Bup Feeds

Patient safety experts are urging hospitals to require physicians to have random drug and alcohol tests. The tests should also be conducted if a patient dies suddenly or is injured unexpectedly during surgery, they write in the Journal of the American Medical Association.

In a commentary published in the journal, the experts say that if a doctor is found to be impaired, the hospital could suspend or revoke their medical license, according to The Baltimore Sun. The incident in some cases could be reported to the state licensing board, wrote Dr. Julius Cuong Pham, an emergency medicine physician at The Johns Hopkins Hospital in Baltimore, Dr. Peter J. Pronovost, Director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality, and Dr. Gregory E. Skipper of the drug and alcohol treatment center Promises, in Santa Monica, California.

They recommend impaired physicians undergo treatment and routine monitoring, as a condition for continued licensure and hospital privileges.

“Patients might be better protected from preventable harm. Physicians and employers may experience reduced absenteeism, unintentional adverse events, injuries, and turnover, and early identification of a debilitating problem,” the doctors added. They note that physicians are as susceptible to alcohol, narcotic and sedative addiction as the general public.

“Patients and their family members have a right to be protected from impaired physicians,” they conclude. “In other high-risk industries, this right is supported by regulations and surveillance. Shouldn’t medicine be the same? A robust system to identify impaired physicians may enhance the professionalism that peer review seeks to protect.”

Nine “recovery courts” will be created in Tennessee to combat substance abuse and mental health issues, state officials announced this week. They will combine services currently found in drug courts, mental health courts and veterans courts.

The Tennessee Department of Mental Health and Substance abuse Services said the new courts will serve juvenile and adult addicted nonviolent offenders, whose participation will be voluntary, according to the Associated Press.

“We are facing a major prescription drug problem in our state,” Department Commissioner Douglas Varney said in a news release. “We need to focus all of our resources in the most efficient, effective and collaborative way to maximize our impact on this issue and drug abuse overall. And because so many people who are dealing with a substance abuse issue also have a mental health issue … these recovery courts will be able to help them get all the help that they need at one time and in one location.”

The new courts will incorporate intensive judicial supervision, treatment services, sanctions and incentives, the article notes. State officials said that while these courts often exist separately in other states, Tennessee will integrate them “in an effort to combine similar issues of mental health, substance abuse, and veterans affairs in one location and to best utilize the available funds.”

Severe DRESS syndrome managed with therapeutic plasma exchange.

Pediatrics. 2013 Mar;131(3):e945-9

Authors: Alexander T, Iglesia E, Park Y, Duncan D, Peden D, Sheikh S, Ferris M

Abstract
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but increasingly described phenomenon of immune activation and organ dysfunction in association with a wide variety of medications. This reaction shows a broad spectrum of clinical presentation and severity, ranging from mild to lethal. Treatment strategies of immune suppression appear be helpful in some cases, but treatment failures occur frequently with reported mortality rates of 5% to 10%. We present a pediatric case of DRESS syndrome associated with either lamotrigine or bupropion, leading to multiorgan involvement and life-threatening complications of respiratory failure and cardiac arrest. After failing to improve with removal of these medications and administration of systemic corticosteroids, our patient showed dramatic, sustained clinical response to therapeutic plasma exchange. To our knowledge, this is the first reported case of therapeutic plasma exchange used for life-threatening DRESS syndrome in a pediatric patient. This case suggests needed research for this therapeutic option in life-threatening DRESS syndrome resistant to high-dose steroids.

PMID: 23420918 [PubMed - indexed for MEDLINE]

This year’s Partnership Attitude Tracking Study (PATS) results, which confirmed that one in four teens has misused or abused a prescription (Rx) drug at least once in their lifetime, received extensive media attention, with numerous national and local media outlets reporting on the findings. Please take a look at just a few highlights below:

Read the story from the Associated Press

Read the HealthDay story, and view a resulting television piece

Read the story from United Press International (UPI)

Listen to Steve Pasierb’s Associated Press Network Radio interview and NPR radio interview

Read the story on WebMD, About.com, The Washington Post and Reuters

The Neurological Center for Pain’s Chronic Pain Rehabilitation Program (CPRP) at the Cleveland Clinic has created a Chemical Education Track designed specifically for patients with chronic non-cancer pain who also have a therapeutic opioid addiction. Initial results are promising. Patients who complete the program report low opioid resumption rates 12 months after they complete the program. They also report sustained improvements in pain severity, mood and pain-related functional impairment.

The Chemical Education Track began in 2009 and was designed to help the growing number of patients with both chronic pain and addiction, explains Sara Davin, Psy.D, MPH, of the Cleveland Clinic’s Neurological Center for Pain (NCP). While it is not a chemical dependency treatment program, patients are educated about addiction and how it has affected their lives and their pain, said Dr. Davin, who spoke about the program with the NCP’s Director, Edward Covington, MD, at the recent American Academy of Pain Medicine meeting.

The CPRP’s intensive day-treatment program lasts three to four weeks, from 7:30 a.m. to 5 p.m. All patients treated in the program, including those in the chemical education track, are offered a variety of services, including medication management, physical and occupational therapy, psychodynamic group therapy, individual psychotherapy, biofeedback training and group and individual cognitive behavioral therapy, including relaxation training. The program also emphasizes weekly participation in family education and family therapy.

“Often people with chronic non-cancer pain have gone through a lot of treatments— and for our patients, pain takes hold of their lives to the point that it is disabling,” Dr. Davin says. “They often are not working, they may have depression and anxiety related to their pain, or maybe it was there before, and got worse as time went on. We don’t offer a cure, but we offer coping strategies and tools to help folks get their lives back.”

All patients in the program, whether or not they have a therapeutic opioid addiction, are tapered off opioids and other habituating medications. “Other, adjunctive medications are used that carry less risk of addiction and have been shown to be more effective in treating chronic non-malignant pain,” she notes.

Each patient coming into the pain treatment program undergoes an extensive evaluation that includes questions about substance use. “If someone is struggling with an active recreational addiction, we ask them to get chemical dependency treatment before they come into the program,” Dr. Davin explains.

Throughout the program, patients are monitored and assessed for possible misuse of opioids and other prescribed medications, through urine toxicology, information from family and through continued meetings with the program staff.

The chemical education track includes daily classes that cover topics such as the myths of addiction, the signs and symptoms of addiction in people with chronic pain who are using prescription medication, and the pros and cons of using opioid medications to treat chronic pain. “We encourage self-help program involvement when appropriate, and we talk about relapse prevention,” Dr. Davin states. “If a patient leaves our program and develops an acute pain incident that requires treatment with opioids, we talk about how they can do that safely without developing a full-blown relapse.”

Drs. Huffman and Sweis of the Neurological Center for Pain have been tracking the outcomes of patients with co-occurring chronic pain and therapeutic opioid addiction who have been treated for pain in the CPRP. Preliminary results indicate these patients do just as well as those without an addiction. Patients with substance use disorders, who were dropping out of the program at higher rates than other patients, are now staying in the program at the same rate, notes Kelly L. Huffman, PhD., M.S. “We found both groups, whether they are in the chemical education track or not, improved on measures of pain, mood and function,” explains Giries W. Sweis, Psy.D., MHS.

Drs. Sweis and Huffman followed 120 patients for a year after they left the program. Only 22.5 percent reported resuming opioid use after one year. Patients who were addicted to opioids were no more likely to resume use than patients without an addiction. They note this is very significant, as abstinence-based chemical dependency programs treating those with non-medical opioid addictions have found relapse rates as high as 91 percent. Only patients who were depressed, whether or not they had a history of substance abuse, were more likely to have resumed opioid use a year after the program. They also noted while co-occuring therapeutic opioid addiction did not increase the odds of resumption, levels of depression at the time of program completion did.

“Overall, our data suggests that our multi-disciplinary CPRP benefits those seeking relief from these intractable conditions. It is especially encouraging to see such a strong and long-lasting improvement in these patients, and based on these findings patients’ mood is more on my radar,” says Dr. Sweis.

Scientists have blocked heroin addiction relapse in rats using a vaccine, according to U.S. News & World Report. They hope the vaccine will be ready for human testing later this year.

The vaccine allows the immune system to neutralize the effects of heroin and its byproducts, before the drug can reach the brain and cause a “high,” scientists from The Scripps Research Institute in California found. They say the vaccine might prevent a person addicted to heroin from overdosing on the drug.

Rats in the study were allowed unlimited access to heroin for several weeks, and then studied for four weeks while they received no heroin. Half of the rats were then given the vaccine, and all of the animals were reintroduced to heroin. “The rats who were not vaccinated relapsed quickly, the vaccinated rats stopped taking it,” said researcher George F. Koob. “In effect, what the vaccine does is prevent heroin from reaching the brain.”

The findings appear in the Proceedings of the National Academy of Sciences.

Last year, a researcher at the Walter Reed Army Institute of Research was awarded a grant from the National Institute on Drug Abuse to develop a vaccine that would treat heroin addiction and protect against HIV.

Former President Bill Clinton this week pledged his foundation will work with the New York Police Department (NYPD) and other partners to address prescription drug abuse, with a focus on college students.

The Clinton Foundation hopes within five years to cut in half the number of young adults ages 18 to 26 who misuse prescription drugs for the first time, the New York Daily News reports. The foundation will recruit colleges to join a Prescription Safe Campus Initiative to implement best practices designed to reduce prescription drug abuse. “This is insane to have the brightest of our young people dropping out under conditions of which their addiction has not been treated or their abuse is out of ignorance,” Clinton said on Monday.

The program will include prevention education programming, student-led awareness campaigns, and increased substance abuse and mental health services on campuses that participate, according to a foundation news release.

NYPD Commissioner Ray Kelly announced the department will work with colleges and universities in New York City to increase awareness about prescription drug abuse during freshman orientation.

The soon-to-be-released update of the manual used to diagnose mental illness lacks scientific validity, says the director of the National Institute of Mental Health (NIMH). The Diagnostic and Statistical Manual of Mental Disorders (DSM) does not reflect the complexity of many disorders, according to Dr. Thomas R. Insel.

The updated version of the DSM, known as DSM-5, is scheduled to be released later this month. Dr. Insel told The New York Times the manual’s way of categorizing mental illnesses should not be used to guide research.

“As long as the research community takes the DSM to be a bible, we’ll never make progress,” Dr. Insel said. “People think that everything has to match DSM criteria, but you know what? Biology never read that book.”

He said the field of psychiatry needs a new paradigm for understanding mental illness. He noted there is a vast amount that scientists still do not know regarding the causes of these disorders.

In a recent NIMH blog post, Dr. Insel wrote DSM diagnoses are based on a consensus about clusters of clinical symptoms, instead of an objective laboratory measure. “In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.”

NIMH has launched the Research Domain Criteria project, which aims to incorporate genetics, imaging, cognitive science and other information to lay the foundation for a new classification system for mental health. He announced NIMH will be re-orienting its research away from DSM categories.

Other critics of DSM-5 have said it will expand the list of what constitutes mental illness and will lead to a needless increase in diagnoses.

The California Supreme Court on Monday ruled local governments can outlaw medical marijuana dispensaries, according to Reuters. The court upheld a ban the city of Riverside enacted in 2010.

Nothing in the state’s law preempts local governments from using their authority to “allow, restrict, limit, or entirely exclude facilities that distribute medical marijuana,” the court ruled. Riverside’s attorney argued California’s medical marijuana law did not weaken local government’s ability to regulate land use.

California was the first state to allow medical marijuana 17 years ago. More than 180 cities and counties in the state have instituted bans on dispensaries, the article notes.

In 2011, some medical marijuana shops in California began closing down, after receiving letters from federal prosecutors threatening their landlords with legal action. Four U.S. attorneys said they would prosecute landlords who rent space to operators of medical marijuana dispensaries. The landlords were threatened with criminal charges or seizure of their assets.

More than a dozen drug companies are working on abuse-resistant painkillers, in the wake of the Food and Drug Administration’s (FDA) decision last month not to approve any generic versions of the original form of OxyContin.

The FDA also approved new labeling for a reformulated version of the drug, which will indicate it is more difficult to crush, and thus harder to abuse than the original version. The original version of OxyContin could be crushed and then snorted or injected. OxyContin’s manufacturer, Purdue Pharma, introduced a tamper-resistant formula in 2010.

The Wall Street Journal reports the FDA on Friday will consider the effectiveness of another painkiller, Opana ER. If the FDA decides that drug deters abuse, it could help guard Opana’s maker, Endo Pharmaceuticals, from competition, since generic painkillers are not tamper-resistant. That would provide extra incentive to create new painkillers that are resistant to abuse, the article notes. Opana turns into a jellylike substance when it is heated up for injection.

Pfizer has two potential new abuse-resistant drugs: Remoxy, which would compete with OxyContin, and Embeda, a morphine drug. Johnson & Johnson is testing an opioid drug that is tamper-resistant, while Purdue Pharma hopes to produce a hydrocodone drug that is resistant to abuse.

“Over time, it should be a scientific race across the whole pharmaceutical industry to create a market where all opioids have abuse-deterrent properties,” Gary L. Stiles, Senior Vice President of Research and Development at Purdue Pharma, told the newspaper.

Smaller biotech companies are developing their own tamper-resistant formulas. One company has created pills that are so hard, that they chip a coffee grinder’s blades when someone tries to use the device to break down the pills.

Law enforcement officials who are trying to crack down on the growing problem of nitrous oxide abuse have limited options to punish people who sell the gas to those who use it to get high, the Los Angeles Daily News reports.

Nitrous oxide, or “nozz,” is a prescription drug inhaled by recreational users to get high, usually from balloons filled from large cylinders. It is also sold as a product to improve car performance. According to the United States Attorney’s Office for the Central District of California, the drug can cause many significant and debilitating side effects, including, in extreme cases, death.

In a news release, the U.S. Attorney’s Office notes, “during the past year, several teens in the Los Angeles region have been killed in car accidents linked to the use of nitrous oxide, and acts of violence have been associated with the inhalation or sale of the drug, according to court documents.” The Los Angeles Sheriff’s Department says sales of nitrous oxide as a drug have dramatically increased in Southern California over the past five years.

A person selling nitrous oxide used by someone to get high can be charged with a misdemeanor violation of the federal Food, Drug and Cosmetic Act, which carries a maximum penalty of one year in prison and up to a $100,000 fine.

While possessing nitrous oxide with the intent to ingest it for non-medical or dental reasons is a misdemeanor in California, intent is difficult to prove, the article notes. In 2009, the state passed a law that makes it a misdemeanor to sell nitrous oxide to a minor.

Southern California officials say the problem is increasing. “I had hoped it would dissipate,” said Los Angeles Deputy City Attorney Veronica De Alba. “But it just seems to be getting bigger.”

A California veterinarian is advocating using medical marijuana to help improve the quality of life for some pets with untreatable conditions, according to ABC News.

Doug Kramer of the Vet Guru animal veterinary center says treating pets with medical marijuana could help pet owners put off the decision to euthanize their animals while treating the pets’ pain.

Ingrid Newkirk, President of People for the Ethical Treatment of Animals, told ABC News, “Our position is that anything that can help animals – if it’s truly, properly administered in the right amount [and] can relieve a dog’s pain – then they should be given the same consideration that humans in pain are given.”

Newkirk cautioned about the potential for abuse when people who use marijuana are around pets. “People amuse themselves by blowing smoke in a dog’s face to get him high or getting the cat drunk, and so, you know, that’s something that one has to guard against,” she said. “It has to be a genuine medical need, and if that is the best course of treatment then we are in favor of it.”

The American Veterinary Medical Association says it does not have a position on the issue of medical marijuana for pets, according to Lynne White-Shim, Assistant Director with the Division of Scientific Activities. She noted it would be important to conduct research into the effects of marijuana on animals before proceeding with treatment, since not all drugs affect humans and animals in the same way.

Fifty percent more pills were collected during the latest National Prescription Drug Take-Back Day, compared with the previous event in 2012, the Drug Enforcement Administration (DEA) announced.

The agency said 742,497 pounds of prescription medications were collected from almost 6,000 sites around the country on April 27, UPI reports. More than 2.8 million pounds of prescription medications have been removed from circulation during the six national take-back days the DEA has sponsored.

The events are designed to provide a safe, convenient and responsible way for people to dispose of their unwanted or expired medications, while educating the public about the potential for abuse of prescription drugs.

According to the 2011 Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, twice as many Americans regularly abused prescription drugs than the number of those who regularly used cocaine, hallucinogens, heroin, and inhalants combined, the DEA noted in a news release. More than 70 percent of people abusing prescription pain relievers say they obtained them through friends or relatives, including the family medicine cabinet.

Abuse-deterrent formulations, an evolving technology against the abuse and misuse of opioid analgesics.

J Med Toxicol. 2012 Dec;8(4):400-7

Authors: Schaeffer T

Abstract
The increased use of opioid pain medication has been mirrored by the increased misuse and abuse of these drugs. As part of a multidisciplinary approach to this epidemic, pharmaceutical companies, with the encouragement of the Food and Drug Administration, have increased the development of abuse-deterrent formulations. While all have the goal of treating pain while mitigating misuse and abuse, there are different technologies utilized to impart the abuse-deterrent properties. The goal of this paper is to review the basis of abuse-deterrent formulations, the different types and approaches of some of the abuse-deterrent products, and their current regulatory status in the USA.

PMID: 23073726 [PubMed - indexed for MEDLINE]

All Rise America! It’s National Drug Court Month. The National Association of Drug Court Professionals (NADCP) is thrilled to announce that we are once again hitting the road this May to celebrate National Drug Court Month with an epic cross-country RV tour of Drug Courts, Veterans Treatment Courts and DWI Courts. All Rise America! will travel over 3,500 miles coast-to-coast to shine a spotlight on communities that prove addicted people belong in treatment, not prison, and that Drug Courts, DWI Courts and Veterans Treatment Courts are the solution for saving lives, reuniting families and making communities safer.

Every stop along the route of All Rise America! will feature events at local treatment courts and highlight inspiring stories of justice reform and personal recovery. Our goal is for every person in America to know about the incredible transformations that take place day in and day out in America’s Drug Courts, DWI Courts and Veterans Treatment Courts. Along the way we will pass the ceremonial All Rise Gavel, a symbol that when one person rises out of addiction and finds recovery, we All Rise. Celebrities and national policymakers are scheduled to appear at events along the route.

Drug Court Graduation in Santa Maria, California

We kicked things off a few days early with an incredible Drug Court and Veterans Treatment Court graduation in Santa Maria, CA yesterday. You can see video and pictures of this and every event on the All Rise America! blog, www.AllRiseAmerica.org.

All Rise America! is not just about the 50 Drug Courts, DWI Courts and Veteran Treatment Courts we will connect with while on the road. This is a celebration of the collective impact that over 2,700 treatment courts have on millions of people who suffer with addiction, mental illness and trauma. It is a celebration for each and every person who believes that treatment, not prison, is where addicted people belong. But it is also a call to action. Every American should be aware of the miracle of Drug Courts. And when they are asked if there is a Drug Court in their town, they should demand that answer be “YES!”

There are several ways to be a part of All Rise America!

Follow every mile on the All Rise America! blog – At each event we will post videos, pictures and updates about the incredible communities we visit. Check in often.

Get social – All month long we will have tons of content on our Facebook and Twitter pages. Make sure you share them and let people know that you support Drug Court.

All Rise America! is made possible by the generous contributions of its sponsors: Alcohol Monitoring Systems, Inc; Siemens Healthcare Diagnostics; and Alkermes. By supporting All Rise America!, these companies demonstrate incredible support for Drug Courts and other treatment courts. They are helping to ensure that individuals suffering from substance abuse disorders receive evidence-based treatment.

West Huddleston, CEO, National Association of Drug Court Professionals

An analysis of college students’ Twitter use finds mentions of the attention deficit hyperactivity disorder (ADHD) drug Adderall spikes during finals. Tweets about the drug are most common in the northeast and south. Some students use Adderall and other ADHD medications to help them focus while studying,

Researchers at Brigham Young University monitored all public-facing Twitter mentions of Adderall over a six-month period, removing those who indicated they were promoting the drug. They found 213,633 tweets from 132,099 users, MedicalXpress reports. Adderall-related tweets averaged 930 per day, but jumped to 2,813 on December 13, and 2,207 on April 30, they report in the Journal of Medical Internet Research.

“Adderall is the most commonly abused prescription stimulant among college students,” lead researcher Carl Hanson said in a news release. “Our concern is that the more it becomes a social norm in online conversation, the higher risk there is of more people abusing it.”

Tweets mentioning Adderall were more common in the middle of the week, and declined by the weekend.  “It’s not like they’re using it as a party drug on the weekend,” Hanson noted. “This data suggests that they’re using it as a study aid. Many of the tweets even made a study reference.”

Per-capita tweets about Adderall were highest in Vermont, Massachusetts and Alabama. Southeast Texas, central Illinois and northern California had the lowest rates.

The study found 9 percent of tweets mentioning Adderall included another substance such as alcohol, cocaine, marijuana or Xanax. Study co-author Michael Barnes said, “Tweets hinting at co-ingestion are particularly troubling because morbidity and mortality risk increases when substances are combined.”

Dozens of colleges are instituting stricter rules for diagnosing and medicating ADHD. The rules are a reaction to the growing overuse of these medications. One study at a large university found 34 percent of students had used a prescription stimulant drug to help them focus when they felt academic stress.

People who drink to improve their mood are three times more likely to become dependent on alcohol, compared with those who don’t use alcohol to feel better or stay calm, new research suggests.

Among people with an increased risk of alcohol dependence, those who drink to improve their mood are less likely to become sober several years later, compared with people who don’t drink to ease painful emotions, the Los Angeles Times reports.

One new study, published in JAMA Psychiatry, included people who were at increased risk of alcoholism, who were asked whether they drank to improve their mood or reduce tension. They were interviewed again several years later, to determine whether they had become, or stayed, alcohol-dependent. “Drinking to self-medicate mood symptoms may be a potential target for prevention and early intervention efforts aimed at reducing the occurrence of alcohol dependence,” the researchers wrote.

A second study, published in the same journal, used brain scanners in 45 people with alcoholism at an inpatient treatment program, while they were in the first four to eight weeks of a 12-step program. They were asked to think about situations when they were relaxed, and then to imagine highly stressful situations or those associated with heavy drinking.

Patients who would later relapse were more likely than those who did not return to drinking to show low activity in regions of the brain associated with regulation of mood, emotional arousal and cognitive control when they thought about stressful situations or drinking-related scenarios. When they were relaxed, they showed increased activity in these brain regions.

In an editorial accompanying the studies, Nora D. Volkow, Director of the National Institute on Drug Abuse, wrote, “A better understanding of a patient’s response to stress and/or alcohol cues is bound to contribute to the design of more personalized and, therefore, effective treatment strategies.”

Georgia Governor Nathan Deal has signed a law that requires pain clinics to be licensed by the state medical board, and new clinics to be owned by physicians. The measure is designed to reduce prescription drug abuse, according to The Wall Street Journal.

The law, which goes into effect July 1, states pain clinics must register every two years or face possible felony indictments. Georgia’s medical board can deny licensing to a pain clinic for reasons including the owner’s prior criminal conviction related to controlled substances, the article notes.

The number of pain clinics jumped in Georgia from 10 in 2010, to 140 the following year, after Florida cracked down on its own “pill mills.” Georgia is the ninth state to require that pain clinics be doctor-owned. Alabama and Indiana are considering similar measures.

Georgia’s prescription-drug monitoring program, aimed at catching people who obtain pain prescriptions from multiple physicians (known as “doctor shopping”), will launch in mid-June. Funding for the program is not guaranteed past this fall, the newspaper states.

In March, a report issued by the Florida Department of Law Enforcement found the number of deaths due to oxycodone decreased by 29 percent in the state in the first six months of 2012, compared with the second half of the previous year. The report provides evidence Florida is successfully fighting the prescription drug abuse epidemic, officials said.

New Jersey Governor Chris Christie on Thursday signed into law a measure that encourages people to report drug overdoses. The law allows people to call 911 to report a drug overdose, without the fear of getting arrested for drug possession themselves.

Governor Christie was joined by singer Jon Bon Jovi for the signing of the law. Bon Jovi’s daughter overdosed at her college dorm in upstate New York last year, but survived. Prosecutors dropped drug charges against her and another student under that state’s Good Samaritan overdose-reporting law, according to the Associated Press.

“What we now have is a comprehensive law we can all be proud of for what it can achieve, the saving of a life to provide the opportunity for individuals, their families, friends and those Good Samaritans involved to reflect on their experience in a way that they probably would have never reflected upon it before,” Christie said in a statement. “A life saved from drug abuse can be a life restored. Families can be spared the anguish of loss, a loss that could have been prevented.”

After signing the law, Governor Christie and Bon Jovi visited with patients at a drug rehabilitation center.

The governor rejected the Good Samaritan Emergency Response Act last fall, saying it was too focused on reporting drug overdoses, instead of deterrence. On Monday, he partially vetoed a bill that makes the overdose antidote naloxone available to spouses, parents and guardians of people addicted to opioid. They would be taught to administer the drug in an emergency. He recommended that measure be combined with the key components of the Good Samaritan bill that protects witnesses and victims from arrest, charge, prosecution, conviction, or revocation of parole or probation, where evidence is obtained as a result of seeking medical assistance.

The state Senate and House both overwhelmingly approved the compromise bill.

The key ingredient in sleep medications such as Ambien has been linked to a 220 percent jump in emergency room visits between 2005 and 2010, according to a new government report. The ingredient, zolpidem, is also found in sleep aids including Eldular and Zolpimist, CBS News reports.

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports there were 6,111 visits due to the medication in 2005. That number rose to 19,487 visits in 2010, according to the report. Three-quarters of patients were 45 or older.

Half of emergency room visits due to zolpidem involved another substance. In 37 percent of visits, zolpidem was combined with another drug that depresses the central nervous system.

“Although short-term sleeping medications can help patients, it is exceedingly important that they be carefully used and monitored,” SAMHSA Administrator Pamela S. Hyde said in a news release. “Physicians and patients need to be aware of the potential adverse reactions associated with any medication, and work closely together to prevent or quickly address any problems that may arise.”

Zolpidem is approved by the Food and Drug Administration (FDA) to treat short-term insomnia, the article notes. In January, the FDA announced it is requiring drug makers to lower current recommended doses of sleep medications containing zolpidem. “New data show that zolpidem blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving,” the FDA noted in a statement.