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Drug Overdose Deaths Rising; Public, Candidates, Media Indifferent


Although deaths from workplace and motor vehicle accidents have declined by about 19% in the last 15 years, deaths in the community and at home have risen 44%, said Janet Froetscher, president and CEO of the National Safety Council. Also, deaths from accidental drug overdoses have increased dramatically, with prescription painkillers the main culprit, according to research presented at today’s Council meeting.

Froetscher reported that increased home and community death rates were most obvious in falls by the elderly and poisoning deaths. According to the Council, poisoning deaths include accidental overdoses from prescription drugs, illicit drugs, other solids and liquid substances, and gases and vapors. Although “The perception is that it’s kids getting into the medicine cabinet,” said Froetscher, that is not the case.

In 2006, about 24,000 people died in the U.S. from accidental drug overdoses, she said. That’s a 100% increase from 2000. But, the greatest increase was seen in accidental poisonings among men and women of working age, 20 to 64, mainly as a result of abusing prescription pain medicines such as oxycodone, methadone, hydrocodone, fentanyl, and buprenorphine. Also, the greatest area of growth in accidental poisoning deaths in the past ten years was seen in patients aged 45 to 64, followed by 25- to 44-year-olds and then 15- to 24-year-olds, according to Froetscher.

Over 38 percent of all overdosing deaths were linked to prescription opiods, said Froetscher, who cited Center of Disease Control and Prevention (CDC) data, with cocaine accounting for approximately one-quarter of all opiod-related deaths, heroin and other illicit drugs accounting for 14 percent, and other and unknown drugs for 22.5 percent. Also, approximately 60 percent of those who used painkillers for nonmedical purposes received their drugs from a friend or family member.

In the Council’s keynote address, William Bennett, former U.S. Secretary of Education and the first “drug czar” under the first President Bush, called for greater awareness of the growing drug abuse problem, including the problem with painkillers, saying “Not too many years ago, we got drug use down.” Bennett added that we need to shift our attention back to this problem and that the media, the public, and the current political candidates have become indifferent to this issue. Bennett also cited a recent drug bust at San Diego State University in which 96 people, including 75 students, were arrested for a stash of drugs and guns. Bennett claims that this story did not receive the press it would have in the past, “If this happened in the ’80s it would have been on the cover of Time or Newsweek,” he noted.

“Drug abuse is not getting the attention it deserves in an election year,” Bennett added. While both Democratic presidential candidate Barack Obama and Republican presidential candidate John McCain’s wife, Cindy, have talked publicly about their past experiences with drugs, neither party’s candidates have used the experiences as a “teachable moment,” Bennett said.

Posted: 9/30/2008 12:03:00 PM

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Prescription drug abuse seen up, cocaine down

From Reuters:

More young adults abused prescription pain drugs last year but their use of cocaine and methamphetamines fell, while illicit drug use by baby boomers in their late fifties soared, a U.S. agency said on Thursday.

The report from the Substance Abuse and Mental Health Services Administration cited said illicit drug use among those aged 55 to 59 more than doubled, to 4.1 percent in 2007 from the previous year.

The government's annual report assessing illicit drug use in the United States offered a mixed picture.

It found that 4.6 percent of men and women ages 18 to 25 reported use of prescription pain drugs for nonmedical reasons in 2007, a 12 percent rise from the previous year, continuing the rising trend of recent years.

About 1.7 percent in this age group used cocaine in 2007, a 23 percent drop from 2006, while 0.4 percent of young adults reported using methamphetamines, down by about a third.

The survey results were based on interviews with about 67,500 people nationwide.

The report found that an estimated 19.9 million Americans ages 12 or older used illicit drugs in the month before responding to the survey, accounting for 8 percent of that population, compares to 8.3 percent in 2006.

Illicit drugs included marijuana, cocaine (including crack), heroin, hallucinogens, inhalants and prescription drugs used for nonmedical purposes.

Marijuana was the most common, with an estimated 14.4 million users. The report estimated that 5.8 percent of Americans were marijuana users in 2007, compared to 6 percent in 2006. There were an estimated 2.1 million cocaine users.

Illicit drug use remained stable among adolescents (ages 12 to 17) last year, the report said, but rates declined between 2002 and 2007, from 11.6 percent to 9.5 percent.

The report also said an estimated 24.3 million Americans ages 18 and up experienced serious psychological distress over the past year, and 16.5 million Americans had suffered at least one major depressive episode.

Posted: 9/24/2008 9:00:00 AM

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Herbal Supplements Containing Lead, Mercury or Arsenic

From The New York Times:

Like many people these days, Lori Potter, a 50-year-old massage therapist living on Kauai, Hawaii, has explored alternative healing for everything from headaches to skin problems. So when she wanted to boost her immune system and lower her stress levels a few years ago, she made an appointment with a visiting practitioner of ayurveda, a medical system that originated in India thousands of years ago and has gained wide popularity in the United States.

He prescribed herbal supplements, which he tested himself for impurities, to help boost her immunity. Soon, Ms. Potter said, she felt more energetic and her digestion was better. After two years, the practitioner stopped visiting the island, and she has not taken any supplements since, she said, because she has not met any practitioners she trusts.

“You never know what’s really in these supplements,” she said. “This is serious stuff, and you can’t just take them without knowing the source.”

Ms. Potter may be right to be wary. A report in the Aug. 27 issue of The Journal of the American Medical Association found that nearly 21 percent of 193 ayurvedic herbal supplements bought online, produced in both India and the United States, contained lead, mercury or arsenic. Almost all of the products were sold through American Web sites. “Some manufacturers advertised that they test for metals, and their products still had them,” said Dr. Robert B. Saper, assistant professor at the Boston University School of Medicine and lead author of the study. The average consumer, he said, “has no way of determining which supplement is free of contaminants and which isn’t.”

No one knows the exact numbers of arsenic, mercury or lead poisoning illnesses in the United States related to ayurvedic medicine. Dr. Saper estimated that there have been 80 cases since 1978, but he believes that is just the “tip of the iceberg.” In 2005, the Centers for Disease Control and Prevention reported a total of 12 cases of lead poisoning associated with ayurvedic products in Texas, New Hampshire, Massachusetts, New York State and California.

While the Western medical community may be concerned about Dr. Saper’s findings, many ayurvedic practitioners and holistic health centers are less so. Of the dozen spas, wellness centers and practitioners contacted for this article, all said they stood behind their products. Some suppliers said they believed that the levels of heavy metals in their ayurvedic products were no greater than in many Food and Drug Administration-approved medicines.

Kevin Casey, the chief of Banyan Botanicals, a maker of ayurvedic products in Ashland, Ore., sells three items that are on Dr. Saper’s list of contaminated supplements.

After the study came out, Mr. Casey said, some of his 15,000 clients, who include practitioners and consumers, called. He said he alleviated their fears after he explained that his products are sent to outside laboratories, and they meet “the standards that we adhere to.”

He added that sales had not suffered since the study, which has “created a dialogue — people are talking about it and understanding that there is the presence of heavy metals, but it doesn’t mean it’s toxic or dangerous.”

Dr. Saper disagreed. Even with relatively low levels of lead in the bloodstream, he said, “a person can be relatively asymptomatic but the lead can still impact their I.Q. It can reduce their cognitive function and increase blood pressure.”

The F.D.A. does not specify maximum acceptable concentrations or daily dose limits for contaminants in dietary supplements. Instead, the onus is on the manufacturer to ensure that its products are safe. What’s more, there are no universally accepted standards for herbal supplements. The Food and Agricultural Organization/World Health Organization Joint Expert Committee on Food Additives Secretariat recommends that a 70-kilogram, or 154-pound, person consume no more than 250 micrograms of lead, 50 micrograms of mercury and 150 micrograms of arsenic per day.

The National Sanitation Foundation International Dietary Supplement Standard, which certifies dietary supplements and ingredients for purity, suggests a daily limit of 20 micrograms of lead, 20 for mercury and 10 for arsenic. California Proposition 65 has limits of 0.5 microgram of lead per day and 10 micrograms of arsenic per day. (There are currently no guidelines for mercury.) But, as Wynn Werner, president of the National Ayurvedic Medical Association pointed out, California does not prohibit sales of these products, but “rather requires a specific warning to the consumer if a product contains these elements above its limits.” None of the tainted supplements in Dr. Saper’s study met the standards for lead set forth by California Proposition 65.

Posted: 9/22/2008 9:30:00 AM

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The Sunshine Vitamin May Relieve Diabetic Pain


Vitamin D may help relieve a painful neurological condition in people with diabetes known as neuropathy, according to a new study published in the Archives of Internal Medicine.

Neuropathy is a common and painful diabetes complication that causes symptoms such as burning, tingling, and numbness, especially in the legs, feet, arms, and hands. This condition can become debilitating and limit a person’s ability to carry out activities of daily living.

Medications may only partially help relieve pain caused from this condition, leaving a strong need for new treatment options. Studies have shown that vitamin D is important in a number of bodily functions including bone growth, keeping the immune system healthy, and aiding in nerve and muscle function. The authors of this study investigated whether vitamin D supplements may help ease the pain of diabetic neuropathy in vitamin D–deficient people.

In this study, 51 people with type 2 diabetes and neuropathic pain were treated with vitamin D supplements that provided an average daily amount of 2,059 IU. All the participants were felt to have marginally low vitamin D status (defined as a serum 25-hydroxyvitamin D concentration of less than 24 ng/ml).

Participants were evaluated for pain initially and after three months of treatment. Three months of treatment with vitamin D led to a significant pain reduction scores on two questionnaires, by 49% and 39% respectively compared with baseline scores. (The mean concentration of 25-hydroxyvitamin D rose to 30 ng/ml after supplementation.)

“Because the treatment of diabetic neuropathic pain is generally unsatisfying for patients and is associated with significant adverse effects, we advocate a trial of vitamin D supplementation in vitamin D-insufficient patients with neuropathic pain,” said Paul Lee and his colleague from the Department of Endocrinology and Metabolism, Concord Repatriation General Hospital in Concord, New South Wales.

The authors believe supplementation is unlikely to have adverse effects at their prescribed dose and may have additional beneficial effects on blood sugar control and bone health. Further research is needed to assess the efficacy, safety, and optimal dose of vitamin D for neuropathic pain.

Posted: 9/19/2008 3:30:00 PM

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FDA Bans Imports of 28 Indian-Made Drugs

From The Washington Post:

The Food and Drug Administration said yesterday that it was halting importation of 28 drugs made by the giant Indian generic drug maker Ranbaxy Laboratories because of manufacturing deficiencies at two of the company's plants.

Douglas Throckmorton, a physician with the FDA's Center for Drug Evaluation and Research, said there was "no evidence of harm to consumers" from drugs made at the Dewas and Paonta Sahib plants, both in India. He called the import ban "a preventive action."

FDA officials said numerous tests of the drugs have found they are not contaminated, sub-potent or unsafe and urged patients taking the drugs not to stop.

The drugs on the list include numerous antibiotics and antivirals, as well as medicines for high cholesterol, diabetes, high blood pressure, seasonal allergies and acne.

FDA officials said the action is not expected to disrupt availability of the medicines to U.S. consumers. All but one -- oral capsules of the antiviral drug ganciclovir -- are made by other companies. Supplies of that medicine will be allowed in after batch-by-batch testing and assurances by the company on the manufacturing process.

Ranbaxy is India's biggest pharmaceutical company and one of the 10 biggest producers of generic drugs in the world.

FDA officials walked a delicate line yesterday, stressing the seriousness of the violations while offering assurances that the risk to the public is essentially zero.

"The nature of the violations really relates to the [manufacturing] process," Autor said. "We did not find any defects in the products themselves."

The FDA inspects the factories of foreign drug companies seeking to sell products in the United States. Because the plants are on foreign soil, the agency has no direct regulatory control over them. Its only leverage is to ban importation of the substances.

Among the problems were "inadequate sterile processing operations"; failure to keep certain areas from being contaminated with compounds that can cause allergic reactions in some people; and inadequate record-keeping.

The company will not be able to export any of the 28 drugs to the United States until the deficiencies are fixed. In the interim, the FDA also will not consider any new drug applications for substances made at the two plants.

Posted: 9/17/2008 10:27:00 AM

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Staph infections linked to SIDS

From (Canada):

A bacterial infection may be an overlooked cause of sudden infant death syndrome, an Australian study suggests.

Researchers analyzed autopsy reports on 130 babies who died of SIDS, 32 who had died suddenly as a result of infection, and 33 who had died of non-infectious causes, such as car collisions.

Sudden Infant Death Syndrome (SIDS), also known as crib death, refers to the sudden and unexpected death of an apparently healthy infant under one year of age.

"We believe that these pathogens are actually causing infection and they may be the cause of SIDS," said study author Dr. Paul Goldwater of the Women's and Children's Hospital and the University of Adelaide.

"We found them in about a quarter of the cases of sudden infant death. Staph always is one of the leading ones and we found it in about 10 percent."

The researchers also analyzed bacteria from normally sterile sites, such as the spleen, of the SIDS babies and compared it with 65 other babies.

Infections at the sterile areas were rare in infants who died from other causes.

But the sterile tissue was infected in nearly one in five babies who died suddenly from infection, and one in 10 SIDS babies, the researchers report in the online version of the Archives of Disease in Childhood.

During life, bacterial contamination of a sterile site signals systemic infection.

Many of the infections were linked to golden staph bacteria, the researchers said.

"What's of particular note is that staph aureus, this golden staph, very commonly carries lethal toxins. And as part of our research, we found two-thirds of SIDS infants actually carry these lethal toxins in their intestines," said Goldwater.

Goldwater recommended that post-mortems in SIDS cases look more carefully for the bacteria in sterile sites before declaring a cause of death. Previously the bacteria may have been dismissed as contamination.

The researchers had to look at cases over a 25-year period to find data to analyze.

Posted: 9/12/2008 9:26:00 AM

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Growing Teen Abuse of Snurf Pills

From WebMD:

Snurf pills and other "herbal" euphoria-enhancing drugs are part of a surge in abuse of over-the-counter drugs by young teens, experts tell WebMD.

Today's reports of four Pennsylvania 10th-graders hospitalized after taking pink pills sold over the Internet as Snurf have parents scrambling to learn more about this little-known drug.

It's not yet clear exactly what the Snurf product actually contains. But the kids' symptoms -- and the effects reported by Snurf takers in online drug-user message boards -- point to dextromethorphan, the cough suppressant ingredient in Robitussin and other over-the-counter medicines.

Dextromethorphan, known by users as DXM, dex, or robo, is a synthetic morphine analog that lacks opioid-like effects, says Deborah Levine, MD, attending physician at New York's Bellevue Hospital Center. Levine recently published a study on "pharming," the abuse of prescription and nonprescription drugs by teens.

"It's the ninth- and 10th-graders who are doing the dex," Levine tells WebMD. "One in 10 kids in grades seven to 12 have used it. In California, they have seen a 15-fold increase in kids age 9-17."

While use of illegal drugs is down among teens, use of DXM and other over-the-counter drugs is on the rise from eighth grade onward, says Michael Windle, PhD, chair of behavior sciences and health education at Emory University's Rollins School of Public Health.

"The message isn't out there of the potential dangers of using these substances. You have a very dangerous combination of fairly easy access with absence of messages of potential harm," Windle tells WebMD.

The Pennsylvania teens may not have been trying to get DXM when they obtained the Snurf pills. Users report that the package listed its "herbal" ingredients as "Fevizia, Palenzia, and De la Amazon."

No such herbs exist, according to multiple references. Since the Pennsylvania school incident, Snurf itself is hard to find on the Internet, although it's been sold at least since 2005.

But other products listing the same ingredients -- such as Snuffadelic and Red Dawn Vector Euphoria Enhancer -- are readily available.

The "herbal" moniker may make teens think the drugs are safe or even healthful, warns Windle, leader of a landmark, 20-year study of the long-term effects of teen substance abuse.

Moreover, Windle says that since these drugs are not illegal, teens often feel that they are more acceptable to peers and even to parents than are illegal drugs such as marijuana.

Yet both the desired effects and the side effects can be devastating. At extreme doses, Levine says, DXM causes the same kinds of dissociative symptoms -- memory loss, depression, anxiety, detachment from self, sense of unreality, blurred sense of identity -- seen with ketamine, a very dangerous drug of abuse known as "special K."

"DXM definitely has toxicity. At the drug doses the kids take -- six to 12 times the regular dose -- you can have serious toxicities, especially if they take cough syrup that contains antihistamines or Tylenol," she says.

Windle warns that "these products can produce a very severe side effect that under some conditions could require hospitalization or even result in death."

Levine warns parents to take stock of their medicine cabinets, including nonprescription drugs.

Posted: 9/10/2008 6:39:00 PM

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FDA posts list of prescription drugs with possible problems

From The Houston Chronicle:

The government on Friday began posting a list of prescription drugs under investigation for potential safety problems, in an effort to better inform doctors and patients.

The first list is a bare-bones compilation naming 20 medications and the potential issue for each. It provides no indication of how widespread or serious the problems might be, leading some consumer advocates to question its usefulness, and prompting industry worries that skittish patients might stop taking a useful medication if they see it listed.

Food and Drug Administration officials said they are trying to walk a fine line in being more open to the public while avoiding needless scares. Congress, in a drug safety bill passed last year, ordered the agency to post quarterly listings of medications under investigation.

"My message to patients is this: Don't stop taking your medicine," said Dr. Janet Woodcock, who heads the FDA's Center for Drug Evaluation and Research. "If your doctor has prescribed a drug that appears on this list, you should continue taking it unless your doctor advises you differently."

The first list included some drugs whose problems already have been publicized, such as the blood thinner heparin and immune-suppressing medications that are being studied for a possible link to cancer in youngsters. Several medications administered in hospitals were listed because of overdoses linked to possibly confusing instructions. Among the drugs taken in the home, insulin and nitroglycerin were cited because of possibly confusing instructions that might be contributing to patients getting the wrong doses.

The listings will be updated for each calendar quarter.

Drugs will be placed on the list based on reports the FDA receives regularly from hospitals, doctors and patients. The list is not just a reflection of raw data, but more like what a police officer would call "probable cause." Officials said a drug will only be listed if FDA safety reviewers determine that a reported problem deserves a closer look.

Consumer advocates called the listing a positive step, but said it needs to be fleshed out.

Posted: 9/9/2008 11:44:00 AM

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Strawberry Quick - rumor or fact?

There have been e-mails circulating on the internet regarding flavored crystal meth products being sold to children.  One such example is, "New drug in Schools...Please pass this on to your friends, neighbors, grandchildren, schools, clubs, etc.  This is a new drug known as 'strawberry quick ' and is the cause of a very scary scenario in the schools right now that we all need to be aware of. This is a type of crystal meth going around that looks like strawberry pop rocks (the candy that sizzles and 'pops' in your mouth). It also smells like strawberry and it is being handed out to kids in school yards. They are calling it strawberry meth or strawberry quick. Kids are ingesting this thinking that it is candy and being rushed off to the hospital in dire condition. It also comes in chocolate, peanut butter, cola, cherry, grape and orange. Please instruct your children not to accept candy from strangers and even not to accept candy that looks like this from a friend (who may have been given it and believed it is candy) and to take any that they may have to a teacher, principal, etc. immediately."

But just how legitimate these claims are is in question.  According to, it is partially true in that "Some drug dealers sell colored crystal methamphetamine that coincidentally resembles "Pop Rocks" or other forms of candy" but go on to say that the claim that "Some dealers sell crystal methamphetamine that has been flavored in order to make it more appealing to children" is False.

In recent news, the Vancouver Courier states, "Detective Jim Fisher, Vancouver Police Department Drug/Gang Section Operational Intelligence Coordinator, said the flavoured crystal meth advisory has circulated online since January 2007, but there appears to be no truth to it. The drug section has not recovered or been made aware of any methamphetamine flavoured with anything resembling Strawberry Quik.

"We've done some research on it because [the question] comes up fairly frequently for us," he said.

Although methamphetamine can have a purplish hue if it was manufactured using red phosphorus, it's a naturally occurring colour and is not added by dealers for appeal, he added.

Health Canada drug analysis labs, which test drug seizures, have confirmed they have never had any such sample submitted to them for analysis, according to Fisher.

The origin of the hoax hasn't been established, but it may be that an original warning gets misinterpreted as it's passed along. "It could have been something where people are saying, 'Hey, this is being said. It doesn't exist, but be careful,' and then it gets morphed into, 'This exists and be careful.'"

And according to the DEA, "Although flavored “hard” drugs (notably “strawberry meth”) have received extensive press in the mass media, to date very few such exhibits have been submitted to the DEA Laboratories."

However, "The DEA Western Laboratory (San Francisco, California) recently received an exhibit consisting of 13 tied, clear plastic bags containing pink, off-white, and white powders, all with a generic, sweet, fruity odor, purported strawberry, lemon, and coconut flavored cocaines. To date, the various exhibits submitted in this case are the first examples of “flavored cocaine” seen at the Western Laboratory.

Bottom line, according to the Vancouver Courier article, is "There's no harm in warning [kids about drugs]. But if they [parents] feel they need to warn them about methamphetamine, the truth is the most common way it's being distributed right now is as a portion of ecstasy. Most buyers aren't aware that the majority of pills police have seized and analyzed contain another drug besides MDMA [ecstasy], and the majority of the pills contain a significant amount of meth. Other drugs found in ecstasy pills include ketamine, cocaine and ephedrine."

Posted: 9/8/2008 2:07:00 PM

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Bisphenol A: If you're alarmed, learn why

From the Los Angeles Times:

Bisphenol A. The name seems vaguely worrisome -- synthetic (not that this is necessarily a bad thing) and non-apple-pie-ish (I'd argue this is). But the headlines are downright alarming, depending on your reading material. Now the National Toxicology Program, part of the National Institutes of Health, has released its final report on the possible human effects of bisphenol A, or BPA, a chemical added to plastics to make it stronger.

In short: The folks there are concerned. Not alarmed, but concerned.

Specifically, the report states that the program has:

* some concern for effects on the brain, behavior and prostate gland in fetuses, infants and children at current human exposures to bisphenol A.

* minimal concern for effects on the mammary gland and an earlier age for puberty in fetuses, infants and children at current human exposures to bisphenol A.

* negligible concern that exposure of pregnant women to bisphenol A will result in fetal or neonatal mortality, birth defects or reduced birth weight and growth in their offspring.

* negligible concern that exposure to bisphenol A will cause reproductive effects in non-occupationally exposed adults and minimal concern for workers exposed to higher levels in occupational settings.

The final report isn't a surprise, conclusive though it seems, as it essentially backs up the draft report released in the spring. The L.A. Times reported then: Chemical in plastic may harm children.

But now Yale University researchers have announced that the chemical may damage the connections between brain cells, possibly leading to memory problems or depression. That research, published online in the Proceedings of the National Academy of Sciences, was conducted in primates and though not exactly final, certainly is provocative. It adds to the growing hysteria, uproar, fear, worry, mild concern, general curiosity, irritation at the hubbub (choose your reaction) about the chemical.

Meanwhile, California legislators are pondering the worthiness of a bill that would ban the chemical from products marketed to children under age 3. Those include baby bottles, sippy cups, formula cans and the like. Said David Lazarus, consumer reporter for the Los Angeles Times, recently: "The fact that U.S. authorities have found at least some risk that BPA could be harmful to children should be sufficient reason to act."

Posted: 9/5/2008 9:28:00 AM

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