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Prescription Drug (Artane) Abuse Rises Among Iraqi Troops

From The New York Times:

The abuse of prescription drugs, widely available in Iraq on the black market and through private pharmacies, has significantly increased since 2003, doctors and other health specialists say, nourished by the stresses of the war and the lack of strict government regulation.

Dealers do a brisk business in tranquilizers, painkillers and other drugs, specialists say, and drug abuse is a problem in the prisons and among Iraqis who live in poor neighborhoods or who are unemployed.

But in recent years, Iraqi soldiers and police officers have also turned to drugs to ease the stresses of their jobs. In particular, they are abusing Artane, a medication that is used to treat Parkinson’s disease and that can have euphoric effects when used in high doses.

“They believe that this Artane allows them to become courageous, to become brave,” said one doctor, who spoke on the condition of anonymity because he was not authorized to speak publicly about the issue.  “They take it so that there is no anxiety, no fear,” he said, “so they can break down doors and enter houses with no shame.”

No clear evidence exists that the misuse of prescription drugs has a significant effect on how soldiers and police officers perform their duties. Nor are any figures available on how widespread drug abuse is in the security forces or whether most of those who use the drugs do so daily.

But Mr. Qasim, 26, estimated that one out of three soldiers in his army unit take Artane or other drugs while on duty. Jalal Ammar, 45, an Iraqi police officer, said “probably 30 percent” of the police officers he worked with used Artane and other medications. Dr. Amir al-Haidari, the manager of drug addiction programs for the Ministry of Health of Iraq, said that alcohol abuse was once a bigger problem than prescription drug abuse, “but after the American invasion of Iraq, alcohol became limited because of the security situation and religious restraints.”

Gen. Ahmed al-Khafaji, an official at the Interior Ministry concerned with police affairs, denied that drug abuse was a significant issue among Iraqi police officers.

“We don’t accept any kind of addiction within the security forces or our troops from the police,” he said, adding that any police officer who was found to abuse drugs “will be dismissed from our ministry forever.”

Maj. Gen. Qassim Atta of the Iraqi military said that the soldiers in Baghdad “have very good mental health and high spirits.”

Asked about the abuse of prescription drugs, he said, “Maybe there are some negative points here and there, but you cannot generalize based on such cases.”

On the street, Artane, Valium and other drugs are known by nicknames, including “the capsule,” “the eyebrow” and “the cross.” Mr. Ammar said that when police officers talked among themselves about the drugs, they referred to them as “appetizers” or “takeout.”

Drug use is forbidden in the Iraqi security forces, but Mr. Qasim said that soldiers took drugs discreetly and that “everyone in the army knows about it.”

Unlike some tranquilizers and drugs like cocaine or heroin, Artane does not produce physical addiction. but can produce psychological dependence. But the drug’s label warns that alcohol, barbiturates or narcotics can intensify its effects.

Psychiatrists familiar with Artane abuse say that addicts vary in how frequently they use the drug, sometimes taking it only when they are under stress.

Keith Humphreys, a professor of psychiatry at Stanford University School of Medicine who specializes in drug addiction and advises Iraqi psychiatrists on mental health treatment, said that widespread Artane abuse was almost unheard of elsewhere.

Posted: 9/26/2011 12:39:00 PM

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‘Fake pot' tied to rash of E.R. visits in Tuscaloosa

From TuscaloosaNews.com:

In the past few months, at least 15 young adults have sought emergency medical treatment at DCH Regional Medical Center with the same symptoms: a racing heart and paranoia.

It sounds like a bad reaction to an illegal drug, but it's not. It's a bad reaction to a legal substance that can be purchased in gas stations and tobacco stores across Alabama.

Marketed as "incense," synthetic marijuana, sometimes called "fake pot," is a herbal product that has been treated with chemicals that mimic the effects of marijuana when smoked. Similar chemicals were made illegal in Alabama last year, but chemists can alter the compounds to remain within the constraints, but perhaps not the spirit, of the law.

Users report that the effects are similar, if not more intense, than the real thing. Some gas station and tobacco store owners in Tuscaloosa who declined to be interviewed on the record about synthetic marijuana said last week that the product is a top seller.

DCH spokesman Brad Fisher said that most of the people who have sought treatment are in their early 20s and are usually discharged within two or three hours, according to emergency room doctors.

Often called "Spice" or "K2," synthetic marijuana is cheaper, easier to obtain and doesn't show up on drug tests. There's no age limit to purchase the product, which is often labeled "not for human consumption."

Police say that it's difficult to enforce the ban on the chemicals that were outlawed last year because they have no way to (field) test the product.

The Regional Poison Control Center at Children's Hospital of Alabama reports receiving 67 calls from people who have smoked synthetic pot since October 2010, according to the Alabama Department of Public Health. Three were children between 6 and 12, 15 were teenagers and 22 were in their 20s. Of those, 76 percent were male. At least 56 were treated for toxic exposure in hospital emergency rooms. According to the American Association of Poison Control Centers, more than 6,700 calls were made to poison control centers nationally in 2010 and in the first seven months of 2011 about synthetic marijuana. 

Posted: 9/26/2011 10:32:00 AM

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For Many, a Life-Saving Drug Out of Reach

From The New York Times:

Overdose now kills more people in the United States than car accidents, making it the leading cause of injury-related mortality according to the latest statistics from the Centers for Disease Control and Prevention. The number of deaths — 37,485 in 2009 — could be cut dramatically if Naloxone were available over-the-counter and placed in every first aid kit.

But that’s not likely to happen until the Food and Drug Administration takes some action. Naloxone is currently available only by prescription. Although dozens of needle exchange programs, rehab centers and pain specialists in at least 16 states distribute it, the prescription requirement severely limits its availability to those organizations that can afford to have doctors on staff.

Naloxone (its brand name is Narcan) can be administered either nasally or by injection. It can rapidly reverse the potentially deadly effects of opioid drugs, which include heroin and prescription pain relievers like OxyContin and Vicodin. It does not produce a high — quite the opposite, in fact, because it blocks the effects of opioids.

Naloxone is much safer than some drugs currently available without a prescription. Both insulin and Tylenol (acetaminophen) can be deadly if misused, but it is impossible to overdose on Naloxone and it has few side effects.

Overdose deaths linked to prescription opioids more than tripled between 1999 and 2006. The majority of fatal overdoses involve either prescription opioids or heroin in combination with alcohol and/or another depressant drug, such as Valium or Xanax.

Some cases do occur when pain patients mistakenly take too much or drink alcohol with their medications, however, most seem to involve people with histories of addiction who get the drugs from non-medical sources. For example, a study of prescription-drug-related deaths in one heavily affected state found that fewer than half of overdose victims had been prescribed the drug(s) that killed them and that 95 percent showed signs of addiction, such as injecting drugs meant for oral use.

But while people with addiction seem to have little trouble getting unprescribed opioids, Naloxone is tougher to get because there is no black market for it and few people even know that they should seek a prescription for it. And many pharmacies do not even carry it, as it is typically only used by ambulance crews and in hospitals.

Naloxone is highly effective because it displaces opioids from the receptors in the brain that depress breathing. Slowed and eventually stopped respiration is what causes opioid overdose death — because this happens over the course of an hour or more, there is often time to intervene.

Unfortunately, many family members and friends of drug users are unaware of the signs of overdose and believe that, as with drunkenness, the best thing to do is let the person “sleep it off.” Such ignorance can be fatal.

The rare cases that have been reported where Naloxone didn’t help have overwhelmingly been either overdoses of other drugs, like cocaine, or situations where the person was dead before the Naloxone was administered.

Posted: 9/26/2011 9:46:00 AM

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Head Shop Owner has made millions of dollars defying synthetic drug bans

From the Star Tribune:

Every morning, dozens of customers line up outside the doors of Last Place on Earth so they can buy fake pot and other synthetic drugs as soon as the store opens at 10 a.m.

They are drawn to this old brick building because they know the head shop is one of the last places in Minnesota that openly sells the sometimes deadly substances despite a July 1 ban on synthetic drugs.

Some come from the Twin Cities, according to owner Jim Carlson. Others travel even farther. On Friday, a trucker from Grand Rapids, Minn., said he started making the 80-mile drive to Carlson's store every three weeks because his neighborhood smoke shop stopped selling "herbal incense."

Duluth resident Heidi Middleton, who was first in line, said she comes almost every day. "If I don't have weed in my system, I go into convulsions and throw up," said Middleton, 38. "It mellows me out."

Any day now, Carlson predicts, police will raid the shop he's owned for 29 years and arrest him. But every day that doesn't happen puts another $16,000 or so in his till, Carlson estimates. That means the small, crowded shop is hauling in almost $6 million a year from synthetic marijuana and stimulants.

"Our sales are just insane," Carlson recently told the Star Tribune. "If anything it's gotten stronger with a lot of my competition getting out of it, nervous, not knowing what's going on."

Local officials, who have tried in vain for years to force Carlson to stop selling drug-related merchandise, think the retailer has gone way too far this time.

"He flaunts and he taunts, and I think it's absolutely disgusting how you can sell a product to people that damages users and innocent bystanders," Duluth City Council Member Todd Fedora said.

Last year, Fedora spearheaded an effort to make Duluth the first city in the state to ban synthetic pot. But the city stopped trying to enforce the ordinance after Carlson threatened to hold the city responsible for his economic losses in a federal lawsuit that claimed the rule was unconstitutionally broad.

Duluth Police Chief Gordon Ramsay said Carlson is on his radar. "We're aware of the problem and are working on it," Ramsay told the Star Tribune Thursday.

Carlson, whose business has tripled since he started selling synthetic drugs two years ago, said he's willing to risk arrest for several reasons: The money is so good, and he believes banning drugs doesn't work and infringes on people's rights.

He also claims to have taken steps to make sure his products don't violate the state's new ban, though the results of a test conducted for the Star Tribune showed that some of his synthetic pot contained a chemical specifically outlawed in Minnesota. Carlson said his supplier made a mistake and has since switched to a legal formula.

"If I get busted, I would demand a jury trial," said Carlson, who complained Monday to the City Council that police were harassing customers in front of his store.

Posted: 9/19/2011 1:44:00 PM

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Bath salts hit U.S. 'like a freight train'

From the Star Tribune:

Cheap to buy, easy to find and mistakenly seen by some users as a legal and mostly harmless alternative to cocaine and other stimulants, bath salts have become the source of a new wave of worried calls to poison control centers nationwide. Last year, those centers received about 300 calls about the synthetic drug.

Already this year, they have logged more than 4,700.

Emergency room doctors, meanwhile, are being forced to take extreme steps to treat some bath salt users who are showing up at hospitals intensely agitated, delusional and even violent. Law enforcement officers are also reporting struggles to subdue hallucinating users who are fighting imaginary people. Some bath salt users are ending up in psychiatric wards.

"It came on like a freight train," said Mark Ryan, long-time poison center director in Louisiana, where the bath salts craze hit early. Bath salts often seem to cause scarier hallucinations than LSD, Ryan said, and sometimes provide the super-human strength of PCP. Far more users experience severe effects compared to other drugs, he said.

Bath salts first appeared in the United States in 2009, according to the U.S. Drug Enforcement Administration (DEA). The drugs are so new that federal agencies are still analyzing their toll, but research conducted by the Star Tribune indicates the products have been confirmed or suspected in more than 15 deaths nationwide.

At least 30 states have banned certain bath salt chemicals, including Minnesota, but the products remain widely available on the Internet. Despite their name, the drugs are far different -- and far more expensive -- than ordinary bath products.

The products are typically sold in powder form in plastic or foil packages and sold under various names, including Bliss, Ivory Wave and Vanilla Sky. The drugs are usually snorted but can also be smoked, injected or swallowed, according to the DEA.

Like cocaine and other stimulants, bath salts initially might make people feel energized and happy longer than other drugs, experts said. When the initial high dies down, users take more and can end up addicted, hallucinating, panicked and violent.

Posted: 9/19/2011 1:39:00 PM

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FDA Declines To Clear Pfizer Antidepressant For Menopausal Symptoms

From The Wall Street Journal:

Pfizer Inc. (PFE) said the U.S. Food and Drug Administration declined to approve an application to market the antidepressant Pristiq as a treatment for certain menopausal symptoms such as hot flashes.

The New York-based drug maker said in a statement on its website Sept. 8 it had received a "complete response letter" from the FDA, which means the Pristiq application cannot be approved in its current form.

Pfizer said it's evaluating the content of the letter and plans further discussions with the FDA.

Posted: 9/16/2011 12:36:00 PM

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NEW STUDY: Hawaii leads nation in meth use at work

From HawaiiNewsNow:

A new study released Friday by Quest Diagnostic Incorporated shows that Hawaii has the highest percentage in the nation of methamphetamine users at work.

According to the study, Hawaii workers test positive for the drug at a rate that's four times higher than the national average.

A University of Hawaii psychiatry professor says Hawaii's location is a prime reason why meth use is so high.

"We're directly in transit lanes of areas of highest production in Korea and the Philippines," Dr. William Haning said. "And it tends to make importation into Hawaii very easy. This is not a drug this is readily identified through the usual screening techniques."

Haning says another reason is the island's service economy, in which many users take meth in an effort to work longer, harder and multiple jobs.
Posted: 9/6/2011 9:42:00 AM

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'Legal highs' prevalence makes ban policy 'ridiculous'

From Guardian News (UK):

New "legal highs" are being discovered at the rate of one a week, outstripping attempts to control their availability and exposing what some experts claim is the "ridiculous and irrational" government policy of prohibition.

Officials monitoring the European drugs market identified 20 new synthetic psychoactive substances in the first four months of this year, according to Paolo Deluca, co-principal investigator at the Psychonaut Research Project, an EU-funded organisation based at King's College London, which studies trends in drug use. He said officials at the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), an early-warning unit, had detected 20 new substances for sale by May this year. In 2010 the agency had noted 41 new psychoactive substances, a record number, many of which were synthetic cathinone derivatives that can imitate the effects of cocaine, ecstasy or amphetamines.

Deluca said that, given the plethora of new substances, the government's attempts to ban legal highs is not a "feasible" solution. "It's also becoming very difficult to know exactly how many new compounds there are, because you have all these brand names and when you test the batch they are different from the following one." The UK, according to his reasearch, remains Europe's largest market for legal highs and synthetic compounds.

The EMCDDA favours generic bans that would cover entire groups of structurally related synthetic compounds, or chemical families, therefore removing the need to ban individual substances as they appear on the market. Deluca said: "It is impossible to implement a ban for every single new compound."
Posted: 9/6/2011 9:36:00 AM

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