October 7, 2015

E-Cigarettes Being Used to Vaporize Marijuana

E-cigarettes are being used by more people to smoke marijuana or synthetic drugs, CNNreports. People use the devices to get high without police, parents or teachers knowing.

E-cigarette devices, known as vape pens, are showing up in a growing number of drug busts, according to CNN. It is almost impossible to tell whether a person is using them to smoke nicotine, marijuana concentrate or synthetic drugs such as K2 or Spice.

“It’s the concealment method; we don’t know what is in a vape pen until we actually have it tested by a forensic laboratory,” said Supervisory Special Agent John Scherbenske of the U.S. Drug Enforcement Administration.

According to Reuters, a new study finds almost 20 percent of high school students who said they used e-cigarettes for nicotine also used them to vaporize marijuana. The study of almost 4,000 teens appears in the journal Pediatrics.

“Forms of cannabis that can be vaporized, like hash oil, can be many times stronger than marijuana that is smoked,” lead researcher Meghan Morean of Oberlin College in Ohio told Reuters. She found that of students who had used e-cigarettes, 18 percent used them to vaporize cannabis in some form, including hash use and wax infused with THC, the main psychoactive ingredient in marijuana.

The study found students were 27 times more likely to use e-cigarettes to vaporize cannabis than adult e-cigarette users.

October 6, 2015

Commentary: Revisiting the Impact of Marijuana Legalization on Children

In December 2011, Join Together published a commentary entitled “Legalization of Marijuana and the Impact on Children.” The article stressed that future laws legalizing marijuana use should have strict provisions designed to prevent underage consumption. In the intervening 44 months, four states plus the District of Columbia have legalized the personal use and possession of small amounts of marijuana,[1] the number of states allowing the medicinal use of marijuana for debilitating medical conditions has increased from 16 to 24[2] and 18 states now allow the limited use of low-tetrahydrocannabinol (“THC”) products to treat seizure disorders.[3] Given all this legislative focus on marijuana laws, are we now at a point where we can determine the impact of marijuana legalization on children?

Well, yes and no. In the sense that there is a growing body of scientific evidence, increased research and more recent data, yes. In the sense that the studies are providing clear answers, no.

At least there is some positive news. Two recent studies published earlier this summer using data from the Monitoring the Future program (MTF) suggest that the expansion of marijuana laws has not resulted in increased usage by teenagers.[4] In particular, these studies conclude that:
  • in the states that legalized the medicinal use of marijuana before 2014, there was no statistically significant change in teens’ (age 13-18) use of marijuana after the law was passed;[5] and
  • when comparing data from 2002 and 2013, the proportion of younger adolescents (age 12-14) strongly disapproving of marijuana use has increased slightly, while the percentage of teens (both ages 12-14 and 15-17) who have used marijuana in the past 12 months has decreased slightly.[6]
And, when looking at the published MTF data, it appears that the students’ perception of the ease with which they can get marijuana has not changed substantially in recent years (if anything it has lowered) and remains lower than the high water mark in the late 1990s.[7]

There are areas of concern in these and other recent studies, however. The same researchers noted above report that:
  • although changes in the law did not alter usage, teen use of marijuana is higher in the states that have legalized the medicinal use of marijuana than in other states, suggesting that the usage rate is a product of “state-level” factors that warrant additional study;[8] and
  • the percentage of adults aged 18-25 who strongly disapprove of marijuana use has dropped significantly in recent years.[9]
Moreover, in data gathered during 2010 and 2011, California students in grades six through eight who had seen marijuana advertising reported that they were twice as likely to use marijuana (or consider using it) than those who had not seen the advertising.[10] Furthermore, since 2000, the number of calls made to U.S. poison control centers concerning marijuana ingestion by children under age six has increased generally, with particular increases in the states that legalized the medicinal use of marijuana during that time.[11]

Although the available research may not yet provide clear answers, lawmakers do seem to be taking heed of concerns about underage access and non-authorized use of marijuana. For example:
only one state that legalized the medicinal use of marijuana after December 2011 allows any form of home cultivation, instead requiring patients to obtain marijuana at state-licensed cultivators/dispensaries;[12]
  • more recent laws and regulations allowing the medicinal use of marijuana often limit the number of cultivators/dispensaries that will be allowed, sometimes require licensed pharmacists to be involved with dispensaries and routinely place stringent restrictions on who can enter dispensaries and on the packing/labeling/testing of marijuana;
  • Louisiana, Minnesota and New York exclude smoking from the list of allowable methods to use marijuana medicinally; and
  • within the past six months, Oregon and Washington have tightened up their regulations concerning the medicinal use of marijuana.
Unfortunately, there is not yet sufficient data from Washington and Colorado to support large scale studies of the impact of legalizing the personal use of marijuana on children in those states. However, once that data develops and researchers have more time to look at it and pre- and post-law change data in all states, it will be important to revisit this question.

by Jon Woodruff, Legislative Attorney, National Alliance for Model State Drug Laws

[1] Alaska, Colorado, Oregon and Washington.

[2] The eight states who have passed laws since December 2011 are: Connecticut, Illinois, Louisiana, Maryland, Massachusetts, Minnesota, New Hampshire and New York.

[3] Alabama, Delaware, Florida, Georgia, Iowa, Kentucky, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming.

[4] “Monitoring the Future” is an ongoing study of U.S. 8th, 10th and 12th graders’ behaviors, attitudes and values on a variety of topics, including illicit drug use.www.monitoringthefuture.org/. The program started collecting data from 12th graders in 1975 and data from 8th and 10th graders in 1991. The latest year of data available is 2014.

[5] Hasin DR, Wall M, Keyes KM, et al. Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: results from annual, repeated cross-sectional surveys. Lancet Psychiatry 2015; 2: 601–08.

[6] Salas-Wright CP, Vaughn MG, Todic J, Cordova D, Perron BE. Trends in the disapproval and use of marijuana among adolescents and young adults in the United States: 2002–2013.The American Journal of Drug and Alcohol Abuse (posted online July 9, 2015).www.informahealthcare.com/doi/abs/10.3109/00952990.2015.1049493.

[7] See Johnson LD, O’Malley PM, Miech RA, Bachman JG, Schulenberg JE. Monitoring the Future National Survey Results on Drug Abuse 1975-2014: 2014 Overview.www.monitoringthefuture.org/pubs/monographs/mtf-overview2014.pdf.

[8] Hasin DR, Wall M, Keyes KM, et al.

[9] Salas-Wright CP, Vaughn MG, Todic J, Cordova D, Perron BE.

[10] D’Amico, EJ, Miles JNV, Tucker, JS. Gateway to Curiosity: Medical Marijuana Ads and Intention and Use During Middle School. Psychology of Addictive Behaviors June 1, 2015.

[11] Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clinical Pediatrics June 7, 2015. Thankfully, the total volume of calls remains low, with fewer than 2,000 calls total over the 14-year period.

[12] The state is Massachusetts, and a patient is allowed to cultivate marijuana at home only if the overseeing state agency is satisfied that the patient faces hardship in accessing a dispensary.

October 5, 2015

Baltimore Sun Editorial on Opioid Misuse

The statistics are sobering. Last year, nearly 900 Marylanders died from opioid misuse, including 578 from heroin alone, which means that opioid deaths account for more than 85 percent of all intoxication deaths throughout the state. And the problem is worsening; the 2014 data represent a 22 percent increase from the previous year and a 76 percent increase since 2010.

Opioids are painkillers, like morphine and others, and the stories of the pain they cause are saddening. Heroin and opioid misuse touches every county, city, town and subdivision in Maryland. It knows no racial, economic, age or gender boundaries.

It even attacks babies still in the womb. A powerful piece in The Washington Post this summer chronicled the trials of Makenzee Kennedy, an infant who spent the first months of her life in Maryland's Mount Washington Pediatric Hospital, where she battled to overcome a heroin addiction that had been passed on in utero. Data suggest that the incidence of cases like Makenzee's — "neonatal abstinence syndrome" — have quadrupled over the past decade.

It's time to take a stand.

Stemming the tide of opioid misuse demands action from all who touch the lives of those affected by this disease — law enforcement professionals, legislators, health care providers, long-term addiction rehabilitation specialists, behavioral health experts and friends and families.

Maryland's hospitals and physicians are on the front lines of this battle and have already begun work to reduce the chances of heroin addiction. According to the Centers for Disease Control and Prevention, 45 percent of people who use heroin are also addicted to prescription opioids.

That's why the Maryland Hospital Association, working with the Maryland Chapter of the American College of Emergency Physicians, has developed opioid prescribing guidelines to be used in emergency departments in Maryland. The guidelines, embraced by Maryland's acute care hospitals and their emergency department physicians, were crafted to allow doctors the flexibility to prescribe opioids when medically necessary while encouraging practices that can reduce the risk of opioid addiction. The guidelines promote:
  • Screening and patient education to help detect and treat conditions that can lead to misuse and safeguard patients against the development of those conditions;
  • Using existing tools like the state's electronic health information exchange and prescription drug monitoring program to allow health care providers to more effectively track potential misuse of opioids, and
  • Standardizing prescribing practices to reduce unnecessary prescriptions (and the number of pills prescribed) to diminish misuse of opioids.
These and other efforts to standardize and improve opioid prescribing in emergency departments are just pieces of a complex social and medical puzzle, and hospitals and physicians welcome the opportunity to work with other stakeholders to address this dangerous and immediate threat. In six months, the Maryland Hospital Association and the Maryland Chapter of the American College of Emergency Physicians will convene emergency medicine leaders to take a hard look at the guidelines' effectiveness.

Gov. Larry Hogan's administration, as well as several key legislative leaders, deserve great credit for shining a spotlight on this problem and for their commitment to developing means to tackle it. Earlier this year, Governor Hogan and Lt. Gov. Boyd Rutherford created the statewide Heroin and Opioid Emergency Task Force. The task force has now identified a series of recommendations, including the prescribing guidelines now being used in hospital emergency departments, which collectively take aim at Maryland's opioid epidemic and form a framework for further consideration and action by the administration and General Assembly.

While it will take time, dedication and vigilance to chip away at this pervasive problem, hospitals and physicians are attacking the challenge on the front lines of care.

September 29, 2015

White House Drug Policy Office Awards $125,000 to County Task Force to Prevent Youth Substance Use in Lake County

Grants Support Administration Efforts to Emphasize Prevention Among Youth

Washington D.C. – Today, Michael Botticelli, Director of National Drug Control Policy (ONDCP), announced 697 Drug-Free Communities (DFC) Support Program grants, totaling $86 million.  The grants will provide local community coalitions funding to prevent youth substance use, including prescription drugs, marijuana, tobacco and alcohol. 

The Lake County Underage Drinking and Drug Prevention Task Force from Lake County, Illinois was one of the grant recipients and will receive $125,000 in DFC grant funds to involve and engage their local community to prevent substance use among youth.  

“We know that evidence-based prevention efforts are the most effective way to reduce youth substance use and to support the roughly 90 percent of American youth who do not use drugs,” said Michael Botticelli, Director of National Drug Control Policy. “By bringing together schools, businesses, law enforcement, parent groups, and other members of the community, DFC-funded community coalitions are helping to protect youth from the devastating consequences of non-medical prescription drug use, heroin and other substance use.”

“Our goal is to make Lake County a safe and healthy environment for our youth,” said Bruce Johnson Task Force Chair. “Prevention is a powerful tool to counteract drug use in our community, and we will use this funding to help youth in Lake County make healthy choices about substance use.”
The Substance Abuse and Mental Health Services Administration (SAMHSA) is responsible for the day-to-day management of the DFC Program.

“Community coalitions continue to drive winning strategies at the local level to reduce the rate of substance misuse,” said SAMHSA Acting Administrator Kana Enomoto. “SAMHSA is pleased to join the Office of National Drug Control Policy in supporting communities that are bringing citizens together to create healthy and drug free environments for our youth.”

Prescription drug abuse prevention is one of the core measures of effectiveness for local DFC coalitions, and coalitions nationwide have led innovative opioid prevention initiatives. For example:

  • In Texas, the Concho Valley C.A.R.E.S. Coalition’s “Mix it, Seal it, Trash it” campaign informs adults about the proper procedure to dispose of unused or expired prescription drugs. They have placed two prescription collection units and conduct two prescription take back projects a year.
  • In Arkansas, the TEA Coalition has distributed over 700 medication lockboxes and encouraged residents to lock up their prescription medications to keep them out of the hands of young people.
  • The Delaware County Heroin Task Force was formed by the District Attorney and County Council Members to raise awareness about the prescription drug and heroin overdose epidemic. This DFC coalition is focusing on the installation of permanent prescription drug disposal boxes and has partnered with local realtors to raise awareness about the importance of locking up prescription medications during open houses.

The DFC’s 2014 National Evaluation Report showed a significant decrease in past 30 day use of prescription drugs among youth in DFC communities. The report also noted increases in the perception of risk, perception of peer disapproval, and perception of parent disapproval in relation to non-medical prescription drug use. The report also found a significant decrease in past 30 day use between the first and most recent data reports for alcohol, tobacco, and marijuana use among middle school and high school youth in DFC communities.

Background on the Drug-Free Communities Support Program
The Drug-Free Communities (DFC) Support Program, created by the Drug-Free Communities Act of 1997, is the Nation’s leading effort to mobilize communities to prevent youth substance use. Directed by the White House Office of National Drug Control Policy (ONDCP), in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA), the DFC Program provides grants to community coalitions to strengthen the infrastructure among local partners to create and sustain a reduction in local youth substance use.

The DFC Program provides grants of up to $625,000 over five years to community coalitions that facilitate youth and adult participation at the community level in local youth drug use prevention efforts.

According to data for 2013, an estimated 3,700 young people per day between the ages of 12 and 17 used drugs for the first time in the preceding year. Additionally, high school seniors are more likely to be current smokers of marijuana than cigarettes and non-medical use of prescription or over-the-counter drugs remains unacceptably high. Parents should also know that 19% of high school seniors in 2014 reported binge drinking (i.e., 5 or more drinks in a row) in the past two weeks.

Recognizing that local problems need local solutions, DFC-funded coalitions engage multiple sectors of the community and employ a variety of environmental strategies to address local drug problems. Coalitions are comprised of community leaders, parents, youth, teachers, religious and fraternal organizations, health care and business professionals, law enforcement, and media. By involving the community in a solution-oriented approach, DFC also helps those youth at risk for substance use recognize the majority of our Nation’s youth choose not to use drugs.

Additionally, DFC-funded communities have proven to be more effective in addressing these complex social issues and have demonstrated an increase in positive outcomes over communities that do not have DFC’s.

Background on the Administration’s National Drug Policy
The Obama Administration’s drug policy treats the national drug challenge as both a public health and public safety issue. This approach is built upon the latest scientific research demonstrating that addiction is a chronic disease of the brain that can be successfully prevented and treated, and from which one can recover. The Administration has directed Federal agencies to expand community-based efforts to prevent drug use before it begins, empower healthcare workers to intervene early at the first signs of a substance use disorder, expand access to treatment for those who need it, support the millions of Americans in recovery, and pursue “smart on crime” approaches to drug enforcement.

For more information about the Administration efforts to reduce drug use and its consequences, or to learn more about the Drug-Free Communities Support Program, visit: http://www.whitehouse.gov/ondcp/Drug-Free-Communities-Support-Program

The Office of National Drug Control Policy seeks to foster healthy individuals and safe communities by effectively leading the Nation’s effort to reduce drug use and its consequences.

September 23, 2015

Second Donation of Naloxone Made to Help Save Lives in Lake County

The Lake County Health Department/Community Health Center and Lake County officials on Tuesday honored a pharmaceutical company for a second donation of a drug administered by law enforcement that has already assisted in saving 33 lives throughout Lake County.

Virginia-based kaléo is matching last year’s donation of 3,000 kits of EVZIO (naloxone HCI injection), to the Health Department. Each kit contains two single-dose EVZIO auto-injectors containing the drug naloxone and a trainer for practice. In cooperation with the Lake County Opioid Initiative, the Health Department’s Substance Abuse Program provides training to police officers in Lake County who in turn train their peers. The trained officers carry the auto-injectors in their squad cars and use them to administer naloxone when responding to a call of a suspected opioid overdose. Voice and visual cues help to guide each officer through the injection process. The naloxone temporarily reverses the effect of an opioid, keeping the victim breathing until emergency aid arrives.

“Lake County is facing a serious heroin problem. By putting these auto-injectors into the hands of police officers and first responders, victims are given a second chance at life,” Lake County Board Chairman Aaron Lawlor said. “We are very thankful for this donation that will truly save lives.”

Heroin deaths have increased sharply in many states, according to a report of death certificate data from 28 states published by the Centers for Disease Control and Prevention. Two things appear to be driving the increase in heroin overdoses: (1) widespread prescription opioid exposure and increasing rates of opioid addiction; and (2) increased heroin supply. Heroin often costs less than prescription opioids and is increasingly available.

“Fifty-nine opioid deaths took place in Lake County in 2014,” said the Health Department’s Executive Director Tony Beltran. “We are grateful to kaléo for helping the County address this growing concern.”

Accepting the honor on Tuesday was Mark A. Herzog, Vice President, Corporate Affairs, for kaléo. “We are pleased to be making this donation as part of our commitment to widen access to naloxone,” he said. “We are honored to support the outstanding efforts of the local law enforcement community to help save the lives of those who are experiencing an opioid overdose.”

September 14, 2015

Young adults believe e-cigarettes, hookahs safer than cigarettes: study

New Brunswick, NJ – Many young adults consider e-cigarettes and hookahs safer than traditional cigarettes, according to a new study from Rutgers University.

The study involved nearly 2,900 adults 18 to 34 years old, both smokers and non-smokers. Nearly 58 percent of participants said e-cigarettes are safer than cigarettes, and about 25 percent believe hookahs are less harmful than cigarettes.

Other findings include:
  • Nearly 63 percent of 18- to 24-year-olds believe e-cigarettes are safer than cigarettes, compared with nearly 55 percent of those 25 to 34. 
  • Almost 33 percent of participants younger than 25, as well as nearly 19 percent of 25- to 34-year-olds, said hookahs are less risky than cigarettes. 
  • Half of participants consider methanol cigarettes, hookahs, cigars, smokeless tobacco and snus as harmful as cigarettes. 
  • Nearly 32 percent said they have smoked at least 100 cigarettes and smoked regularly. 
"This is concerning as it suggests that even a substantial proportion of nonsmokers may view hookah as being a relatively safer and acceptable way to use tobacco," the researchers wrote.

Although participants said they believe some products are less safe than cigarettes, they still use them, according to researchers.

The study was published Aug. 24 in the journal Health Education & Behavior.

Ingredients in e-cigarettes are unknown because they are not labeled, and evidence is lacking on whether e-cigarettes are safe, according to the National Library of Medicine.

September 8, 2015

Kids younger than 12 misusing prescription drugs, study suggests

Ann Arbor, MI – More than 10 percent of children have illegally used another individual's prescription medication, and an increasing number are doing so at a younger age, according to a new study from the University of Michigan.

Researchers analyzed data of more than 5,000 Detroit-area students and found the number of children illegally taking prescription drugs at a younger age has more than doubled over a 10-year period.

Of children born between 1991 and 1995 who illegally took another person's prescription drug, about 35 percent reported doing so before turning 12. However, among younger children – those born between 1996 and 2000 – 76 percent who illegally used prescription medication reported doing so before age 12.

Additionally, the number of children prescribed controlled medication before turning 12 has about doubled in a 10-year period, and the researchers found that receiving a prescription before that age was associated with a greater chance of using someone else's prescription at a younger age.

The drugs abused included opioids, stimulants, sedatives and anti-anxiety drugs. The study was published online Aug. 17 in the Journal of Addiction Medicine.

Prescription drugs are the most fatally abused drug in the United States, and more 35- to 54-year-olds die from unintentional drug overdoses than in motor vehicle crashes, according to the National Safety Council.