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Tag: substance abuse

  • Blinken under pressure to push China on role in lethal fentanyl trade when he visits Beijing | CNN Politics

    Blinken under pressure to push China on role in lethal fentanyl trade when he visits Beijing | CNN Politics



    CNN
     — 

    Members of Congress are urging Secretary of State Antony Blinken to pressure China to do more to curb the flow of fentanyl and synthetic opioids into the United States on his visit to the country which is expected to take place in the next few days.

    On Wednesday, a group of 14 Republican senators led by Marco Rubio of Florida wrote to Blinken ahead of his trip highlighting China’s role in the “fentanyl crisis” as one of many issues they wanted him to address.

    More than 100,000 Americans died of drug overdoses from July of 2021 to July of 2022 and two thirds of those deaths were fueled by synthetic opioids, primarily fentanyl, according to the CDC.

    An extremely powerful synthetic drug, fentanyl is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin.

    The Chinese government cracked down on the manufacture and distribution of fentanyl in 2019, in a move that was hailed by the Trump administration. As a result, China it is no longer the primary source of fentanyl getting into the US. But it’s still the key source of precursor chemicals which are often shipped to Mexico and used by cartels to produce fentanyl which is brought over the border.

    “China is the leading producer of these precursor chemicals and is shipping and selling them to the two major Mexican cartels (Sinaloa and New Generation) producing fentanyl,” explained David Luckey, a senior international and defense researcher at RAND Corporation.

    “Virtually 98% of the precursor chemicals that are made used to make fentanyl are coming from China,” Democratic Rep. David Trone of Maryland told CNN. Getting China to engage on this crisis “has got to be Secretary Blinken’s number one mission when he gets there.”

    Experts and lawmakers say the production of precursor chemicals in China is a primary factor fueling the ongoing opioid crisis.

    “Synthetic opioid trafficking is an area where even a few meaningful steps from the PRC (People’s Republic of China) can play a significant role in combating this worsening epidemic and saving American lives,” Trone wrote in a letter to Blinken last month. He urged Blinken not to negotiate with Chinese officials on other topics until he has secured a commitment from Beijing to do more to stem the fentanyl crisis.

    Trone, whose nephew died of a fentanyl overdose, believes China should commit to adopting rules requiring drug companies to know who their customers are, put into place and enforce export regulations on the chemical sector, and cooperate with US agencies including the Drug Enforcement Administration and Office of National Drug Control Policy to crack down on the fentanyl trade.

    Blinken has directed his team at the State Department to work with interagency partners to do “everything possible” to address this deadly crisis which is the leading killer of Americans between the ages of 18 to 49, State Department spokesperson Ned Price said earlier this year.

    But it’s unclear what direct asks he will make of the Chinese government during his visit.

    “Though its past action has helped to counter illicit synthetic drugs, we continue to urge the PRC to take additional meaningful concrete action to curb the diversion of precursor chemicals and equipment used by criminals to manufacture fentanyl and other synthetic drugs,” Price said.

    Some lawmakers believe that Blinken should offer trade talks with China if it engages on efforts related to stemming the fentanyl crisis. Yet other congressional aides say that China will only respond to pressure and believe that the administration should consider steps including additional sanctions related to the dangerous substances – to force their engagement.

    Todd Robinson, the top State Department official for international narcotics and law enforcement affairs, said that the effective way to approach the challenge will be through “collaboration and cooperation.”

    “China has its own problems with narcotics. Mexico has problems has its problems with narcotics. Colombia also has a problem. And what we’ve been saying is, this is no longer an issue where you can solely use one or the other. Everybody’s got a problem.”

    But the need for Chinese engagement is clear: reducing the supply of precursor chemicals from China would have a “huge” impact on the crisis and would “mean a dramatic decrease” in US deaths resulting from drug overdoses, Robinson said.

    China is the largest producer of chemicals that are in everyday products such as cleaning supplies. Many Chinese companies have begun producing and selling the precursor chemicals in addition to the chemicals they have already been producing.

    Challenges to tackling the root of the problem persist when China and other countries often turn the tables on the US and blame Americans for the addiction problem which drives the demand.

    “It’s not as simple as saying, ‘China, stop producing and exporting these chemicals’. There are several sides to this issue. In response, China, for example, could counter with, ‘Americans, stop buying and using drugs,’” said Luckey.

    Many Americans with a direct connection to the crisis are watching Blinken’s trip closely.

    West Virginia – which had more than 1,300 deaths due to synthetic opioids from March of 2021 to March of 2022, according to the CDC – is an epicenter of the domestic crisis.

    Jordan Dennison lives in the state, grew up with parents who were drug addicts, and developed his own opioid addiction in his teens. A few years ago – after more than 10 overdoses – he finally got clean. The 30-year-old now works at an outreach program to get addicts into treatment.

    “Drugs led me to lose everything. Every relationship I ever had. I came to learn that what I was using was not heroine it was fentanyl. I was getting it off the street, I would go anywhere to get it,” he told CNN. “I never knew where it came from, but I always assumed it was coming from China.”

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  • Overdose deaths involving buprenorphine did not proportionally increase with new flexibilities in prescribing

    Overdose deaths involving buprenorphine did not proportionally increase with new flexibilities in prescribing

    Newswise — The proportion of opioid overdose deaths involving buprenorphine, a medication used to treat opioid use disorder, did not increase in the months after prescribing flexibilities were put in place during the COVID-19 pandemic, according to a new study. These data provide evidence that may help to inform buprenorphine prescribing policies. Published today in JAMA Network Open, this study was a collaborative effort between researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the Centers for Disease Control and Prevention (CDC).

    These data are consistent with a recent study reporting that COVID-era expansion of methadone access for the treatment of opioid use disorder was not associated with an increase in methadone-involved overdose deaths.

    In 2021, nearly 107,000 people died of a drug overdose, with 75% of those deaths involving an opioid. The overall rise in overdose deaths is largely attributable to the proliferation in the drug supply of illicit fentanyl, a highly potent synthetic opioid. Though the benefits of providing medication for opioid use disorder are well-known, only 22% of people with opioid use disorder receive medications. Buprenorphine, one of these medications, helps reduce opioid misuse, decrease risk for injection-related infectious diseases, and decrease risk for fatal and non-fatal overdoses.

    “Research has shown beyond a doubt that medications for opioid use disorder are overwhelmingly beneficial and can be lifesaving, yet they continue to be vastly underused,” said NIDA Director and senior author, Nora Volkow, M.D. “Expanding more equitable access to these medications for people with substance use disorders is a critical part of our nation’s response to the overdose crisis. The findings from this study strengthen existing evidence suggesting that greater flexibility in prescribing may be one safe method for working toward this goal.”

    While the recently signed Fiscal Year 2023 omnibus appropriations bill amended the Controlled Substances Act to eliminate the requirement that clinicians obtain a specific waiver to prescribe buprenorphine to treat opioid use disorder, buprenorphine remains a Schedule III controlled substance with restrictions on prescribing. During the onset of the COVID-19 pandemic, the United States government implemented prescribing flexibilities to facilitate buprenorphine access for patients with opioid use disorder. These updated policies allowed clinicians to remotely prescribe buprenorphine to new patients without conducting in-person examinations, expanded payment for telehealth services, and provided flexibility on accepted communication technologies to deliver clinical care for people with substance use disorders via telehealth. 

    To investigate the impact of these policy changes, researchers used data from the CDC’s State Unintentional Drug Overdose Reporting System (SUDORS) to assess overdose deaths from July 2019 to June 2021 in 46 states and the District of Columbia. SUDORS combines data from death certificates, medical examiner and coroner reports, and postmortem toxicology testing.

    Researchers found that buprenorphine was involved in a very small proportion of drug overdose deaths between July 2019 and June 2021. During this study period, there were 1,955 buprenorphine-involved overdose deaths, which represented 2.2% of the 89,111 total overdose deaths and 2.6% of the 74,474 opioid-involved overdose deaths recorded in the SUDORS dataset. Between April 2020 and June 2021, when buprenorphine prescribing regulations were relaxed in response to the COVID-19 pandemic, the researchers found that while monthly opioid-involved overdose deaths increased overall, the proportion of those deaths involving buprenorphine did not increase.

    Additionally, the study found that 92.7% of buprenorphine-involved overdose deaths also involved at least one other drug, compared to 67.2% of deaths involving an opioid other than buprenorphine. Specifically, compared with other opioid-involved overdose deaths, buprenorphine-involved overdose deaths were more likely to also involve prescription medications such as benzodiazepines (36.9% vs. 14.5%), antidepressants (13.9% vs. 5.0%), and anticonvulsants (18.6% vs. 5.4%). Buprenorphine-involved overdose deaths were less likely to also involve illicitly manufactured fentanyls (50.2%) compared to other opioid-involved overdose deaths (85.3%).

    “These findings help us better understand the circumstances of overdose deaths involving buprenorphine, which is crucial in our ability to inform policy, ensure safety, and improve clinical outcomes for people with substance use disorders,” said Lauren Tanz, Sc.D., an epidemiologist at CDC’s National Center for Injury Prevention and Control and lead author on the study. “It is important to note the presence of other drugs in overdose deaths involving buprenorphine. The complex nature of substance use disorders and polysubstance use requires specific strategies to address it.”

    Data also showed that non-Hispanic white people represented a higher proportion of the deaths involving buprenorphine (86.1%), compared to deaths related to other opioids (69.4%). In contrast, buprenorphine-involved overdose deaths included fewer Black, non-Hispanic people (5.7%), and Hispanic people (5.5%) compared with other opioid-involved overdose deaths (18.8% and 9.4%, respectively), which the authors note might be related to inequitable access to treatment.

    Regardless of the drugs involved, the investigators found that most people who died of an overdose involving any opioid, including buprenorphine, had no evidence of current treatment for substance use disorders. In addition, most deaths occurred without another person being present, a known risk factor for fatal overdose.

    For more information on substance and mental health treatment programs in your area, call the free and confidential National Helpline 1-800-662-HELP (4357) or visit www.FindTreatment.gov. 

    Reference: LJ Tanz, et al. Trends and Characteristics of Buprenorphine-Involved Overdose Deaths Prior to and During the COVID-19 Pandemic. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2022.51856 (2023).

    ###

    About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov.

    About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

    About substance use disorders: Substance use disorders are chronic, treatable conditions from which people can recover. In 2020, over 40 million people in the United States had at least one substance use disorder. Substance use disorders are defined in part by continued use of substances despite negative consequences. They are also relapsing conditions, in which periods of abstinence (not using substances) can be followed by a return to use. Stigma can make individuals with substance use disorders less likely to seek treatment. Using preferred language can help accurately report on substance use and addiction. View NIDA’s online guide.

    NIH…Turning Discovery Into Health®

    NIH National Institute on Drug Abuse (NIDA)

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  • Justice Department sues pharmaceutical company for allegedly failing to report suspicious opioid sales | CNN Politics

    Justice Department sues pharmaceutical company for allegedly failing to report suspicious opioid sales | CNN Politics


    Washington
    CNN
     — 

    The Justice Department on Thursday alleged that the AmerisourceBergen Corporation, one of the country’s largest pharmaceutical distributors, and two of its subsidiaries failed to report hundreds of thousands of suspicious prescription opioid orders to pharmacies across the country.

    The lawsuit, which spans several states, alleges that AmerisourceBergen disregarded its legal obligation to report orders of controlled substances to the Drug Enforcement Agency for nearly a decade. The company ignored “red flags” that pharmacies in West Virginia, New Jersey, Colorado and Florida were diverting opioids into illegal drug markets, the suit says.

    “The Department of Justice is committed to holding accountable those who fueled the opioid crisis by flouting the law,” Associate Attorney General Vanita Gupta said in a statement Thursday.

    “Companies distributing opioids are required to report suspicious orders to federal law enforcement. Our complaint alleges that AmerisourceBergen – which sold billions of units of prescription opioids over the past decade – repeatedly failed to comply with that requirement,” she added.

    If AmerisourceBergen is found liable at trial, the company faces billions of dollars in financial penalties, the Justice Department said.

    Lauren Esposito, a spokesperson for AmerisourceBergen, countered on Thursday in a statement that said the Justice Department’s complaint rested on “five pharmacies that were cherry picked out of the tens of thousands of pharmacies that use AmerisourceBergen as their wholesale distributor, while ignoring the absence of action from former administrators at the Drug Enforcement Administration – the DOJ’s own agency.”

    She added: “With the vast quantity of information that AmerisourceBergen shared directly with the DEA with regards to these five pharmacies, the DEA still did not feel the need to take swift action itself – in fact, AmerisourceBergen terminated relationships with four of them before DEA ever took any enforcement action while two of the five pharmacies maintain their DEA controlled substance registration to this day.”

    Yet AmerisourceBergen was allegedly aware that in two of the pharmacies, drugs it distributed were likely being sold in parking lots for cash, the Justice Department said. In another pharmacy, the company was allegedly warned that patients likely suffering from addiction were receiving opioids, including some people who later died of a drug overdose.

    The Justice Department also noted in its lawsuit that AmerisourceBergen’s reporting systems for suspicious opioid orders were deeply inadequate, and that the company intentionally changed its reporting systems to reduce the number of orders flagged as suspicious amid the opioid epidemic.

    Even when orders were flagged as suspicious, AmerisourceBergen often didn’t report those orders to the DEA, according to the complaint.

    Opioids are involved in the vast majority of drug overdose deaths, though synthetic opioids – particularly fentanyl – have played an outsized role. Synthetic opioids – excluding methadone – were involved in more than 72,000 overdose deaths in 2021, about two-thirds of all overdose deaths that year and more than triple the number from five years earlier.

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  • Navigating the Holidays When Your Adult Child Has Substance Issues

    Navigating the Holidays When Your Adult Child Has Substance Issues

    Editor’s note: The names of the parent and the son were changed at their request to protect their identity and privacy.

    Dec. 28, 2022 — Lawrence McCarthy, a Texas-based doctor, is looking forward to seeing his 26-year-old son, Sam, during the holidays. Sam, who’s been living in another state and hasn’t been home for many months, has an alcohol use disorder and has also been a frequent user of marijuana. 

    McCarthy, who asked that his real name not be used for this article, says that he looks forward to seeing his son, but he has a bottom line. 

    “I’d prefer for him to be working his own recovery program and not using. I haven’t seen him for a long time, and I don’t know if he’s still committed to his recovery. But even if he’s using, I’m still willing to see him — as long as he doesn’t use at my house and he’s sober when he’s here.”

    McCarthy arrived at this approach after extensive work in a parent recovery group, which not only gave him support but also helped him develop and adhere to boundaries. 

    “I don’t know how I would have navigated this situation without the group,” he says. 

    Unfortunately, many parents are navigating this difficult situation alone. A new online platform, Recovery Education and Applied Learning (REAL), has been launched to address the needs of these parents. 

    “We’re a comprehensive, evidence-based online educational platform that includes a course and resources as well as access to a community where other parents of youngsters with substance abuse issues are asking the same questions,” says REAL’s Chief Medical Officer Eric Collins, MD. 

    New Resource

    Collins joined REAL because he knew parents needed “access to more information, support, and community as they help their adolescent and young adult child work toward recovery.”

    Laurie Dhue, the chief brand officer of REAL, has been in recovery, sober from alcohol and drugs, for 16 years. Prior to her work in the recovery field, Dhue was an award-winning national news anchor who hosted shows on three major cable news networks.

    Dhue was still a national news anchor when it became known that she had a substance use problem. 

    “The world found out that I had an issue with alcohol and drugs and my anonymity was broken publicly,” she reports. “I thought my life was over and at first; I felt stigma and shame. But telling my story publicly was what eventually led me to leaving the news business and getting into the recovery community full-time and led me to join REAL.”

     Dhue, who is almost 54, says her substance use started in college. 

    “I drank alcoholically and abused cocaine until age 37,” she says. “My drinking and drugging got worse after I left college and I drank all the time, not only during the holidays.”

    In those days, “there were few resources and no internet. Parents weren’t as aware back then as they are now. But even now, parents are often in the dark and feel isolated and stigmatized. I’m sure this resource could have been very helpful to my parents if such a thing had existed.”

    You Are Not Alone

    The REAL platform consists of four components:

    • An 18-module course that provides education about aspects of parenting, addiction, and navigating the issues that arise
    • A library of resources that is continually updated and used in the coursework
    • A calendar of events – live weekly workshops in which parents can talk to experts, who provide answers to their questions
    • Community, which enables participants to connect with others in similar situations.

    Dhue entered a 12-step sober community, Alcoholics Anonymous. 

    “It saved my life. Parents will find comfort on our platform, realizing they’re not the only ones going through this, and find connection and community,” she says. 

    The approaches presented on their platform are “consistent and appropriate, and anyone in the 12-step world would appreciate and recognize them,” Collins says. But the platform also uses other approaches that appeal to people who don’t necessary resonate with the 12-step approach, including evidence-based psychotherapies such as cognitive-behavioral therapy (CBT).

    The comprehensive platform also offers information about medications to reduce risk of overdose and to reverse overdoses. 

    Pre-Holiday Conversations

    “The holidays are a festive time. For people with substance use disorders, holidays can be an excuse to drink and use drugs,” Collins says. Kids coming home from college may continue their heavy alcohol or drug use, while those returning from rehab centers may meet up with former “drinking buddies.”

    “Communicate your values and engage in problem solving before the holidays start, since one ounce of prevention is worth a pound of cure,” he advises parents. Initiating these conversations can be challenging, but “children want those conversations, even if they act like they don’t want them.” 

    The REAL course encourages parents “to rehearse the conversations with their partners before planning to have a conversation with their kids. You get better at doing things the more times you practice.” It’s a “complex process,” he warns, and kids “might get angry.” But practicing the conversations allows you to deal with their anger as well.

    Setting Boundaries

    McCarthy says that effective conversations come best from parents with clear boundaries. 

    “Do I want to see my son? If so, do I have healthy boundaries to protect me? Am I working a program of recovery to heal my own issues and work with any difficulties that may arise before and during his visit? Do I have a power outside myself to reach out to, and am I part of a group of other parents in similar situations who are finding mental, emotional, and spiritual healing through a 12-step program like Al-Anon?”

    If the answer to these questions is “yes,” that doesn’t mean it will be easy, but it’s much easier. 

    “I can communicate to my son that I would really like him to come over but that he needs to be sober, respectful, and honest when he’s here,” McCarthy says. 

    Boosting Your Child’s Chances of Sobriety

    One question that has come up among the families in McCarthy’s recovery group is whether alcohol should be served during the holidays if the recovering child is visiting, or if there should even be alcohol in the house.

    “Every family is different,” he observes. “But the most nurturing and supportive thing that I’ve found is not to have alcohol in the house when someone with substance use issues is coming over.”

    This may be difficult to accomplish, especially if other guests want to bring alcohol to your meals and also involves setting boundaries. 

    “Tell your guests you have an alcohol-free home and they need to respect that.”

    He advises avoiding potentially “triggering topics of conversation during family get-togethers, like politics or religion, or triggering topics specific to your family that might evoke unpleasant memories or old conflicts when the recovering adolescent or young adult is around.”

    If family members want to engage in these discussions, McCarthy suggests going into another room or area of the house.

    If you’re part of a recovery group or REAL, don’t hesitate to reach out. This is a time when parents need to be there for each other for emotional support and practical suggestions.

    Clear boundaries, open conversations, and a helpful support system can give you the best chance to have holidays that lead to family bonding and set the groundwork for ongoing healing in the future.

    Resources for Parents

    REAL

    A subscription-based educational platform for parents and families of young adults navigating a substance use disorder starting at $49.95/month.  

    Al-Anon Family Groups

    A free 12-step program offering in-person and online meetings for family members affected by a loved one’s alcohol use problem.  

    Families Anonymous

    A free 12-step program offering in-person and online meetings for family members affected by a loved one’s alcohol use problem.  

    Smart Recovery Family and Friends

    Offers free online and in-person resources and meetings to help family and friends of people with alcohol and substance use disorders to cope with their loved one’s situation.  

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  • The Retreat & Recovery At Ramapo Valley Behavioral Health Program at Hackensack Meridian Health to Benefit from Generous $100,000 Gift

    The Retreat & Recovery At Ramapo Valley Behavioral Health Program at Hackensack Meridian Health to Benefit from Generous $100,000 Gift

    Newswise — Edison, NJ – December 22, 2022 – Hackensack Meridian Health Foundation is pleased to announce the receipt of a generous $100,000 gift from an anonymous private foundation to benefit behavioral health patients at Hackensack Meridian Retreat and Recovery At Ramapo Valley, a division of Hackensack Meridian Carrier Clinic, a nationally recognized leader in substance use disorder treatment and care. 

    The Retreat & Recovery at Ramapo Valley, located in Mahwah, was established in 2019 as a tremendous effort of community collaboration, including the inspired vision of foundation friends and benefactors Caryl and James Kourgelis. 

    “We are truly grateful for this much-needed support to benefit our critical programs at The Retreat & Recovery At Ramapo Valley,” said Michael Loch, director of development, Behavioral Health, Hackensack Meridian Health Foundation. “Philanthropy is crucial in providing our team and patients with what they need, especially as the mental health crisis continues to grow. The generous gifts we receive allow for a greater number of those in need to receive the best treatment they deserve, close to home.”

    Funds will be used to support the important work of The Retreat & Recovery At Ramapo Valley’s treatment team and programs grounded in evidence-based practice, wellness and integrative medicine. The facility’s holistic care model provides every aspect of support and intervention necessary to address the whole person: mind, body and spirit.

    “What a heartwarming gift,” said Patricia Toole, president and chief hospital executive, Carrier Clinic. “Community support and philanthropy play a vital role in helping us achieve our maximum potential. The Retreat & Recovery At Ramapo Valley provides comprehensive clinical care designed to meet the specific needs of each patient, and we are so thankful.” 

    To learn more about Hackensack Meridian Health Foundation or how to support Behavioral Health, visit HackensackMeridianHealth.org/Give. 

    ABOUT HACKENSACK MERIDIAN HEALTH FOUNDATION

    Hackensack Meridian Health Foundation, a registered 501(c)(3), is the philanthropic division of Hackensack Meridian Health, a leading not-for-profit health care organization that is the largest, most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care. The foundation oversees fundraising for the network’s three academic medical centers, two children’s hospitals and seven community-based medical center foundations, as well as key initiatives, programs and services offered by Hackensack Meridian Health, including nursing support, behavioral health, children’s health, Hackensack Meridian Health’s Center for Discovery & Innovation and Hackensack Meridian School of Medicine.  

    Hackensack Meridian Health Foundation has been designated as both a High Performer Overall and Healthcare System High Performer by the Association for Healthcare Philanthropy (AHP) within their 2022 Report on Giving. 

    Visit www.HackensackMeridianHealth.org/Donate for more information.

     

    ABOUT HACKENSACK MERIDIAN HEALTH

    Hackensack Meridian Health is a leading not-for-profit health care organization that is the largest, most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care. The network has 18 hospitals and more than 500 patient care locations, which include ambulatory care centers, surgery centers, home health services, long-term care and assisted living communities, ambulance services, lifesaving air medical transportation, rehabilitation centers, urgent care centers, physician practice locations, and a fitness and wellness center. With more than 35,000 team members and 7,000 physicians, Hackensack Meridian Health is a distinguished leader in health care philanthropy and committed to the health and well-being of communities throughout New Jersey. 

    The network’s notable distinctions include having more U.S. News-ranked hospitals than any other health system in New Jersey, as ranked by U.S. News & World Report, 2022-23. Hackensack University Medical Center is nationally-ranked by U.S. News & World Report in four specialties, more than any other hospital in New Jersey. Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center, and K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center, are ranked #1 in the state and top 20 in the Mid-Atlantic Region by U.S. News & World Report’s 2022-23 Best Children’s Hospital Report. Additionally, their combined nephrology program ranks in the top 50 in the United States. To learn more, visit www.HackensackMeridianHealth.org. 

     

    Hackensack Meridian Health

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  • Pandemic Brought Surge in Teen Drug Overdose Deaths

    Pandemic Brought Surge in Teen Drug Overdose Deaths

    By Steven Reinberg 

    HealthDay Reporter

    TUESDAY, Dec. 20, 2022 (HealthDay News) — Deaths of teens from drug overdoses soared starting in late 2019, and though they appear to be on the decline, they remain much higher than in 2019, U.S. health officials report.

    Most of these deaths are due to illegally made fentanyl mixed with other drugs, said study author Lauren Tanz, an epidemiologist at the U.S. Centers for Disease Control and Prevention.

    “Adolescent overdose deaths increased substantially between 2019 and 2021; however, these deaths are preventable, and overdoses do not have to end in death,” Tanz said. “We all play a role as parents, family members, friends and communities to prevent overdoses and save lives.”

    Using data from the CDC’s State Unintentional Drug Overdose Reporting System, the researchers found that overdose deaths among 10- to 19-year-olds began to rise in late 2019. Among 14- to 18-year-olds, overdose deaths jumped 94% from 2019 to 2020 as the COVID-19 pandemic raged on.

    Between the second half of 2019 and the second half of 2021, monthly overdose deaths among teens jumped a median 109%, Tanz said. Those involving illicitly manufactured fentanyl rose 182%. (Median means half of months had higher rates, half lower.)

    About 9 in 10 overdose deaths involved at least one opioid, more than 8 in 10 involved illicitly manufactured fentanyl, and nearly one-quarter involved counterfeit pills, according to the report.

    The availability of fentanyl has driven the surge in overdose deaths, according to Dr. Nora Volkow, director of the U.S. National Institute on Drug Abuse.

    “Over the past few years, there has been a marked expansion in the drug supply of illicit fentanyl, a cheap, very potent synthetic opioid drug,” she said. “While people may seek out fentanyl intentionally in some cases, many people are not aware whether the drug they are using contains fentanyl, which can put them at high risk of overdosing.”

    The surge of fentanyl in the drug supply is of enormous concern, Volkow said, especially the contamination of counterfeit pills made to resemble prescription drugs such as ADHD (attention-deficit/hyperactivity disorder) medications, sleep aids or painkillers.

    “It is absolutely crucial to educate young people that pills purchased via social media, given to someone by a friend or obtained from an unknown source may contain deadly fentanyl,” Volkow said.

    Mental illness also contributed to the surge, Tanz said.

    More than 40% of teens who died from a drug overdose had a history of a mental illness, such as depression or suicidal or self-harm behavior, or had been treated for a mental health condition, the researchers found.

    “Our results show that overdose deaths among adolescents continued to rise from January to June 2020, coinciding with the pandemic’s onset, and was possibly related to declining mental health,” Tanz said. Social isolation and lack of access to school-based mental health services may also have played a role.

    Linda Richter, vice president for prevention research and analysis at the Partnership to End Addiction, in New York City, said, “This report should be a wake-up call to all families, communities, educators, health professionals, policymakers and young people themselves that what was an opioid epidemic is now a fentanyl crisis causing an unacceptable number of completely preventable deaths among teenagers.” She was not involved in the study but reviewed the findings.

    “These deaths are rising as illegal drug use is generally declining among youth, which indicates that it’s not that more teens are using dangerous drugs, but rather that those who are using the drugs are increasingly likely to die from them,” Richter said.

    Volkow struck a similar chord.

    “Drug use among adolescents is becoming more dangerous, but not necessarily more common,” she said.

    Researcher Tanz said steps to prevent overdose deaths are urgently needed. These include:

    • Promoting prevention.
    • Monitoring risk behaviors, such as poor school performance and teens associating with others who use drugs; promoting positive social and life skills; and improving well-being.
    • Educating teens about the dangers of illicitly manufactured fentanyl and counterfeit pills.
    • Educating family and friends on ways to recognize warning signs of drug use.
    • Learning how to respond to an overdose.
    • Training friends and family to use naloxone, a medicine used to rapidly reverse an opioid overdose, and expanding access to it.
    • Ensuring access to effective treatment for mental health problems and substance abuse.

    The study was published Dec. 16 in the CDC’s Morbidity and Mortality Weekly Report.

    More information

    The U.S. Department of Health and Human Services has more about preventing drug overdoses.

     

    SOURCES: Lauren Tanz, ScD, MSPH, epidemiologist, U.S. Centers for Disease Control and Prevention, Atlanta; Nora Volkow, MD, director, U.S. National Institute on Drug Abuse; Linda Richter, PhD, vice president, prevention research and analysis, Partnership to End Addiction, New York City; Morbidity and Mortality Weekly Report, Dec. 16, 2022

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  • TikTok Star Cooper Noriega’s Cause Of Death Confirmed By Coroner

    TikTok Star Cooper Noriega’s Cause Of Death Confirmed By Coroner

    TikTok star Cooper Noriega’s cause of death has been confirmed by a Los Angeles coroner six months after he died, several news outlets reported.

    The social media star’s body was found in a mall parking lot in Burbank, California, on June 9. Paramedics were unable to revive him. He was 19.

    The Los Angeles County Medical Examiner-Coroner reportedly determined that Noriega died due to the combined effects of several drugs: fentanyl, lorazepam and alprazolam. The latter two are sedatives commonly known under the brand names Ativan and Xanax; they can be prescribed to treat anxiety and other conditions. The coroner said recent use of clonazepam, another anxiety medication, also contributed to Noriega’s death.

    The death was ruled an accident.

    Hours before his death, Noriega posted a TikTok while lying in bed with the caption: “who else b thinking they gon d!€ young af.”

    Four days prior, he said he was creating a Discord account called “Coop’s Advice,” intended as a safe space to discuss addiction and mental illness. He also opened up about his struggles with addiction that he said started when he was 9 years old.

    “I would like to use the influence I’ve been given to create a space built on spreading awareness and normalizing talking about mental illness,” he wrote in an Instagram post. “My goal is to eventually open a rehab where people aren’t traumatized at the end of their recovery, and where staff members are trusted people.”

    Noriega’s TikTok account is followed by more than 3.2 million users.

    Since his death, his family have posted from his Instagram account that they intend to make his vision for Coop’s Advice a reality.

    “We will continue to spend the rest of our lives finishing everything Cooper every dreamed of. We will honor his legacy forever,” the family said in a statement in June. “Our beautiful boy, we love you forever.”

    The family has established the Coop’s Advice Foundation, which aims to “become a leader in the movement to rethink how our society understands and addresses mental health and addiction, especially among the members of GenZ.”

    “Cooper’s life and work shined a light on the urgent need to destigmatize addiction and support comprehensive mental health, and Coop’s Advice will ensure that light continues to shine,” the foundation’s site reads.

    Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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  • Outpatient Visits Are Critical to Success of Treating Opioid-Use Disorder, Researchers Find

    Outpatient Visits Are Critical to Success of Treating Opioid-Use Disorder, Researchers Find

    Newswise — People with opioid-use disorder who enter treatment are at risk for relapse, overdose or death if they engage in less than two outpatient visits in their first month of care, according to a study coauthored by Rutgers researchers.

    The study, published in The American Journal of Psychiatry, examined the likelihood of patients continuing treatment for opioid-use disorder during their first month in care based on how often they engaged in outpatient visits or other professional services.

    “Engagement in outpatient visits or professional services appears to be a necessary condition for adequate care retention,” said study coauthor Stephen Crystal, the director of the Center for Health Services Research at the Rutgers Institute for Health, Health Care Policy and Aging Research and Distinguished Research Professor at the Rutgers School of Social Work. “Monitoring this engagement may help identify and address barriers and disparities in outcomes.”

    Starting an individual on medication for opioid-use disorder and then retaining them in professional care are two evidence-based interventions for reducing overdoses, according to the National Academies of Sciences, Engineering and Medicine. Researchers said patients participating in outpatient visits during treatment can be a measure of success for care retention, but there is a need to assess how this measure applies specifically to individuals with opioid-use disorder who are receiving medication, such as buprenorphine, as part of treatment.

    Using data reported between 2011 and 2019 from a multisite buprenorphine clinic throughout eight states, researchers examined the relationship between participating in outpatient visits and care retention in nearly 20,000 individuals. The patients were predominately male and non-Hispanic, which is broadly representative of people nationwide who are using buprenorphine for opioid use disorder treatment, according to prior research from study authors.

    Researchers found that nearly half of patients who participated in multiple outpatient visits in their first month of care remained in treatment for a minimum of six months, whereas 2.9 percent of patients who didn’t participate in multiple visits remained in treatment after six months.

    “This finding is critically meaningful and could guide intervention development to prioritize stabilization of high-risk patients early in treatment,” said Arthur Robin Williams, lead author of the study and an assistant professor at Columbia University Department of Psychiatry. “Without early engagement, the great majority of patients will be lost to relapse and possible death.”

    The study’s findings align with the priorities of organizations such as the Substance Abuse and Mental Health Services Administration, which support care coordination and peer navigation services early in treatment to help stabilize patients who otherwise might be lost to follow up. 

    “Many of these services are not currently reimbursable by payers, so insurance plans need to create bundled rates to be more innovative,” Williams said.

    More research is needed to identify patients at the greatest risk for overdose, said the researchers, adding that further research can demonstrate the importance of milestones in opioid-use treatment to develop care-performance measures.

     

    ABOUT RUTGERS INSTITUTE FOR HEALTH, HEALTH CARE POLICY AND AGING RESEARCH 

    Rutgers Institute for Health, Health Care Policy and Aging Research advances health and well-being through meaningful, rigorous and impactful research in the critical areas of behavioral health, health services, health disparities, health policy, health economics, pharmacoepidemiology, and aging research. 

    Since its 1985 founding, the Institute has become nationally renowned for interdisciplinary and translational research. The Institute’s 57,000 square foot facilities are home to six members elected to the National Academy of Medicine and 200 members representing over 30 schools, institutes, and units with adjunct members from 29 national and international universities.

    Institute for Health, Health Care Policy and Aging Research at Rutgers University

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  • Marijuana-dependent patients at higher risk for infection after knee or shoulder arthroscopy procedures

    Marijuana-dependent patients at higher risk for infection after knee or shoulder arthroscopy procedures

    Key takeaways 

    • A higher infection rate found by new research should raise a “red flag” for patients and providers and should be discussed along with other risk factors before an arthroscopic procedure.  
    • Higher rates of deep vein thrombosis (DVT) were also found among these patients, but the study’s analysis determined they were not statistically significant. 
    • The study has identified the need for additional research to better understand the relationship between marijuana dependence and potential postoperative complications. 

    Newswise — SAN DIEGO: Patients who are dependent on marijuana may face higher infection rates following knee and shoulder arthroscopy—a minimally invasive surgery in which a small camera is inserted to diagnose and sometimes treat injury—according to a study presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022. 

    Using PearlDiver, a national insurance claims database, researchers from the University of Chicago performed a retrospective study of patients with marijuana dependence who underwent knee or shoulder arthroscopy for the postoperative complications of deep vein thrombosis (DVT), pulmonary embolism (PE), and infection.  

    “Marijuana has been gaining so much popularity, but it’s a risk factor we aren’t really catching,” said lead study author Sarah Bhattacharjee, MD, who conducted the research while she was a medical student at the University of Chicago. Dr. Bhattacharjee is now a surgical resident in orthopaedic and sports medicine at the University of Washington. “The higher infection rate found by this new study should raise a ‘red flag’ for patients and providers and should be discussed along with other risk factors before an arthroscopic procedure.” 

    Although the effect of marijuana use has been studied in pain management and cardiovascular health, few studies have looked at the potential effects of marijuana use by patients who are undergoing surgery. More states are legalizing marijuana, and the size of the cannabis market is predicted to reach $91.5 billion by 2028.* Given that trend, the team of researchers from the University of Chicago set out to determine if marijuana-dependent users face an increased risk of complications following knee or shoulder arthroscopy.  

    “There’s so much information out there on smoking, alcohol, and other substances, but not on marijuana use,” said study coauthor Jason Strelzow, MD, assistant professor of orthopaedic surgery, University of Chicago. “As providers and surgeons, we should be discussing marijuana use with our patients, something that we have traditionally shied away from.” 

    Study details 

    All patients undergoing knee or shoulder arthroscopy were identified retrospectively in PearlDiver. Next, patients who had a diagnostic code for marijuana dependence were also identified within each surgery category; this is a rigid definition requiring patients to three or more criteria, such as using marijuana longer than intended, difficulty in cutting down use, spending a lot of time in obtaining or recovering from marijuana, and high tolerance.  

    The rates of DVT, PE, and infection within 90 days were assessed for all patients. Univariate analyses of marijuana dependence on all outcomes were performed, followed by a multivariate logistic regression analysis controlling for known patient comorbidities (other medical conditions). 

    Key findings 

    • The researchers identified 1,113,944 knee and 747,938 shoulder arthroscopy patients. Out of those 1,861,892 patients, 21,823 patients had a diagnostic code for marijuana dependence.  
    • Within both subgroups, the marijuana dependence cohort experienced increased rates of infection and DVT, while the PE rate stayed the same.  For the shoulder arthroscopy group, the rates of infection increased from 0.7%  to 1.7%, the DVT rate from 0.2% to 0.4%, while PE stayed at 0.2%. In the knee arthroscopy group, the rates of infection increased from 1.1% to 2.6%, the DVT rate rose from 0.2 to 0.3%, and PE stayed at 0.3%.   
    • In the multivariate analyses controlling for a variety of patient risk factors, including tobacco use or a history of diabetes, marijuana dependence was identified as an independent risk factor for infection within both cohorts. In this study, a statistical measure called a p-value (‘p’ stands for probability) was used to determine if the detected relationship was due to chance (p-values of 0.001 or below) or did, in fact, exist (p-values above 0.001). For the knee group, the p-value was 1.85, and for the shoulder group it was 1.65. 

    (Note: The presenting author reported on updated data from the podium during the conference reflecting stable PE rates.) 

    Dr. Strelzow hopes surgeons will use the study results to help inform marijuana-dependent patients about risks, benefits, and available alternatives, such as reducing or eliminating marijuana use six months prior to an arthroscopic procedure. 

    Although the study focused on minimally invasive surgery, Dr. Strelzow said that “we would expect similar or larger effects with more open or invasive procedures.” 

    Future research opportunities 

    The study has identified the need for additional research to better understand the relationship between marijuana dependence and postoperative complications. In addition, given that the study used very rigid criteria for marijuana dependence, there are opportunities for future clinical studies to investigate how various levels of marijuana use impact postoperative complications.  Dr. Strelzow said he plans to study the impact of marijuana dependence on fracture healing. 

    There are no author disclosures to report. 

    ________________________ 

    *Legal Cannabis Market Size Worth $91.5 Billion By 2028 | CAGR: 26.3%: Grand View Research, Inc. press release, July 27, 2021. Assessed at: https://www.grandviewresearch.com/industry-analysis/legal-cannabis-market?utm_source=prnewswire&utm_medium=referral&utm_campaign=HC_27-July-21&utm_term=legal-cannabis-market&utm_content=rd1 (.) 

    # # # 

    About the American College of Surgeons  

    The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates a surgeon is a Fellow of the American College of Surgeons.  

    American College of Surgeons (ACS)

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  • New York City announces its largest fentanyl seizure in history, eclipsing record bust from last month | CNN

    New York City announces its largest fentanyl seizure in history, eclipsing record bust from last month | CNN



    CNN
     — 

    Days after federal officials announced the largest fentanyl seizure in New York City history, an even greater quantity of the highly addictive substance has been found, authorities say.

    Two people have been arrested and charged with multiple drug and firearm charges in connection to the seizure on October 7 at a Bronx apartment building, prosecutors said in a news release.

    Authorities found roughly 300,000 rainbow-colored fentanyl pills inside two closets in the apartment, and more than 22 pounds of the drug in powdered form were wrapped in clear plastic packaging in multiple rooms, according to the Office of the Special Narcotics Prosecutor for the City of New York. The total sum of the drugs is worth about $9 million in street value, officials said.

    The historic seizure saved lives, according to DEA Special Agent in Charge Frank Tarentino.

    “Hundreds of thousands of lethal pills were lying in wait in a Bronx apartment to be unleashed onto our streets. In today’s world, the potential to overdose is dangerously high,” Tarentino said. “There is no quality control in these fake pills and it only takes two milligrams of fentanyl to be lethal.”

    The seizure comes after federal officials announced last week that a woman has been charged with concealing about 15,000 rainbow-colored fentanyl pills in a Lego box as part of a drug trafficking scheme in September. That seizure at the time was also deemed the largest of fentanyl in New York City’s history.

    Fentanyl is a synthetic opioid that’s highly addictive. It can be up to 50 times stronger than heroin and 100 times stronger than morphine, the US Centers for Disease Prevention and Control said.

    Rainbow fentanyl comes in bright colors and can be used in pill form or powder.

    “Rainbow fentanyl is the latest threat we face in our fight against the opioid epidemic that sadly continues to ravage our communities – a multi-colored poison specifically designed to attract younger users,” Nassau County District Attorney Anne T. Donnelly said.

    And as Halloween nears, officials have been warning families to be especially vigilant regarding their children’s candy before they consume it.

    The dangerous drug has been a major driver of fatal and nonfatal overdoses in the US as well as the opioid epidemic.

    Although there has been a slight decrease in recent months in drug overdose deaths, the numbers remain high. About 108,000 people died of a drug overdose in the 12-month period ending May 2022 – which is down from the record high of more than 110,000 deaths reported in the 12-month period that ended March 2022, CDC provisional data published Wednesday shows.

    The latest overdose death figure remains 32% than it was two years earlier and higher than any other period before November 2021, according to the CDC data. Synthetic opioids, including fentanyl, were involved in more than two-thirds of deaths in the 12-month period ending May 2022, and psychostimulants were involved in nearly a third.

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  • Thai PM orders tighter gun control, drugs crackdown after mass killing | CNN

    Thai PM orders tighter gun control, drugs crackdown after mass killing | CNN

    Thai Prime Minister Prayut Chan-o-cha on Monday ordered law enforcement agencies to tighten gun ownership rules and crack down on drug use following a mass killing by an ex-policeman at a daycare center that left has the nation in shock.

    A total of 36 people including 24 children were killed in a knife and gun rampage last week by an ex-cop who later killed himself in Uthai Sawan, a town 500 kilometers (310 miles) northeast of Bangkok. It was one of the worst child death tolls in a massacre by a single killer in recent history.

    Prayut has instructed authorities to proactively search and test for the use of illicit drugs among officials and communities, and step up treatment for addicts, government spokesperson Anucha Burapachaisri said in a statement.

    The prime minister has ordered government registrars to revoke the gun licenses of registered owners who have reportedly behaved in a way that “threatens society” and “creates chaos or causes unrest,” Anucha said, alongside a crackdown on illegal gun sales, weapons smuggling, and the use of illegal firearms.

    Thai authorities plan to recall guns from officials and police officers who have misused their firearms or have behaved aggressively on duty.

    Regular mental health checks will also be required for gun license applicants and holders, Police Chief Police General Damrongsak Kittiprapas told reporters.

    Gun ownership is high in Thailand compared with some other countries in Southeast Asia. Illegal weapons, many brought in from strife-torn countries, are common.

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  • Baseball great Alex Rodriguez reflects on steroid abuse, his past with J-Lo | CNN

    Baseball great Alex Rodriguez reflects on steroid abuse, his past with J-Lo | CNN

    Editor’s Note: Watch “Who’s Talking to Chris Wallace?” on CNN TV Sundays at 7pm ET. New episodes with full-length interviews are availble on HBO Max each Friday.



    CNN
     — 

    Baseball great Alex Rodriguez is opening up about mistakes in his personal and professional life, and how they are shaping his growing business empire.

    In an interview on CNN and HBO Max’s “Who’s Talking to Chris Wallace?”, Rodriguez said the performance-enhancing drug scandal that marred his legacy was “the most embarrassing moment of my career.”

    “The hardest thing I’ve ever had to do in my life was face my daughters Natasha and Ella and tell them this is the mistake that Daddy made,” he told host Chris Wallace

    Rodriguez said that because of the stringent culture of professional baseball, he was denied a happy ending to his otherwise legendary baseball career.

    “I understood my mistake, and I’ve taken full responsibility for it,” he added.

    The 14-time Major League Baseball all-star said he was “bullish” about the future of baseball despite warning signs that viewers are less motivated to watch games.

    Rodriguez, who just last week was passed by Albert Pujols on the MLB’s home run list, says if he were MLB commissioner he would “open the floodgates,” and give fans more access to America’s pastime.

    “We have to be proactive, meaning I would put cameras on guys,” he told Wallace. “The players that are driving to the park, I want to see them at home.”

    Rodriguez wanted coverage to expand so that fans have insight into the clubhouses, batting cages and bullpens.

    The World Series winner also advocated for Major League Baseball to plant its flag on America’s Independence Day, much like the National Football League does with Thanksgiving.

    “If you look at July 4, it’s a wide-open day. There’s no football, there’s no basketball, there’s no soccer,” he said, noting that the MLB should make the Fourth of July “all about baseball.”

    “Every game, we’re going to wire (put a microphone on) these guys and we’re going to have interviews, and everybody is at home watching baseball at a barbecue with their families.”

    Another change that Rodriguez wanted to make to baseball included increasing financial literacy education for players – like teaching them about capital markets, investments and the importance of balancing a checkbook.

    “I read something where it was over 50% of athletes were going bankrupt after their playing days,” Rodriguez said. “That’s a tragedy.”

    In his post-playing career, Rodriguez has turned his own focus to business. He told Wallace his investment firm, A-Rod Corp, is a “mini-Berkshire Hathaway” – referring to the multinational conglomerate owned by billionaire Warren Buffett, who Rodriguez considers a mentor.

    A-Rod Corp is an investment firm that houses his vast real estate holdings, as well as private equity and venture capital investments.

    “If you were to put value in our enterprise, it’s probably somewhere between 1 billion and 2 billion,” Rodriguez told Chris Wallace.

    The former shortstop also discussed his break-up with pop icon Jennifer Lopez. Lopez married actor Ben Affleck in July 2022 after she and Rodriguez ended their multi-year relationship the year prior.

    “With Jennifer, look, it was a good experience. And I wish her and the children – who are smart, and beautiful and wonderful – I wish them the very best,” Rodriguez said.

    Telling CNN’s Chris Wallace that, despite his multiple high-profile relationships, he now feels that his previous relationships and the impact of his 2014 suspension from the MLB have made him “husband material” in the future.

    Wallace asks A-Rod if he thinks he’s ‘good husband material.’ See his response

    “I think I’m going to make a wonderful partner or husband and father post-suspension because of the lessons learned of my biggest mistakes.”

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  • 3 Things To Consider Before Trying A Nonalcoholic Drink If You’re Sober

    3 Things To Consider Before Trying A Nonalcoholic Drink If You’re Sober

    In recent years, accessibility to nonalcoholic beverages has surged, and perhaps for good reason. The COVID-19 pandemic alone brought in a new wave of sober-curious people, amid a rise in alcohol consumption during the isolation of lockdowns.

    To meet this shift, drinks like CBD-infused seltzers, zero-proof liquors, nonalcoholic wines and more have filled the shelves for those who are looking for party options without the buzz.

    CBD drinks, for example, promise to take the edge off after consumption thanks to the properties in cannabidiol, a nonpsychoactive part of a cannabis plant that may promote a sense of relaxation. Nonalcoholic, or “NA,” beverages give sober folks a substitute for the drinks that many may have previously relied on in social settings.

    But for those who have a difficult relationship with alcohol, are these alternatives really a solution? Or is the need for them a sign of something greater? Speaking to HuffPost, substance misuse experts and people who are sober shared a few questions to consider if you’re turning to these beverages when you give up drinking:

    1. What’s my motive for drinking nonalcoholic beers, wines or cocktails?

    A recurring topic that occurs in 12-step substance misuse recovery meetings is motive. What is your motive for doing X vs Y? The spectrum of answers may range from attending a wedding to visiting a bar with nonsober friends.

    Some may feel uncomfortable around their peers who still drink. It is hard to socialize without booze when you’ve become so accustomed to having a drink in hand to feel normal. Some may find solace in nonalcoholic beverages to put on the facade that they are still drinking, perhaps because they haven’t fully disclosed the change to friends. Others may insist that they are just taking a break from alcohol for health reasons.

    Whatever the case may be, it is important to acknowledge what the motive is for wanting to indulge in nonalcoholic drinks in the first place and to address that. Those in recovery need to examine whether the motive behind drinking the nonalcoholic beverage is potentially detrimental to their sobriety.

    “I feel as if you should be fully abstinent for the first two years of sobriety,” said Ashley Loeb Blassingame, a co-founder of an online substance abuse counseling program named Lionrock Recovery, noting that these kinds of problems “aren’t substance-specific.”

    “Then, check your motives to see if the desire for an NA beverage is still there,” she continued.

    If the desire is still there and you decide to try an NA beverage, think about why you are doing it. Is something missing in your sobriety? Is your recovery checklist in order?

    “How much do you like the taste of a NA beverage? Or do you like it because it tastes similar to alcohol?” Blassingame said.

    If drinking a beverage that tastes similar to alcohol could be triggering, it is important to have a plan in order. In recovery, the idea of a true nonalcoholic beverage is alluring, and with so many new options becoming available, it is OK to wonder about them. Just make sure you are valuing your sobriety more than anything and not becoming a victim of surreptitious marketing.

    If you’re sober-curious but not dealing with an addiction, full abstinence might not be totally necessary right now. In those circumstances, practicing moderation tactics ― like drinking NA beverages ― is a good entryway into the recovery world.

    For both those in recovery and those who are sober-curious, it is important to have a network in place — people you can rely on in a time of need or bounce questions off without fear of judgment, according to Blassingame.

    Henrik Sorensen via Getty Images

    Consider your motive when deciding whether to try a CBD-infused or nonalcoholic drink.

    2. Do the drinks I’m choosing contain traces of alcohol?

    The reality is that many nonalcoholic beverages include small amounts of alcohol. This is known as a low alcohol by volume, or ABV.

    A sober-curious individual partaking in these alternative beverages is different from someone in recovery doing so. The former may look at these options as healthier choices. The latter has more at stake, with the consumption of low-ABV drinks potentially igniting the craving for something stronger.

    If you’re in recovery, be mindful of the ingredient list for anything you’re consuming, experts told HuffPost. This does not mean diligently checking every household item, but it is good to be aware of what is in your food and beverages, as well as how certain ingredients can affect you. Beverages like kombucha have an ABV of 0.5%, and while that may not be enough to even remotely affect some, others may feel a buzz due to overconsumption.

    Check the alcohol volume in drinks you’re choosing. Then ask yourself why you may want them — and be radically honest about it.

    3. Does this align with my definition of sobriety?

    Sobriety isn’t one-size-fits-all, and this applies to the beverages people choose to consume, according to Trey Laird, the CEO and founder of a sober living facility in Connecticut known as The Lighthouse.

    “I have worked with clients who have tried both nonalcoholic drinks and CBD. For some of them, it has a purpose, and I don’t judge them,” Laird said, adding that people in recovery who drink them should disclose this to someone they trust beforehand.

    He warned, however, that these beverages can become a slippery slope in some cases. Some of his clients have reported drinking one bottle of O’Doul’s, which in turn leads to drinking a six-pack to feel a slight buzz. In Laird’s personal recovery, he hasn’t found the need to indulge in nonalcoholic drinks.

    “For me, I have been sober since 2011 and have gone this long without trying a nonalcoholic beer or wine,” he said.

    Lindsey Metselaar, the host of the dating and relationship podcast “We Met at Acme,” feels similar to Laird in terms of her own recovery. She isn’t interested in trying nonalcoholic drinks, and she argued that the consumption of CBD products in recovery is unnecessary and does not equal sobriety.

    The distinction needs to be clearly defined for you, Blassingame said. In her opinion, the term “sober” implies recovery in the traditional sense, which can include meetings, therapy and more.

    “It is the difference between someone running a marathon [on occasion] … versus an endurance athlete,” she said, noting that to her, sobriety and recovery imply complete abstinence from all mood and mind-altering substances ― even drinks like CBD-infused beverages or low-ABV beer alternatives.

    The sober-curious, however, may think of the change as just abstaining from drinking, with the option to either maintain that or consume alcohol when they want.

    Decide what aligns with your needs for your relationship with alcohol, and then make an informed decision about whether drinking alternative beverages will fit into those plans, the experts said. And no matter what, make sure you’re relying on a support system to guide you through it.

    Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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  • There aren’t enough facilities to treat all kids hooked on opioids | CNN Politics

    There aren’t enough facilities to treat all kids hooked on opioids | CNN Politics

    A version of this story appears in CNN’s What Matters newsletter. To get it in your inbox, sign up for free here.



    CNN
     — 

    After writing several previous newsletters on the stunning rise in opioid overdoses in the US, including among adolescents, I thought it was worth taking a look at what happens after an overdose, particularly for adolescents.

    I talked to Dr. Sivabalaji Kaliamurthy about what he’s encountering. A child and adolescent addiction psychiatrist who is board certified in general psychiatry, child psychiatry and addiction psychiatry, Kaliamurthy is also the director of the addiction clinic at Children’s National Hospital in Washington, DC.

    He told me that his clinic, which he set up in early 2022, has gone from getting one or two opioid use referrals per month to eight or more per month now, a year later.

    He particularly wanted to discuss some major news: The opioid overdose antidote naloxone, sold as Narcan, got approval from the US Food and Drug Administration on March 29, the day we talked, to be sold over the counter.

    Excerpts from our conversation, edited for flow, are below.

    WOLF: What is your reaction to Narcan being available over the counter?

    KALIAMURTHY: When I do an evaluation (of a patient), regardless of the substance use, you’re always talking about naloxone, brand name Narcan. …

    The message that I present parents with is always that it’s kind of like having a fire extinguisher at home. You hope you never need to use it, but you’re glad that you have it if you need to use it.

    Access is important. There are some controversies around increasing access to naloxone and fears that this may encourage more substance use. We have scientific research looking into this very specific question.

    And overall, there’s one study that came out this month that found that across 44 states where they increased access to naloxone for adolescents, it did not increase the rates of substance use in this population. And in some states, it actually decreased opioid use among adolescents. …

    The FDA approved the over-the-counter sale of naloxone, specifically the brand Narcan, because of how easily it can be administered. Naloxone also comes in other formulations, like injections, but Narcan is a nasal spray. We’re hoping that it will be out later this summer.

    The challenge remains how much is it going to cost? On average, it can cost anywhere between $50 to $100 right now. If it becomes over-the-counter, we don’t want insurances to stop covering [it].

    It will be interesting to see how the manufacturer goes about introducing it over the counter.

    WOLF: You said it’s like a fire extinguisher. Should everybody have it, or just people whose kids have demonstrated addictive behavior?

    KALIAMURTHY: Everyone should have it. Naloxone is not a treatment; it is more of an antidote. It reverses opioid overdoses, and the person who has the opioid overdose is never the one who’s going to use it somewhere in the community.

    WOLF: I’ve reported on a surge in overdoses. What are you seeing at Children’s?

    KALIAMURTHY: We are seeing an increase in the number of kids presenting to the hospital after experiencing an opioid overdose, and in general, opioid overdose deaths in the DMV (Washington, DC, Maryland, Virginia) region have significantly increased in the last two years. That aligns with a national trend we are seeing with regards to opioid overdoses.

    WOLF: Is there a profile for who these kids are? Do they share any traits?

    KALIAMURTHY: Yes. Let me talk about the kids we do see for opioid-related concerns first.

    At Children’s National, children often present after experiencing an overdose or having a medical complication because of using these M30, or the fake Percocet pills. We’ve had kids come in following conditions such as preliminary hemorrhage, where they were bleeding into their lungs, and overdose is not the only concern.

    Apart from that, we also have had kids presenting actively using these pills. They haven’t overdosed yet but they’re asking for help to stop using these pills.

    Some things that we have noticed, and this is the trend across the DMV region … the kids who are presenting to treatment, these are kids who are motivated to stop – they predominantly identify as Hispanic in ethnicity. Most of them have Medicaid for insurance.

    A lot of them, you know, they come to us – the average age is about 16, 16½ and their first use of opioids, these pills, was about a year ago. So the average first use was about 15 to 15½ years of age. They are really struggling, and they want to get better.

    KALIAMURTHY: Another common trait: cannabis use is quite common in this population. Pretty much every patient that I’ve come across started off around age 12 using cannabis products. This includes the flower and bud, vapes or edibles. Soon they transition to using the M30 pills.

    There are various different reasons, one of which is just access. A lot of other kids are using it. They’re using it in schools. They try it, they like it, and then it escalates and they stop using other substances.

    Most of these kids start off with crushing and try it nasally by snorting it and then they transition to smoking. What they do is they put these pills on a piece of aluminum foil, heat it up and inhale the fumes that come up. We haven’t had anyone come in who reported using any of these pills intravenously.

    WOLF: How is treatment for adolescents different than treating adult users who are seeking help?

    KALIAMURTHY: We have to take into consideration their developmental age and the psychological development that’s happening in adolescence, which is very different from adults.

    Oftentimes, this is the first point of entry into opioid use for these kids. Fentanyl, which is one of the most powerful opioids of abuse out there, is the first point of entry into opioid use for these children.

    Where for adults, they might have been prescribed pain medications. Or they might have started on opioids through other routes and might have used less potent products before transitioning to fentanyl.

    KALIAMURTHY: Historically, adolescents were not always the most motivated to seek treatment for substance use. What we would see was they would start off with experimenting, there would be a problem, it would take a few years and they’re adults by the time they’ve entered treatment and they’re trying different things to treat themselves before they enter treatment.

    With adolescents, now we are seeing that they can tell that they need help, and they are motivated and they are entering treatment.

    We have to take into account the presence of parents or guardians, how the school system interacts with them, what else do they do in their communities. There’s an increased association of violence and legal trouble that some of these patients end up in that we need to address while treating them. And these are some differences when it comes to treating adolescents versus adults.

    WOLF: One local community’s opioid response coordinator stressed to me that lack of availability of treatment is a real problem. Is that something that you agree with?

    KALIAMURTHY: Absolutely. That is a real problem at this point, because there is a huge discrepancy between the number of kids who need treatment and the available resources.

    The challenge is we can limit access and prevent these kids from getting the pills. But then you have a huge population of kids who are dependent on these pills, who can’t tolerate withdrawal symptoms, who have what we call opioid use disorder. That is going to perpetuate the problem if we’re not treating them. We need to do more in terms of increasing access to care for these kids.

    WOLF: Can you illustrate that capacity issue for me, through numbers or data? Or is it more anecdotal?

    KALIAMURTHY: Treatment is across different realms.

    For example, when a child is using these pills, and they have a problem with substance use, they need to go and be evaluated by a professional who has expertise in both addressing and evaluating mental health and addiction problems. And we don’t have very many people being able to do that.

    KALIAMURTHY: The first-time response is usually a counselor or social worker, sometimes physicians.

    But generally, there’s very little expertise in the pediatric health space with regards to addressing substance use-related problems. Screening is the point of entry.

    KALIAMURTHY: Then, say they need detox beds. Once they’ve entered treatment, we want to help them get through those initial days when their body is kind of adjusting to not using these pills, and we refer to that as detox.

    At Children’s National Hospital, when the kids come to the emergency room, we are not able to admit them for detoxes all the time. Sometimes we do end up admitting them.

    This depends on the availability of beds. The number of pediatric beds is very small to begin with. And beds may not always be available when somebody presents to the emergency room detox.

    And then there’s who is on call? Who’s available to treat these kids? I spoke about the lack of expertise in general, across the pediatric health space, so all that will determine whether a child is able to get access to detox services.

    That’s the detox part of treatment, which can be anywhere between two to five days.

    Detox doesn’t always mean somebody needs to be admitted. I also do outpatient detox where we are helping kids stop by providing them with medications and guiding their parents or guardians and the child on how to go through detox.

    KALIAMURTHY: Once you go through detox, depending on the extent of the problem, a child may require admission to a rehabilitation facility for anywhere between a month to six months.

    When we look at the number of facilities in the DMV region that provide this kind of rehab, I don’t think Virginia has any, DC doesn’t have any, Maryland has two. One is Sandstone Treatment Center, which is a private institution. The other is a treatment center, which is closer to Baltimore. There’s a limitation on who they can take.

    WOLF: Let me interrupt you. In a region that has millions of people, there are only two facilities that will take adolescents for one to six months’ treatment for substance use?

    KALIAMURTHY: Yes. For substance use.

    WOLF: Is that just a function of there’s more demand for those kinds of facilities among older people who are more likely to face addiction problems? Is that something the system is pivoting to address right now?

    KALIAMURTHY: It’s unclear. The system wants to help, but the challenge is historically adolescents are not always the most eager and motivated to get help.

    When we look at treatment programs, that didn’t exist in the past. They often relied on the judicial system, where some of these kids might have been mandated to treatment.

    Now we know that substance use disorders are chronic disorders and mandates don’t always work. Courts have stopped mandating treatment, because it’s like you mandate it for a month and then they come out and then what happens? There’s a lot of issues with mandating treatment.

    Now, most of the programs that were present prior to the pandemic also shut down during the pandemic because the needs also declined.

    This is not financially lucrative. That’s one reason why they’re having a huge issue with finding systems and having the county or the state take over with regards to creating the system.

    WOLF: I cut you off there. You were moving from the one-to-six-month facility to the next step in the process.

    KALIAMURTHY: So the next step is really engaging these kids in treatment. Not all kids require one to six months. Some kids might be OK with just completing detox and engaging in regular outpatient level of care. This might involve what we call intensive outpatient combined with medication.

    Which is where I would come in. A lot of what I do is provide medications for addiction treatment. These medications, the first part is for the detox to help with the child’s symptoms, but once you go through withdrawals, you can still have significant cravings to go back to using.

    The challenge, again, is the number of facilities. There are more options for intensive outpatient, but again, they are packed. The wait times to get in are longer now, and some of them are just virtual-only options, which may be good for some kids, but some kids might need more inpatient help.

    KALIAMURTHY: After this step, we have regular outpatient therapy and recovery support services, which is also lacking.

    The recovery support services are services which help kids get back on track academically. Catch up with your credit, get up on your grades and form a healthy, functioning resume. Get help finding part-time jobs. Keep these kids engaged in activities outside of school so that they are less likely to go back to the path that they were on which led to the substance use.

    WOLF: What’s your message to parents who are trying to keep an eye on their kids?

    KALIAMURTHY: Let’s look at the national-level data that we have collected up to 2021. Substance use is actually on the decline.

    Which is interesting because what is happening is that even though substance use among kids is on the decline – that’s both in middle school and high school – the substances that kids are using have become so much more potent.

    Take cannabis, which if you measure the potency by the percentage of THC content, has gone up significantly. The average THC percentage in the ’60s and ‘70s was like 2-5%. And now it’s like 20-25%. And kids are more likely to use what they call the concentrates, which is like 80% or more THC.

    When I talk to parents, the first thing I’m telling them about is the landscape of different substances that are out there, and kids are more likely to start off with cannabis or alcohol before they transition to the M30 pills.

    KALIAMURTHY: If you think about modifiable and non-modifiable risks, some risks just cannot be changed. These are things like genetics, family history and also if a child has a history of any traumatic experiences. Those are not things you can necessarily change. There are modifiable risk factors, like if a child has ADHD, they’re more likely to be at risk for developing substance use problems.

    If there are untreated mental health conditions, such as depression, anxiety, they’re more likely to have problems. We know that. The kids who identify as LGBTQ+, they also tend to have more risk factors in terms of initiating substances that transition into a problem.

    But also, we need to rethink how families address substances in the household. Kids learn by modeling they see from adults in their life and also the direct conversations we have. What are their values as a family around use of substances? These are not just legal and illegal – all substance use can have some harm. And early initiation is going to lead to more likelihood of having a problem.

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  • ‘Spiritworks ~ a God Story; Freedom From Addiction’ by Book Author Rick Greene

    ‘Spiritworks ~ a God Story; Freedom From Addiction’ by Book Author Rick Greene

    Sick and tired of being sick and tired…

    Press Release
    –


    updated: Aug 15, 2017


    LOS ANGELES, August 15, 2017 (Newswire.com)
    –
    ​Book author Rick Greene, also known as “Spiritworks” releases his second edition of his book, “Spiritworks ~ A  God Story” which is now called “Spiritworks ~ A God Story; Freedom From Addiction.” 

    Rick Greene’s book expressly tells his own personal story as he recalls his road to addiction, the life of his once lost soul who eventually found sobriety through God, and how he was able to overcome the pain of his past. Rick Greene aka “Spiritworks” story is one of faith, hope, love, obedience and the hunger for what God can do to bring his believers out of the darkness of living in a world of drugs and alcohol.  

    From the streets of Cincinnati, Ohio, to jail, to finding God. From drugs and alcohol to living sober, ‘Spiritworks’ story is one of hope, and a life of purpose. Through this purpose ‘Spiritworks’ was led to donating a kidney to a complete stranger. ‘Spiritworks’ found the love, peace, and joy to serve God and be the husband and father God wants him to be.

    Rashane K. Crayton, Dream It PR & Marketing

    Book author Rick Greene also known as “Spiritworks” was born in Cincinnati, Ohio. The youngest of 11 children, Rick Greene remembers the sting of verbal and physical abuse inflicted by his alcoholic mother. However, there was one bright spot in his young life, his father. Rick’s father was the one that woke the children up every Sunday morning and took them to church. Even though his father was a functioning alcoholic, he loved his children. The relentless abuse issued out by his mother left Rick convinced that he was a failure. To make matters worse was a learning disability that went ignored. Rick eventually started drinking, smoking weed and ultimately using cocaine to escape. At 19, he married and started a family. Rick worked temp jobs, but feeding his addiction was his priority. “I wasn’t eating. I was skinny. My skin didn’t look good, you know. You look like you live. I looked like a slave to Satan,” he says.

    Rick eventually left his family, knowing he was only harming them. For more than a decade, Rick was in and out of jail for child support violations — just more reminders that he was a complete failure. One day, Rick was getting ready to appear in court once again, and decided to get high to soften the blow. This time, Rick decided he’d had enough. Rick asked the Lord for forgiveness and gave Him his life. He then went to court and was sentenced to six months. During that time, he read the Bible and began to understand that he had great worth in God’s eyes. 

    After his release, Rick started making things right: He found a church home, stayed off drugs, and caught up with his child support. In time, Rick was able to forgive his mother and found it freed him. Rick has since remarried. He and Stephanie are active in their church but spend most of their spare time with their two boys. Rick knows he’s made his share of mistakes, but he knows his self-worth is defined by God’s love and forgiveness. “The Holy Spirit is always reminding me, Rick, you’re forgiven, Father God’s given you a clean slate. Jesus is sweeter than honey. And once you taste Him, I promise you, you’ll want more.”

    “Spiritworks ~ A God Story; Freedom From Addiction” is available now on Amazon.com.

    For interviews and professional bookings contact: Rashane Crayton, Dream It PR & Marketing, dreamitpr@yahoo.com.

    Source: Rick Greene

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