The overwhelming majority of those who abuse opiates or become addicted get the medications from friends or family and have previously used drugs, such as cocaine.

According to research published in The Archives of Internal Medicine – most of the millions of Americans abusing opiate medications are getting these drugs from friends or family members, and not from legitimate medical sources.

Looking at data from the 2008 National Survey on Drug Use and Health researchers at Yale University found that:

• Only 20% of drug abusers use legitimate prescriptions as their primary source of access to drugs
• 69% of drug abusers list friends or family as their primary source of drugs, and for users between the ages of 18 and 25, that percentage shoots up to 77%
• Only 3% of people using legitimately prescribed opiates will become addicted
• 80% of OxyContin abusers have also used cocaine

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Here’s one very compelling reason to quit opiates sooner rather than later.

Need a good reason to seek treatment for an opiate addiction?

Well you might find the inspiration you’ve been looking for in a new study out of the Kaiser Center for Health Research that links just three to four months of high dose opiate use with a significantly increased likelihood of erectile dysfunction…50% higher!!!

The Study

The researchers examined the medical records of 11 327 men with back pain who were enrolled with Kaiser Permanente in Portland Oregon. Many of these men received prescriptions for opiates to control their pain.

The study looked to investigate:

1. Did getting prescribed opiates increase a man’s likelihood to request erectile dysfunction (ED) medication, such as sildenafil, tadalafil or testosterone replacement within 6 months?
2. What factors influenced an increased likelihood to require ED medication?

The Results

Over a 12 month time period around seeing a doctor for back pain

• 6.7% of men not prescribed opiates received a prescription for an ED medication
• 12.5% of men prescribed low dose opiates for 120 days or longer (or 90 days or longer with 10 or more prescription refills) received a prescription for an ED medication
• 19.3% of men on higher doses of opiates (120 morphine equivalents or greater per day) for 120 days or longer (or 90 days or longer with 10 or more prescription refills) received a prescription for an ED medication
• Having depression and taking sedative hypnotics, like benzodiazepines, also increased a man’s likelihood of requiring an ED medication
• Surprisingly, neither obesity nor smoking were associated with an increased likelihood to require an ED medication

Commentary

The study authors recommend that primary care physicians weigh the risks of sexual dysfunction when making prescribing decisions and that patients receive information about these sexual risks and about possible alternative therapies, such as cognitive behavioral therapy and physiotherapy exercises.

Opiates are known to decrease testosterone levels. The study authors suggest that this is the most probable explanation for their negative influence on erectile functioning.

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Mass. state drugs commission calls opiate use in the commonwealth an “epidemic” and to emphasize the point, compares the numbers of state citizens that die in overseas combat with those that die from drug overdoses – saying that drug overdoses cause 42 times more deaths.

According to the Massachusetts OxyContin and Heroin Commission, the state is in the middle of an opiate addiction “epidemic” that’s resulting in a terrible death toll.

The commission has just released a 71 page addiction report and to emphasize the human costs of addiction, the commission has compared the dangers of serving overseas with the risks of using drugs on the streets of Massachusetts, writing, “The Commonwealth is losing men and women on its streets at a rate of 42 to 1, compared to what the state is losing in two wars overseas.”

Between 2007 and 2007, the state lost 78 soldiers in combat overseas. Over that same period, 3265 in the state died from drug related causes.

State Senator, Steven Tolman, who chairs the commission, said, “We have a health crisis here. None of them [addicts] want to be sick. You could have a son or a daughter who was brought up properly with all the morals and values, and, when they get hooked on the stuff, it doesn’t matter; it’s all out the window.’’

Although the numbers affected are substantial, public perceptions of addiction tend to minimize the policy response. In an analogy statement, the commission wrote, “If the H1N1 virus killed 3,000 people in a five-year period in Massachusetts, the crisis would be center stage. Because of the stigma surrounding substance abuse, this epidemic is left in the shadows.’’

Some of the 20 recommendations made by the commission include:

• Improving prescription drug monitoring programs
• Protecting people who help overdosing drug users get medical care from liability or arrest
• Reducing criminal penalties for drug users who seek treatment
• Furthering support to “recovery high schools”
• Increasing investment in alternative to incarceration programs, such as drug courts

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As a way to make one bag of heroin intoxicate 2 people, some East African addicts will inject a small quantity of blood from a person who has just used heroin, a practice known as flashback. Experts say that this is the most efficient possible way to transfer HIV infection.

Like a perfect storm to transmit HIV/AIDS infection, heroin addicts in the East African are injecting each others blood as a way to share the high of a dose of injected heroin.

University of Texas researchers who studied the practice, known as flashblood, have been documented its occurrence in Tanzania, Kenya and Zanzabar.

They say that amongst the subjects that studied, commonly sex workers, someone who had made enough money for a bag of heroin would offer flashblood, as a kindness against heroin withdrawal symptoms, to a friend who had not earned sufficiently.

After injecting heroin into a vein, a user typically draws blood back into the syringe and re-injects, sometimes 3 or 4 times, to ensure that all of the heroin in the syringe is moved into the body. When offering a flashback, the user will inject and then draw blood back into the syringe only once, and then offer this blood to another addict.

Although experts say that a teaspoon or so of blood seems like an insufficient amount to transfer a heroin high, the researchers say that women offered a flashback would react after injection similarly to those who had taken an injection of straight heroin (passing out) – possibly a result of small quantities of heroin that remain in the syringe, as well as from the heroin in the blood.

HIV/ADIS infection rates in East African countries range from 3% to 8%, much lower than the 15% to 25% seen in southern Africa, however, since flashback in East Africa seems practiced mostly by women, many of whom work in the sex industry, the possibility of increased infections rates are worrisome. Nora Volkof, Director of the National Institute on Drug Addiction commented, saying, “Injecting yourself with fresh blood is a crazy practice — it’s the most effective way of infecting yourself with H.I.V…Even though the number who do it is a relatively small group, they are vectors for H.I.V. because they support themselves by sex work.”

In Tanzania, 64% of female heroin addicts are HIV positive. Many of these women work in the sex industry to support their heroin habits. Heroin in East Africa comes directly from manufacturing countries like Afghanistan making it relativity cheap and very potent.

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Police say that the average cheese heroin user in Dallas is getting younger, and doctors confess that they just don't know how to treat an addiction in those as young as 9.

What do you do with a 9 year old Heroin Addict?

Dallas Texas is enduring its third year of what officials call a "mini epidemic" of cheese heroin addiction, and doctors say they are seeing a disturbing new trend.

Cheese heroin is a combination of low grade Mexican black tar heroin, and crushed sleep medications, such as Tylenol PM. The drug is cheap but very addictive; 1 dollar will buy a line, and users snort the drug for a high that wears off fast, leaving users in a state of withdrawal within a couple of hours.

Nationwide, the average heroin user is older and white, but in Dallas, the new generation snorting heroin is Hispanic, and hasn't yet moved out of middle school.

Doctor Carlos Tirado, a psychiatrist at UT Southwestern Medical Center says that "Kids as young as 9 or 10 years of age coming to the hospital emergency rooms or detox facilities in acute heroin withdrawal." He asks, "Do you send a 9-year-old to an AA meeting?"

Cheese heroin contains typically between 1% and 3% heroin, and the high wears off quickly. Police say that users describe needing a fix 8 or more times per day, with some kids saying they wake up in the middle of the night in full withdrawal.

There have been 8 overdose deaths linked to cheese heroin in the last 21/2 years, and although police have had some success in reducing access at high schools, Hispanic parents complain that their neighborhoods are full of the drug.

Police Detective Jeremy Liebe, who works with the Dallas Independent School District Police Department, says that although he has personally arrested over 300 in connection with the drug, that "This is not a problem we can arrest our way out of."

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Researchers say that not everyone with childhood ADHD has the same increased risk of adult substance abuse, hyperactivity, for example, does not increase the risks. 

There's been a lot of research linking childhood ADD/ADHD with an increased risk of adult substance abuse disorders.

But is everyone with an attention deficit disorder at equal risk of substance abuse and addiction?

That's what researchers at The University of Montreal wanted to know, and to find out they followed 1803 school kids from the ages of 6 to 12 and had teachers and parents evaluate each annually on measures of inattention, hyperactivity an oppositional/defiant behaviors.

They then followed up with each study subject at age 21, to evaluate for substance use and abuse.

The Results

• By age 21, 13.% were alcohol abusers or alcohol dependent, 9.1% were marijuana abusers or dependent, 2.0% were cocaine abusers or dependent and 30.7% smoked cigrettes.
• Compared to children without ADD/ADHD symptoms, children with oppositional or defiant tendencies (such as being very quick to anger, being inconsiderate of others, being unwilling to share etc.) were 2.9 times more likely to grow into adults with cocaine problems, 2.1 times more likely to have a marijuana problem and 1.4 times more likely to smoke cigarettes.
• Children described as very inattentive were 1.7 times more likely to smoke cigarettes at age 21.
• There was no significant link found between inattention and an increased risk of other drug use and no link at all between hyperactivity in childhood and substance abuse at adulthood.

Commentary

Commenting on the significance of the findings, lead researcher Jean-Baptiste Pingault, Ph.D., noted that not everyone with ADHD shares a similar risk of adult substance abuse, saying, “By taking into account the unique effect of inattention and hyperactivity, which had seldom been considered separately before, we came to realize that the link between ADHD symptoms in childhood and substance abuse in adulthood was overestimated and hyperactivity in itself did not seem, in this study, to predispose for future substance abuse."

Read the full study results in Molecular Biology.

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A large-scale survey of readers of a clubbing magazine reveals that 15% of those polled take white powder drugs without knowing what they’re taking, and that most are already drunk or buzzed when they make that risky decision.

According to a MixMag survey of more than 15 000 respondents in the UK, America and Canada, people are willing to do some very risky things to get high, especially when they’re drunk.

• 15% of all respondents admitted to using white powder drugs in a club without knowing what they were taking. Among respondents between the ages of 18 and 25, that percentage climbed to 19%.
• Of those who took unknown drugs, one in three said they got the drugs from a person they did not trust.
• 80% of those taking unknown drugs were already intoxicated at the time of ingestion.

Commenting on the results, survey leader Dr. Adam Winstock declared, "What worries me is that people's judgment is already impaired when they are taking a substance they don't know. You are much more likely to run into trouble if you mix drugs, or mix drugs with alcohol – and if you are taking a drug you don't know from someone you don't know, that is really upping the risk."

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Norwegian researchers say that the myth of the laid back pot smoker might have more than a kernel of truth to it - basing their assertion on the results of a research study on marijuana use and motivation at work.

Are marijuana users less motivated on the job?

That’s what Norwegian researcher Christer Hyggen wanted to know; and to find out he tapped into data from a 25 year long study on almost 1500 Norwegian subjects.

The subjects, who were in their late teens and early twenties at the onset of the study in 1987, filled out surveys at five intervals over the 25 year study period. The surveys included questions on marijuana use habits and attitudes about work and work commitments.

The Findings

• People who reported smoking marijuana within a year of being asked reported less commitment to work than abstainers
• People who reported smoking marijuana within 12 months of being asked on only one of the 5 questionnaires (the experimenters) became as committed to work as the never-users over time.
• People who continued to report marijuana use over the 5 surveys became less committed to work as they aged into adulthood.  

Commenting on the findings, Hyggen explained that he cannot say that marijuana use causes lower work performance, only that it is associated with it, but that in general, "people who quit smoking cannabis increase their work commitment, and people who take up smoking cannabis reduce their work commitment."

The full research results can be found the journal, Addiction.

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The American Heart Association has recommended that doctors start asking emergency room visitors complaining of chest pain, whether they had been using cocaine.

"Chest pain, have you been using cocaine, sir?"

The American Heart Association has recommended that doctors ask certain people complaining of chest pain whether they had been using cocaine.

Two common medications used in the emergency treatment of a heart attack can be deadly to a patient having a cocaine induced heart attack. Doctors are recommended to ask about cocaine use when atypical patients come in complaining of heart attack symptoms – particularly patients under the age of 45, and those without heart disease risk factors, such as smoking or obesity.

American Heart Association statement author, Dr. James McCord, explains that there has been a significant increase in cocaine induced emergency room visits over the last several years, and that studies show that cocaine can both cause a heart attack, or make an existing heart attack more severe.

Cocaine causes an increased pulse rate, as well as creates an increased heart demand for oxygen. Conversely, cocaine constricts blood vessels, leading to a diminished supply of oxygen to the heart – and this combination can be deadly.

Two drugs often used in the emergency treatment of a heart attack are Beta-blockers and clot busting drugs.

Beta-blockers normally lower blood pressure without causing a further constriction of the arteries. In cocaine users, Beta-blockers seems to have the opposite effect, actually increasing blood pressure. In animal studies, the combination of Beta-blockers and cocaine has led to seizures and death.

Clot busting drugs, when used by those high on cocaine, can lead to bleeding in the brain.

The American Heart Association released the information in its organizational journal.

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Researchers say that after 75 degrees Fahrenheit, cocaine overdoses start to increase – and as the mercury rises, so do the risks.

Researchers at the University of Michigan say that as warmer weather approaches, cocaine overdoses are likely to increase.

They looked at overdose statistics for New York City and compared these to temperature statistics by date and found that fatal cocaine overdoses start to increase as the temperature passes 75 Farenheit (24 Celsius) – and that as the temperature continues to climb, the rate of overdoses continues to rise.

The scientists say that cocaine becomes more dangerous on hotter days, because:

• It interferes with the body’s ability to cool itself
• It interferes with a person’s ability to accurately perceive an elevated body temperature (and thus take measures to reduce it)
• Overheated cocaine users require less cocaine to overdose, as their bodies are already under duress

The researchers say that below 24 Celsius, changes in temperature do not affect a person’s risk of overdose.

In New York City as the summer months approach, they predict that each week with a temperature over 24 C will see 2 additional overdoses per each 2 degree C increase in temp. For example, an average weekly temperature of 26 C would lead to 2 additional overdoses over cooler week averages – while an average weekly temperature of 32 would cause an additional 8 cocaine overdoses per week compared to the average numbers of deaths per week in cooler periods.

Lead researcher Dr. Amy Bohnert, wants more people to know about the risks of cocaine use on hot days, saying, “My sense is that not many people who use cocaine think about this as a risk.” She says that information campaigns need to target 2 groups of people, addicts and recreational users, and that although overdose prevention interventions should be introduced into high drug use areas, that addicts are not the main consumers of cocaine, saying, “The vast majority of drug users are people who have jobs and who contribute to society.”

The full research findings can be read in the March edition of the journal, Addiction.

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Need a good reason to stop using cocaine? How about this – researchers at the Veterans Health Administration say that using cocaine increases your risks of glaucoma by 45% and accelerates the age of onset by about 20 years.

Open angle glaucoma is the second leading cause of blindness and it's a disease which is rarely symptomatic until late stages of disease progression. Researchers at the VA wondered what environmental factors might play a role in increasing a person’s susceptibility for the disease and to find out, they made use of their enormous pool of data; sourcing information from the 5.3 million people who had used VA outpatient clinics within a 12 month period.

Surprisingly, they found that past and present cocaine use correlated very highly with an increased likelihood of developing open angle glaucoma (the most prevalent type of glaucoma). They found that:

• Past and present cocaine users were 45% more likely to develop open angle glaucoma than non cocaine users
• Past and present drug users who developed glaucoma contracted the disease on average some 20 years earlier than those with glaucoma who had never used illegal drugs (54 versus 73)
• Of the 5.3 million veterans who used outpatient health services over a 12 month period, 83 000 had glaucoma

Commentary

The researchers say that if further research confirms these very strong correlation links then cocaine abuse is very likely one of the few modifiable risk factors for the development of glaucoma later in life.

The full research results can be found in the September 2011 edition of Journal of Glaucoma.

Indiana University School of Medicine (2011, September 30). Cocaine users have 45 percent increased risk of glaucoma

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People who use methamphetamine are at increased risk to develop Parkinson’s disease, probably because chronic methamphetamine use can damage dopamine systems and Parkinson’s occurs as a result of insufficient dopamine in the brain.

Canadian researchers at Toronto’s Centre for Addiction and Mental Health (CAMH) looked at the hospital records of roughly 300 000 people admitted to California hospitals between 1990 and 2005 and confirmed a long held suspicion – that using methamphetamine does result in an increased risk of Parkinson’s disease later in life.

Of the hospital records examined, 40 000 involved admissions related to amphetamine use, 35 000 involved admissions related to cocaine use and 208 000 involved admissions related to appendicitis, with no known addiction present. All study subjects were at least 30 years of age at the time of their admission.

The results:

• Over the 16 years of the study, those patients who were hospitalized for conditions related to amphetamine use had a 76% increased probability of coming down with Parkinson’s disease.
  
• Those admitted for conditions related to cocaine use had no increased risk of developing Parkinson’s disease. 
  

Scientists have long suspected that methamphetamine abuse might lead to Parkinson’s disease. Parkinson’s disease occurs from a deficiency of the neurotransmitter dopamine in the brain and chronic meth abuse is known to damage systems in the brain necessary for dopamine production.

Lead researcher Dr. Russell Callaghan of CAMH commented on the study results, saying "This study provides evidence of this association for the first time, even though it has been suspected for 30 years. The findings are significant because meth and similar stimulants are the second-most commonly used illicit drugs in the world. The current study will help us anticipate the full long-term medical consequences of such problematic drug use.”

The researchers stress that no link has been found between people who use low doses of amphetamine like drugs on a prescription basis (for ADHD and other conditions) and an increased risk of Parkinson’s.  People abusing amphetamines recreationally, they say, tend to take far greater doses than those people who use the same types of drugs therapeutically.

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A UK study on Ketamine reveals that it is now the 4th most popular drug amongst clubbers, that most drug users are unaware of its serious dangers and that when the UK government reclassified the drug as a controlled substance – use went up and the price went down.

A report by the UK’s Independent Scientific Committee on Drugs reveals dangerous levels of ignorance on the effects of ketamine, a drug that has been rising in popularity over the last decade as it has declined in price.

According to the report:

• Ketamine is now the 4th most popular drug among UK clubbers. In 2001, only 25% of clubbers had taken the drug, but by 2009, that percentage had climbed to 68%
• In 2006, there were about 85 000 regular users of the drug, by 2009 that figure had climbed to 125 000 regular users
• Ketamine is an addictive drug that can result in bladder, liver and kidney damage
  
• Ketamine is very wrongly classified as a Class C controlled substance, which is the lowest classification of risk. Marijuana is classified as Class B and ecstasy is Class A.
  
• The government should not reclassify the drug, however, as research suggests that by reclassifying ketamine its price would fall and its usage would increase
  

One of the report’s authors, Professor Val Curran, says the work was produced for professionals and the general public alike to highlight the dangers of and lack of information around one of the UK’s most popularly abused substances, saying, “It is vital that ketamine users and professionals have access to accurate information on ketamine use to reduce its potential harms.”

Members of the Independent Scientific Committee on Drugs have called on government to increase support and treatment opportunities for ketamine users and to increase awareness among the general public about the risks of ketamine use.

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Marijuana is up once again but teen drinking shows a slight decline. More on these statistics and other highlights from the 2010 Monitoring the Future Survey of teens about drug and alcohol use.

For 36 straight years, researchers at The University of Michigan have surveyed Americans teens to get a better idea of adolescent attitudes on and usage of drugs and alcohol.

Some highlights from the 2010 survey, which was released today, include:

• Marijuana use continues to rise, and daily marijuana use is at its highest rate sine the early 1980s - 6.1% of 12^th graders use marijuana on a daily basis.

• 35% of high school seniors admit to smoking marijuana at least once over the past year.

• After marijuana, Vicodin is the most commonly abused illicit drug, with 8% of high school seniors admitting to past year use – this is down from 9.7% in 2009.

• Over the past 30 days, more high school seniors smoked marijuana (21.4%) than tobacco (19.2%)

• Teen drinking is on the decline. 41.2% of high school seniors admitted to past year drinking, which is down from 43.5% in 2009. Binge drinking (drinking 5 or more drinks in a sitting) is also down slightly, with 23.2% of high school seniors admitting to past year binging, compared to 25.2% in 2009.

• 5.5% of high school seniors used salvia over the past 12 months

In commenting on the survey results, NIDA Director Nora D. Volkov expressed concern about rising marijuana use, saying, "These high rates of marijuana use during the teen and pre-teen years, when the brain continues to develop, place our young people at particular risk. Not only does marijuana affect learning, judgment, and motor skills, but research tells us that about 1 in 6 people who start using it as adolescents become addicted."

Read all survey results at 2010 Monitoring the Future Survey.

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Doctors in San Francisco, LA and Rochester New York are saying that levamisole (an agricultural de-worming agent) tainted cocaine is causing people to show up in hospitals with purplish decaying skin on the face and ears.

The vast majority of cocaine sold at the retail level in America is cut with an agricultural de-worming drug that drug traffickers use to boosts cocaine’s potency and stretch their profits (by 2009, DEA tests revealed 70% contamination).

But while adding agricultural supplies to the powder might make good financial sense to a drug baron, it may not be what the casual user would want, especially since doctors say that it’s causing users to develop a condition called purpura.

Purpura manifests as painful purplish dead and decaying skin, generally around the ears or face. The condition is very uncomfortable and people with purpura are at increased risk of developing peripheral infections.

A team of doctors who published a study on the cocaine caused condition say that at first, no one could figure out what was causing the increase of purpura being seen in hospital emergency rooms across the country. It wasn’t until they looked at levamisole as a possible culprit and doctors began testing purpura subjects for cocaine that things started to make a little more sense. Dermatologist and contributing study author Dr. Mary Gail Mercurio explained, saying, "When we first started seeing these patients they all had a similar clinical picture, but they were really an enigma because they weren't falling into any other pattern we'd seen before. When a colleague at the National Institutes of Health mentioned levamisole contamination, we did toxicity screens and lo-and-behold, all the patients came up positive for cocaine. We had our diagnosis."

The study authors say they aren’t sure how levamisole is causing the disorder, but say that purpura is treatable and that the condition goes away with cessation of tainted cocaine use.  Overall, however, the medical researchers aren’t so optimistic, warning, "We believe these cases of skin reactions and illnesses linked to contaminated cocaine are just the tip of the iceberg in a looming public health problem posed by levamisole.”

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