Monthly Archives: January 2008

New NSDUH Report: Nicotine Dependence: 2006

In the United States, tobacco is used more widely than illicit drugs, and it is implicated in more deaths each year than alcohol and illicit drugs combined. In 2006, 72.9 million Americans aged 12 or older (29.6 percent of the population) were current (i.e., past-month) users of tobacco, and 84.5 percent of these users smoked cigarettes. Nicotine dependence, which is measured for cigarette users, has been found to be associated with increased risk of alcohol and illicit drug use and of mental disorders.

Date Added: 01/25/08
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Fda puts coke/meth treatment on fast track

Sabril may block cravings for stimulantsThe U.S. Food and Drug Administration (FDA) has given Fast Track designation to vigabatrin, an anticonvulsant marketed as Sabril, for evaluation as an anti-craving drug for cocaine and methamphetamine addiction. If approved, it would be the first medication ever approved for the treatment of addiction to stimulants.The Fast Track designation at the FDA is intended to speed up the evaluation of drug treatments aimed at life-threatening disorders for which no current treatments exist. A 2006 study by the Substance Abuse and Mental Health Services Administration estimated that there were more than one million cocaine and methamphetamine addicts in the U.S.First synthesized as a drug treatment for epilepsy in 1974, Sabril increases brain levels of the neurotransmitter GABA, an inhibitory compound also implicated in alcoholism. According to a press release from Ovation Pharmaceuticals, a marketer of the drug, “Sabril may block the euphoria associated with cocaine administration in humans and may suppress craving by increasing brain levels of gamma-aminobutyric acid (GABA).” Catalyst Pharmaceutical Partners has also announced plans to proceed with Sabril testing.Ovation is collaborating with the NIDA on Phase II studies to evaluate the safety of Sabril, with Phase III trials scheduled for the end of this year. FDA has never approved the drug for use in the U.S., citing concerns over retinal damage in patients overseas.Earlier animal testing and two limited early-stage studies on human addicts in 2003-2004 have convinced the company that Sabril diminishes cravings for stimulants. It may also blunt the euphoric effect of meth and cocaine. “This is unheard of in addiction treatment,” Stephen Dewey of the Brookhaven National Laboratory, a member of an earlier vigabatrin study team, told New Scientist in 2003. “There are no medicines that are effective at blocking cocaine craving in addicts.”Writing in the November 2004 issue of Synapse, Jonathan D. Brodie and colleagues at the New York University School of Medicine reported that “A rapid elevation in nucleus accumbens dopamine characterizes the neurochemical response to cocaine, methamphetamine, and other drugs of abuse. CITE Previously, we demonstrated that this response and associated behaviors are attenuated or even blocked by Vigabatrin, an antiepileptic drug and an irreversible inhibitor of GABA-transaminase.”However, the New Scientist also reported that many doctors who work with cocaine addicts were skeptical. “Cocaine is a recreational drug. The vast majority of people who take cocaine or crack want to continue doing so,” said Allan Parry, a drug counselor in Liverpool, UK. “So in that sense this work is only likely to be relevant to a tiny minority of people. People often give up cocaine because their lifestyle changes or they just grow up.”Ovation said it was “pleased that the FDA has recognized the significant need for effective treatment options to address stimulant addiction, which is a major public health problem.”Since there are no FDA-approved medications for cocaine or methamphetamine addiction, current treatment strategy centers on cognitive and behavioral approaches. (Source: Addiction Inbox) Continue reading

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New DASIS Report: Geographic Differences in Substance Abuse Treatment Admissions for Methamphetamine/Amphetamine and Marijuana: 2005

Admissions to substance abuse treatment by State can be monitored with the Treatment Episode Data Set (TEDS), an annual compilation of data on the demographic characteristics and substance abuse problems of those admitted to substance abuse treatment, primarily at facilities that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once during a single year.

Date Added: 01/22/08
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CSAT Grant: Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) is accepting applications for fiscal year (FY) 2008 for the Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services grants.

Date Added: 01/18/08
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Cocaine is cocaine: new sentencing guidelines

U.S. Supreme Court relaxes jail time for crack crimes In a little-noted ruling last month, the U.S. Supreme Court bowed to reality and restored a measure of sanity to cocaine sentencing guidelines. The Court ruled, on a 7-2 vote in the case of Kimbrough v. U.S., that federal judges had the discretion to reduce prison terms for crack-cocaine offenses.The move was an effort by the Supreme Court to bring crack cocaine sentences more in line with sentencing guidelines for powdered cocaine. Many drug experts expressed relief, noting that the changes were long overdue. “There’s no scientific justification to support the current laws,” said National Institute of Drug Abuse (NIDA) director Dr. Nora Volkow.Writing for the majority, Judge Ruth Bader Ginsburg noted that the two substances in question “have the same physiological and psychotropic effects.” A number of federal judges have long advocated the change, the importance of which was demonstrated when the U.S. Sentencing Commission announced that as many as 20,000 federal inmates serving time for crack possession may be due for sentence reductions, based on the new ruling.A 1986 law, the Anti-Drug Abuse Act, reset mandatory minimum sentences for cocaine, allowing for as much as a 100-to-1 disparity between prison time for crack and prison time for powdered cocaine. As an article in the International Herald Tribune noted, the law allowed a prison term of “five years for trafficking in 5 grams of crack, or less than the amount in two packets of sugar. It would take 100 times as much cocaine [in powder form] to get the same sentence.”Several bills with a similar aim have been introduced in Congress, including legislation jointly sponsored by Senators Edward Kennedy and Orrin Hatch, which would revise the crack-powder sentencing ratio to 20-1.This Alice-in-Wonderland situation was triggered by the cocaine-related death of college basketball star Len Bias in 1986. The widely publicized death set off a cocaine panic in America that quickly reached the White House and Congress. In addition, doctors and the press were busy wildly overestimating the number of handicapped “crack babies” being born. Craig Reinarman, author of the book, “Crack in America,” told the Associated Press: “You had politicians manipulating fear, and instead of being seen as a more direct mode of ingestion of a very old drug, [crack] became a demonic new substance.”Moreover, civil rights advocates have long claimed that the sentencing structure is racist: Blacks prefer crack and Whites prefer powder, if arrest records are any indication. (Crack is produced by dissolving powdered cocaine and baking soda in water, then boiling away the water.)According to Graham Boyd of the American Civil Liberties Union (ACLU) drug law reform project, “This may be the first sentencing decision since the mid-1980s that actually talks about justice, that seems to have some blood in it.”“There is a sense of a turning point,” Jack B. Weinstein, a federal district court judge in New York, told Newsweek. “The cost [of the current drug war] is tremendous, to the community and to taxpayers.”Justices Clarence Thomas and Samuel Alito dissented in the case. (Source: Addiction Inbox) Continue reading

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CMHS Grant: Older Adults Targeted Capacity Expansion (TCE) Grant Program

Happy New Year from SAMHSA News! Our top stories for 2007 include preventing suicide on college campuses, Social Security benefits for homeless individuals, and rural substance abuse issues. Other topics include treatment for older adults and HIV/AIDS outreach. To find a topic of interest to you, view the 2007 Annual Index.

Date Added: 01/17/08
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SAMHSA News Year in Review

Happy New Year from SAMHSA News! Our top stories for 2007 include preventing suicide on college campuses, Social Security benefits for homeless individuals, and rural substance abuse issues. Other topics include treatment for older adults and HIV/AIDS outreach. To find a topic of interest to you, view the 2007 Annual Index.

Date Added: 01/15/08
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Vote of no confidence for prometa

Addiction drug loses major fundingIt is composed of three common and inexpensive drugs used for other purposes. It has never been subjected to clinical double blind testing. It costs thousands of dollars for the full treatment package, and the company that markets it says it cures about 80 percent of the drug addicts who use it.If that description sounds familiar—if it seems to give off a faint whiff of blue-green algae and multi-level marketing—such concerns have not stunted the promotion and acceptance of the anti-addiction drug Prometa. But MSNBC reported last week that Prometa, the drug “cocktail” designed to combat addiction to cocaine and methamphetamine, was dealt a severe blow when accountants in Pierce County, Washington froze the funding for an $800,000 pilot program, citing irregularities in testing.The treatment involves intravenous infusions of Flumazinil, a reversal agent for benzodiazepines like Valium and Klonopin. The second drug, hydroxyzine, is an antihistamine, and the third, sold as Neurontin, as an anti-seizure medication frequently used “off prescription” as a treatment for a number of ailments, including alcoholism and hearing loss.The treatment does not require approval by the Food and Drug Administration (FDA) because all three ingredients are already in common use in clinics and hospitals. The Prometa Regimen marketed by Hythium involves formulating the protocol and contracting with doctors to deliver the medications.To date, there is no published clinical data to support treatment for addiction with these three drugs in proprietary combination.Marketed heavily by anecdote and personal testimonials, the Prometa marketing campaign included ads in 2006 featuring the late comedian Chris Farley, who died of a drug overdose.Hythiam, the company that markets Prometa, has touted the treatment with claims of success rates as high as 98 per cent, but Pierce County Councilman Shawn Bunney found the results of the county audit “alarming,” according to MSNBC. “It’s clear to me that we are much more involved in a marketing scheme…”Hythiam Executive Vice President Richard Anderson disagreed. “The people who are using it,” he said, “the doctors, patients, administrators, and drug court judges—are seeing an impact with it, so I think the treatment will carry it at the end of the day.”The dispute centers on the manner in which dropouts were counted in surveys done by Hythiam’s non-profit arm, the Pierce County Alliance. The Alliance had been responsible for administering the Prometa program in Pierce County drug courts. According to county auditors, dropouts and no-shows (patients who fail to show up for drug testing) were not included in the Alliance’s final report on 35 patients over a 14-month period. In Pierce and neighboring counties of Washington, drug courts record no-shows as equivalent to positive drug tests. This was not how the alliance scored it, although alliance spokespeople have insisted that county officials have misunderstood the mechanics of the study.An investigation by the Tacoma News Tribune threw more cold water on the Prometa numbers. “According to the multiple public statements by the alliance,” wrote Sean Robinson, 86 percent of the Prometa clients ‘remained drug-free’ at the end of the 14-month program. According to county auditors, the number was 50 percent.”Furthermore, the alliance “defined success in the Prometa program as 60 or more days of clean drug tests…. In Pierce County, drug-court clients must show 90 days of clean drug tests… In Snohomish and Thurston counties, drug-court clients must show six months.”Investors in Hythiam, which is publicly traded, were counting on the Pierce program after similar programs in Fulton County, Georgia, and in Idaho failed to get off the ground. Things only got worse when the Tacoma News Tribune revealed that several county officials who had gotten behind the program also owned Hythiam stock.Small rural communities that have felt the impact of meth sales and production in their communities are looking for help, and represent a significant market for an anti-addiction medication. However, in the case of Prometa, “The marketing is way ahead of the science,” claimed Lori Karan of the Drug Dependence Research Laboratory at the University of California-San Francisco. (Cite Join Together)Double-blind studies of Prometa are underway at the University of California-Los Angeles and at the University of South Carolina. (Source: Addiction Inbox) Continue reading

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