Bup Feeds

Introverts With Few Positive Feelings at Higher Risk of Drug Abuse: Study

Drug and Alcohol News (JoinTogether.com) - Thu, 04/17/2014 - 11:40am

Introverts who tend to have fewer positive feelings, or to not be attracted to rewards in life, are more likely to abuse drugs than more extroverted people with positive emotions, a new study suggests.

Studying personality may help scientists better understand and treat substance use problems, according to the researchers from the National Institute on Drug Abuse. Researcher Dr. Sergi Ferré said people who are extroverted and have more positive emotions may be more open to rewards other than good feelings that come from using a drug. For instance, they may feel rewarded by certain social situations such as winning a game or receiving a promotion.

In contrast, people who are introverted and have fewer positive feelings may have less interest in these rewards, and instead be more influenced by pleasant sensations that come from using drugs.

The researchers found having a tendency to experience negative emotions, such as anxiety or depressed mood, is associated with substance use disorder. Having a difficult time stopping a behavior or action once it is started is also linked with an increased risk of substance abuse, The Huffington Post reports.

The researchers noted the likelihood a person will abuse drugs involves many factors, including genes, personality, environment and past drug use. The findings appear in the journal Trends in Cognitive Sciences.

Categories: Bup Feeds

Commission Asks For Shorter Drug Trafficking Sentences

Drug and Alcohol News (JoinTogether.com) - Thu, 04/17/2014 - 11:40am

The U.S. Sentencing Commission, which advises federal judges, is recommending shorter prison sentences for most federal drug trafficking offenders, according to Reuters. Up to 70 percent of these offenders would receive shorter prison sentences if the commission’s recommendations are not opposed by Congress.

“This modest reduction in drug penalties is an important step toward reducing the problem of prison overcrowding at the federal level in a proportionate and fair manner,” Commission Chair Judge Patti B. Saris said in a news release. “Reducing the federal prison population has become urgent, with that population almost three times where it was in 1991.”

Last month, U.S. Attorney General Eric Holder testified in favor of changing federal guidelines to reduce the average sentence for drug dealers. He told the Sentencing Commission the Obama Administration supports changing guidelines to reduce the average drug sentence by about one year, from 62 months to 51 months. The proposed changes would reduce the federal prison population by about 6,550 inmates over the next five years, the article notes. Currently, half of the 215,000 inmates in the federal prison system are serving time for drug crimes.

The new rules will go into effect on November 1, unless Congress votes to stop the sentencing guidelines, the article notes. Drug traffickers with the greatest quantities of drugs would not receive reduced sentences.

Reducing sentences could result in less leverage for prosecutors, warned Scott Burns, Executive Director of the National District Attorneys Association. He said district attorneys often use the threat of long sentences to convince drug offenders who have witnessed larger crimes to cooperate. “They can use the leverage of the threat of harsher punishment in order to solve murder cases and prosecute drug kingpins,” he said.

Categories: Bup Feeds

Post-Surgical Analgesia in Rainbow Trout: Is Reduced Cardioventilatory Activity a Sign of Improved Animal Welfare or the Adverse Effects of an Opioid Drug?

Buprenorphine Research (PubMed) - Thu, 04/17/2014 - 9:00am
Related Articles

Post-Surgical Analgesia in Rainbow Trout: Is Reduced Cardioventilatory Activity a Sign of Improved Animal Welfare or the Adverse Effects of an Opioid Drug?

PLoS One. 2014;9(4):e95283

Authors: Gräns A, Sandblom E, Kiessling A, Axelsson M

Abstract
The use of fish models in biomedical research is increasing. Since behavioural and physiological consequences of surgical procedures may affect experimental results, these effects should be defined and, if possible, ameliorated. Thus, the use of post-surgical analgesia should be considered after invasive procedures also in fish, but presently, little information exists on the effects of analgesics in fish. This study assessed the effects of an opioid drug, buprenorphine (0.05 mg/kg IM), on resting ventilation and heart rates during 7 days of postsurgical recovery in rainbow trout (Oncorhynchus mykiss) at 10°C by non-invasively recording bioelectric potentials from the fish via electrodes in the water. Baseline ventilation and heart rates were considerably lower compared to previously reported values for rainbow trout at 10°C, possibly due to the non-invasive recording technique. Buprenorphine significantly decreased both ventilation and heart rates further, and the effects were most pronounced at 4-7 days after anaesthesia, surgical procedures and administration of the drug. Somewhat surprisingly, the same effects of buprenorphine were seen in the two control groups that had not been subject to surgery. These results indicate that the reductions in ventilation and heart rates are not caused by an analgesic effect of the drug, but may instead reflect a general sedative effect acting on both behaviour as well as e.g. central control of ventilation in fishes. This resembles what has previously been demonstrated in mammals, although the duration of the drug effect is considerably longer in this ectothermic animal. Thus, before using buprenorphine for postoperative analgesic treatment in fish, these potentially adverse effects need further characterisation.

PMID: 24736526 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Opioid-related mortality and filled prescriptions for buprenorphine and methadone.

Buprenorphine Research (PubMed) - Thu, 04/17/2014 - 9:00am
Related Articles

Opioid-related mortality and filled prescriptions for buprenorphine and methadone.

Drug Alcohol Rev. 2014 Apr 16;

Authors: Wikner BN, Ohman I, Seldén T, Druid H, Brandt L, Kieler H

Abstract
INTRODUCTION AND AIMS: To assess opioid-related mortality and correlation with filled prescriptions for buprenorphine and methadone.
DESIGN AND METHODS: A register study, including data from the Swedish Forensic Pathology and Forensic Toxicology databases 2003-2010, the Prescribed Drug Register and the National Patient Register.
RESULTS: A total of 1301 deaths, assessed as related to buprenorphine, methadone or heroin, or a combination of them, were studied. The largest number of fatalities was related to intake of heroin (n = 776), followed by methadone (n = 342) and buprenorphine (n = 168). The total annual number of fatal cases related to the studied drugs more than doubled (116 to 255) during the study period. There were increases in mortality related to both buprenorphine and methadone: from 1 to 49 cases for buprenorphine, and from 19 to 81 cases for methadone. Only one-fifth of the fatal cases had a filled prescription for the maintenance drug assessed as the cause of death.
DISCUSSION AND CONCLUSION: This study showed that most fatalities were not related to filled prescriptions of maintenance drugs, and a substantial illicit use of buprenorphine and methadone resulting in deaths was revealed. To prevent opioid toxicity deaths it is important to make efforts not only to reduce drug diversion from maintenance programs, but also to improve the control of drug trafficking and other illegal sources. [Wikner BN, Öhman I, Seldén T, Druid H, Brandt L, Kieler H. Opioid-related mortality and filled prescriptions for buprenorphine and methadone. Drug Alcohol Rev 2014].

PMID: 24735085 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Pharmacokinetic-pharmacodynamic modelling of intravenous buprenorphine in conscious horses.

Buprenorphine Research (PubMed) - Thu, 04/17/2014 - 9:00am
Related Articles

Pharmacokinetic-pharmacodynamic modelling of intravenous buprenorphine in conscious horses.

Vet Anaesth Analg. 2014 Apr 16;

Authors: Love EJ, Pelligand L, Taylor PM, Murrell JC, Sear JW

Abstract
OBJECTIVE: Describe the pharmacokinetics of buprenorphine and norbuprenorphine in horses and to relate the plasma buprenorphine concentration to the pharmacodynamic effects.
STUDY DESIGN: Single phase non-blinded study.
ANIMALS: Six dedicated research horses, aged 3-10 years and weighing 480-515 kg.
METHODS: Thermal and mechanical nociceptive thresholds, heart and respiratory rates and locomotor activity were measured before and 15, 30, 45 & 60 minutes and 2, 4, 6, 8, 12 & 24 hours post-administration of 10 μg kg(-1) buprenorphine IV. Intestinal motility was measured 1, 6, 12 & 24 hours after buprenorphine administration. Venous blood samples were obtained before administration of buprenorphine 10 μg kg(-1) IV and 1, 2, 4, 6, 10, 15, 30, 45 & 60 minutes, and 2, 4, 6, 8, 12 & 24 hours afterwards. Plasma buprenorphine and norbuprenorphine concentrations were measured using a liquid chromatography-tandem mass spectroscopy (LC-MS/MS) assay with solid-phase extraction. A non-compartmental method was used for analysis of the plasma concentration-time data and plasma buprenorphine concentrations were modelled against two dynamic effects (change in thermal threshold and mechanical threshold) using a simple Emax model.
RESULTS: Plasma buprenorphine concentrations were detectable to 480 minutes in all horses and to 720 minutes in two out of six horses. Norbuprenorphine was not detected. Thermal thresholds increased from 15 minutes post-buprenorphine administration until the 8-12 hour time points. The increase in mechanical threshold ranged from 3.5 to 6.0 Newtons (median: 4.4 N); and was associated with plasma buprenorphine concentrations in the range 0.34-2.45 ng mL(-1) .
CONCLUSIONS AND CLINICAL RELEVANCE: The suitability of the use of buprenorphine for peri-operative analgesia in the horse is supported by the present study.

PMID: 24735059 [PubMed - as supplied by publisher]

Categories: Bup Feeds

[Comment on this case report].

Buprenorphine Research (PubMed) - Thu, 04/17/2014 - 9:00am
Related Articles

[Comment on this case report].

J Mycol Med. 2012 Sep;22(3):294-7

Authors: Chiron LM, Pihet M, Rouleau F, de Gentile L, Bouchara JP, Chabasse D

PMID: 23518130 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

Commentary: Cigarettes and Pharmacies Don’t Mix

Drug and Alcohol News (JoinTogether.com) - Wed, 04/16/2014 - 11:34am

By now, almost everyone has heard the big announcement from CVS/pharmacy that their stores will become tobacco-free by October 1. This is a significant milestone, and yet it’s just the latest chapter of a long story.

Have you heard about Fred Mayer? He is the Marin County, California pharmacist who made the courageous choice — decades ago — to rid his pharmacy of tobacco. Fred proclaimed “enough is enough,” gathered up the cigarettes one day, and had a bonfire out back. No corporate hand-wringing about “revenue loss” and “customer choice.” Just a good local decision from an upright pharmacist whose primary interest was the health of his customers and his community.

And do you know about Terence (Terry) Gerace? For the last few years, Terry has been showing up in Washington D.C.’s Dupont Circle, staging a one-man silent protest. His sign is simple and to the point: “CVS Sells Poison.” Tough words, but right on. Doesn’t he deserve a tweet from Michelle Obama, too?

In 2008, when San Francisco passed the first tobacco-free pharmacy ordinance in the United States, it wasn’t easy. With the ordinance came a three-pack of lawsuits: from Philip Morris, Walgreens, and Safeway. Law briefs from these organizations are a fascinating part of our tobacco-control history, documenting corporate fear of change, mixed with disdain for the health of the people.

Happily, San Francisco just celebrated its fifth anniversary of tobacco-free pharmacies, and the light is green to any community that is ready to pass a similar policy. Over 75 communities in Massachusetts have done just this too.

Safeway: With your slogan “Ingredients for Life”, and your pharmacies at the back of the store, will you continue to sell and propel Marlboros into our neighborhoods?

Walgreens: With your slogan “The Pharmacy America Trusts” will you continue to do the tobacco industry’s bidding by pushing e-cigarettes, Swisher Sweets, Newports and chew into our young, people of color, LGBT, low-income and other vulnerable communities?

Your local pharmacist knows best: Cigarettes and Pharmacies don’t mix.

Bob Gordon is the winner of Legacy’s 2013 Community Activist Award. For the majority of his career, Mr. Gordon has been a leader in addressing tobacco-related harms within the LGBT community. His leadership has been pivotal in bringing the LGBT community together to take a stand against the tobacco industry, while championing smoking-cessation classes geared specifically to LGBT and HIV-positive smokers. He currently serves as Project Director for the California LGBT Tobacco Education Partnership in San Francisco, California. To learn more about Bob Gordon and his work, visit the Legacy website.

Categories: Bup Feeds

Google Isn’t Doing Enough to Stop Illegal Drug Sales Online, Some Attorneys General Say

Drug and Alcohol News (JoinTogether.com) - Wed, 04/16/2014 - 11:34am

Google is not doing enough to stop online sales of illegal drugs and fake prescription medicines, according to a group of state attorneys general. The company says it disabled 4.6 million pharmaceutical or health supplement ads last year.

Last December, 24 attorneys general sent a letter to Google outlining their concerns, The Washington Post reports. The letter led to private meetings with Google executives. Some attorneys general say they are satisfied with the company’s response, while others are not, the article notes.

The company says since it toughened its advertising policy in 2010, the number of ads placed by unlicensed pharmacies has decreased by 99.9 percent. In 2011, Google agreed to pay $500 million to avoid being prosecuted for aiding illegal online pharmaceutical sales. In the settlement, the company acknowledged it had improperly and knowingly assisted online pharmacy advertisers, allegedly based in Canada, to run ads for illegal pharmacy sales that targeted American customers.

Company emails, disclosed as part of a shareholder lawsuit, indicate the company knew of the risks of illegal pharmacy ads long before they stopped allowing them, the newspaper reports.

Google says it will hire 120 people this year to look for rogue ads and videos, and will eliminate 1,200 predicted search phrases, including “how to become a drug dealer,” which have led people to illegal web sites. Mississippi Attorney General Jim Hood says he will pursue legal action if the company does not also remove sites that sell illicit drugs and other illegal products from its search results.

Categories: Bup Feeds

Occasional Marijuana Use May Change Structure of Young People’s Brains: Study

Drug and Alcohol News (JoinTogether.com) - Wed, 04/16/2014 - 11:33am

Occasional marijuana use may change the brain structure in young adults, a new study suggests. Marijuana may cause changes related to motivation, emotion and reward. The changes occurred in the areas of the brain involved in processing emotion and forming long-term memories, and in reward and addiction, HealthDay reports.

The study included 40 college students ages 18 to 25. Half said they used marijuana at least weekly, and were not considered drug-dependent. The other half of the participants did not use marijuana. The participants underwent MRI brain scans. In marijuana smokers, the amygdala and nucleus accumbens regions of the brains were abnormally shaped, and the nucleus accumbens was larger. The more a person used marijuana, the more pronounced the brain changes.

Low-level marijuana use may make a person more vulnerable to addiction, or to changing their emotions or thought processes, according to the researchers. “These are two brain regions you do not want to mess around with,” said study co-author Dr. Hans Breiter of Northwestern University Feinberg School of Medicine. “All parts of the brain are important, but some, like these, are more fundamental. It raises a very serious issue, given that we saw these changes in casual marijuana users.”

While previous studies have indicated similar changes in brain structure in people who were heavy marijuana users, this is the first study to indicate that even casual marijuana use can change a person’s brain, said study lead author Jodi Gilman of the Massachusetts General Hospital Center for Addiction Medicine. “We were interested in looking at these young adults who aren’t addicted,” she said. “They aren’t reporting any problems from marijuana, and yet we still see these brain changes.”

The study will appear in The Journal of Neuroscience.

Categories: Bup Feeds

Private Equity Firm Hopes for Profits From Substance Treatment Facilities

Drug and Alcohol News (JoinTogether.com) - Wed, 04/16/2014 - 11:33am

The private equity firm Bain Capital recently took over the largest chain of substance treatment facilities in Massachusetts, The Boston Globe reports. Bain, which usually makes investments in brand-name companies such as Dunkin’ Donuts, sees treating addiction as big business.

Bain paid $58 million for Habit OPCO Inc., which has 13 locations in Massachusetts. It made the purchase through another company it owns, CRC Health, the largest provider of substance abuse treatment and behavioral health services in the nation.

Substance abuse treatment is a $7.7 billion industry, and is growing at a rate of about 2 percent annually, the article notes. A growing number of people addicted to opioids are middle- and upper-middle class, according to Deni Carise, Deputy Chief Clinical Officer for CRC Health.

At Habit OPCO facilities, patients are charged $135 a week for methadone treatment, including daily doses of liquid methadone, access to healthcare professionals, and other services. While some patients have private insurance, others are covered through Medicaid or pay cash.

Dr. Kevin P. Hill, director of the Substance Abuse Consultation Service at McLean Hospital in Belmont, Massachusetts, says he is concerned about the care that some for-profit methadone clinics provide. “The problem I find with some of the for-profit clinics is the absolute minimum required by law becomes the absolute maximum they’re willing to do for their patients,” Hill said.

Habit OPCO and CRC staff say profits are not their main goal. “Frankly, the way to make a lot of money in this particular business is to do it badly,” CRC’s Carise said. “We’re just not going to do that.” She noted the Affordable Care Act, and a law that requires equal insurance coverage for mental health conditions, will give clinics more access to private health insurance. The new laws will help make treatment more affordable for people who previously had no insurance, she said.

Categories: Bup Feeds

Massachusetts Cannot Ban Zohydro, Federal Judge Says

Drug and Alcohol News (JoinTogether.com) - Wed, 04/16/2014 - 11:32am

Massachusetts cannot ban the new pure hydrocodone drug Zohydro ER (extended release), a federal judge said Monday. The company that makes the drug, Zogenix, argued in a lawsuit that the ban is unconstitutional, according to The Wall Street Journal.

Last Month, Massachusetts Governor Deval Patrick announced Zohydro would be banned in the state. He cited a public health emergency stemming from opioid abuse.

The drug is a pure form of the painkiller hydrocodone. The Food and Drug Administration (FDA) approved Zohydro ER in October for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Drugs such as Vicodin contain a combination of hydrocodone and other painkillers such as acetaminophen. Zohydro is designed to be released over time, and can be crushed and snorted by people seeking a strong, quick high.

This week, U.S. District Judge Rya Zobel issued a preliminary injunction on the ban. The judge said the state appears to have overstepped its authority in banning Zohydro. She noted Zogenix was likely to be successful in pursuing a court order to permanently lift the ban. In her ruling, Judge Zobel said the ban would “undermine the FDA’s ability to make drugs available to promote and protect the public health.”

“Today’s legal ruling was a positive step forward for Massachusetts patients,” Roger Hawley, Chief Executive Officer of Zogenix, said in a news release. “We invite concerned officials to engage with us to discuss fair and appropriate safeguards for pain medications like Zohydro ER rather than seeking to ban or restrict one specific treatment.”

Governor Patrick said he was disappointed in the ruling, the newspaper notes. “Addiction is a serious enough problem already in Massachusetts without having to deal with another addictive narcotic painkiller sold in a form that isn’t tamper proof,” he said in a statement. “We will turn our attention now to other means to address this public-health crisis.”

Categories: Bup Feeds

Component analysis of Iranian crack; a newly abused narcotic substance in iran.

Buprenorphine Research (PubMed) - Wed, 04/16/2014 - 8:30am
Related Articles

Component analysis of Iranian crack; a newly abused narcotic substance in iran.

Iran J Pharm Res. 2014;13(1):337-44

Authors: Farhoudian A, Sadeghi M, Khoddami Vishteh HR, Moazen B, Fekri M, Rahimi Movaghar A

Abstract
Iranian crack is a new form of narcotic substance that has found widespread prevalence in Iran in the past years. Crack only nominally resembles crack cocaine as it is widely different in its clinical signs. Thus the present study aims to quantify the chemical combination of this drug. The samples included 18 specimen of Crack collected from different zones of Tehran, Iran. All specimens were in the form of inodorous cream solid powdery substance. TLC and HPLC methods were used to perform semi-quantitative and quantitative analysis of the components, respectively. The TLC analysis showed no cocaine compound in the specimens while they all revealed to contain heroin, codeine, morphine and caffeine. All but two specimens contained thebaine. None of the specimens contained amphetamine, benzodiazepines, tricyclic antidepressants, aspirin, barbiturates, tramadol and buprenorphine. Acetaminophen was found in four specimens. HPLC revealed heroin to be the foundation substance in all specimens and most of them contained a significant amount of acetylcodeine. The present analysis of the chemical combination of Crack showed that this substance is a heroin-based narcotic which is basically different from the cocaine-based crack used in Western countries. Studies like the present one at different time points, especially when abnormal clinical signs are detected, can reveal the chemical combination of the target substance and contribute to the clinical management of its acute or chronic poisoning.

PMID: 24734089 [PubMed]

Categories: Bup Feeds

Almost One-Fourth of Pregnant Women on Medicaid Filled Opioid Prescriptions: Study

Drug and Alcohol News (JoinTogether.com) - Tue, 04/15/2014 - 11:07am

Almost one-quarter of pregnant women enrolled in Medicaid in 2007 filled a prescription for opioids, a new study finds. The risks of opioids to a developing fetus are largely unknown, The New York Times reports.

An estimated 1.1 million pregnant women were enrolled in Medicaid in 2007. The program covers medical expenses for 45 percent of births in the United States, according to the newspaper. The study, published in Obstetrics & Gynecology, found the rate of opioid prescribing is on the rise—18.5 percent of pregnant women enrolled in Medicaid in 2000 filled opioid prescriptions, compared with 23 percent in 2007.

“To hear that there’s such a high use of narcotics in pregnancy when I see so many women who worry about a cup of coffee seems incongruous,” Dr. Joshua A. Copel, a professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine, told The New York Times.

The reason for the increase in opioid prescribing for pregnant women is unclear, but may be partly due to back pain.

An article published earlier this year in Anesthesiology, which included 500,000 privately insured women, found 14 percent were given opioid painkillers at least once during their pregnancy. Both studies found codeine and hydrocodone were the most commonly prescribed opioids during pregnancy. Most of the women took the drugs for a week or less.

The Medicaid study found stark regional differences in opioid prescribing. Among pregnant women in Utah, 41.6 percent were prescribed opioids, compared with 35.6 percent in Idaho, 9.6 percent in New York and 9.5 percent in Oregon. “The regional variation really concerned me the most,” said Dr. Pamela Flood, a professor of anesthesiology and pain medicine at Stanford University. “It’s hard to imagine that pregnant women in the South have all that much more pain than pregnant women in the Northeast.”

Categories: Bup Feeds

Bipartisan Senate Group Forms to Fight Prescription Drug Abuse

Drug and Alcohol News (JoinTogether.com) - Tue, 04/15/2014 - 11:06am

A bipartisan group of senators has formed to fight prescription drug abuse, according to The Hill. The group will look for innovative solutions to opioid abuse.

The Prescription Drug Abuse Working Group, part of the Senate Health, Employment, Labor and Pensions (HELP) Committee, will convene a series of meetings about prescription drug abuse, involving local, state and federal officials, private coalitions, and companies developing novel technologies for combating abuse. The group will focus on hydrocodone, oxycodone and other narcotics that can be easily abused, according to HELP Committee Chairman Tom Harkin of Iowa.

Committee Ranking Member Lamar Alexander of Tennessee has been an outspoken critic of the Food and Drug Administration’s (FDA) approval of the pure hydrocodone drug Zohydro. In February, he and two other Republican senators wrote to FDA Commissioner Margaret Hamburg to protest the agency’s decision to approve the drug. They wrote, “We believe the approval of pure hydrocodone products without methods to prevent abuse, misuse, and diversion, including abuse-deterrent formulations, poses a significant danger to our constituents, as it could worsen the drug abuse epidemic in our country.”

In a news release announcing the new Senate working group, Alexander said, “Not a day goes by that we don’t hear news of how prescription drug abuse is harming Americans across the nation, including in Tennessee. We are launching this working group to look at the problem from all angles—particularly what the federal government is doing to enable the mayors, governors, and law enforcement and public health officials who are working hard to address the problem.”

Categories: Bup Feeds

Senators Find E-Cigarette Makers Are Targeting Young People

Drug and Alcohol News (JoinTogether.com) - Tue, 04/15/2014 - 11:05am

E-cigarette makers are targeting young people with free samples distributed at music and sporting events, according to an investigation by 11 Democratic members of the U.S. House and Senate. The companies are also running radio and television ads during programs aimed at young people, the lawmakers said.

They hope their report will speed the release of e-cigarette regulations by the Food and Drug Administration (FDA), according to The New York Times. Some public health experts say e-cigarettes could help reduce the rate of regular cigarette smoking, while others are concerned the devices could encourage young people to try traditional cigarettes.

The report included results from a survey of eight major e-cigarette producers. All eight said they had given away free samples, and six said they had sponsored events. According to the report, 348 events featured free samples and sponsorship in 2012 and 2013, “many of which appeared geared toward youth.”

Lorillard, which makes the e-cigarette Blu, was responsible for the most free samples and sponsorships, the report found. The company sponsored Freedom Project, a national music tour. Ads for Blu ran in Sports Illustrated, and featured women in bikinis. A spokesman for the company said it does not advertise to youth.

Representative Henry Waxman of California, who led the inquiry into e-cigarettes with Senator Richard Durbin of Illinois, said in a news release, “E-cigarette makers are starting to prey on kids, just like the big tobacco companies. With over a million youth now using e-cigarettes, FDA needs to act without further delay to stop the companies from marketing their addictive products to children.”

Categories: Bup Feeds

Vending Machine in Colorado Dispenses Marijuana

Drug and Alcohol News (JoinTogether.com) - Tue, 04/15/2014 - 11:04am

A vending machine that dispenses marijuana will soon be open for business in Colorado, NPR reports. The machine is able to verify a customer’s age, according to its creators.

Customers can also purchase marijuana-infused snacks from the machine, which is called ZaZZZ. It is designed to be used by medical marijuana patients, and will be located in licensed stores.

Stephen Shearin of Tranzbyte, the parent company of American Green, which built the machine, said, “Your identity is confirmed against active biometrics.” The machine may help dispensary owners reduce employee theft, the article notes.

Several other companies, including MedBox, also have created marijuana vending machines, but so far they have been kept behind store counters, according to NPR.

Categories: Bup Feeds

The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients.

Buprenorphine Research (PubMed) - Tue, 04/15/2014 - 6:30am

The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients.

Drug Alcohol Depend. 2014 Mar 15;

Authors: Edelman EJ, Chantarat T, Caffrey S, Chaudhry A, O'Connor PG, Weiss L, Fiellin DA, Fiellin LE

Abstract
BACKGROUND: Opioid dependence is a major risk factor for HIV infection, however, the impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected opioid-dependent patients is unknown.
METHODS: We conducted a longitudinal analysis of 303 HIV-infected opioid-dependent patients initiating buprenorphine/naloxone treatment. Outcomes included self-reported past 90-day needle-sharing and non-condom use. We assessed trends over the 12 months using the Cochran-Armitage trend test. Using generalized estimating equations, after multiple imputation, we determined factors independently associated with needle-sharing and non-condom use, including time-updated variables. We then conducted a mediation analysis to determine whether substance use explained the relationship between time since treatment initiation and needle-sharing.
RESULTS: Needle-sharing decreased from baseline to the fourth quarter following initiation of buprenorphine/naloxone (9% vs. 3%, p<0.001), while non-condom use did not (23% vs. 21%, p=0.10). HIV risk behaviors did not vary based on the presence of a detectable HIV-1 RNA viral load. Patients who were homeless and used heroin, cocaine/amphetamines or marijuana were more likely to report needle-sharing. Heroin use fully mediated the relationship between time since treatment initiation and needle-sharing. Women, patients who identified as being gay/lesbian/bisexual, those married or living with a partner and who reported heroin or alcohol use were more likely to report non-condom use. Older patients were less likely to report non-condom use.
CONCLUSIONS: While buprenorphine/naloxone is associated with decreased needle-sharing among HIV-infected opioid-dependent patients, sexual risk behaviors persist regardless of viral load. Targeted interventions to address HIV risk behaviors among HIV-infected opioid-dependent populations receiving buprenorphine/naloxone are needed.

PMID: 24726429 [PubMed - as supplied by publisher]

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Differential diagnosis for a stable patient maintained on buprenorphine who gives a urine toxicology screen negative for buprenorphine.

Buprenorphine Research (PubMed) - Tue, 04/15/2014 - 6:30am

Differential diagnosis for a stable patient maintained on buprenorphine who gives a urine toxicology screen negative for buprenorphine.

Am J Addict. 2014 May;23(3):318-9

Authors: Sethi R, Petrakis I

PMID: 24724891 [PubMed - in process]

Categories: Bup Feeds

Suboxone versus Methadone for the Treatment of Opioid Dependence: A Review of the Clinical and Cost-effectiveness

Buprenorphine Research (PubMed) - Fri, 04/11/2014 - 6:00am

Suboxone versus Methadone for the Treatment of Opioid Dependence: A Review of the Clinical and Cost-effectiveness

Book. 2013 11 14

Authors:

Abstract
Addiction to opioids causes major medical, social, and economic problems to both the individual and society. Opioid dependence is defined as a strong desire to use the substance, difficulty in controlling its use, the presence of a physiological withdrawal state, tolerance of the use of the drug, neglect of alternative pleasures and interests and persistent use of the drug, despite harm to oneself and others. It is a complex disease involving physiological, psychological, genetic, behavioral and environmental factors. In Canada, it is estimated that there were more than 80,000 regular illegal opioid users in 2003. The number of illegal drug-related overdose deaths in Canada was 958 in 2002. Opioid dependence is related to the abuse of not only illegal opioid drugs (e.g. heroin), but also some of the most commonly prescription drugs, such as codeine-containing Tylenol, hydromorphone, oxycodone, morphine and others. Treatment of opioid dependence includes three approaches: stabilization, detoxification and maintenance. Stabilization is usually achieved by opioid substitution treatments to ensure that the drug use becomes independent of mental state (such as craving and mood) and independent of circumstances (such as finance and physical location). The next stage is detoxification that is to withdraw from opioids. The final step is maintenance to prevent relapse. Detoxification refers to the process by which the effects of opioid drugs are eliminated in a safe and effective manner, such that withdrawal symptoms are minimized. Appropriate use of the detoxification agents plays a crucial role in increasing the successful detoxification rate, while minimizing the side effects and withdrawal symptoms. Methadone (μ-opioid receptor agonist) or buprenorphine (μ-opioid receptor agonist and κ-opioid receptor antagonist) are recommended first-line treatments in opioid detoxification. Naloxone is an opioid antagonist without agonist properties. In opioid-dependent patients, naloxone precipitates withdrawal. Suboxone (buprenorphine/naloxone) was approved by Health Canada in 2007 for substitution treatment in opioid drug dependence in adults. It is a fixed combination of buprenorphine (a partial μ-opioid receptor agonist) with naloxone (an opioid antagonist) in a 4:1 ratio. The addition of naloxone to buprenorphine is expected to decrease the intravenous abuse of buprenorphine, because when taken sublingually, absorption of naloxone is minimal, however it can rapidly precipitate opioid withdrawal when injected. Suboxone is recommended for the treatment of opioid dependence for patients in whom methadone is contraindicated (such as patients at high risk of, or with QT prolongation, or hypersensitivity to methadone). The purpose of this review is to provide evidence on the comparative clinical effectiveness and cost-effectiveness of use of Suboxone compared with methadone, for the treatment of patients with opioid dependence. Subgroups such as children and pregnant women may also have access to opioids thus, the clinical benefits and risks of Suboxone for these patients will be examined as well, when evidence is available.


PMID: 24716256

Categories: Bup Feeds

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