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Addicts Who Can’t Find Painkillers Turn to Anti-Diarrhea Drugs

From The New York Times:

They call it the poor man’s methadone.

The epidemic of opioid addiction sweeping the country has led to another form of drug abuse that few experts saw coming: Addicts who cannot lay hands on painkillers are instead turning to Imodium and other anti-diarrhea medications.

The active ingredient, loperamide, offers a cheap high if it is consumed in extraordinary amounts. But in addition to being uncomfortably constipating, it can be toxic, even deadly, to the heart.

A report published online in Annals of Emergency Medicine recently described two deaths in New York after loperamide abuse. And overdoses have been linked to deaths or life-threatening irregular heartbeats in at least a dozen other cases in five states in the last 18 months.

Most physicians just recently realized loperamide could be abused, and few look for it. There is little if any national data on the problem, but many toxicologists and emergency department doctors suspect that it is more widespread than scattered reports suggest.

Some toxicologists argue that the sales of loperamide should be limited, much as the nonprescription drug pseudoephedrine was restricted a decade ago to help prevent the manufacturing of crystal meth.

Posted: 8/29/2016 11:17:00 AM

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Party drug ketamine closer to approval for depression

From CNN:

The Food and Drug Administration put the experimental drug esketamine (also known as ketamine) on the fast track to official approval for use in treating major depression, Janssen Pharmaceutical announced Tuesday. This designated "breakthrough therapy" would offer psychiatrists a new method for treating patients with suicidal tendencies and would qualify as the first new treatment for major depressive disorder in about half a century.

In some quarters, though, this potentially effective medicine can't escape its reputation as "Special K," a street drug known for producing a high similar to an out-of-body experience -- and sometimes used as a date rape drug.

Ketamine was first synthesized in 1962 by Calvin Stevens at Parke Davis Laboratories, according to Encyclopedia Britannica. It received FDA approval for use in humans in 1970, and shortly after, Army doctors used the drug on American soldiers fighting in Vietnam as an analgesic and sedative. Yet its minor hallucinogenic side effects soon warned doctors off treating people. Today, ketamine's most common use is as a veterinary anesthetic.

A concern with using ketamine to treat depression is that it can reverse tolerance to opioids, Coffman said. Essentially, patients will get a higher dose of pain medicines, she explained, so any psychiatric uses would require "close oversight" by a multidisciplinary team of doctors.
Iosifescu said the short-term effects are known, but the long-term effects remain mysterious.
 
Another concern is the similarity between prescription ketamine and the street drug, a substance of abuse.

These are all reasons why Janssen's formulation will be provided and administered in doctors' offices or clinics, not distributed by pharmacies.
Posted: 8/22/2016 10:21:00 AM

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Drugged Driving Increases While Drunk Driving Decreases

From: Insurance Journal

The nation’s decades-long campaign to combat drunk driving continues to make our roads safer, but use of marijuana and prescription drugs is increasingly prominent on the highways, creating new safety questions, according to two studies released by the Department of Transportation’s National Highway Traffic Safety Administration.

One study, the latest version of NHTSA’s Roadside Survey of Alcohol and Drug Use by Drivers, found that the number of drivers with alcohol in their system has declined by nearly one-third since 2007, and by more than three-quarters since 1973.

But the same survey found a large increase in the number of drivers using marijuana or other illegal drugs. In the 2014 survey, nearly one in four drivers tested positive for at least one drug that could affect safety.

A one-third reduction in alcohol use over just seven years “shows how a focused effort and cooperation among the federal government, states and communities, law enforcement, safety advocates and industry can make an enormous difference,” said NHTSA Administrator Mark Rosekind.

However, Rosekind said, the survey raises “significant questions about drug use and highway safety. The rising prevalence of marijuana and other drugs is a challenge to everyone who is dedicated to saving lives and reducing crashes,” said NHTSA Administr

The reports are consistent with another study released in June by Public Health Reports. This study found that since 1993, the profile of a drugged driver has changed substantially. More drivers are now testing positive for prescription drugs, cannabis, and multiple drugs, and they are more likely to be older than 50.

“While we’ve seen a decrease over the years in motor vehicle fatalities involving people under the influence, the nature of those crashes is changing,” said the Public Health Reports study author, Fernando Wilson, PhD, associate professor at the University of Nebraska Medical Center.

Wilson found that the percentage of drugged drivers with three or more drugs in their system nearly doubled from 1993 to 2010, increasing from 11.5 percent to 21.5 percent.

Learn more about drugged driving and state-by-state impared driving laws at StopDUID.org


NMS Labs Announces Crucial New Tool for Impaired Driving Investigation

NMS Labs, a leading international forensic and clinical reference laboratory, announces the branding of its DUID confirmatory testing results report—ProofPOSITIVE®, An NMS Labs Confirmation Report.

Awareness of the extent of involvement of both therapeutic and abused drugs in impaired driving investigations and fatal crashes continues to grow. The technology to complete the investigation, however, is often lacking, with inadequate testing being performed or lack of understanding of the implications of the drug test findings. NMS Labs has announced the release of its new branded drug confirmation test, ProofPOSITIVE®, to provide a targeted, economical solution to identifying the drugs or combinations of drugs that can account for impairment, and clear interpretive advice provided right on the report. Prepared based on a study of the most common drugs encountered in the Drug Recognition Expert (DRE) and Driving Under the Influence of Drugs (DUID) programs nationwide, ProofPOSITIVE® reinforces NMS Labs commitment to the DRE program, and its need for timely, intelligent, targeted, testing that is also economical.

Since not all tests are created equal, choosing a high-quality laboratory, well informed in the area of DUID testing is essential. NMS Labs ISO-level quality from leaders in forensic laboratories accreditation, ABFT and ASCLD-LAB, and it’s internationally recognized experts in DUID provide confidence to investigators that their tests are in the right hands.

The new test was developed by Dr. Barry Logan, nationally recognized for his leadership and contribution to the field of drug impaired driving. Logan explained, “We’ve added key new compounds to this test to reflect our discovery of the latest trends in drug use in vehicle fatalities and arrests. We expect that this will increase drug detection rates in DUID and vehicular crimes cases by about 10%.” In addition, Logan noted that the ProofPOSITIVE® service adds on testing for more exotic drugs in circumstances where the driver’s impairment cannot be accounted for by the initial screening results. NMS Labs experienced court qualified toxicologists review and sign each report, and provide testimony when required.

“We needed to tell our story better, and ProofPOSITIVE® is simply the right message to resonate with those needing a dependable, quality confirmatory report and interpretive advice on the meaning of results in the court setting,” noted Julie Ruth, Sr. Director of Marketing at NMS Labs

The ProofPOSITIVE® confirmation report reflects NMS Labs alignment with National Safety Council’s recent recommendations for DUID drug testing, providing police with the most relevant targeted approach to DUID testing as well as contributing to the growing momentum around the use of oral fluid as an accepted forensic sample in DUID investigations. Additional details can be found on NMS Labs website.

 

New pain pill's approval: 'Genuinely frightening'

From CNN:

A potent little painkiller is causing a big stir.

A coalition of more than 40 health care, consumer and addiction treatment groups is urging the Food and Drug Administration to revoke approval of the prescription drug Zohydro.

The hydrocodone-based drug is the latest in a long line of painkillers called opioid analgesics. The FDA approved the medication last fall to treat chronic pain, and it is set to become available to patients in March.

"It's a whopping dose of hydrocodone packed in an easy-to-crush capsule," said Dr. Andrew Kolodny, president of the advocacy group Physicians for Responsible Opioid Prescribing. "It will kill people as soon as it's released."

The concerns echoed by all groups are broadly about the drug's potency and abuse potential. They say they fear that Zohydro -- especially at higher doses -- will amplify already-rising overdose numbers.

"This could be the next OxyContin," says a petition on Change.org asking the FDA to reconsider.

"You're talking about a drug that's somewhere in the neighborhood of five times more potent than what we're dealing with now," said Dr. Stephen Anderson, a Washington emergency room physician who is not part of the most recent petition to the FDA about the drug. "I'm five times more concerned, solely based on potency."

Both Zohydro's maker, Zogenix, and the FDA assert the drug's benefits outweigh its risks.

Galer said the company will focus its commercial efforts on a small group of doctors with good experience prescribing opioids, so that only appropriate chronic pain patients would receive the drug.

Bigger, stronger opioids -- especially those containing hydrocodone -- are a concern. Hydrocodone (Zohydro's sole ingredient) is one of the most frequently prescribed -- and abused -- opioids.

For that reason, in October, the FDA said it intended to shift hydrocodone-containing drugs from Schedule III to Schedule II. That rescheduling (still pending approval by the Drug Enforcement Administration) would mean much stricter dispensing and prescribing rules for hydrocodone-containing products.

Zohydro will enter the market already classified as a Schedule II -- one reason both the FDA and the drug's maker are confident it will not contribute to the broader overdose problem.

Zohydro's labeling will feature warnings about abuse, addiction and misuse, and Galer said Zogenix is working on an abuse-deterrent version of Zohydro that should become available in three years.

Posted: 2/27/2014 3:54:00 PM

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Concerns Over New Dangerous Drug "Gravel" Spreading To Central Ohio

From WBNS-10TV (Columbus, OH):

Law enforcement is being warned tonight about a new, dangerous drug called gravel.

The cocktail can include rat poison, bath salts and methamphetamine. It reportedly makes users paranoid and suicidal.

It got the name gravel by the way it looks.

"When you combine a variety of drugs, none of which are good, you get a combination of something that is even worse than the sum of its parts," said Paul Coleman, the president and CEO of Maryhaven.

The new drug is being tracked in the southern part of the United States. A task force there is now warning law enforcement here in Central Ohio that it may be heading this way.

Posted: 2/27/2014 9:36:00 AM

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Drug Use Drops for America's Youth, Rises in the Over 50 Crowd

From ABC News:

Drug use among America's youth is dropping, but it's booming among people over 50, a U.S. government survey released Wednesday shows.

Last year, the rate of illicit drug use among children and teenagers 12 to 17 years old dropped to 9.5 percent, down from 11.6 percent a decade earlier, according to the Substance Abuse and Mental Health Services Administration's (SAMHSA) latest national survey.

Meanwhile, illicit drug use among adults 50 to 64 years old has increased in the past decade.

Specifically, illicit drug use among adults 50 to 54 has more than doubled since 2002, reaching 7.2 percent last year. For people 55 to 59, such drug use has more than tripled, reaching 6.6 percent last year.

Marijuana is by far the most-used illicit drug among both children and adults, according to SAMHSA, a division of the Department of Health and Human Services.

At a press conference Wednesday in Washington, officials expressed particular concern about use by those 12 to 17 years old.

"There's no question that marijuana is harmful to the developing brains of adolescents," said SAMHSA administrator Pamela Hyde, adding that marijuana use has been linked to "significant I.Q. declines."

As for young adults – those 18 to 25 years old – rates of illicit drug use have remained somewhat steady over recent years, with a slight increase in marijuana use, according to the survey.

Illicit drug use among children had remained steady at 10.1 percent from 2009 to 2011, which was a slight increase from years before. Overall, though, use for that age group has dropped in the past decade.

The data was released at the start of September to help kick off National Recovery Month, a government-sponsored promotion of preventing and treating substance abuse and mental health disorders.

Posted: 9/5/2013 11:37:00 AM

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No bath salts detected: Causeway attacker Rudy Eugene had only pot in his system, medical examiner reports

From The Miama Herald:

Rudy Eugene, the man who chewed off a homeless man’s face on the MacArthur Causeway and was shot to death by Miami police, had no drugs in his system other than marijuana, the Miami-Dade Medical Examiner’s office said Wednesday.

The bizarre details of the attack prompted speculation that the 31-year-old attacker was under the influence of harder drugs. Soon after the incident, for example, the head of the Miami police union publicly speculated that Eugene was on “bath salts,” synthetic stimulants that have been blamed for seemingly psychotic episodes in other cases around the country.

But the medical examiner — after seeking help from an outside forensic toxicology lab — could find no evidence of the common components of “bath salts” in Eugene’s system. Nor did the lab find evidence of synthetic marijuana or LSD.

The medical examiner also found that Eugene had not ingested cocaine, heroin, PCP, oxycodone, amphetamines or any other known street drug other than marijuana — a drug not known for sparking violence.