UPC Weekly Blog 8/31/12:Abuse of ADHD Medications

Abuse of ADHD Medications

As school starts, many students will return to school on ADHD
medications. Attention Deficit Hyperactivity Disorder is not uncommon;
roughly 8% of children and teens aged 4 to 17 years have the
condition. Consequences of untreated symptoms can be substantial.  The
goal of all of ADHD therapies is to help patients focus more, and
therefore improve their symptoms. However, some students abuse these
drugs to concentrate, stay awake longer, finish their work faster, get
better grades, and to lose weight.

Drugs for ADHD fall into several categories. Many ADHD drugs act by
stimulating such chemical neurotransmitters in the brain as dopamine
and epinephrine. Some of the most familiar ADHD medicines, called
methylphenidates, fall into this category including Concerta, Ritalin,
Metadate, Daytrana and dexmethylphenidate (Focalin).

In 2008, Monitoring the Future (MTF) researchers determined that 2.9%
of 10th-graders and 3.4% of 12th-graders abused methylphenidate.1

Abuse is more commonly found in another stimulatory class of drugs:
amphetamine-based ADHD medications. These include dextroamphetamine
(Adderall, Dextrostat, Dexedrine) and lisdexamfetamine (Vyvanse).
Amphetamine abuse rates are at least double those of methylphenidates.
According to the MTF, 6.4% of 10th-graders and 6.8% of 12th-graders
used prescription amphetamines nonmedically in 2008. Amphetamines
ranked third among 12th-graders for past-year illicit drug use.

Although it may seem illogical, stimulatory drugs like Ritalin and
Adderall (or “vitamin R” and “Addy,”) deliver a calming and focusing
effect on people with ADHD. The opposite is true for those who take
them without a physiologic need.
Amphetamine abuse continues to escalate well into the college years as
a means students use to perform better in school (Adderall is
sometimes referred to as “college crack” or “the Adderall advantage”
for this reason). As many as 20 percent of college students have used
Ritalin or Adderall to study, write papers and take exams, according
to recent surveys.

 In an April 20 blog post on Stanford University’s “Wellsphere”
website, a self-described recent college graduate identified as Amanda
T. provided a personal account of the perceived benefits of ADHD
medications among often overwhelmed students.

“Medications such as Adderall make an all-nighter seem easy. In fact,
in a world where the work load exceeds the amount of hours in a day,
such medications are often viewed as a miracle drug to many college
students,” she wrote. “You can cram for two exams all day and then are
still able to stay up all night and write that 50 page research paper
that you put off until the very last minute.”

Teens and young adults who take these drugs for their stimulatory
properties are at risk for serious side effects, including dangerously
high BP, irregular heartbeat, difficulty breathing, seizures and
tremors, and mood disorders. At consistently high levels or with
repeated use, stimulant-based ADHD drugs can cause stroke and such
cognition changes as confusion, hallucinations, delusions, and
paranoia. These drugs can be addictive, which means that sudden
abstinence can also lead to the onset of withdrawal symptoms. The
NSDUH also reports that teens abusing stimulants are twice as likely
to engage in delinquent behavior than teens of the same age who do not
use these drugs nonmedically.2

Some drugs used to treat ADHD are not stimulant-based. Examples
include atomoxetine (Strattera) and certain antidepressants, such as
bupropion (Wellbutrin). There is less potential for abuse with these
drugs, and they can be good options for treating children and teens
with known substance-abuse issues.

Some of the major symptoms of stimulant substance abuse include:
•       Behavioral changes
•       Problems in school, failure to complete homework
•       Change in activities or friends
•       Heightened attention, long periods of sleeplessness or not eating
•       Unusual behaviors, including secrecy and isolation, unexplained spending
•       Legal problems

Physical consequences include:
•       Memory lapses, fatigue, and depression
•       Heart problems and seizures
•       Psychological difficulties including confusion and delusions
•       Unusual behaviors, including secrecy and isolation
•       Aggressiveness, irritability, mood swings
•       Hyperactivity, euphoria
•       Weight loss
•       Dilated pupils, dry mouth and nose

Family members may notice money and other personal or household items
missing. Since teens can often buy stimulants from younger children
with legitimate prescriptions, parents should be instructed to keep a
mental note of friends and relatives with access to these medications.
It is also important to speak directly to youth about the need to make
sure all medications for personal use are taken only as prescribed.
Parents should be the sole party responsible for dispensing ADHD
medication outside of the school.

References
1. Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE. Monitoring
the future national survey results on drug use, 1975-2006, volume 1,
secondary school students (NIH Publication No. 08–6418A). Bethesda,
Md.: National Institute on Drug Abuse, 2009: 450-453.
2. Substance Abuse and Mental Health Services Administration, Office
of Applied Studies. (February 28, 2008). The NSDUH Report—Nonmedical
Stimulant Use, Other Drug Use, Delinquent Behaviors, and Depression
among Adolescents. Rockville, Md.

UPC Weekly Blog 8-24-12: A Back to School Conversation You Need to Have

Ulster Prevention Council blog: A Back to School Conversation You Need to Have

An article from NIH News in Health:

As college students arrive on campus this fall, it's a time of new experiences, new friendships and making memories that will last a lifetime. Unfortunately for many, it can also be a time of excessive drinking and dealing with its aftermath - vandalism, violence, sexual aggression and even death. For those beginning their college experience, a rapid increase in heavy drinking over a relatively short period of time can cause serious problems with the transition to college. Alcohol abuse can also be a problem for high school students. Fall semester is a good time to sit down with your child to have a frank discussion about drinking.

We go through many changes in our teen years. Relationships change as our bodies and brains mature. Recent research has shown that the human brain continues to develop into a person's early 20's.
This period is also marked by taking risks. This can include risky drinking. And early drinking is associated with other risky behavior, such as academic failure, unsafe sexual behavior and drug use. Over the long-term, early drinking is associated with an increased risk of developing an alcohol use disorder at some time during the life span.
The consequences of excessive drinking by young people are more significant, more destructive and more costly than many parents realize. According to the College Drinking Task Force report to NIH's National Institute on Alcohol Abuse and Alcoholism (NIAAA), drinking by 18- to 24-year old college students contributes to an estimated 1,700 student deaths, 599,000 injuries and 97,000 cases of sexual assault or date rape each year.
Students form their expectations about alcohol from their environment and from each other. As they face the insecurity and stresses of establishing themselves in a new social setting, environmental and peer influences combine to create a culture of drinking. This culture actively-or at least passively -promotes drinking through tolerance, or even unspoken approval, of college drinking as a rite of passage.
The transition to college can be difficult, with about 1 of 3 first-year students failing to enroll for their second year. Anecdotal evidence suggests that the first 6 weeks of the first semester are critical to a first-year student's academic success. Many students begin drinking heavily during these early days of college, and this can interfere with their successful adaptation to campus life.
But parents can still play a major role in preventing alcohol problems. The time to start is before your child leaves for college. As the fall semester begins, prepare your college-age children by talking with them about the consequences of drinking. Stay involved during the crucial early weeks of college. Inquire about campus alcohol policies, and ask your children about their roommates and living arrangements.
High school students can also come under pressure to drink from their peers at school. It's important to talk to your high school students about peer pressure and how to resist it. They need to know that alcohol can harm their judgment, coordination and reflexes. It can cause them to lose control, take chances and do things they never would do otherwise. In fact, alcohol is linked with an estimated 5,000 deaths in people under age 21 each year-more than all illegal drugs combined.
When you sit down to talk with your child about the consequences of drinking, discuss the penalties for underage drinking as well as how alcohol use can lead to date rape, violence and academic failure. Underage drinking has also been linked with deaths and injuries from burns, falls, alcohol poisoning and suicide.
Discuss drinking and driving. Motor vehicle crashes are the leading cause of death in people aged 15 to 20. Deadly crashes involving alcohol are twice as common in teens compared with people 21 and older.

Now's the time to talk to your children about the dangers of alcohol. Help prevent them from doing something that they - and you - might regret for the rest of their life.

UPC weekly blog 8/17/12: Erowid

Erowid
Are you aware of Erowid? Do you know what the word Erowid means? If not, ask the nearest teen or young adult.  They will probably be familiar with erowid.org. When youth are looking for information about drugs of abuse, they often start at Erowid.
I’m going to let the site speak for itself, and allow you to draw your own conclusions regarding Erowid.

Erowid was founded in October 1995 by two people who call themselves Fire and Earth Erowid. As of January 2008, operation of the site was taken over by the newly formed non-profit Erowid Center. The site states that the word Erowid is a created word based on indo-european roots meaning approximately "Earth Wisdom".

Erowid.org states that it is “an online library of information about psychoactive plants, chemicals, and related topics”.

“Although the risks and problems of psychoactives are widely discussed, it's also clear that psychoactive plants and chemicals have played a positive role in many people's lives. Unfortunately, there is a serious lack of balance in the information provided by many resources. As our culture struggles with integrating the increasing variety and availability of these substances into its political and social structures, new educational models are clearly needed. Erowid is founded on the belief that a healthy relationship with psychoactives is one grounded in balance, where use is part of an active, intellectual, physical, and spiritual life. We believe that access to information is key to creating these healthier relationships with psychoactives.”

Erowid.org states that it contains more than 50,000 documents related to psychoactives including images, research summaries & abstracts, media articles, experience reports, information on chemistry, dosage, effects, law, health, drug testing, and traditional & spiritual use. It takes over 37 gigabytes of disk space. Each day, Erowid receives an average of 3.8 million file hits (445,000 page hits). We get an average of 55,000 unique visitors a day, viewing about 8 pages each. They estimate that more than 12 million unique people visited Erowid.org during the past year.

Erowid states that it “contains thousands of unique documents and images created and collected by thousands of authors, photographers, and artists. The information found on the site spans the spectrum from solid peer reviewed research to fanciful creative writing. We work hard to provide accurate information, but we also archive things like historical documents, experience reports, fiction, and satire which may be valuable despite not being "accurate".

”The value of any specific piece is unique to that article and there is no way to make blanket statements about the "accuracy" of the site as a whole. Is a piece of poetry "accurate"? Is a historical document which describes the state of knowledge about a substance in 1750 "inaccurate"? As with all resources, the accuracy of each article or page needs to be considered on its own merits.”

”There are nearly 3000 experience reports in our Experience Vaults, most submitted anonymously. These vary in quality from extremely reliable & well written to the poorly written and the possibly fabricated.”

”Some of the information has never been published anywhere else (such as dosage information about uncommon illicit recreational drugs) and is based primarily on the testemony(sic) of those who have used a substance.”

Erowid does not violate any federal or state law. Some people are concerned that simply providing controversial and diverse information about controlled substances (aka 'illegal drugs') could be a violation of the law. The issues are more complicated that a simple yes-no answer can provide, but generally there are two major components: first, 'illegal drugs' are not 'illegal' in all cases, and second, it is legal to talk about them as long as one is not otherwise committing, facilitating or encouraging the commission of a specific criminal act.

” The main thing that we strive to avoid and try to train all our volunteers to avoid is providing specific advice to individuals that could be used in the commission of a crime.”

UPC Weekly Blog 8/13/12:Mobile App Helps Teens Quit Smoking

Mobile App Helps Teens Quit Smoking

My teens are attached to their cell phones at the thumbs!
A new effort to help teens quit smoking will use one of their most constant companions: the mobile phone. SmokefreeTXT is a free text message service from NIH that provides 24/7 encouragement, advice and tips for teens trying to quit smoking.
Smoking is the leading preventable cause of death in the United States. Its health consequences build up over time and include many different types of cancer, heart disease and respiratory diseases.
Nearly 20% of teens are current smokers. “Unless we make efforts to intervene today, they will most likely continue smoking into adulthood,” says Dr. Yvonne Hunt, a program director in tobacco control research at NIH.
Many teens want to quit. Go online to teen.smokefree.gov. To enroll on the go using a mobile phone, text QUIT to iQUIT (47848).

UPC Weekly Blog 8/3/12:Stimulant and Performance Drug Abuse

Stimulant and Performance Drug Abuse 


"Facts on Stimulants" is part of a series of fact sheets from the National Institute on Drug Abuse (NIDA) that are designed to inform students, parents, educators, and mentors about the harmful effects of prescription drug abuse.
As their name suggests, prescription stimulants increase—or "stimulate"—activities and processes in the body. This increased activity can boost alertness, attention, and energy. It also can raise a person's blood pressure and heart rate. In the past, stimulants were used to treat a variety of conditions, including asthma and other respiratory problems, obesity, and neurological disorders. As their potential for abuse and addiction became apparent, doctors began to prescribe them less often. Now, stimulants are prescribed for treating only a few health conditions, including attention deficit hyperactivity disorder (ADHD), narcolepsy (a sleep disorder), and, in some instances, depression that has not responded to other treatments.

Stimulants include Dextroamphetamine (Dexedrine and Adderall) and Methylphenidate (Ritalin and Concerta). Street names for these drugs are Skippy, the smart drug, vitamin r, bennies, black beauties, roses, hearts, speed, or uppers.

Prescription stimulants are normally taken in pill form, but some people who abuse them crush the tablets and snort or inject them, which can cause complications because insoluble fillers in the tablets can block small blood vessels. Stimulants have been abused for both "performance enhancement" (e.g., to stay up all night cramming for an exam) and to get high.
The brain is made up of nerve cells that send messages to each other by releasing chemicals called neurotransmitters. Common stimulants, such as amphetamines and methylphenidate, have chemical structures that are similar to certain key brain neurotransmitters called monoamines, including dopamine and norepinephrine. Stimulants enhance the effects of these chemicals in the brain and body.
When doctors prescribe stimulants, they start with low doses and increase them gradually until they fully treat the condition for which they are prescribed. However, when taken in doses and routes other than those prescribed, stimulants can increase the dopamine in the brain very quickly, disrupting normal communication between brain cells, producing euphoria, and increasing the risk of addiction. Addiction is when a person compulsively seeks out the drug and abuses it despite knowing about the harmful consequences.
Stimulant abuse can be extremely dangerous. Taking high doses of a stimulant can cause an irregular heartbeat, dangerously high body temperatures, and the potential for heart failure or seizures. For some people, taking high doses of certain stimulants, or repeatedly abusing them, can lead to feelings of hostility or paranoia.
Stimulants should not be mixed with antidepressants (because they may enhance the effects of a stimulant) or over-the-counter cold medicines that contain decongestants. This mixture can lead to dangerously high blood pressure or irregular heart rhythms.
People show varying degrees of withdrawal symptoms after chronic stimulant abuse. Those who do have symptoms report an inability to experience pleasure (anhedonia) and sometimes suicidal thinking; anxiety and irritability; fatigue, lack of energy, and changes in sleep patterns; and intense drug cravings. Supportive therapies and treatment of mood symptoms may help lessen these effects.
Treatment for stimulant addiction is based on behavioral therapies proven effective for treating cocaine or methamphetamine addiction. These include contingency management, a form of therapy that allows patients to earn rewards that promote healthy living if patients attend treatment and stay off drugs; and cognitive behavioral therapy, which teaches patients to recognize risky situations, avoid drug use, and cope more effectively with problems. Recovery support groups may also be effective when combined with a behavioral therapy.

UPC Weekly Blog 8/1/12:Maker of Oxycontin Hopes to Extend Exclusive Rights to the Drug

Maker of Oxycontin Hopes to Extend Exclusive Rights to the Drug

An article from Join Together:

The manufacturer of the painkiller OxyContin is trying to extend its exclusive rights to the drug, which is set to go off patent in 2013, The Wall Street Journal reports. Purdue Pharma LP says a reformulated version of the drug may substantially decrease abuse of the opioid.
The company spent $100 million to develop the new version of OxyContin. The courts will decide whether the company can protect its reformulation, the article notes. Purdue Pharma has 16 patent infringement lawsuits pending against 10 makers of generic drugs.
According to the company, the new version of OxyContin, introduced in 2010, is more difficult to abuse than the original pill. The patent on the old drug is scheduled to expire next year, while the patent on the new formulation extends to 2025.
Generic drug manufacturers say they are able to make their own formulations of the drug that are difficult to abuse. The Food and Drug Administration (FDA) is reviewing what safeguards or reformulations generic OxyContin should have. The FDA is expected to announce its ruling by the end of this year. Little research has been done to determine whether reformulated painkillers are more difficult to abuse, the article notes.
The new OxyContin tablets have been hardened to make it more difficult for them to be broken, chewed or crushed. When they are exposed to moisture or dissolved in water, they turn into a thick gel, which makes the drug difficult to snort or inject.
The company points to a 22 percent decline in the street price of the drug from 2010 to 2011, as evidence the new formulation is cutting down on abuse. The number of visits to poison control centers and admissions to addiction treatment programs due to OxyContin have also declined since the drug was reformulated, they said.


Cheryl DePaolo

Director of The Ulster Prevention Council