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Tuesday, May 31, 2011

Substance abuse exacerbated by traumatic events

Earlier this month, a paper published in the journal Drug and Alcohol Dependence highlighted the increase in alcohol use and abuse in people directly affected by Hurricanes Katrina and Rita (August and September 2005).

The study used pre- and post-hurricane data to prospectively detect effects of these traumatic events on heavy drinking, including binge drinking, in adults living in Mississippi, Louisiana, and Alabama. Drinking was exacerbated by low income and low socioeconomic status. Social support provided during the 2 months after the hurricanes buffered against these effects, suggesting that providing immediate social support may reduce alcohol use problems in populations affected by such disasters.

A prior report in adolescents found that trauma associated with Hurricane Rita increased alcohol use.

These studies add to a growing body of research reporting associations between substance abuse problems and disasters, both natural and man made.

For example, earlier this year, a study reported alcohol use data from 10 smaller scale traumatic events taking place between 1987-1995 (plane crash, shootings, tornado, floods, earthquake, and fire). The study concluded that alcohol drinking increased primarily in individuals who used alcohol as a coping mechanism prior to the traumatic event.

Substance abuse increased in a Swiss sample surveyed online after the Indian Ocean Tsunami of December 2004.

Further, a number of studies have shown that substance abuse problems increased in the period immediately following the September 11 2001 World Trade Center (WTC) terrorist attacks in New York. A recent analysis indicated that substance abuse disorder diagnosis rate from September 11-December 31 was proportional to proximity to the attack site: people living within 5 miles of the WTC at the time of the attacks were 5 times more likely to be diagnosed with a substance abuse problem than people living 30 miles away. Moreover, the diagnosis rate over the same time interval in the year before the attacks (September 11 – December 31, 2000) exhibited the opposite relationship (proximity to the WTC was associated with lower substance abuse diagnosis rates).

Together, these studies support the idea that major traumatic events have the capacity to increase substance abuse problems, particularly in those living close to the event, those with low socioeconomic status, and those with prior substance use histories. The data suggesting that it may be possible to reduce substance abuse problems by introducing immediate social support are intriguing and merit followup.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Friday, May 27, 2011

The Next Frontier Conference and Neuroscience Research

Wednesday May 25, 2011 was the 50th anniversary of a speech by President John F. Kennedy who called out to Americans to support the extraordinary effort to reach and explore the moon:

“...I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to earth...” (President John F. Kennedy, May 25, 1961)

Wednesday also was the final day of the Inaugural Next Frontier Conference, convened to discuss the present state of neuroscience research and to provide a call to action to accelerate research and treatment progress, particularly for brain disorders affecting soldiers and veterans.

Conference participants included Vice President Joseph Biden, NIH Director Francis Collins, NIMH Director Thomas Insel, NINDS DIrector Story Landis, FDA Commissioner Margaret Hamburg, Apollo 11 astronaut Buzz Aldrin, and Conference Co-Director and former U.S. Representative Patrick J. Kennedy.

Mr. Kennedy, leader of the One Mind Campaign and a Sponsor of the Mental Health Parity Bill, is the recipient of this year's CPDD Distinguished Service Award, to be presented at the CPDD Plenary Session on Sunday, June 19, 2011. On Monday afternoon, June 20, he will present a Presidential Special Lecture entitled: We Must Be of One Mind for Research.

Mr. Kennedy has likened the challenges and urgency necessary to develop better treatments for brain disorders to those confronting America at the time of his uncle's call for moon exploration:

“The One Mind campaign is modeled on the space program’s unification of disparate applied-science and engineering disciplines over the coming decade –– with a goal of integrating the health-care work of widely-scattered specialists in biology, brain surgery, genetics, addiction, spinal cord injury, computer imagery and many more fields.”

An informative article on the One Mind Campaign can be found in the Providence Journal, which focuses on improving treatments and findings cures for brain disorders sustained by our servicemen and women and veterans.

According to the Next Frontier, 100 million Americans are affected by brain disorders, including 300 thousand servicemen and women and veterans, and thus there is great urgency to advance neuroscience research to treat all Americans.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Saturday, May 14, 2011

Impressive Results From the Second National Take Back Initiative

Results are in from the 2nd National Take Back Initiative held on April 30th and they are impressive, with substantially more medications returned to more return locations than in the prior Take-Back event. Over 188 tons of unused medications were returned to over 5,000 return locations across the US.

The event was sponsored by a number of state and federal agencies and spearheaded by the Drug Enforcement Administration (DEA), and it follows on the first such event held last September.

Take Back events enable people to safely discard unused medications including prescription drugs that could otherwise fall into the wrong hands and be abused. Prescription drug abuse, particularly abuse of drugs with psychoactive properties such as pain medications (e.g., oxycontin) and stimulants, has become a major public health problem in the US.

Although no statistics yet are available on the types and proportions of drugs returned during the Take Back Initiatives, a study of spontaneously returned medications to pharmacies and surgeries in England suggests that drugs acting on the brain (including pain medications) make up around 24% of the total of returned drugs.

In a California study conducted by the Teleosis Institute from June – December 2007 (“Research Data on Unused Medicine”), a similar proportion of the return total (23%) was of drugs acting on the brain including painkillers, although controlled substances were excluded from collection efforts and amounted to only 2% of the total.

Given that the Take Back events encourage people to discard all unused medications, including controlled substances, it will be very interesting to see collection data to help determine the efficacy of these events in reducing the supply of controlled substances available for diversion.

A 2008 report by Avalere Health LLC suggests that millions of pounds of unused prescription medications sit in medicine cabinets across the US, so it seems that scaling up Take Back Initiative events and developing additional means for people to discard unused controlled substance medcations could be beneficial in reducing the US prescription medication abuse problem.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.