Friday, June 22, 2012

UPC Weekly Blog 6/22/12: Seniors and Alcohol

As schools begin long awaited summer vacations I’d like to turn my attention to senior citizens for a few weeks.

While seniors are still under-represented in treatment, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that admissions for substance abuse treatment for people age 50 and older nearly doubled between 1992 and 2008. Alcohol abuse remains the leading cause of substance abuse hospitalizations for seniors.

The site provides a wealth of information regarding seniors and alcohol abuse, including the following:

As people age, they may become more sensitive to alcohol's effects. One reason is that older people metabolize, or break down, alcohol more slowly than younger people. So, alcohol stays in their bodies longer. Also, the amount of water in the body is reduced with age. As a result, older adults have a higher percentage of alcohol in their blood than younger people after drinking the same amount of alcohol.
Aging lowers the body's tolerance for alcohol. This means that older adults can experience the effects of alcohol, such as slurred speech and lack of coordination, more readily than when they were younger. An older person can develop problems with alcohol even though his or her drinking habits have not changed.
Drinking too much alcohol can cause health problems. Heavy drinking over time can damage the liver, the heart, and the brain. It can increase the risk of developing certain cancers, damage muscles and cause immune system disorders. It can also increase the chances of getting osteoporosis, a common disease in older adults, especially women. Osteoporosis makes bones weaker and more likely to break.
Drinking too much alcohol can make some health conditions worse. These conditions include diabetes, high blood pressure, congestive heart failure, liver problems, and memory problems. They also include mood disorders such as depression and anxiety. Adults with major depression are more likely than adults without major depression to have alcohol problems.
Many older adults take medicines, including prescription drugs, over-the-counter (non-prescription) drugs, and herbal remedies. Drinking alcohol can cause certain medicines to not work properly and other medicines to become more dangerous or even deadly. Mixing alcohol and some medicines can cause sleepiness, confusion, or lack of coordination, which may lead to accidents and injuries. It also may cause nausea, vomiting, headaches, and other health problems.
Dozens of medicines interact with alcohol, with possible negative effects. Here are some examples.
  • Taking aspirin or arthritis medications and drinking alcohol can increase the risk of bleeding in the stomach.
  • Taking the painkiller acetaminophen in large doses and drinking alcohol can increase the chances of liver damage.
  • Cold and allergy medicines that contain antihistamines often make people sleepy. Drinking alcohol can make this drowsiness worse and impair coordination.
  • Drinking alcohol and taking some medicines that aid sleep, reduce pain, or relieve anxiety or depression can cause sleepiness and poor coordination.
  • Drinking alcohol and taking medications for high blood pressure, diabetes, ulcers, gout, and heart failure can make those conditions worse.
Medications stay in the body for at least several hours. So, there can still be a problem if a senior drinks alcohol hours after taking a pill. Some medication labels warn people not to drink alcohol when taking the medicine.

Cheryl DePaolo
Ulster Prevention Council, Director

Monday, June 18, 2012

UPC Special Monday Blog! 6/18/12: Prescription Drug Reform

Recently Gov. Cuomo issued a press release announcing a significant prescription drug reform package. The measures outlined by the agreement address several of the largest concerns that are often raised regarding prescription drug abuse, including forged prescriptions, doctor shopping, overuse of hydrocodone, youth access to prescription drugs, and educating providers about the proper balance of pain management with abuse prevention.

Here is the press release in its entirety:

Contact Information:
Governor's Press Office
NYC Press Office: 212.681.4640
Albany Press Office: 518.474.8418
New York State Chief Information officer/Office for Technology
Andrew M. Cuomo - Governor

Governor Cuomo, Attorney General Schneiderman, and Legislative Leaders Announce Agreement to Make New York State a National Leader in Fighting Prescription Drug Abuse

Albany, NY (June 5, 2012)

Governor Andrew M. Cuomo, Attorney General Eric Schneiderman, Senate Majority Leader Dean Skelos, and Assembly Speaker Sheldon Silver today announced a landmark agreement on a comprehensive prescription drug reform package that will make New York State a national leader in curbing prescription drug abuse.
The new law will include a series of provisions to overhaul the way prescription drugs are distributed and tracked in New York State, including enacting a “real time" prescription monitoring registry to provide timely and enhanced information to practitioners and pharmacists; requiring all prescriptions to be electronically transmitted; improving safeguards for the distribution of specific prescription drugs that are prone to abuse; charging a workgroup of stakeholders with the responsibility to help guide the development of medical education courses and other public awareness measures regarding pain management and prescription drugs; and requiring the Department of Health to establish a safe disposal program for unused medications.
"This landmark agreement will help put a stop to the growing number of fatalities resulting from overdoses on prescription drugs," Governor Cuomo said. "We have seen too many untimely deaths as a result of prescription drug abuse, and today New York State is taking the lead in saying enough is enough. I commend Attorney General Schneiderman, Majority Leader Skelos, and Speaker Silver for their hard work in putting together this groundbreaking reform package that will help protect New Yorkers and put an end to prescription drug abuse."
Attorney General Eric Schneiderman said, "This is a major victory for the people of New York. With I-STOP, we will create a national model for smart, coordinated communication between health care providers and pharmacists to better serve patients, stop prescription drug trafficking, and provide treatment to those who need help. I applaud the Governor, Assembly and Senate for agreeing to take action and curb the prescription drug crisis that has impacted families in every corner of this state. Now, New York will be a national leader in protecting the public from the devastating consequences of prescription drug abuse."
Senate Majority Leader Dean Skelos said, "The effects of prescription drug abuse are being felt all across this state, especially among young people who are using painkillers to disastrous consequences. I commend Senator Lanza, who has championed this bill for more than three years, and Senator Hannon, the Chairman of the Senate Health Committee, for recognizing early on that a legislative remedy was a critical and necessary step. I thank the Governor, the Attorney General, and our colleagues in the Assembly for working with us to lead the charge in cracking down on prescription drug abuse so New Yorkers are better protected."
Assembly Speaker Sheldon Silver said, "Prescription drug abuse has become a pervasive problem in communities across the state. This legislation will help to control prescription drug abuse by creating a real-time online database enabling doctors and pharmacists to track certain controlled substances. This initiative will ensure patients receive the medication they need and deter those who seek to abuse them. I applaud Governor Cuomo for his leadership on this issue and commend Attorney General Schneiderman and my colleagues in the legislature for supporting this important life saving measure."
Senator Andrew Lanza said, "This historic agreement will allow New York to be at the forefront of the battle against the prescription drug abuse epidemic, which has destroyed families and lives from one end of the state to the other. The agreed upon legislation will allow doctors and pharmacists to have the information they need to ensure that we turn the tide on this deadly crisis. I thank the Governor, Attorney General Schneiderman, Senator Skelos, the Speaker, Senator Hannon and Assemblyman Cusick for working so long and so hard in this cooperative effort."
Senator Kemp Hannon said, "Comprehensive action to address the misuse of painkiller drugs in New York is needed. In the last documented year, over 22 million prescriptions for painkilling drugs were written – without refills – in a state with only 19 1/2 million people. The cooperation and collaboration evidenced by this legislation marks the beginning, not the conclusion of a concentrated effort to bring a balance to these drugs. This bill reflects the Senate's work as evidenced by our two roundtables and a report, addressing the number one health crisis today."
Assembly Member Michael Cusick said, "I want to thank Governor Cuomo, Attorney General Schneiderman, Speaker Silver and all of my colleagues who worked together to craft this agreement. This is meaningful legislation that provides an essential tool to allow for the responsible dispensation of prescriptions by medical professionals and pharmacists. It will protect access to critical medication for patients who truly need it. But at the same time, appropriate controls will be implemented to restrict access of abusers and ensure those who profit from the abuse face the necessary consequences."
Illicit use of prescription medicine has become one of the nation’s fastest-growing drug problem. According to the federal Centers for Disease Control and Prevention (CDC), nearly 15,000 people die every year of overdoses due to prescription painkillers. In 2010, 1 in 20 people in the United States over the age of 11 reported using prescription painkillers for nonmedical reasons in the past year. During the period 1999 through 2008, overdose death rates, sales, and substance abuse treatment admissions related to prescription painkillers all increased substantially. Sales of opioid painkillers quadrupled between 1999 and 2010. Enough opioid painkillers were prescribed in 2010 to medicate every American adult with 5mg of hydrocodone every four hours for a month. Moreover, an estimated 70 percent of people who abuse prescription painkillers obtained them from friends or relatives who originally received the medication from a prescription. The problem is of particular concern with respect to young adults and teens.
Details of the legislation are as follows:
The Creation of a New and Updated Prescription Monitoring Program (I-STOP)
The legislation will require updating and modernization of Department of Health (DOH)’s Prescription Monitoring program (PMP) Registry to make it one of the best systems in the nation to monitor prescription drug abuse and to help the medical community provide better care. The new system will substantially decrease opportunities for “doctor shoppers" to illegally obtain prescriptions from multiple practitioners. The legislation requires enhancement and modernization of DOH’s secure prescription monitoring program registry, which will include information about dispensed controlled substances reported by pharmacies on a “real time" basis, to effectively stop doctor shopping and combat the circulation of illegally-obtained prescription drugs.
The PMP Registry will be secure and easily accessible by practitioners and pharmacists, allowing them to view their patients’ controlled substance history. In addition, this legislation strikes the right balance by requiring health care practitioners to consult the PMP Registry before prescribing or dispensing the controlled substances that are most prone to abuse and diversion, while exempting practitioners from consulting in specific situations in order to protect patient access to needed medications. Moreover, pharmacists, for the first time, will now be able to consult the PMP Registry before dispensing a controlled substance.
Mandating Electronic Prescribing of Controlled Substances
The comprehensive package will make New York a national leader by being one of the first states to move from paper prescriptions to a system mandating the electronic prescribing (e-prescribing) for all controlled substances with limited exceptions. E-prescribing is critical to help to eliminate diversion that results from the alteration, forgery, or theft of prescription paper.
In addition, electronic prescribing enhances patient care by minimizing medication errors due to misinterpretations of handwriting on written prescriptions. It is estimated that 20 percent of the approximately 7,000 annual deaths caused by medication errors are attributable to misinterpretations of written prescriptions. Moreover, medication errors are estimated to cost the nation’s health care system over $70 billion each year. In New York, adverse drug events due to errors in written and oral prescriptions carry an annual cost to the health care system of approximately $130 million.
E-prescribing will also improve the efficiency of practitioners and pharmacies. Approximately 30 percent of prescriptions require pharmacists to call physicians due to poor handwriting on prescription forms. Additionally, e-prescribing is also more convenient for consumers, who would otherwise need to either wait at the pharmacy for a prescription to be filled, or make separate trips to drop off the prescription form and then pick up the medication.
E-prescribing of controlled substances will ensure that controlled substance transactions are transmitted in a secure, encrypted fashion to their intended recipient.
Updating the Controlled Substance Schedules to Stop Abuse of Certain Drugs, While Protecting Patient Access
The legislation combats prescription drug abuse by removing hydrocodone from Schedule III and placing it on Schedule II regardless of formulation. Hydrocodone is among the most abused and diverted prescription medications. In New York, last year, over 4.3 million hydrocodone prescriptions were filled — the most in the state. Nationally, eight percent of all high school seniors used hydrocodone for non-medical purpose. In 2009 alone, there were over 86,000 emergency room visits resulting from the non-medical use of hydrocodone.
Placing hydrocodone on Schedule II will control abuse by eliminating automatic refills and, in general, by limiting the amount prescribed or dispensed to a maximum 30-day supply. However, to protect legitimate access for those patients who need these drugs, the bill will not alter a practitioner’s ability under existing regulations to prescribe a supply of up to 90 days if he, or she, indicates on the face of the prescription that the patient has one of several enumerated conditions, including chronic pain.
The legislation will also add another drug, tramadol, to Schedule IV. Tramadol is a painkiller and is viewed as a drug of concern by the DEA.
Improving Education and Awareness of Prescribers to Stem the Tide of Prescription Drug Abuse
According to the CDC, a significant percent of abused medications are prescribed to the person that abuses them. This comprehensive legislation recognizes the need for increased education amongst health care providers about the potential for abuse of controlled substances, and the proper balancing of pain management with abuse prevention.
The bill would expand the functions of the workgroup to be established by the Department of Health under the existing Prescription Pain Medication Awareness Program, so that the workgroup will be responsible for making recommendations on: (1) continuing education for practitioners and pharmacists on pain management issues; (2) protecting and promoting access by patients with a legitimate need for controlled substances; (3) the implementation of the I-STOP provisions; and (4) inclusion of additional controlled substances in the consultation requirements of I-STOP. To carry out these functions, the Commissioner of Health will include additional stakeholders, including but not limited to consumer advocacy organizations, health care practitioners and providers, pharmacists and pharmacies, and representatives of law enforcement agencies.
Creating a Safe Disposal Program to Safely Dispose of Prescription Drugs 
Recognizing that more than 70 percent of the abused prescription medications are obtained from friends or relatives, this legislation requires DOH to institute a program for the safe disposal of unused controlled substances by consumers. Through the program, DOH will work with local police departments to establish secure disposal sites for controlled substances on the premises of police stations. At these sites individuals can voluntarily surrender unwanted and unused controlled substances.
Under present law, individuals can only safely dispose of controlled substances during an approved take back event or, various methods of self-disposal that are either burdensome or harmful to the environment. Moreover, current federal regulations prohibit patients from returning unused controlled substances to pharmacists and doctors. This program will help alleviate this problem by providing a continual safe disposal option to New Yorkers.

Friday, June 15, 2012

Ulster Prevention Council Blog 6/15/12: The Power of Parenting

 Ulster Prevention Council Blog: The Power of Parenting: Empowering Parents to Act

When a parent suspects that their child is using drugs and/or alcohol, intervening swiftly and appropriately is vital. Casual drug use can quickly turn into drug abuse or dependence and can lead to accidents, legal trouble and serious health issues.

The New York State Office of Alcoholism and Substance Abuse Services (OASAS) has several new resources available in their The Power of Parenting: Empowering Parents to Act series.

These brochures are suitable for prevention programs, health offices, school counselors, treatment programs, and human services agencies:

  • How to Know? I think my Child is using alcohol and/or drugs
  • What to Do? I know my Child is using alcohol and/or drugs
  • What Now? My Child is in Recovery

Digital copies of these brochures are available at
To obtain a supply of color copies of these publications, contact me at the Ulster Prevention Council; (845) 458-7406 or

Another great resource can be found online. The first link produced in a Google search of “I think my child is using drugs” is . This Partnership for a Drug Free America site has video clips and walks a parent step by step through a process of asking about substance use, looking for signs and symptoms, learning about risk factors, finding out why teens use, and exploring common drug and alcohol myths and misperceptions.

A third resource for parents is the Parents Toll-Free Helpline. Callers that feel overwhelmed, stressed or have a specific question about their child’s drug or alcohol use can speak to a Parent Specialist social worker or psychologist in English or Spanish, Monday to Friday, 10:00 am - 6:00 pm ET at 1-855-DRUGFREE (1-855-378-4373).

Friday, June 8, 2012

UPC Weekly Blog 6/8/12: Under 21

Although prom season has come to an end locally, with graduation parties and summer vacation still to come, I’d like to make parents and the community aware an important new resource. The information below is excerpted from a press release sent out by Governor Cuomo on May 23:
In May, Governor Cuomo announced that three state agencies launched an initiative to help curb impaired driving by underage youths and ensure that teenagers are aware of the extreme dangers of getting behind the wheel of a car while intoxicated.
The Governor's Traffic Safety Committee (GTSC) has teamed up with the state Office of Alcoholism and Substance Abuse Services (OASAS) and the New York State Police to promote the "It's Your Community, It's Your Call" hotline. The hotline encourages individuals to call 1-866-UNDER21 to report underage drinking, potentially helping stop young people from driving under the influence of alcohol. The hotline goes directly to State Police, who forward the call to the appropriate jurisdiction. The anonymity of callers is protected.
"All across New York State, our young people are celebrating the end of the school year, including attending proms and other celebrations with friends and family," Governor Cuomo said. "For our teenagers, who are just beginning their adult lives, never is it more important to make responsible decisions and follow the laws of the state which are designed to keep youth from tragic harm. This hotline will enable members of the community to keep an eye out and make sure that our young people are kept safe and avoid the devastating consequences that result from impaired driving."
Drivers under 21 represent about five percent of licensed drivers, but are involved in more than 12 percent of fatal crashes. In publicizing "It's Your Community, It's Your Call," the GTSC's traffic safety initiative has purchased radio and television spots as well as billboard ads to raise awareness and promote the hotline.
Department of Motor Vehicles Commissioner and GTSC Chair Barbara J. Fiala said, "The season for proms and graduations can be a joyous time for teenagers and their families. Unfortunately, the partying that often surrounds these events can turn joy into tragedy when teens impaired by alcohol decide it's OK to drive. Underage drinking is a major concern and utilizing the hotline can head off potentially tragic situations when teenagers drive while impaired."
OASAS Commissioner Arlene González-Sánchez said, "We know that half of all high school seniors in New York State have consumed alcohol. Prom and graduation season is a very exciting time of year for both students and parents. During this time of celebration, we must do everything possible to eliminate alcohol-related accidents among prom attendees and graduates with zero tolerance toward the consumption and possession of alcoholic beverages. You can help prevent a tragedy in your community by using the 1-866-UNDER21 hotline."
New York State Police Superintendent Joseph A. D'Amico said, "The New York State Police proudly join the Governor's Traffic Safety Committee and the Office of Alcoholism and Substance Abuse Services in the continued effort to discourage, detect, and apprehend underage users of alcohol. With the school prom and graduation season upon us, the 1-866-UNDER21 hotline will serve as a means for concerned parents, friends and citizens to report the purchase or use of alcohol by minors, or the operation of motor vehicles by underage impaired drivers. Our communities must work with law enforcement to keep our young citizens safe by preventing underage drinking and its needless resulting tragedies."

Friday, June 1, 2012

Ulster Prevention Council Blog 6/1/12: Eyeballing, Vodka Tampons, and Drinking Hand Sanitizer

Eyeballing vodka is a practice that has gained popularity with college and high school students in Europe and the U.S. It involves either pouring a shot of vodka directly on the eyeball or holding the bottle to the eyeball and upending it. Those who do it claim that vodka eyeballing induces drunkenness faster than drinking it can, because it passes easily through the mucous membrane and enters the bloodstream directly through veins at the back of the eye, although some experts are skeptical about the claims and believe that those who do it simply convince themselves that it's having such an effect. Vodka eyeballing can cause sore, weepy, bloodshot eyes and lead to permanent eye damage.

Vodka tampons may have originated in Germany.  Youth believe that it gives them a quicker, longer high, and that they can avoid detection as they will have no alcohol on their breath. Females insert the tampons in their vaginas, and males insert them in their rectums. A super tampon holds about a shot of vodka. The alcohol gets absorbed directly into the bloodstream fairly quickly, because of the vascular structure.  There is no gag reflex, so youth won’t throw up if they have alcohol poisoning, and if they lose consciousness health professionals won’t necessarily know what is wrong, delaying treatment. Using a beer bong rectally follows the same concept, and is referred to as “butt chugging”.

Drinking hand sanitizer is another troublesome practice, particularly as the product is readily available to underage youth. Hand sanitizer is 62-65% ethyl alcohol (120 proof). Drinking 2 ounces of it is equivalent to drinking 3 ounces of 80-proof tequila. The American Association of Poison Control Centers say that nationwide in 2011 they received 622 calls related to hand sanitizer exposure. Thus far in 2012, the number of calls is already over 200.

The trend has become mainstream enough for Jimmy Kimmel and John Kusack to drink Purell in celebration of Cinco de Mayo on Jimmy Kimmel Live. Later in the show Cusack asked Kimmel, "Do you feel the Purell kicking in?". "I feel cleaner inside," Kimmel said. Cusack agreed, adding, "It's lemony. It's fresh."

Youth are finding ways to separate the alcohol from the gel, making it more palatable. An internet search showed that simply using salt appears to be the most common method. Diluting the gel is also common. Others distilled it to isolate the disinfectant’s ethyl alcohol, leading to a shot that can be three times as alcoholic as vodka. Using less appealing foam sanitizer rather than gel serves to deter youth.

Granted, youth have used mouthwash, cough medicine and vanilla extract in the past in order to obtain alcohol. However, teens who are engaging in behaviors such as these to get an alcohol high should be evaluated for larger substance abuse problems.

Cheryl DePaolo
Director, Ulster Prevention Council
85 Grand St.
Kingston, NY 12401
Voice: 845-458-7406
Fax: 845-458-7407
Cell: 845-392-4714