you see a lot of these celebrities checking in and out of rehab, does it sort of glamorize it for kids?  And teach them hey, you can use, you can check into rehab, you can come back, you can – you know.  Is there a mixed message there?

WALTERS:  There is.  Some young people interpret it the way you describe; of it’s something you do and you can get away with it by going into rehab.  We do a lot of research on young people’s attitudes for purposes of helping shape prevention programs in the media, as well as in schools and for parents.  We do a lot with providing material to parents.  I would say that compared to where we’ve been in the last 15 or 20 years, there’s less glamorization today.

I think we should also remember the positive, because we reinforce that.  A lot of young people – obviously not all or we wouldn’t have this death – believe that taking drugs makes you a loser.  They’ve seen that a lot of those celebrities are showing their careers going down the toilet because they can’t get away from the pills and the drugs and the alcohol.  And I think they see that even among some of their peers.  That’s a good thing.  We should reinforce that as parents: teaching our kids that drug and alcohol use may be falsely presented to you as something you do that would make you popular, make you seem like you should have more status in society generally.  But actually, look at a lot of these people; they’ve had enormous opportunities, enormous gifts, and they can’t stop themselves from throwing them away.  And they may not stop themselves from throwing away their lives. 

I think you could use these events as a teachable moment.  It can go two ways.  Help your child understand what the truth is here.  And I tell young people – and I think parents have to start this more directly – this is the way this is going to come to you:  Somebody you really, really want to like you; somebody you really, really like; someone you may even love — or think you love — they’re going to say come and do this with me.  If you can’t find any other reason to not do this with them, say, “Before we do this, let’s go to a treatment center.  Let’s go talk to people who stood where we stood and said it’s not going to happen to me.”  If everybody, when they got the chance to start, thought of an addict or somebody who was dead, they wouldn’t start.  The fact is that does not enter their mind. 

Many people in treatment centers understand that part of the task of recovery is helping other people avoid this.  So they’re willing to talk about it.  In fact, that’s part of their path of staying clean and sober, which not many kids are going to be able to do on their own.  But it makes them think that what presents itself as something overwhelmingly attractive has behind it a horrible dimension, for their friends as well as for themselves.  And more and more, I think kids understand this.

We can use the science of this as a disease, and the experience of many families.  Remember, uncle Joe didn’t used to be like this.  Especially Thanksgiving, when we have families getting together and all of a sudden mom’s going to get loaded and become ugly in the corner.  We also have to remember we have an obligation to reach out to those people, and to get them help.  We can treat them.  Nobody gets sober, in my experience, by themselves.  They have to take responsibility.  But you have to overcome the pushback, and addiction and alcoholism have, as a part of the disease, denial.  When you tell somebody they have a problem, they get angry with you.  They don’t say hey thanks, I want your help.  They don’t hit bottom and become nice.  That’s a myth.  They need to be grabbed and encouraged and pushed.  Almost everybody in treatment is coerced – by a family member, by an employer, sometimes by the criminal justice system.

So remember that, when you find your child using and they want to lie to you up down and sideways saying, “It’s the first time I’ve ever done it.”  No, no, no, no, no, that’s the drugs talking.  That shows you, if anything, you have a bigger problem than you realized and you need to reach out, get some professional help.  But don’t wait!

Source:    National Institute of Citizen Anti-drug Policy (NICAP)

DeForest Rathbone, Chairman, Great Falls, Virginia, 703-759-2215, DZR@prodigy.net

A pilot study by Addiction Switzerland traced the alcohol incentives on the routes of 16 to 19-year-old adolescents in everyday life and in social networks. On average, the test subjects in the five largest Swiss cities encountered an alcohol incentive every five minutes. Alcohol was also omnipresent in social networks, transported by friends and influencers, who are often paid for it. The study showed the frightening normality of alcohol in the everyday life of adolescents.

 Alcohol marketing is aimed strongly at young people, as they are the customers of tomorrow. A pilot study by Addiction Switzerland , financed by the Federal Customs Administration, looked into the question of how much adolescents are actually exposed to alcohol stimuli. The study layout was partly based on an earlier study on tobacco marketing : Here, too, the typical routes and activities taken by young people in everyday life and when going out in Geneva, Lausanne, Bern, Basel and Zurich were traced. All alcohol incentives encountered were systematically recorded. In addition, the alcohol incentives encountered by the young people in social networks were recorded.

At least half of the incentives are intentional

On average, the distances (including activities such as sports, cinema, restaurant, etc.) were covered within six hours each. 73 alcohol stimuli were recorded per trip, which means, on average, a reminder of the alcohol every five minutes! It should be said that the investigation in autumn 2020 came at a time when the Covid measures were becoming stricter again and the exit bars were closing again, and fewer events were taking place in public spaces. It can be assumed that advertising activity has been reduced accordingly during this period.

Half of the stimuli recorded related to alcohol advertising or the promotion of alcoholic beverages. The other half consisted of apparently random alcohol stimuli: Empty bottles and cans in public spaces, depictions of where alcohol plays a role (e.g. an occasion where people drink), what is offered on a menu card, etc.

In addition, all perceived prevention messages should be recorded. But it turned out that these were almost completely absent on the paths of the young people.

On social media: the power of images and influencers

Alcohol marketing has partly shifted to the internet. 85% of young people between the ages of 12 and 19 spent an hour or more per day on the Internet in 2019 , the majority of them are also on social networks, which has probably increased during the pandemic . On Snapchat, Instagram and Tiktok in particular, they receive numerous pictures and messages from friends and acquaintances who have alcohol as their topic. The alcohol advertising by influencers is also noticeable.

A society banalizing alcohol does not protect its youth

The results of this pilot study impressively show how strongly young people are already confronted with alcohol. It becomes normal for them to include alcohol. This is alarming in view of the around 400 young people who are admitted to hospital in Switzerland every year because of alcohol poisoning. A large part of these alcohol stimuli is consciously placed or at least it is tolerated that adolescents are also advertised. Sucht Switzerland therefore calls for the measures to be taken to protect young people to be stepped up. These include the restriction of alcohol advertising and thus the reduction in the attractiveness of alcohol among young people.

Source:   mportner-helfer @ suchtschweiz.ch May 2021

Filed under: Alcohol,Internet,Youth :

Abstract

Among individuals with substance use disorders (SUDs), comorbidity with other psychiatric disorders is common and often noted as the rule rather than the exception. Standard care that provides integrated treatment for comorbid diagnoses simultaneously has been shown to be effective. Technology-based interventions (TBIs) have the potential to provide a cost-effective platform for, and greater accessibility to, integrated treatments. For the purposes of this review, we defined TBIs as interventions in which the primary targeted aim was delivered by automated computer, Internet, or mobile system with minimal to no live therapist involvement. A search of the literature identified nine distinct TBIs for SUDs and comorbid disorders. An examination of this limited research showed promise, particularly for TBIs that address problematic alcohol use, depression, or anxiety. Additional randomized, controlled trials of TBIs for comorbid SUDs and for anxiety and depression are needed, as is future research developing TBIs that address SUDs and comorbid eating disorders and psychotic disorders. Ways of leveraging the full capabilities of what technology can offer should also be further explored.

Source: Technology-Based Interventions for Substance Use and Comorbid Disorders: An Examination of the Emerging Literature – PubMed (nih.gov) May/June 2017

Abstract
Aim: To evaluate the effectiveness of an online school-based prevention program for ecstasy (MDMA) and new psychoactive substances (NPS).

Design: Cluster randomized controlled trial with two groups (intervention and control).

Setting: Eleven secondary schools in Australia.

Participants: A total of 1126 students (mean age: 14.9 years).

Intervention: The internet-based Climate Schools: Ecstasy and Emerging Drugs module uses cartoon storylines to convey information about harmful drug use. It was delivered once weekly, during a 4-week period, during health education classes. Control schools received health education as usual.

Measurement: Primary outcomes were self-reported intentions to use ecstasy and NPS at 12 months. Secondary outcomes were ecstasy and NPS knowledge and life-time use of ecstasy and NPS. Surveys were administered at baseline, post-intervention and 6 and 12 month post-baseline.

Findings: At 12 months, the proportion of students likely to use NPS was significantly greater in the control group (1.8%) than the intervention group [0.5%; odds ratio (OR) = 10.17, 95% confidence interval (CI) = 1.31-78.91]. However, students’ intentions to use ecstasy did not differ significantly between groups (control = 2.1%, intervention = 1.6%; OR = 5.91, 95% CI = 1.01-34.73). There was a significant group difference in the change from baseline to post-test for NPS knowledge (β = -0.42, 95% CI = -0.62 to -0.21, Cohen’s d = 0.77), with controls [mean = 2.78, standard deviation (SD = 1.48] scoring lower than intervention students (mean = 3.85, SD = 1.49). There was also evidence of a significant group difference in ecstasy knowledge at post-test (control: mean = 9.57, SD = 3.31; intervention: mean = 11.57, SD = 3.61; β = -0.54, 95% CI = -0.97 to -0.12, P = 0.01, d = 0.73).

Conclusions: The Climate Schools: Ecstasy and Emerging Drugs module, a universal online school-based prevention program, appeared to reduce students’ intentions to use new psychoactive substances and increased knowledge about ecstasy and new psychoactive substances in the short term.

Keywords: Adolescents; ecstasy; internet; new psychoactive substance; prevention.

Source: https://pubmed.ncbi.nlm.nih.gov/26880476/ April 2016

The Internet hosts many unregulated marketplaces for otherwise regulated products. If extended to marijuana (or cannabis), online markets can undermine both the U.S. Controlled Substances Act, which bans marijuana sales, and the regulatory regimes of states that have legalized marijuana. Consequently, regardless of the regulatory regime, understanding the online marijuana market should be a public health
priority. Herein, the scale and growth trajectory of the online marijuana marketplace was assessed for the first time by analyzing aggregate Internet searches and the links searchers typically find.

METHODS
First, the fraction of U.S. Google searches including the terms marijuana, weed, pot, or cannabis relative to all searches was described monthly from January 2005 through June 2017 using data obtained from Google. Searches were also geotagged by state (omitting Alaska, Montana, North Dakota, South Dakota, Vermont, West Virginia, and Wyoming because of data access restrictions). The subset of shopping searches was then monitored by tracking queries that also included buy, shop, and order (e.g., buy marijuana) in aggregate. Searches that included killer, cooking, or clay (e.g., weed killer) were considered unrelated and excluded from all analyses.
Linear regressions were used to compute pooled means to compare between time periods and log-linear regressions were used to compute average growth. Raw search volumes were estimated based on total Google search volume using comScore (www.comscore.com).
Searches in a Google Chrome browser without cached data were executed during July 2017 using the 12 combinations of marijuana and shopping root terms (i.e., buy marijuana). The results would be indicative of a Google user’s typical search results. The first two pages of links, including duplicates (N¼279, with seven to 12 links per page), were analyzed (because nearly all searchers click a link on the first two pages, with as much as 42% selecting the first link). Investigators recorded whether each linked site advertised mail-order marijuana (excluding local deliveries in legal marijuana states) and its order in the search results. Two authors agreed on all labels. Analyses were computed using R, version 3.4.1.

RESULTS
Marijuana searches grew 98% (95% CI¼84%, 113%) as a proportion of all searches from 2005 through the partial 2017 year (Figure 1). The subset of marijuana searches indicative of shopping grew more rapidly over the same period (199%, 95% CI¼165%, 243%), with 1.4–2.4
million marijuana shopping searches during June 2017. Marijuana shopping searches were highest in Washington, Oregon, Colorado, and Nevada. The compounding annual growth rate for marijuana shopping searches since 2005 was significantly positive (po0.05) in 42 of
the 44 studied locations (all but Alabama and Mississippi), suggesting demand is growing across the nation. Forty-one percent (95% CI¼35%, 47%) of shopping search results linked to retailers promising mail-order marijuana (Table 1). Retailers occupied 50% (95% CI¼42%, 59%) of the first page results and for eight (of 12) searches, the first link led to a mail-order marijuana retailer. For some searches (e.g., order marijuana), all of the first-page links were marijuana retailers.

Table 1: Online Mail-Order Marijuana Retailers on Internet Search Engines, 2017

Search results
Retailer First link First page Second page Total
Yes 8 (67) 66 (50) 48 (32) 114 (41)
No 4 (33) 65 (50) 100 (68) 165 (59)

Note: Data were collected by executing searches in July 2017. Cells show the frequency and percent of links (by column) in the first two
pages of Google search results that claim to sell mail-order marijuana in response to 12 searches that contained unique combinations of the
following terms: cannabis, marijuana, pot, or weed with buy, order, or shop, such as buy cannabis, buy marijuana, buy pot, or buy weed.
Searches were executed on a new Google browser without cached data. Two authors agreed on the labels 100% of the time.

DISCUSSION
Millions of Americans search for marijuana online, and websites where marijuana can be purchased are often the top search result.
If only a fraction of the millions of searches and thousands of retailers are legitimate, this online marketplace poses a number of potential public health consequences. Children could purchase marijuana online. Marijuana could be sold in states that do not currently allow it.

Initiation and marijuana dependence could increase. Products may have inconsistent potency or be contaminated. State and local tax revenue (which can fund public health programs) could be negatively impacted.
Regulations governing online marijuana markets (even if policy changes favor legalized marijuana) need to be developed and enforced. Policing online regulations will require careful coordination across jurisdictions at the local, state, and federal level with agreements on how to implement regulations where enforcement regimes conflict. Online sales are already prohibited under virtually every regulatory regime—all sales are illegal under federal statute and legal marijuana states like Colorado ban online sales—yet the market appears to be thriving.
Government agencies might work with Internet providers to purge illicit marijuana retailers from search engines, similar to how Facebook removes drug-related pages. Moreover, online payment facilitators could refuse to support marijuana-related online transactions.
This study was limited in that who is buying/selling and the quantity of marijuana exchanged cannot be measured. Further, some searches may be unrelated to seeking marijuana retailers, and some retailers may be illegitimate, including scams or law enforcement bait. The volume of searches and placement of marijuana retailers in search results is a definitive call for public health leaders to address the previously unrecognized dilemma of online marijuana.

ACKNOWLEDGMENTS
This work was supported by a grant from the National Institutes of Mental Health (R21MH103603). Mr. Caputi acknowledges scholarships from the Joseph Wharton Scholars and the George J. Mitchell Scholarship programs. Dr. Leas acknowledges a training grant from the National Heart, Lung, and Blood Institute (T32HL007034). No other financial disclosures were reported by the authors of this paper.

Source: Online Sales of Marijuana: An Unrecognized Public Health Dilemma – American Journal of Preventive Medicine (ajpmonline.org) March 2018

Oxford academics say sales of synthetic opioid drug are proliferating on illicit websites, with Britain a significant player

Drug paraphernalia seized by North Yorkshire police in a recent case. Photograph: North Yorkshire police/PA

The UK is the largest host of fentanyl sales on the darknet in Europe, with 1,000 trades being made in the last few months, research shows.

Experts at the Oxford Internet Institute said the UK was a “significant player” in the trade of the synthetic opioid, a controlled class A drug that can be up to 100 times stronger than heroin. They warned that the drug was increasingly appearing on illicit websites.

It follows repeated warnings from the National Crime Agency for people to be “vigilant about fentanyl to protect themselves and their loved ones”, following at least 60 deaths linked to the substance.

A team at the institute has been scraping the world’s largest darknet marketplaces since April 2017. It found that the US accounts for almost 40% of global darknet trade, followed by Canada (15%) and Australia (12%). The largest seller in Europe is the UK (9%), followed by Germany, accounting for 5% of sales.

Joss Wright, a research fellow at the institute, said: “Why is the UK a significant player? … It’s because we have a relatively strong tech sector and users of the web, but also geographically the UK is quite well placed for trade coming from the US.”

He said that since data gathering began in April, there had been 4,850 trades in the US and about 1,000 in the UK.

Darknet markets or cryptomarkets have been operating since the launch of Silk Road in February 2011. On the darknet, those selling substances are able to remain relatively anonymous as their IP addresses are masked. People buy drugs using the online currency bitcoin.

Mark Graham, a professor of internet geography at the institute, said: “Many of the sellers in places like the US, Canada, and western Europe are likely intermediaries rather than producers themselves. While darknet marketplaces can, in theory, be accessed from anywhere in the world, our data suggests that there is often a local geography of trading. In other words, buyers tend to buy from domestic rather than international sellers.”

Two men were jailed last month for importing fentanyl and other class A drugs before selling them on the darknet. Ross Brennan, 29, from York, was sentenced to more than 13 years after making hundreds of thousands of pounds with 27-year-old Aarron Gledhill from Huddersfield, who was sentenced to just under four years for his part in the crime.

In what has been described as the first case of its kind in the UK because of their sophisticated use of technology, police searched Brennan’s property and found drugs with a street value of tens of thousands of pounds. They also seized a Chemistry for Dummies book, address labels, bags of cutting powder, a mixing machine, a microscope, a set of scales and packages from around the world.

The offences took place between 2013 and 2016. Between June and September 2015 alone, Brennan made 225 transactions using a dark website called AlphaBay, which has since been shut down.

Wright said fentanyl was appearing “more and more” on the dark web. “There has been a rise in the number of sales of that product … the darknet is a good place to buy things with extra guarantees of security and there is increasing trade there,” he said.

In response, some darknet marketplaces – including the drug market Hansa, which was shut down in July – had started banning fentanyl sales amid concerns it would attract too much attention from law enforcement, he said.

Judith Aldridge, a criminologist at the University of Manchester, said she would be surprised if sales of fentanyl did not increase. “Interestingly, over the past 12 months we’ve seen a demonisation of fentanyl, with many in the darknet community opposed to their sales on crypto-markets.”

Dr Andres Baravalle, from the University of East London, said research showed that 398 of 36,000 darknet adverts had mentioned fentanyl so far in 2017.

The Global Drug Survey 2017 said: “Despite disruptions from law enforcement efforts and scams, the size and scale of darknet markets for drugs continues to grow. At the time of the report there were over 20 functioning markets, according to dnstats.net.”

Graham, from the institute, said this had not deterred dealers. “Our research so far shows that shutting down these marketplaces has not reduced the total amount of trade. It’s a whack-a-mole game, so it is not reducing demand and supply … when you shut down one website another pops up. There is no indication it’s radically reducing demand or supply on these markets.”

Source: https://www.theguardian.com/society/2017/oct/16/uk-accounts-for-largest-share-of-darknet-fentanyl-sales-in-europe October 2017

Meet Ryan Hampton, 36, recovery advocate, political activist and recovering heroin addict igniting America’s social media feeds with stories of hope, recovery and activism. From his advocacy that led Sephora to take their eyeshadow branded “druggie” off the shelves to the activism that urged an Arizona politician to apologize for a statement stigmatizing addiction, he’s certainly become a social media powerhouse for all things addiction, recovery and policy. And with an estimated 7 out of 10 people on social media platforms, it’s no coincidence he’s found success taking the addiction advocacy fight digital.

Today, more than 22 million people are struggling with addiction, and it’s estimated that as a result, more than 45 million people are affected. But what many people don’t realize is that there are more than 23 million people living in active, long-term recovery today. Yet, because of shame and stigma, many stay silent. To fight this often-lethal silence, Hampton has urged the public to speak up and share personal stories of recovery through his recently launched Voices Project. The project, a collaborative effort to encourage people across the nation to share their story, exists to put real faces and names behind the addiction epidemic.

A Personal Struggle

Before becoming a national recovery advocate and social media powerhouse, Hampton himself faced a personal struggle with addiction. A former staffer in the Clinton White House, Hampton did not appear to be a likely candidate for heroin addiction, or so stigma would say. But after an injury and subsequent prescription for pain medication, Hampton found himself addicted to opiates, eventually leading to a heroin addiction that would span more than a decade.  After a long struggle, Hampton decided to get help.

It was the phone call that started his recovery journey that changed everything – his life and his view on the power of his phone. After getting sober, he began connecting with others in recovery, amazed at the magnitude of the digital community. But still, while uncovering these online stories of recovery, Hampton lost four friends to opioid addiction.

It was a breaking point for Hampton – one that led to the beginning of a movement that would someday reach and impact millions.

A Notable Partner

Hampton began reaching out to others in recovery and started realizing the power of digital tools to connect and build an online recovery community. And as he was slowly networking and meeting others in recovery, on October 4, 2015, Hampton’s advocacy met its catalyst: Facing Addiction.   The non-profit organization hosted a concert at the National Mall in Washington, D.C., an event that drew thousands to the capitol with celebrities, musicians and other well-known names willing to publicly celebrate the reality of recovery and call for reform in the addiction industry. Hampton, a Los Angeles resident, tuned into the event from across the country through Facebook Live and was again inspired by the content delivered through his mobile phone.

After meeting co-founders of Facing Addiction, Jim Hood and Greg Williams, Hampton plugged in, partnered and even joined the Facing Addiction team as a recovery advocate.

The importance of online advocacy aligns with Facing Addictions’ national priorities, shares CEO Jim Hood, “When enough people tell enough stories and the people who are impacted by addiction look like all of us and our kids and neighbors and relatives, the stigma has to start going away. And then we can get to work.”

After partnering with Facing Addiction, Hampton understood the priorities, the strategy and the mechanism. Said by Hampton, “I stand on the shoulders of giants”.

Leveraging the power of the algorithms at his fingertips every day, Hampton has grown his online presence to be one of the most influential in the recovery movement. Digital communication helped him get to treatment, connected him with Facing Addiction, and now is the platform in which he is sharing recovery stories from across the nation.

In just one week, more than 200 stories were submitted to the Voices Project and over 500 people sent in personal messages to express their support. Among those speaking up are notable voices such as pro skateboarder and former Jackass member Brandon Novak;   Grammy Award-winning musician Sirah;  rapper Royce da 5’9’’;   American politician and mental health advocate Patrick Kennedy;  former child actress and now-addiction counselor Mackenzie Phillips, and more.

According to Royce da 5’9’’, “Addiction is a problem that we all have to deal with. It affects us all in one way or another, and having someone giving it a voice, a name and a face not only helps get rid of the stigma regarding addiction, but he’s [Ryan] on the forefront letting people know there are solutions out there and recovery is real.”

Patrick Kennedy shares the importance of building a digital recovery movement to influence and support political reform in the addiction recovery space. “With the push of a button we’ll be able to have others show up to support communities across the nation,” says Kennedy, “because their fight is our fight.”

“The face of addiction is everyone,” Sirah shares. “The Voices Project gives people a voice and a connection to hope.”

The hope offered through open dialogue about addiction and recovery has now grown into a digital movement.

The pages that Hampton started with $20 and an old computer have gained more than 200,000 followers across platforms, reaching nearly 1 million people each week. “We’re the fastest-growing social movement in history – and the funny thing is, we’re a community that nobody ever wanted to be a part of,” Novak says.

“This is the one space where we cannot be ignored. The time has come for us to speak out, and we’re a community that speaks loudly. With addiction, we’re dealing with imminent death every day,” Hampton says. “Through social media, we’ve found an innovative way to communicate with each other and connect with people we haven’t met, and now, we’re having this conversation with the rest of the world.”

Perhaps the most intriguing impact of Hampton’s work is the paradoxical ability to bring the work of addiction recovery advocacy online – only to take it back offline through real-world change in communities across the country. According to Hampton, the work he’s doing shouldn’t stay digital – it should impact community laws, help new non-profits emerge and influence real people to seek treatment and find it.

“No matter if you have social media or not – your way of doing this is talking about addiction at the dinner table, to a parent or a friend or an employer. You should not be afraid to tell your story of recovery or loss and, most importantly, your story of struggle and how you need help. It may not just change your life, it may change someone else’s life,” Hampton says.

At the crux of digital advocacy in the addiction recovery realm are real lives being saved – people finding treatment, families finding hope and those in recovery being freed of stigma that can keep them in shame and silence.  This is the mission that has fuelled Hampton’s work since the beginning. And Hampton’s reason is hard to refute: “My story is powerful, but our stories are powerful beyond measure.”

Source: https://www.forbes.com/sites/toriutley/2017/04/18/the-recovering-heroin-addict-shaking-social-media/2/#273606f0689c

Two 13-year-old boys in the ski town of Park City, Utah died within 48 hours of each other in September, likely overdosing on a powerful heroin substitute that had been delivered — legally — to their homes by the U.S. mail, and is now turning up in cities across the nation.

Ryan Ainsworth was found dead on his couch two days after his best friend Grant Seaver passed away. “I wish I had been better warned,” sang one of their friends at a massive memorial service. “But now it’s too late.”

The death toll could have been worse, say investigators, since as many as 100 Park City students had apparently been discussing the drug “Pink” on SnapChat and other social media.

“This stuff is so powerful that if you touch it, you could go into cardiac arrest,” Park City Police Chief Wade Carpenter told NBC News. “The problem is if you have a credit card and a cell phone, you have access to it.”

One toxicology lab has linked 80 deaths to the synthetic opioid known as Pink. DEA

Pink, better known by chemists as U-47700, is eight times stronger than heroin, and is part of a family of deadly synthetic opioids, all of them more powerful than heroin, that includes ifentanyl, carfentanil and furanyl fentanyl. By themselves or mixed with other drugs, in forms ranging from pills to powder to mists, they’re killing thousands of people across the country, say law enforcement and health officials. The powerful, ersatz opioids are part of a surge of synthetic drugs, including bath salts and mock-ups of ecstasy, being shipped into the U.S. from China and other nations.

So far, however, only four states have made Pink illegal. It can still be ordered legally on-line and delivered to your home. The internet has many websites a Google search away where the drug is available for as little as $5 plus shipping.

Melissa Davidson, mother of a Park City teen who had friends in common with the dead boys, showed NBC News on her home computer screen how easy it was to find the drug for sale with just a few keystrokes. “Look! There are like pages and pages that you can buy this stuff online.”

According to the U.S. Centers for Disease Control, total opioid overdose deaths nearly quadrupled between 1999 and 2014, rising from 8,050 to 28,647. The portion of those deaths caused by synthetic opioids, however, rose almost twice as fast, from just 730 in 1999 to 5,544 in 2014.

Because of the surge in opioid-related deaths, and the regular appearance of new synthetics on the market, there is a time lag in toxicology reports from coroners, and the possibility that some deaths are mistakenly linked to other, better known substances.

But Pink, a relative newcomer among the synthetics, has been implicated in 80 deaths across the country in just the past nine months, according to Pennsylvania-based NMS Labs, which conducts forensic toxicology tests.

The Drug Enforcement Administration said it is aware of confirmed fatalities associated with U-47700 in New Hampshire, North Carolina, Ohio, Texas, and Wisconsin. Though its own tally is only 15 deaths, an agency spokesperson said the number was probably higher because of challenges and delays in reporting.

On Sept. 7, the DEA took initial steps toward banning the drug nationally by giving notice of its intent to schedule the synthetic opioid temporarily as a Schedule 1 substance under the federal Controlled Substances Act.

Some states aren’t waiting for a permanent federal ban. In late September, Florida Attorney General Pam Bondi signed an emergency order outlawing the drug after it was tied to eight deaths in recent months. Florida joins Ohio, Wyoming and Georgia in outlawing the compound and other states are looking to do the same.

In some states, law enforcement is just learning about a threat that is especially challenging because so many transactions are done by computer and through the mail. And the chemists who manufacture the drugs can invent new variants as fast as the states can outlaw them.

“The hardest part is when something new comes up, and no one in the country or world has seen it in a forensic setting yet and trying to decide what that actual structure or drug is,” said Bryan Holden, senior forensic scientist with the Utah Department of Public Safety. “Sometimes we have had cases where the substance sat for months and months — no one had ever seen it before, and until someone else sees it or manufactures it then we kind of know what it is.”

The DEA has been using so-called temporary bans more and more often to combat designer synthetic drugs have made their way into the U.S. from China and other parts of the world. The U47700 ban allows them three years to research whether something should be permanently controlled or whether it should revert back to non-controlled status.

But experts say the most effective prevention may start in the home, at the computer and the mailbox.

“I’m worried about you,” Melissa Davidson told her 17-year-old daughter Jane.

Jane, however, was worried about her friends at school. “I can’t imagine the kids I’m in math class with, just not being there one day. One bad decision can have permanent consequences.”

Source:  http://www.nbcnews.com/storyline/americas-heroin-epidemic/pink-stronger-heroin-legal-most-states-n666446     15th Oct.2016

Filed under: Internet,Synthetics,USA :

A new survey finds an estimated 17 percent of American high school students say they drink, smoke or use drugs during the school day. The National Center on Addiction and Substance Abuse (CASA) at Columbia University found 86 percent of teens say they know which of their peers are abusing substances at school, CNN reports.

The findings come from an annual telephone survey of about 1,000 students ages 12 to 17. According to the survey, 60 percent of high school students say drugs are available on school grounds, and 44 percent know a classmate who sells drugs at school. Marijuana is the most commonly sold drug at school. Prescription drugs, cocaine and Ecstasy are also available.

Social media plays a role in peer pressure to use drugs and alcohol, the study found. Three-quarters of students said they are encouraged to use marijuana or alcohol when they see images of their peers doing so. The survey found 45 percent said they have seen photos online of their classmates drinking, using drugs or passing out, up 5 percent since last year.

For the first time in the history of the survey, a majority of private school students—54 percent—said their school was “drug-infected.” In 2011, that figure was 36 percent.

Teens are more likely to use drugs or alcohol if they have been left alone overnight, and are less likely to do so if they regularly attend religious services, the survey found.

“The take away from this survey for parents is to talk to their children and get engaged in their children’s lives,” Emily Feinstein, project director of the teen survey, said in a news release. “They should ask their children what they’re seeing at school and online. It takes a teen to know what’s going on in the teen world, but it takes parents to help their children navigate that world.”

Source:  www.partnership@drugfree.org.  5th Sept. 2012

Universal Internet-based prevention for alcohol and cannabis use reduces truancy, psychological distress and moral disengagement: A cluster randomised controlled trial.

Abstract

AIMS:

A universal Internet-based preventive intervention has been shown to reduce alcohol and cannabis use. The aim of this study was to examine if this program could also reduce risk-factors associated with substance use in adolescents.

METHOD:

A cluster randomised controlled trial was conducted in Sydney, Australia in 2007-2008 to assess the effectiveness of the Internet-based Climate Schools: Alcohol and Cannabis course. The evidence-based course, aimed at reducing alcohol and cannabis use, consists of two sets of six lessons delivered approximately six months apart. A total of 764 students (mean 13.1years) from 10 secondary schools were randomly allocated to receive the preventive intervention (n=397, five schools), or their usual health classes (n=367, five schools) over the year. Participants were assessed at baseline, immediately post, and six and twelve months following the intervention on their levels of truancy, psychological distress and moral disengagement.

RESULTS:

Compared to the control group, students in the intervention group showed significant reductions in truancy, psychological distress and moral disengagement up to twelve months following completion of the intervention.

CONCLUSIONS:

These intervention effects indicate that Internet-based preventive interventions designed to prevent alcohol and cannabis use can concurrently reduce risk-factors associated with substance use in adolescents.

Source:  Prev Med. 2014 May 10;65C:109-115. doi: 10.1016/j.ypmed.2014.05.003. [Epub ahead of print]

The NDPA have been concerned for some time about the easy availability of drugs online.   There are sites actively promoting the legalization of drugs, misinformation about drugs, and even sites showing young children smoking cigarettes and encouraging others to do so.   Shocking research showed recently that 8 out of 10 of  UK youngsters watch porn online.   The world wide web has been a tremendous force for good in many ways – but there is a very dark side to the internet.  The following items show the extent of  big business involved in making money out of selling illegal drugs online.   (is Google the Tesco of  the internet ?)

——————————————————————————————–

The article below from today’s Wall Street Journal shows the effectiveness of going after companies that aid and facilitate the illicit drug trade. Several years ago, I queried Amazon.com for a book on a particular drug that I was interested in learning more about and along with the responses from the Amazon.com search engine came a pop-up offering to sell me the very drug I was asking about — a Schedule II controlled substance – without a prescription! I wrote a letter to Amazon.com indicating that this could be interpreted as a “facilitation” violation of the Controlled Substances Act and needed to be stopped immediately.

Back came a nice letter (by FedEx) from Amazon.com’s chief counsel  advising me that the company was just as upset and concerned as I but was powerless to stop these “pop-ups.” The chief counsel said that the ad likely was inserted by one of the anonymous servers used to transmit my Internet request to Amazon.com. It seems that data mining software used by the servers detect key words used in emails and unencrypted messages that pass through them and automatically generate unsolicited return messages to the sender offering, as in my case, something for sale. On the basis of what little I knew about all this, I concluded nothing further could be done.

I was wrong! Fortunately, in the interim, brighter minds at my alma mater (DOJ) and elsewhere figured this out and concluded that Google was one of several companies at fault.

A fine of $500  million is a drop in the proverbial bucket for Google. Of potentially greater interest here may be what happens after Google settles the current criminal case. Unlike a civil case in which a defendant may settle without having to admit wrongdoing, a settlement in a criminal case usually requires admissions of guilt to specific law violations. If this is the case, will there be subsequent state actions filed against Google on behalf of harmed residents? Will we begin seeing TV ads asking “If you or a loved one ever ordered drugs via the Internet, call the law offices of so-and-so; you may be eligible for a cash settlement, etc.”?

Given the fact that unregistered Internet “rogue” pharmacies more often than not sell counterfeit drugs or outdated, toxic, and/or ineffective drugs and, in doing so, accept only credit cards or international money orders in payment, I’m sure there are retrievable records of such purchases and possibly aggrieved patients who may have been harmed by products illegally advertised and sold via the Internet and facilitated by the advertising services provided by Google. When all is said and done, the total payout for these potential claims, if indeed they are viable, could be several times the amount of the proposed settlement in the current criminal case against Google. Better yet, it should be enough to end or severely curtail this aspect of modern-day drug dealing.

John J. Coleman, PhD  President, Drug Watch International  2011

Google Near Deal in Drug Ad Crackdown

Read more: http://online.wsj.com/article/SB10001424052748703730804576319572448399628.html#ixzz1MGNqwAfe

Google Inc. is close to settling a U.S. criminal investigation into allegations it made hundreds of millions of dollars by accepting ads from online pharmacies that break U.S. laws, according to people familiar with the matter.

The Internet company disclosed in a cryptic regulatory filing earlier this week that it was setting aside $500 million to potentially resolve a case with the Justice Department. A payment of that size would be among the highest penalties paid by companies in disputes with the U.S. government.   Google gave few details in its filing about the probe, saying only that it involved “the use of Google advertising by certain advertisers.”   The federal investigation has examined whether Google knowingly accepted ads from online pharmacies, based in Canada and elsewhere, that violated U.S. laws, according to the people familiar with the matter.

A Google spokesman declined to comment, as did a Justice Department spokeswoman.     WSJ’s Thomas Catan reports that Google is close to settling with the government over allegations that the company made millions from illegal ad companies.

Search engines can be liable if they are found to be profiting from illegal activity. In December 2007, the three largest Internet companies, Google, Microsoft Corp. and Yahoo Inc. agreed to pay a combined $31.5 million fine to settle civil allegations brought by the Justice Department that they had accepted ads from illegal gambling sites.

Prosecutors can charge such acts under a number of different statutes. From a legal standpoint, a key distinction for Google would be that the illegal activity allegedly took place through its paid advertising service, not just the results that its search engine produces.

There are scores of websites that offer to sell prescription drugs. Some violate U.S. laws by selling counterfeit or expired medicines or dispensing without a valid doctor’s prescription.  One question under investigation is the extent to which Google knowingly turned a blind eye to the alleged illicit activities of some of its advertisers—and how much executives knew, the people familiar with the matter said.   The probe has been conducted by the U.S. Attorney’s Office in Rhode Island and the Food and Drug Administration, among other agencies, according to these people. A spokesman for Rhode Island U.S. Attorney Peter Neronha declined to comment. A spokeswoman for the FDA said the investigation was ongoing and declined to comment further.

Google generated nearly $30 billion in total ad revenue in 2010, largely from its AdWords system. AdWords helped revolutionize online advertising, offering marketers the chance to bid to display their ads when people searched for certain keywords on the Google search engine. An advertiser only pays when a user clicks on the ad.

Google, like other Internet companies, has struggled for years to deal with what it calls “rogue online pharmacies.” In 2003, for instance, Google said it banned ads from U.S. companies that offer drugs like Vicodin and Viagra without a prescription.   Google acted after rivals, including Yahoo and Microsoft, made similar moves as the FDA began publicly pressuring sites to accept only drug ads from licensed Internet pharmacies.

But Google said in 2004 it would continue carrying ads for Canadian pharmacies that send medicines to U.S. customers. The decision riled some U.S. druggists and drew criticism from regulators.  After the FDA began its latest investigation, Google made changes last year to its policies for drug ads, according to a person familiar with the matter.

Google said in February 2010 it would begin allowing ads only from U.S. pharmacies accredited by the National Association of Boards of Pharmacy and from online pharmacies in Canada that are accredited by the Canadian International Pharmacy Association.   In September Google filed a federal lawsuit in San Jose, Calif., seeking to block individuals running illegitimate pharmacies from advertising on its search engine and to recover damages.

“Rogue pharmacies are bad for our users, for legitimate online pharmacies and for the entire e-commerce industry—so we are going to keep investing time and money to stop these kinds of harmful practices,” Google lawyer Michael Zwibelman wrote on the company blog at the time.

Sergey Brin, Google’s co-founder and a current high-ranking executive and board member, sidestepped questions about the investigation at a conference Wednesday and alluded to the fact that Larry Page is now running the company.

“Luckily, since we changed roles a few months ago, I don’t have to deal with filings, and the DOJ, the SEC or other acronyms,” Mr. Brin said, using the initials for the Justice Department and Securities and Exchange Commission.

The current investigation is Google’s latest brush with law enforcement and regulatory agencies in both the U.S. and abroad. The company is facing multiple investigations into possible antitrust and privacy violations in several nations. Google maintains that its breakneck growth will inevitably attract greater regulatory scrutiny, and that it’s done nothing wrong in connection with other probes.    There are other signs the government is serious about cracking down on illegal online pharmacies. On Thursday, entering the words “no prescription required” into Google’s search engine produced an ad that led to a Justice Department alert reading: “Prescription Drugs. Buying online could mean doing time.”

Source:  Wall Street Journal     MAY 13, 2011

 

 

 

The story that broke one afternoon in mid-March was startling, even to editors who have been around for a while.
A 19-year-old man had died and 10 others were sickened in a mass overdose after experimenting with a synthetic drug during a party in Blaine.
We have written before about the problems of designer synthetic drugs, which are molecularly different from illegal drugs and sometimes can be acquired legally in shops or over the Internet. But this was the first time we had seen such deadly ramifications. After covering the case in Blaine, which resulted in one man being charged with third-degree murder, we set out to discover just how big a problem these drugs are posing in society. Our preliminary research revealed that this was a growing problem nationally, with devastating consequences across the country.
In the months since, we have researched or acquired dozens of these synthetic drugs, to discover how easy they are to buy and whether consumers are given any warnings at all when they buy the drugs.
We have talked to users, victims and witnesses across the country about some of the unintended consequences of ingesting synthetic drugs. And we have enlisted a number of experts, researchers and businesses in the greater Twin Cities community to help us identify what exactly is in the most common compounds so we can pinpoint the true risk to consumers. For example, Internet Exposure, a web development and marketing firm, is conducting research for us on how people are using the Internet to research and buy drugs, while MedTox Laboratories in St. Paul is testing chemicals for us.
The results of our investigation will unfold in stories that we will publish over the next few months, with the first appearing online today. It is a tragic story of a party that went wrong in a small town in Oklahoma, with eerie similarities to the party in Blaine earlier this year. We went to Oklahoma to illustrate that if synthetic drugs are a problem in such a small, tight-knit community like Konawa, they can create trouble anywhere in Middle America.
Police officer Kat Green, who arrives at the party in Oklahoma to find her own son nearly incapacitated, repeatedly wonders why her son would put something in his body without knowing exactly what it was.
Why indeed, would anyone?
The answer to that question seems to be that these partygoers are taking synthetic drugs because they think it will be fun, the drugs are often touted as legal, and the drugs are easily acquired, making them seem less dangerous than illegal drugs like marijuana, cocaine or hallucinogens. (Some people also take synthetic drugs because they may not show up on drug tests. )
Pamela Louwagie, who has been one of the primary reporters on this investigation, said that some of the partygoers in both Blaine and Oklahoma had researched the drugs they thought they were acquiring, while others “simply seemed to trust that their friends had done enough research to be safe.
“It was striking that, in each case, they didn’t get what was ordered,” Louwagie said. “That showcases the true danger in these things. Many of these substances, while they have been around … for a while, are truly untested. And if you buy them, you don’t know what they have been mixed with and, in some cases, whether you’re even getting the right thing.”
What’s also striking is the trust buyers put in the notion that it is safe to acquire a synthetic drug over the Internet, from an unproven source.
We hope that when we have finished our investigation, we will have helped parents, teenagers and other adults truly understand the risk that synthetic drugs pose — as well as the dangers of buying substances from some unknown source somewhere around the globe who just happens to advertise on the Internet.
I’ll be sharing this story with my own daughters; I urge others to share it with friends and family as well.

Source: Nancy Barnes, Editor, www. StarTribune.com 24th July 2011


Combining a randomised trial with a ‘real-world’ test, studies of the Dutch Drinking Less programme have gone further than any others to establish the beneficial impacts of web-based alcohol self-help interventions.

Abstract

The study was a ‘real-world’ test of a promising Dutch internet-based self-help intervention for problem drinking. A previous randomised trial employing the methodological safeguards possible in tightly controlled research (particularly the recruitment of a comparison group not given access to the intervention) had established that the intervention reduced drinking. At issue in the featured study was whether similar drinking reductions would be seen when the intervention was made freely available to the general public. If they were, then the assumption could be made that these too were caused by having access to the intervention.

Drinking Less is an on-line, interactive programme with no personal therapist input. Aimed at risky drinkers among the general adult population, the intervention is based on principles derived from motivational interviewing, cognitive-behavioural therapies and self-control training. Its home page offers links to alcohol-related information, treatment services, a discussion forum, and the Drinking Less self-help programme, the core of the intervention. Over a recommended six weeks (though this is entirely up to the user) the programme guides visitors in preparing to change their drinking, setting goals , implementing change, and finally sustaining it, preferably by drinking within recommended limits.
The earlier trial had found that six months later, at least 17% of adult problem drinkers randomly allocated to this intervention had reduced their drinking to within Dutch guidelines, compared to just 5% allocated to an on-line alcohol education brochure. Before the study, both groups had averaged about 55 UK units a week. At follow-up, the Drinking Less group had cut consumption to about 36 UK units a week, but the brochure group had barely changed.
The featured study monitored what happened when over 10 months spanning 2007 and 2008 the web site was advertised to the Dutch public. During this time round 27,500 people visited the site, of whom 1625 signed up for the self-help programme, accessing it on average 23 times. Typically they were well educated, employed, middle-aged men. On average they drank about 50 UK units a week, and nearly all who completed the on-line AUDIT screening questionnaire scored in a range indicative of alcohol abuse or dependence.
During the first seven of the 10 months, 378 of site visitors who signed up to the Drinking Less programme also agreed to participate in research to assess its impact. On average they drank roughly the same amount (95% exceeded Dutch guidelines) as all 1625 who signed up and were also similar in age, sex, employment, and motivation to change. Despite some statistically significant differences, they were also broadly similar to participants in the earlier randomised trial. Over 8 in 10 had never received professional help for their drinking. A few weeks later a survey suggested that after signing up, nearly 9 in 10 went on to use the programme, though generally only a few times.
Of the 378 in the baseline sample, 153 responded to an on-line follow-up survey six months later. Before signing up to the programme, just 4% had confined their drinking within Dutch guidelines; six month later, 39% did so. They had also nearly halved their average consumption from 50 UK units to 27. On the ‘fail-safe’ assumption that the intervention had no impact on people who were not followed up, still the drinking reductions were statistically significant; from 5%, the proportion drinking within guidelines rose to 19%, and consumption fell from 51 UK units to 42.
Next the analysts compared these results with those from the six-month follow-up in the randomised trial. Based only on respondents to the follow-up surveys, and adjusting for differences between the samples, in the ‘real-world’ test over twice as many (unadjusted figures 36% v. 19%) people moved to drinking within Dutch guidelines. When the assumption was made that in both trials the intervention had no impact on people not followed up, the figures still favoured the ‘real-world’ test (15% v. 10%), but the difference was no longer statistically significant.
The researchers concluded that the featured study had shown that the benefits established by the randomised controlled trial would be sustained when the intervention was made routinely and generally available to the public. The expected throughput of 3000 Drinking Less programme users a year would amount to nearly 3% of the country’s problem drinkers who would otherwise not have received professional help. Probably because they require the drinker to take the initiative and visit the site, such interventions reach people who, compared to the totality of problem drinkers, are more likely to be women, employed, highly educated, and motivated to change their drinking. Given its low cost per user, this type of intervention seems to have a worthwhile place in a public health approach to reducing alcohol-related problems.
Though only a minority of site visitors may sign up for web-based alcohol programmes, nevertheless the numbers engaged can be very large, and the risk-reductions seem of the order typical in studies of brief advice to drinkers identified in health care settings. In these settings screening programmes typically identify people who are not actually seeking help for drinking problems – ‘pushing’ them towards intervention and change – while web sites ‘pull’ in people already curious or concerned about their drinking. As such these two gateways can play complementary roles in improving public health and offering change opportunities to people who would not present to alcohol treatment services. However, in Britain and elsewhere, both tactics reach only small fractions of the population who drinking excessively, leaving the bulk of the public health work to be done by interventions which drinkers generally cannot avoid and do not have seek out, such as price increases and availability restrictions.
With its combination of a randomised trial and a ‘real-world’ test, the featured research programme has gone further than any other in establishing the beneficial impacts of web-based alcohol interventions. However, largely because many site users do not complete research surveys, it remains impossible to be sure that the results seen in such studies will be replicated across the entire usership of the sites. Details below.

Strengths and limitations of the featured study

The featured study’s combination of a randomised trial with all its methodological safeguards, and a ‘real-world’ trial approximating normal conditions, affords what seems to be the best indication to date of the contribution web-based self-help interventions could make to reducing heavy drinking and associated health risks. However, its twin pillars are weakened by the fact that many people either did not join the studies or did not supply follow-up data; those who did may not have been typical of all the people who might access such sites. In the randomised trial, 40% of the baseline sample did not complete the six-month follow-up survey, and in the featured study, nearly 60%. Though on the measures taken by the study the respondents generally seemed typical of the baseline sample, clearly something was sufficiently different to cause them to respond while the others did not. In both studies this problem was catered for by assuming that non-responders were also non-changers. Though this almost certainly underestimated the impact of the intervention, still in both there remained significant and worthwhile improvements.
What could not be catered for in either study was the degree to which people who join such studies differ from the much greater number who would use the web sites, but decline participation in research. This problem was especially apparent in the featured study, in which it seems that around 6% of site visitors signed up for the self-help programme. Of these, perhaps a third or slightly more of the people who signed up for the programme during the relevant period also agreed to participate in the research. In some important ways (including amount drunk and motivation to change) they seemed similar to the bulk of programme sign-ups, though the researchers suspect they were more likely to have engaged with the programme.

Opening more doors to change for more people

A review of computer-based alcohol services for the general public has rehearsed the advantages: immediate, convenient access for people (the majority in developed nations) connected to the internet; consequently able to capitalise on what may be fleeting resolve; anonymous services sidestep the embarrassment or stigma which might deter help-seeking; such services are available to people unwilling or less able to talk about their problems to a stranger; generally they are free and entail no travel costs or lost income due to time off work; very low operating cost per user if widely accessed; easily updated. In consumption terms, the drinking problems of web site users are comparable to those of drinkers who seek treatment, yet few have received professional help, perhaps partly because their higher socioeconomic status and greater resources have enabled them to restrict the consequential damage. People who actually engage with web-based assessments of their drinking problems have more severe problems than those who just visit and leave. Including the randomised trial which paved the way for the featured study, the review found eight studies which evaluated the effectiveness of computer-based interventions for the general public. In all but one the users significantly improved on at least one of the alcohol-related measures recorded by the studies.
A particular role for alcohol self-help sites may be to offer an easy, quick and accessible way to for drinkers to actualise their desire to tackle their problems, especially when that desire is allied with the resources to implement and sustain improvements without face-to-face or comprehensive assistance. After conducting the Project MATCH trial, some of the world’s leading alcohol treatment researchers argued that “access to treatment may be as important as the type of treatment available”. The implication is that in cultures which accept ‘treatment’ as a route to resolving unhealthy and/or undesirable drinking, having convincing-looking and accessible ‘treatment doors’ to go through may be more important than what lies behind those doors, as long as this fulfils the expectations of the client or patient. This is likely to be especially the case for people who retain a stake in conventional society in the form of marriages, jobs, families, and a reputation to lose. These populations – the kind the featured study suggests are attracted to self-help alcohol therapy web sites – have more of the ‘recovery capital’ resources needed to themselves do most of the work in curbing their drinking.

The British Down Your Drink site

The best known British alcohol self-help web site is the Down Your Drink site run by a team based at University College London, an initiative originally funded by the Alcohol Education and Research Council and now by the Medical Research Council’s National Prevention Research Initiative. In 2007 this was revised to offer set programmes from a one-hour brief intervention to several weeks, but also to generally give the user greater control over the use they made of the site. The approach remained based on principles and techniques derived from motivational interviewing and cognitive-behavioural therapies.
The previous version had been structured as six consecutive modules to be accessed weekly. An analysis of data provided by the first 10,000 people who registered at the site after piloting ended in September 2003 revealed that most were in their 30s and 40s, half were women, nearly two-thirds were married or living with a partner, just 4% were unemployed, and most reported occupations from higher socioeconomic strata. As an earlier study commented, site users were predominantly middle class, middle aged, white and European. Six in 10 either did not start the programme, or completed just the first week. About 17% completed the six weeks. Of these, 57% returned an outcome questionnaire. Compared to their pre-programme status, on average they were now at substantially lower risk, and functioning better and living much improved lives. The sample had been recruited over about 27 months, a registration rate of about 4500 a year. By way of comparison, in England during 2008/09, around 100,000 adults were treated for their alcohol problems at conventional services. User profile and site usage had been similar during the earlier pilot phase. Results from surveys sent to pilot programme completers indicated that three quarters had never previously sought help for their drinking.

Source: Published in Findings 19 May 2010 Alcoholism: Clinical and Experimental Research: 2009, 33(8), p. 1401–1408

Combining a randomised trial with a ‘real-world’ test, studies of the Dutch Drinking Less programme have gone further than any others to establish the beneficial impacts of web-based alcohol self-help interventions.
Abstract The study was a ‘real-world’ test of a promising Dutch internet-based self-help intervention for problem drinking. A previous randomised trial employing the methodological safeguards possible in tightly controlled research (particularly the recruitment of a comparison group not given access to the intervention) had established that the intervention reduced drinking. At issue in the featured study was whether similar drinking reductions would be seen when the intervention was made freely available to the general public. If they were, then the assumption could be made that these too were caused by having access to the intervention.

Drinking Less is an on-line, interactive programme with no personal therapist input. Aimed at risky drinkers among the general adult population, the intervention is based on principles derived from motivational interviewing, cognitive-behavioural therapies and self-control training. Its home page offers links to alcohol-related information, treatment services, a discussion forum, and the Drinking Less self-help programme, the core of the intervention. Over a recommended six weeks (though this is entirely up to the user) the programme guides visitors in preparing to change their drinking, setting goals , implementing change, and finally sustaining it, preferably by drinking within recommended limits.
The earlier trial had found that six months later, at least 17% of adult problem drinkers randomly allocated to this intervention had reduced their drinking to within Dutch guidelines, compared to just 5% allocated to an on-line alcohol education brochure. Before the study, both groups had averaged about 55 UK units a week. At follow-up, the Drinking Less group had cut consumption to about 36 UK units a week, but the brochure group had barely changed.
The featured study monitored what happened when over 10 months spanning 2007 and 2008 the web site was advertised to the Dutch public. During this time round 27,500 people visited the site, of whom 1625 signed up for the self-help programme, accessing it on average 23 times. Typically they were well educated, employed, middle-aged men. On average they drank about 50 UK units a week, and nearly all who completed the on-line AUDIT screening questionnaire scored in a range indicative of alcohol abuse or dependence.
During the first seven of the 10 months, 378 of site visitors who signed up to the Drinking Less programme also agreed to participate in research to assess its impact. On average they drank roughly the same amount (95% exceeded Dutch guidelines) as all 1625 who signed up and were also similar in age, sex, employment, and motivation to change. Despite some statistically significant differences, they were also broadly similar to participants in the earlier randomised trial. Over 8 in 10 had never received professional help for their drinking. A few weeks later a survey suggested that after signing up, nearly 9 in 10 went on to use the programme, though generally only a few times.
Of the 378 in the baseline sample, 153 responded to an on-line follow-up survey six months later. Before signing up to the programme, just 4% had confined their drinking within Dutch guidelines; six month later, 39% did so. They had also nearly halved their average consumption from 50 UK units to 27. On the ‘fail-safe’ assumption that the intervention had no impact on people who were not followed up, still the drinking reductions were statistically significant; from 5%, the proportion drinking within guidelines rose to 19%, and consumption fell from 51 UK units to 42.
Next the analysts compared these results with those from the six-month follow-up in the randomised trial. Based only on respondents to the follow-up surveys, and adjusting for differences between the samples, in the ‘real-world’ test over twice as many (unadjusted figures 36% v. 19%) people moved to drinking within Dutch guidelines. When the assumption was made that in both trials the intervention had no impact on people not followed up, the figures still favoured the ‘real-world’ test (15% v. 10%), but the difference was no longer statistically significant.
The researchers concluded that the featured study had shown that the benefits established by the randomised controlled trial would be sustained when the intervention was made routinely and generally available to the public. The expected throughput of 3000 Drinking Less programme users a year would amount to nearly 3% of the country’s problem drinkers who would otherwise not have received professional help. Probably because they require the drinker to take the initiative and visit the site, such interventions reach people who, compared to the totality of problem drinkers, are more likely to be women, employed, highly educated, and motivated to change their drinking. Given its low cost per user, this type of intervention seems to have a worthwhile place in a public health approach to reducing alcohol-related problems.
Though only a minority of site visitors may sign up for web-based alcohol programmes, nevertheless the numbers engaged can be very large, and the risk-reductions seem of the order typical in studies of brief advice to drinkers identified in health care settings. In these settings screening programmes typically identify people who are not actually seeking help for drinking problems – ‘pushing’ them towards intervention and change – while web sites ‘pull’ in people already curious or concerned about their drinking. As such these two gateways can play complementary roles in improving public health and offering change opportunities to people who would not present to alcohol treatment services. However, in Britain and elsewhere, both tactics reach only small fractions of the population who drinking excessively, leaving the bulk of the public health work to be done by interventions which drinkers generally cannot avoid and do not have seek out, such as price increases and availability restrictions.
With its combination of a randomised trial and a ‘real-world’ test, the featured research programme has gone further than any other in establishing the beneficial impacts of web-based alcohol interventions. However, largely because many site users do not complete research surveys, it remains impossible to be sure that the results seen in such studies will be replicated across the entire usership of the sites. Details below.
Strengths and limitations of the featured study
The featured study’s combination of a randomised trial with all its methodological safeguards, and a ‘real-world’ trial approximating normal conditions, affords what seems to be the best indication to date of the contribution web-based self-help interventions could make to reducing heavy drinking and associated health risks. However, its twin pillars are weakened by the fact that many people either did not join the studies or did not supply follow-up data; those who did may not have been typical of all the people who might access such sites. In the randomised trial, 40% of the baseline sample did not complete the six-month follow-up survey, and in the featured study, nearly 60%. Though on the measures taken by the study the respondents generally seemed typical of the baseline sample, clearly something was sufficiently different to cause them to respond while the others did not. In both studies this problem was catered for by assuming that non-responders were also non-changers. Though this almost certainly underestimated the impact of the intervention, still in both there remained significant and worthwhile improvements.
What could not be catered for in either study was the degree to which people who join such studies differ from the much greater number who would use the web sites, but decline participation in research. This problem was especially apparent in the featured study, in which it seems that around 6% of site visitors signed up for the self-help programme. Of these, perhaps a third or slightly more of the people who signed up for the programme during the relevant period also agreed to participate in the research. In some important ways (including amount drunk and motivation to change) they seemed similar to the bulk of programme sign-ups, though the researchers suspect they were more likely to have engaged with the programme.
Opening more doors to change for more people
A review of computer-based alcohol services for the general public has rehearsed the advantages: immediate, convenient access for people (the majority in developed nations) connected to the internet; consequently able to capitalise on what may be fleeting resolve; anonymous services sidestep the embarrassment or stigma which might deter help-seeking; such services are available to people unwilling or less able to talk about their problems to a stranger; generally they are free and entail no travel costs or lost income due to time off work; very low operating cost per user if widely accessed; easily updated. In consumption terms, the drinking problems of web site users are comparable to those of drinkers who seek treatment, yet few have received professional help, perhaps partly because their higher socioeconomic status and greater resources have enabled them to restrict the consequential damage. People who actually engage with web-based assessments of their drinking problems have more severe problems than those who just visit and leave. Including the randomised trial which paved the way for the featured study, the review found eight studies which evaluated the effectiveness of computer-based interventions for the general public. In all but one the users significantly improved on at least one of the alcohol-related measures recorded by the studies.
A particular role for alcohol self-help sites may be to offer an easy, quick and accessible way to for drinkers to actualise their desire to tackle their problems, especially when that desire is allied with the resources to implement and sustain improvements without face-to-face or comprehensive assistance. After conducting the Project MATCH trial, some of the world’s leading alcohol treatment researchers argued that “access to treatment may be as important as the type of treatment available”. The implication is that in cultures which accept ‘treatment’ as a route to resolving unhealthy and/or undesirable drinking, having convincing-looking and accessible ‘treatment doors’ to go through may be more important than what lies behind those doors, as long as this fulfils the expectations of the client or patient. This is likely to be especially the case for people who retain a stake in conventional society in the form of marriages, jobs, families, and a reputation to lose. These populations – the kind the featured study suggests are attracted to self-help alcohol therapy web sites – have more of the ‘recovery capital’ resources needed to themselves do most of the work in curbing their drinking.
The British Down Your Drink site
The best known British alcohol self-help web site is the Down Your Drink site run by a team based at University College London, an initiative originally funded by the Alcohol Education and Research Council and now by the Medical Research Council’s National Prevention Research Initiative. In 2007 this was revised to offer set programmes from a one-hour brief intervention to several weeks, but also to generally give the user greater control over the use they made of the site. The approach remained based on principles and techniques derived from motivational interviewing and cognitive-behavioural therapies.
The previous version had been structured as six consecutive modules to be accessed weekly. An analysis of data provided by the first 10,000 people who registered at the site after piloting ended in September 2003 revealed that most were in their 30s and 40s, half were women, nearly two-thirds were married or living with a partner, just 4% were unemployed, and most reported occupations from higher socioeconomic strata. As an earlier study commented, site users were predominantly middle class, middle aged, white and European. Six in 10 either did not start the programme, or completed just the first week. About 17% completed the six weeks. Of these, 57% returned an outcome questionnaire. Compared to their pre-programme status, on average they were now at substantially lower risk, and functioning better and living much improved lives. The sample had been recruited over about 27 months, a registration rate of about 4500 a year. By way of comparison, in England during 2008/09, around 100,000 adults were treated for their alcohol problems at conventional services. User profile and site usage had been similar during the earlier pilot phase. Results from surveys sent to pilot programme completers indicated that three quarters had never previously sought help for their drinking.
Source: Published in Findings 19 May 2010 Alcoholism: Clinical and Experimental Research: 2009, 33(8), p. 1401–1408

For Immediate Release – January 5, 2010 – (Toronto) – A recent evaluation by the Centre for Addiction and Mental Health (CAMH) shows that online interventions for problem alcohol use can be effective in changing drinking behaviours and offers a significant public health benefit.
In the first evaluation of its kind, the study published in Addiction found that problem drinkers provided access to the online screener www.CheckYourDrinking.net, reduced their alcohol consumption by 30% — or six to seven drinks weekly – rates that are comparable to face-to-face interventions. This result was sustained in both the three and six month follow-up.
Source: www.camh.net 5 Jan.2010

 

  • Problem drinking in Western societies leads to disease and death, as well as social and economic problems.
  • Few problem drinkers seek treatment help.
  • New findings show that a 24/7 free-access, anonymous, interactive, and Web-based self-help intervention can aid problem drinkers in the privacy of their own homes.
Problem drinking in Western societies contributes to disease and death as well as social and economic woes. Yet only a small number of people with alcohol problems – 10 to 20 percent – ever seek and participate in treatment. This study examined the real-world effectiveness of a 24/7 free-access, anonymous, interactive, and Web-based self-help intervention called Drinking Less (DL) at www.minderdrinken.nl. Findings show that DL can help problem drinkers in the privacy of their own homes. “We were concerned that so few problem drinkers access the help they need,” said Heleen Riper, a senior scientist at the Trimbos Institute and the Vrije Universiteit in the Netherlands, as well as corresponding author for the study.
“This may not come as a surprise, given that addiction services predominantly focus on severely dependent people.”

“Web-based interventions can provide a cheap and easily accessible intervention for the large majority of problem drinkers who are not treated,” noted Reinout W. Wiers, professor of developmental psychopathology at the University of Amsterdam.

Riper and her colleagues wanted to expand the use of DL – a self-help intervention for adults without therapeutic guidance – from a clinical trial to the community. “DL consists of motivational, cognitive-behavioral, and self-control information and exercises,” she said. “It helps problem drinkers decide if they really want to change their problem drinking and, if so, helps them set realistic goals for achieving a change in their drinking behavior, providing tools and exercises to maintain these changes, or deal with relapse if it occurs.”

The study authors recruited 378 (199 females, 179 males) of the 1,625 community-based people who used DL from May to November 2007 to complete an online survey six months later. All lived in the Netherlands; the vast majority, 91.5 percent, was of Dutch origin. Outcome measures included alcohol consumption during the preceding four weeks, and mean weekly alcohol consumption. The collected data were then compared with those from the previous trial of DL.

“The observed effectiveness of DL in a randomized, controlled trial setting was maintained when we offered the intervention to the general population in a real-world setting,” said Riper. “After six months, participants decreased their mean weekly alcohol consumption, and 18.8 percent changed their drinking patterns to ‘low risk drinking.’ For 84 percent of the participants, this was their first professional contact for problem drinking. Furthermore, more than half was female, indicating that this form of help is highly acceptable for female problem drinkers.”

Dutch guidelines for “low-risk drinking” are: for men, drinking less than 21 standard units per week, or six or more units at least one day per week; and for women, drinking less than 14 standard units per week, or four or more units at least one day a week. One standard unit contains 10 g of ethanol. In contrast, American standard drinks contain more alcohol, about 14 g. Thus, Dutch guidelines in terms of American drinks would mean: less than 15 drinks per week and no more than five in a row for men; and for women, no more than 10 drinks per week and no more than three in a row.

Both Riper and Wiers believe these findings from the Netherlands could easily be applied to a North American population. “This research is all about real world applications,” said Wiers. “Similar websites could easily be translated and/or developed in other countries.”

“While Web-based and digital interventions might not be effective for everyone,” added Riper, “almost 20 percent of our participants were able to change their problem drinking to low-risk, while others became aware of their problems and were more willing to seek professional guidance. Our study also indicated that Web-based treatment like this is effective for people with different educational backgrounds.”

Riper recommended that interventions such as DL become the “first step” to a collective approach to problem drinking in which online and offline services become integrated. “Web-based self-help … should be seen as an additional form of service next to existing services,” she said. “It could be used as a stand-alone intervention, expanded with therapeutic guidance for those who are ready for it, or used to mitigate waiting times. It also provides accessibility for populations who live in low-density areas where professional services are scarce. Alone it cannot change the world, but it could help to make a difference once integrated.”

Wiers agreed. “I think that this is an important first step in internet-delivered interventions for alcohol abuse and dependence,” he said. “I foresee that in the future these cognitive motivational approaches could be augmented by other approaches that can be delivered over the internet, such as interventions that directly interfere with cognitive processes in alcohol problems. In addition, internet-based treatments can become part of the aftercare of regular treatment, helping to prevent relapse back home, one of the major challenges in treating alcohol-use disorders.”

 

Source: Alcoholism: Clinical & Experimental Research (ACER). 33(8): 1401-1408. 2009

 

 

 

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Filed under: Alcohol,Internet :

Internet surfers are far more likely to come upon Web sites with wrong and potentially dangerous information about illicit drug use than they are to find more reliable, informed sites, a new study shows. A study in Thursday’s issue of The New England Journal of Medicine (news-web sites) found that popular Internet search engines tend to direct users to sites that appear to promote drug use and provide incorrect and even dangerous information. Often overlooked by the popular search engines are those Web sites that provide reliable information on illegal drugs, including sites funded by the federal government, the study found. Some 24% of college students use the Internet to find information about illegal drugs with some sites recording 160,000 hits a day, researchers said. Edward Boyer and two other doctors at Children’s Hospital in Boston conducted the survey, studying seven ‘partisan’ sites “that promulgate information about illicit drugs. We looked at fairly common illicit substances, we found that serious errors were pretty easy to find,” Boyer told Reuters. “Not only do partisan Web sites condone drug use with its attendant health risks, but any adverse effect arising from illicit substances potentially would be mismanaged with potentially lethal consequences.

For example, one promotes ‘ for poisoning from psychedelic mushrooms such as ingesting carbon tetrachloride, which can destroy the liver. By contrast, sites with reliable information, especially those funded by the federal government, are often ignored or given a low priority by popular search engines that rank sites for information on Ecstasy and other illegal drugs. “We were stunned to find the federal government sites were absent from some searches entirely,” even thou the government is spending millions of dollars developing them, Boyer said. One reason is that those creating government-sponsored sites seem to ‘lack the technical expertise’ to make them appear prominently in a search, he said. For example, most Web sites use hidden keywords to help search engines flag them. Home pages for sites that promote drug use contain up to 60 such keywords.

But the home page for freevibe (http://www.freevibe.com), with drug information from the National Youth Anti-Drug Media Campaign, had none. In order to find freevibe in a search, consumers had to know to ask specifically for freevibe.  “In all searches, antidrug sites from the federal government failed to appear as often as the partisan sites, which dominate the search results when people are looking for information on illicit substances such as Ecstasy, GHB, or ‘psychedelic mushrooms,’ the researchers said. GHB, or garrnpahydroxybutyrate, is similar to Rohypnol, the so-called date rape drug, according to the National Clearinghouse for Alcohol and Drug Information. “These data suggest that the US government, despite extensive and costly efforts, currently does not provide effective alternative sources of information about drugs on the Web, where partisan sites still get the attention of both search engines and users,” the researchers said. The Office of National Drug Control Policy, which sponsors the freevibe site, criticized the study and chastised the authors for failing to contact the agency before putting out the letter. As far as I know, the people who wrote that letter never contacted this office, said Jennifer Devallance, a spokeswoman for the agency.
She said there were more than 3,000 links around the Web to either freevibe or The Anti-Drug, (http://www.theatidrug.com)which targets parents.

Source: Author Gene Emey. Reported in an article published in New England Journal Medicine 2001.
Filed under: Internet :

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