Milwaukee Gangs, Substance Abuse and HIV Risk to be
Studied at Medical College
The Medical College of Wisconsin has received a $2.1 million, four-year grant from the National Institute of Health’s National Institute on Drug Abuse to study the role of gangs and environmental factors on gang members’ drug use, sexual activity, and other high-risk behaviors.

Julia B. Dickson-Gomez, PhD, associate professor of psychiatry and behavioral medicine and a faculty member in the Medical College’s Center for AIDS Intervention Research (CAIR), is the primary investigator of the grant.

This is one of the first projects to explore relationships between environmental factors, gang structure and norms on gang members' sexual risk. More than 450 male and female members of Latino and African-American gangs will be interviewed about their daily activities, to determine how gang structure, social context and the environment influence sexual risk.

The interviews will be used to help identify the social context and physical setting in which sexual risk factors and drug and alcohol use occur. In the final phase of this project, researchers will conduct focus groups to help identify components of a multilevel prevention intervention. Results for this study will be used to develop the first multi-level intervention targeting multiple risk behaviors among adolescent gang members in a subsequent project.

The Center for AIDS Intervention Research at MCW is one of five HIV prevention research centers in the United States funded by the National Institute of Mental Health. CAIR’s missions are the development of improved ways to prevent HIV infection, the development of new approaches to improve the health of persons affected by HIV/AIDS, and disseminating its research findings to service providers in the United States and throughout the world so they directly benefit from CAIR’s work.

ABH RESEARCH NEWS - Week of January 23, 2012

West Virginia University Pharmacy Students Educate
Youth about Prescription Drug Abuse
According to the Centers for Disease Control and Prevention, prescription drug abuse and its consequences are the fastest growing drug problem in America. To help combat that trend, three second-year students in the West Virginia University School of Pharmacy have introduced a new patient care project called GenerationRx. Developed by the Ohio State University College of Pharmacy and conducted in partnership with the American Pharmacists Association (APhA), GenerationRx is a nationwide program that aims to educate communities about the dangers of prescription drug abuse.

WVU pharmacy students Kayla Hetrick of Fort Hill, Pa., Kimberly Kimble of Middlebourne, W.Va., and JoeMichael Fusco of Clarksburg, W.Va., learned about the program while attending the American Pharmacists Association-Academy of Student Pharmacists (APhA-ASP) Mid-year Regional Meeting last fall and felt it was important to implement the project in schools and community groups across the Mountain State.

“One of the statistics that we tell people is that in 2001, there were 91 drug-related deaths in the state of West Virginia,” Fusco said. “That number went up to 390 in 2008,” Hetrick added. “Actually putting numbers on it and showing people that it’s a growing problem are impactful.”

Fusco and Hetrick are co-committee chairs of the WVU chapter’s initiative and they, along with fellow student pharmacists and ASP members, plan to take the program into middle schools, high schools, parent meetings, church meetings and even nursing homes.

“Teenagers need to be taught that prescription drug abuse is illegal and that the side effects from them are serious and can be deadly,” Kimble said. “Parents and grandparents need to be taught how to properly store their medications and to recognize the signs that their children or grandchildren are abusing prescription drugs.”

Kimble had an opportunity to present the GenerationRx program to high school students in West Virginia. The reaction she got from the students was eye opening. “While at the high school, I had students who told me they knew people who were abusing prescription medication,” she said. “I was not expecting the students to open up to me. It just hit home how much of a problem prescription drug abuse is in this area.”

Fusco, Hetrick and Kimble feel it is important to educate everyone in the community — from adolescents to older adults — in order to prevent anyone from even starting to abuse prescription drugs and to also help guide people who are struggling with addiction.

“As future pharmacists, we need to realize and make other healthcare professionals and the community at large aware that prescription drug abuse is a huge problem, and I think education is the best way to help stop it from happening,” Hetrick said.

“[Pharmacists] are the only people in healthcare who are specifically trained in prescription medication,” Fusco added. “Being specialists and being the people who in the future will be dispensing these medications, it is our responsibility to let people know the risks that they are taking.”

ABH RESEARCH NEWS - Week of January 16, 2012

Global Study Finds Drug Abuse
Highest in Richer Nations
About 200 million people worldwide use illicit drugs each year, and use is highest in wealthier nations, a new study shows. The researchers also found that the burden of health problems caused by illicit drug use in developed countries is similar to that caused by alcohol, but much less than that caused by tobacco.

Experts in the United States weren't surprised by the numbers, and said that more needs to be done to reduce Americans' dependence on illegal drugs. The study "serves to confirm something addiction experts have known for some time -- that the extent of illicit drug use and abuse in developed countries like the United States has reached epidemic proportions," said Dr. Jeffrey T. Parsons, a professor in the department of psychology at Hunter College, in New York City.

The analysis of available data from a team of Australian researchers estimates that there are up to 203 million marijuana users, anywhere from 14 million to 56 million amphetamine users, 14 million to 21 million cocaine users, and 12 million to 21 million opioid users around the world.

The researchers also estimate that there are 15 million to 39 million "problematic users" of opioids (which include prescription painkillers such as Oxycontin or Vicodin), amphetamines or cocaine, and 11 million to 21 million people who inject drugs worldwide.

Marijuana use appears to be highest in Oceania (Australia/New Zealand), with up to 15 percent of those aged 15 to 64 using the drug, according to estimates made by the UN Office on Drugs and Crime. Amphetamine use was also highest in Oceania (2.8 percent of this age group), while use of heroin and other opioids was highest in the Near and Middle East (up to 1.4 percent). Cocaine use was highest in North America (1.9 percent).

There is no gold-standard method for estimating the true number of illicit drug users and no one method is ideal for all drugs or all countries, said Louisa Degenhardt, of the National Drug and Alcohol Research Centre at University of New South Wales, Sydney, and the Burnet Institute in Melbourne, and colleague Wayne Hall of the University of Queensland Centre for Clinical Research in Brisbane.

Lack of data also means there are no estimates of the extent of use, or the health effects, of Ecstasy; hallucinogenic drugs; inhalants; or non-medical use of benzodiazepines such as valium or anabolic steroids.

The study, published Jan. 6, is the first in an addiction series appearing in The Lancet. The toll on human health from illicit drug use is enormous. According to the investigators, the most recent (2004) data from the World Health Organization suggest that illicit drugs caused 250,000 deaths that year, compared with 2.25 million deaths from alcohol and 5.1 million deaths due to tobacco.

Years of life lost because of illicit drug use were 2.1 million, compared with 1.5 million for alcohol. That's likely because drug deaths generally affect younger people while deaths from alcohol (and tobacco) tend to affect middle-aged and elderly people, the researchers said.
Illicit drug use also caused 13 million years lost to disability (disability-adjusted life years, or DALYs). Wealthy nations, including the United States, are lagging in efforts to beat back the scourge of drug abuse, experts said.

"Unfortunately, the U.S. has made little progress in the prevention and treatment of drug abuse in the past decade," Parsons said. "More research is needed on effective educational and prevention programs designed to reach young people before they begin to use/abuse illicit drugs," he added.
And expert Dr. Marc Galanter said that "it is important that we call attention to very serious drug abuse problems that still exist in the United States. For example, we are seeing recent increases in abuse of painkillers in the United States, as well as the abuse of MDMA [Ecstasy] by adolescents and young adults. Abuse of these particular drugs is not prevalent in less industrialized countries."

Galanter is director of the division of alcoholism and substance abuse at NYU Langone Medical Center/Bellevue, and a professor of psychiatry at the NYU School of Medicine, in New York City. He said that while drug abuse remains at serious levels, "we have made great progress in treatment in many areas, particularly, in the early recognition of alcohol abuse and alcoholism by the general public. This has led to people seeking help before problems become much more serious." Still, Galanter said, "much more, however, needs to be done."

The new study also "puts substance use in a societal context," noted Dr. Bruce Goldman, director of Substance Abuse Services at the Zucker Hillside Hospital of the North Shore-LIJ Health System, in Glen Oaks, N.Y. "Social norms have a very powerful impact on drug use patterns," he said, and "we need to create norms where substance use and availability, especially for young people is not acceptable."

SOURCES: Marc Galanter, M.D., director, Division of Alcoholism and Substance Abuse, NYU Langone Medical Center/Bellevue, and professor, psychiatry, NYU School of Medicine, New York City; Bruce Goldman, M.D., director, Substance Abuse Services, Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, NY; Jeffrey T. Parsons, M.D., professor, department of psychology at Hunter College, New York City; The Lancet, news release, Jan. 5, 2012 More information: The U.S. National Institute on Drug Abuse has more about drug abuse and addiction.

ABH RESEARCH NEWS - Week of January 09, 2012

Chinese Herbal Medicine May Provide
Novel Treatment for Alcohol Abuse
UCLA researchers have identified how a component of an ancient Chinese herbal anti-hangover medicine called dihydromyricetin, isolated from the plant Hovenia, counteracts acute alcohol intoxication and withdrawal symptoms. The research team found that dihydromyricetin blocks the action of alcohol on the brain and neurons and also reduces voluntary alcohol consumption, with no major side effects, in an early study with rats.

Specifically, dihydromyricetin inhibited alcohol's effect on the brain's GABAA receptors, specific sites targeted by chemicals from brain cells. Alcohol normally enhances the GABAA receptors' influence in slowing brain cell activity, reducing the ability to communicate and increasing sleepiness — common symptoms of drunkenness. The next stage of the research will involve human clinical trials, the researchers said.
 
The research team determined that dihydromyricetin may provide a molecular target and cellular mechanism to counteract alcohol intoxication and dependence, leading to new therapeutic treatments — all based on an ancient "folk medicine" treatment that has been used by humans for at least 500 years.

Alcohol use disorders are the most common form of substance abuse, affecting more than 76 million people worldwide, according to the World Health Organization. Only an estimated 13 percent of people identified as having an alcohol use disorder receive medical treatment, partly due to a lack of effective medications without major side effects. Although alcohol impacts most organ systems, its effect on the brain in developing intoxicating, sedative and addictive properties is critical.

Associate Professor Jing Liang, M.D., Ph.D., and Professor Richard W. Olsen, Ph.D., both from the department of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA, are available for interviews. The study was funded by the National Institutes of Health. The research appears in the Jan. 4 online edition of the Journal of Neuroscience: http://www.jneurosci.org/content/32/1/390. A copy of the full study is also available.

ABH RESEARCH NEWS - Week of January 02, 2012

Report Shows Treatment Admissions for Abuse of Prescription Pain
Relievers have Risen 430 Percent from 1999-2009
A new report shows that while the overall rate of substance abuse treatment admissions among those aged 12 and older in the U.S. has remained nearly the same from 1999 to 2009, there has been a dramatic rise (430 percent) in the rate of treatment admissions for the abuse of prescription pain relievers during this period. The report by the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that the rate of treatment admissions primarily linked to these drugs rose from 10 per 100,000 in the population in 1999 to 53 per 100,000 population in 2009.

The rise in treatment admissions related to the abuse of prescription drug pain relievers occurred in every region of the country, but was highest in the states of Maine, Vermont, Delaware, Kentucky, Maryland, Arkansas, Rhode Island, and West Virginia.

The report finds that while the overall rate of substance abuse treatment admissions has remained virtually the same for the U.S during this period (759 per 100,000 population in 1999 versus 753 per 100,000 population in 2009) there have also been significant changes in the rates involving specific substances of  abuse and various regions of the country.

For example, the rate for admissions primarily related to marijuana disorders has climbed 33 percent – from 102 per 100,000 population in 1999 to 136 per 100,000 population in 2009. Nearly all areas of the nation experienced this sharp rise except for the Mountain region, particularly the states of Idaho, Montana, Colorado, Nevada, and Utah.

On the other hand, the admissions rate for the treatment of primary cocaine abuse dropped by 34 percent during this same period – from 107 per 100,000 population in 1999 to 71 per 100,000 population in 2009. This drop was experienced throughout every region of the country.

“While some aspects of substance abuse treatment admissions have changed – meeting the overall need remains an essential public health priority,” said SAMHSA Administrator Pamela S. Hyde. “The increasing numbers of people entering treatment for prescription drug abuse is the latest indicator of the severity of the problem. Concerned family members or friends who think a substance abuse problem may exist should seek help. Treatment is effective and people recover.”

In April, the Administration released a comprehensive action plan designed to address the national prescription drug abuse epidemic while protecting the delivery of effective pain-management. Titled “Epidemic: Responding to America’s Prescription Drug Abuse Crisis,” the plan includes support for the expansion of state-based prescription drug monitoring programs, more convenient and environmentally responsible disposal methods to remove unused medications from the home, education for patients and healthcare providers, and support for law enforcement efforts that reduce the prevalence of "pill mills" and doctor shopping. The other major findings from the SAMHSA report include:

• The admission rate for the treatment of primary alcohol abuse was 14 percent lower in 2009, than it was in 1999, 314 per 100,000 population versus 364 per 100,000 population.
• The admission rate for treatment of primary alcohol abuse was higher than the admission rate for treatment of illicit drug abuse in 46 out of the 50 reporting states and jurisdictions.
• Admissions for the treatment of methamphetamine/amphetamine soared between 1999 and 2005 from 32 per 100,000 population to 69 per 100,000 population, and then dropped every year through 2009 – down to a rate of 44 per 100,000.

The report, “Treatment Episode Data Set (TEDS) 1999 to 2009, State Admissions to Substance Abuse Treatment Services” is based on the report of thousands of substance abuse treatment facilities throughout the nation and Puerto Rico. TEDS is an administrative data system providing descriptive information about the national flow of admissions to specialty providers of substance abuse treatment. Copies of this report and all its detailed findings are available on the web at: http://wwwdasis.samhsa.gov/teds09/teds2009stweb.pdf . For related publications and information visit the SAMHSA website at www.samhsa.gov .

SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities. SAMHSA offers an on-line treatment locator service that can be access at www.samhsa.gov/treatment or by calling 1-800-662-HELP (4357).