Category: Articles

White House Recently Met to Discuss America’s Opioid Crisis

Articles, Education, International, United States

White House Recently Met to Discuss America's Opioid Crisis On June 19, the White House held a summit conference on Opioids, hosted by Office of National Drug Control Policy Acting Director Michael Botticelli. Calling the opioid problem in America an epidemic, Mr. Botticelli—himself a recovering alcoholic—introduced Attorney General Eric Holderer and Vermont Governor Peter Shumlin, who discussed possibilities for new ways to view drug addiction and offered their thoughts on how policy changes could be effected that could stem the tide of drug abuse.

Among the items discussed was the potential for saving lives with the drug naloxone, which can reverse the effects of an opiate overdose and prevent respiratory arrest. Statistics were given indicating a fourfold increase since 1999 in annual deaths attributable to prescription pain medications (twofold for heroin). Doctor Nora Volkow, Nora D. Volkow, M.D., Director of the National Institute on Drug Abuse, gave a brief talk on the latest research into addiction.

To watch videos of the presentations, click on the following links:

  • Opening Session
  • Rx Drug and Heroin Epidemic in the States
    Robert Morrison, Executive Director, National Association of State Alcohol and Drug Abuse Directors (NASADAD)
  • Panel I – Prevention, Intervention and Treatment
    Dr. Hillary Kunins, Acting Executive Deputy Commissioner, Division of Mental Hygiene, Assisting Commissioner for the Bureau of Alcohol and Drug Use, New York City Department of Health and Mental Hygiene (DOHMH); Dr. Traci Green, Assistant Professor of Emergency Medicine and Epidemiology, Brown University; Dr. Josh Sharfstein, Secretary, Maryland Department of Health and Mental Hygiene
  • Panel II: Overdose and Infectious Disease Prevention
    Nancy Hale, Program Director, Operation UNITE; Dr. Michelle Lofwall, Associate Professor, Departments of Psychiatry and Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky College of Medicine; Dr. Ed Bernstein, Professor and Vice Chair for Academic Affairs, Emergency Medicine, Boston University School of Medicine
  • Addiction Research
    Nora D. Volkow, M.D., Director of the National Institute on Drug Abuse

Can Drugs Cause Mental Illness?

Articles, Understanding Addiction

Can Drugs Cause Mental Illness Drug addiction and other mental illnesses can be co-occurring disorders, and it is often the case that one causes the other. If an underlying disorder such as depression or anxiety is a pre-existing condition, substance abuse may develop in response. The person may find relief in self-medication and, upon repetition, not only develop a dependency but also exacerbate the original problem, resulting in what is referred to as comorbidity.

On the other hand, where there is no pre-existing condition, but drug experimentation elevates to abuse and dependency, the long-term effects of the drug being used can result in the emergence of other types of mental illness, ranging from moderate to severe.

Most studies indicate a clear correlation between amphetamine use and acute psychosis. Although in many cases the condition is resolved by abstinence, in others there are spontaneous relapses (of psychosis). “Flashbacks” to prior psychotic episodes can be triggered by stress. As not all amphetamine abusers experience psychosis, it is unclear whether the syndrome is caused by the drug (or by the associated lack of sleep, hydration, and nutrition) or an underlying, pre-existing tendency is being triggered by the drug.

There is evidence that marijuana can induce psychosis, and hallucinogens such as psilocybin and LSD can trigger episodes, although these latter substances are not considered addictive. Extended heavy marijuana use can more likely promote depression, but abstinence, aided by treatment, can ameliorate or even eliminate the effects.

Long-term abuse of alcohol can produce a number of mental-health problems, including depression, anxiety, paranoia, phobias, and suicidal tendencies. Whether or not these conditions were pre-existing, perhaps at sub-clinical levels, alcoholism can, over time bring about the full expression of any or all of these problems to the extent that dual-diagnosis is appropriate for treatment. As most current alcoholics also abuse drugs and most drug addicts abuse alcohol, the likelihood of another mental health condition arising is high.

Thank You to Our Visitors from the Thanyarak Institute

Articles, Education, International

Earlier in the month, we had an opportunity to host a large group of visitors from the Ministry of Public Health, the Princess Mother National Institute on Drug Abuse Treatment (PMNIDAT or the Thanyarak Institute) and the Office of Narcotics Control Board (ONCB).

The Thanyarak Institute is Thailand’s first and largest treatment center with seven branches located throughout the country. It is under the supervision of the Department of Medical Services, Ministry of Public Health.

With Cognitive Behavioral Therapy (CBT) becoming an important component in addiction treatment at the national level, our visitors were able to experience both of our world class facilities and learned more about how CBT can be professionally integrated into a treatment program.

This was only the first visit with more cooperation planned between DARA and the Thanyarak Institute.

In addition to staffs from the Thanyarak Institute, our VIP visitors also include:

Dr. Isara Chaiwiriyabunya, M.D., Director, Udon Thani Cancer Hospital, Department of Medical Services, Ministry of Public Health
Mrs. Suparp Chaiyanit, Senior Officer, Department of Health, Ministry of Public Health
Mrs.Anchalee Sirisabphya, Director of Drug Demand Reduction Bureau, Office of Narcotics Control Board
Ms.Naruemon Kamonwatin, Plan and Policy Analyst, Senior Professional Level, Office of Narcotics Control Board
Ms.Tanittha Poonsin, Plan and Policy Analyst, Practitioner Level, Office of Narcotics Control Board
Ms.Chutima Thitipongkornpuchara, Law Enforcement Office, Professional Level, Office of Narcotics Control Board
Dr. Prapapun Chuchareon, Director, Mahidol University’s ASEAN Institute for Health Development, Addiction Studies Program
Ms. Narumon Arayaphiphat, Deputy Director, Thanyarak Kohnkaen Hospital

Teenage Drug Use: No sign of Abatement

Articles, Education, International

Teenage Drug Use No sign of Abatement According to statistics, the US leads the world in illegal drug use, but the problem is pervasive throughout the globe. In the Punjab region of India, for example, drug use has ramped up among young people in the last decade, and the number of students graduating from post-secondary schools has diminished. A report published in 2011 showed that teenage drug use is endemic, with 1 ½  to 2 million young people caught in the cycle of addiction. Iran is experiencing an expansion of heroin use, with over 7o% of its addicts (estimated at between 2 million and 5 million) aged 18 to 25. In Russia, heroin kills 80 people every day, and most of its 2 ½ million addicts are between the ages of 18 and 39. Cheap heroin from neighboring Afghanistan has flooded the country since the early 90s.

Treatment is available in various forms throughout the world. Alcoholics Anonymous was established in Russia in the late 80’s, but it’s effect on drug use there is questionable, and treatment for drug addiction is hard to find. The Akal Academy of India represents an attempt to deal with the problem there and has shown success.

In the US, teenage drug use has shifted its trajectory. What once started with alcohol and marijuana experimentation and then might have taken years to progress into addiction now accelerates quickly to dependency via the abuse of pain medications. The era of cocaine as a party drug to augment drinking is over, and the use of pills such as Oxycodone, Hydrocodone, and Dilaudid is now prevalent among teens. Also popular is abuse of tranquilizers like Xanax. The arc to dependency is rapid, and the move to snorting or smoking heroin, which is less expensive, is a logical next step in the progression.

Worldwide, the problems attendant to teenage drug use are similarly tragic: overdoses, neglected health, HIV and hepatitis, criminal activity, incarceration, interrupted education, loss of productivity, and alienation from loved ones are consequences that know no boundaries.

Drug Addiction—A Problem without Borders

Articles

Drug Addiction—A Problem without Borders It’s tempting to blame alcoholism and drug addiction within a society on any number of things: liberal attitudes, cultural exposure through media, emphasis on individual freedom of choice, an ethos that includes “a right to feel good”—all these and more can be pointed to as society’s collective responsibility for alcohol and drug problems. And these, of course, entirely leave aside the issue of poverty, as well as other mental health issues and policies.

Now, consider a nation with harshly conservative attitudes, censored media, and a culture centered around a state-sponsored religion with a fundamentalist bent, and try to explain a drug and alcohol problem in the same light.

Saudi Arabia is experiencing a substance-abuse problem to the extent that compulsory drug testing is being considered. A judge in the city of Jeddah points to the recent explosion in divorce rates (over 500 a month recently) stemming from alcohol and drug use and the subsequent abuse of wives. Speed, in the form of Captagon (a Ritalin-like stimulant) has reached epidemic proportions in some areas. Hashish, alcohol, and heroin are also abused. All of these are highly illegal and possession could lead to imprisonment or the death penalty.

Interestingly, according to an article from the Department of Neurosciences at King Faisal Hospital, “Peer pressure and psychosocial stresses were risk factors for initiation as well as relapse of substance abuse. Anxiety, depression . . . were the most common co-morbid disorders.”

So, the common factors, across societal boundaries, appear to be peer pressure, stress, anxiety, and depression. Once these are present, and a particular substance or combination of substances offers temporary relief, self-medication and repetition follow, along with a high risk for addiction. As long as the underlying factors are relieved, they don’t get addressed in their own right and eventually become aggravated and more difficult to find relief from, hence the cycle of addiction.

For those caught in the progressive grip of addiction—can’t moderate and can’t abstain altogether—help is available through treatment. Medical detox may be necessary, after which the addict must learn how to face and be free from the underlying factors of addiction.