Smackin’ the suburbs

View 18 year old, Kristen Delgado’s rehab story produced by the U.S. News and World Report

Youthful experimentation with drugs and alcohol has taken a worrisome turn with the recent surge in popularity of heroin among teens.

Early this week the Washington Post published a two part series on the devastating effects of heroin in the Virginia suburbs. The first part focuses on the death two years ago of Alicia Lannes, a 19 year-old Virginia girl.  The second part follows the recent trial of her friends and boyfriend who supplied her with the drug, used it themselves and didn’t seek help for her when she fatally overdosed.

Centerville, where Lannes lived and grew up is the type of place that turns out cookie-cutter, over-achieving kids. It’s also a place where heroin use runs rampant. It’s a predominantly white, upper-middle class  community close to Washington, D.C. with a median income of roughly $88,000. The median income for families is over $105,000.

Authorities, teachers and parents have considered a number of reasons why adolescents use.  Some point to boredom as a contributing factor. Others imagine users look to heroin to escape the pressures of contemporary adolescent life.

Quoted in a Pittsburghlive.com article, superintendent of Jeanette City Schools, where heroin use in high schools is rising dramatically, Vince Aiello, also notes that addition is frequently more pronounced in more affluent neighborhoods where kids have cash to buy drugs.

Other suburban communities have seen a surge in petty crime accompanying the rise in popularity of heroin. Students, who have no real fixed income independent of their parents’, look instead to theft, selling stolen goods for cash or stealing money from their parents to pay for drugs as their addictions intensify. There has also been an increase in drug-related violence in some areas.

Because hard drug use is so taboo and most users do so in secret, officials really have no idea just how many students are using or have used heroin. But public health officials and health care professionals have seen a worrisome increase in the number of adolescents overdosing and entering drug rehabilitation programs due to heroin addiction.

Most tragic of all, however is that fact that the system is so overburdened by the number of kids seeking or forced into treatment, that facilities have begun to turn patients away. In other cases, addicts are placed in programs that are not comprehensive enough to handle the depth of their addictions. Frequently they relapse shortly after treatment.

One user, Jamie Greene whose story is recounted in the Pittsburgh Live article struggled with addiction for some time. At the age of 21 she entered rehab but was forced from the program before completion when her state- supplied insurance ran out. She died of an overdose a few months later.

Cutting the “Cheese”: New type of heroin sweeps Texas

Sarah Aviles died at 17 of a drug overdose after using "cheese" heroin for many years. She fits the profile of most users in the Dallas are where "cheese" use is highest: young, latino and from a lower income, immigrant background. Click image for the full report from Dallasnews.com.

The development of a new type of heroin has made the drug cheaper and more accessible to users across the U.S. This new variation of heroin, “cheese” contains heroin cut with the over the counter sedative, diphenhydramine found in Tylenol P.M. The drug arrived on the scene in 2005 and is commonly snorted as opposed to injected.

CNN issued a report on the rapid spread of “cheese heroin” due in part to the fact that it is so cheap. Users can buy a single hit for $2. They explain the name derives from the Mexican slang word for heroin, “chiva.” The substance also bears remarkable likeness to grated parmesan cheese.

Dallas, Texas saw what NPR described in an article as a “mini-epidemic” of cheese use in 2007.

“Cheese” is to heroin, what crack is to coke. While heroin is most popular among white, higher income consumers, “cheese” is most popular among lower income latino consumers. Additionally, drug suppliers have marketed the substance to a younger crowd.

To the surprise of teachers, parents and police, it has hit middle schools incredibly hard. “Cheese” use is now as common in some Dallas communities as smoking pot.

The NPR article quotes Dr. Carlos Tirado, who specializes in psychiatry and works with drug users. “Reports that we were seeing were pretty striking. Kids as young as 9 or 10 years of age coming to the hospital emergency rooms or detox facilities in acute heroin withdrawal.”

The addiction symptoms in some ways are worse with cheese as compared to heroin. While cheese contains a comparatively lower grade of heroin, it wears off more quickly causing users to use more frequently and experience withdrawal symptoms more frequently.

Users are tend to view “cheese” as a less serious drug than heroin making it more acceptable to use casually, in part because users sniff it as opposed to injecting it.

Dirty Money: The economics behind the drug trade

From a policy standpoint, drug use takes on a much greater significance than the individual choice to use or not. Each year, the U.S. spends an estimated $40 billion on prosecuting and imprisoning drug users and dealers, barring the illegal import of drugs into the country and related anti-drug campaigns.

That expenditure can also be added to lost revenue from not taxing the import and sale of drugs. Though the public health issues must be confronted head on by government, prohibition may not be the most effective means of doing so, nor the most fiscally well-reasoned approach.

Many opponents point to the “War on Drugs” as the most costly war in American history that we are still losing. NPR published a timeline chronicling the history and growing intensification of the War on Drugs.

The piece was published in collaboration with a Frontline documentary, which presents the conclusion reached by interviewees that the U.S.’s current strategy has cost billions and yielded few results at best, and at worst has helped to deepen the violence and drama of the drug trade.

Another study published by the Drug Policy Alliance lists the economic impact of the war on drugs at a national and state level. Though the piece demonstrates that treatment is the most effective way of decreasing drug use, the administration has yet to change course. During the late 80s, at the same time that prison budgets grew 30%, we saw over an 18% cut in funding for higher eduction.

In contrast to U.S. policy, many countries have looked to liberalized drug policy focusing on treatment as opposed to law enforcement. The Netherlands for instance has a more lax drug policy, while Switzerland experimented with “Needle Park” a zone where drugs could be freely bought, sold and used. Both countries however soon reverted to stricter drug policy after their cities became hotspots for “drug tourism,” drawing users from across Europe.

While the DEA stands by their philosophy of strict prohibition, despite the fact that in many cases it leads to clandestine trading, increased violence and government corruption in drug producing countries, rehabilitation and treatment options for addicts have proved the most effective in reducing drug use.

Former head of the DEA, Jack Lawn suggests in the Frontline piece, “Let’s create an organization that says, ‘Well, this year ninety percent of this budget is going to go into education and prevention. Would that work? We won’t know unless we try it. But twenty years of doing it the other way certainly has not worked.’”

Legalize it?

With the country still in the grip of the worst economic recession since the Great Depression, policy makers are beginning to think creatively about how to solve the budget crisis. Many politicians are even looking to the legalization of marijuana as a means of creating new revenues for the state and federal government.

Not only would legalization reduce the amount of money currently spent on fighting marijuana trafficking, it would lessen the financial burden on prisons for incarcerating violators of marijuana laws, most often for distribution. Pair that cost cutting with tax revenues from the import and sale of the drug and states could have some hefty funds at their disposal to help face record unemployment and cuts to public services and education.

An April issue of Time Magazine looks into the persuasive argument for the legalization of marijuana. Joe Klein writes, “It is estimated that pot is the largest cash crop in California, with annual revenues approaching $14 billion. A 10% pot tax would yield $1.4 billion in California alone.” It would also provide other economic benefits in the form of new jobs in a variety of fields related to the cultivation, processing and sale of marijuana.

As the benefits of legalization of marijuana, at least to a certain extent, come to light, support for legalization has increased dramatically, as reported in a Washington Post article on Monday. Republican Governor Arnold Schwarzenegger has even agreed to consider a California marijuana bill that would provide much needed cash to the economically depressed state. In May, the New York Times reported that he called for a study of the potential benefits of marijuana policy reform.

Much of the growing popular support of legalization is also credited to generational biases. Baby-boomers and younger members of the population tend to have a more laid back approach to marijuana laws.

Perhaps the most reasonable approach is one that permits the legal use of marijuana, at least to a limited extent in order to generate tax revenues and diminish the financial burden that fighting the use and trade of the drug puts on the system.

At the same time, a portion of the revenues should be reserved for public health campaigns and education programs discouraging children from using marijuana under the model of tobacco use prevention programs. Such programs have proven enormously effective in the past with decreased use of tobacco among adolescents.

Buzz kill: FDA cracks down on alcohol energy drink makers

Alcoholic energy drinks such as SPARKS may soon be taken off the market following the FDA's increased scrutiny of the combination of substances the drinks contain.

The FDA last week gave notice to 27 alcoholic energy drink manufacturers that they would have 30 days to supply evidence of the safety of the mixture of caffeine and alcohol contained in the drinks. The refreshments are designed to give consumers an energy boost paired with an alcoholic buzz. According to a recent article on aboutlawyers.com, the decision to investigate the safety of the drinks’ ingredients came after 18 state attorney generals raised questions in a letter about the safety of the combination of the substances.

Since the FDA has not approved the combination, it is deemed illegal to produce and distribute under the Federal Food, Drug, and Cosmetic Act, as explained in the letter sent to the various manufacturers.

Objectors base their views on the belief that the addition of caffeine to the drinks can give users a boost in energy, allowing them to drink more without feeling fatigued. The LA Times reports that the task force appointed by the FDA “argues that the caffeine can mask the intoxicating effects of alcohol, possibly leading to an increase in drunk driving, sexual assault and other destructive behavior.”

In response to pressure from the task force, last year  Annheuser-Busch Cos. and MillerCoors, the largest brewers in the country took their alcoholic energy drink products off shelves. Producers of drinks explicitly billed as alcoholic energy drinks have already stopped production of those products.

But young drinkers have been combining the two substances without the help of pre-packaged drinks. For instance the cocktail, vodka redbull contains the same ingredients and is readily available in bars across the country. The classic rum and coke endeavors to achieve a similar effect. Will the removal of pre-mixed energy drinks really stop consumers from mixing caffeine and alcohol?

Japanese hit the bottle

The video depicts former Japanese finance minister who was accused of being drunk at the February G7 conference. His performance brought international visibility to the heavy use of alcohol among Japanese businessmen and the greater trend of increased alcohol use in the country over the last 50 years.

In Japan it is not uncommon for salary men to hit the bars en masse. As the country’s economic prosperity rises, so has its consumption of alcohol, but few people there recognize alcoholism as a disease.

The Canadian Medical Association reports that Japan currently has three million problem drinkers. Since 1960, alcohol consumption has quadrupled. Alcoholic beverages are readily available in convenience stores, conventional bars, as well as in “standbars,” where vending machines dispense cheap booze.

Drinking is often seen as an important component of social/business interaction. To turn down a drink offer from a boss is a terrible insult. Additionally, it provides many with an outlet for aberrant behavior in a typically rigid social atmosphere.

The report quotes the former president of the Foreign Correspondents Club of Japan, Charles Pomeroy. An excerpt of the article reads,  ”in a tightly knit society where concealing emotions and frustrations is a highly developed and necessary part of maintaining ‘consensus,’ getting drunk is a socially sanctioned safety valve.” Pomeroy  adds, “alcohol here plays the role of psychiatry in the West… I think the country would explode without it.”

Perhaps due to the heavy reliance on alcohol as a means of coping with the strict social codes, few Japanese accept alcoholism as a legitimate disease or even view excess use as a problem. A Reuters article published last week features the story of a Japanese salaryman, Yoshiyuki Takeuchi, who was ostracized for seeking help for his drinking.

Following his six month stint in a treatment facility, Takeuchi returned to a demoted position and received little sympathy from co-workers. Many of them refused to speak with him at all, he recalls. Now he devotes much energy to helping others recognize and seek help for their alcohol abuse issues. He has been sober for 1o years.

Women and Alcohol: Wine is fine but liquor’s quicker

On the topic of alcohol use and abuse, many organizations, including this blog, have placed a heavy emphasis on the general health risks and community level effects of alcohol abuse. But alcohol also has particularly destructive  potential for women.

The National Institute on Alcohol Abuse and Alcoholism published a short informational booklet on the health risks associated with alcohol use in women. It lists several risks that heighten with alcohol use including increased risk of car accidents and other injuries, violence, suicide, depression, stroke, high blood pressure and certain kinds of cancer.

Additionally, it is well known that women have a lower threshold for alcohol than men. Our increased sensitivity to alcohol compared to men’s puts us at a higher risk of being the victim of violence or sexual assault,  having unsafe sex, contracting STDs or unwanted pregnancies.

Alcohol abuse in women is also linked to a variety of emotional issues. For instance, the NIAAA reports that, “women who have trouble with their closest relationships tend to drink more than other women. Heavy drinking is more common among women who have never married, are living unmarried with a partner, or are divorced or separated. (The effect of divorce on a woman’s later drinking may depend on whether she is already drinking heavily in her marriage.) A woman whose husband drinks heavily is more likely than other women to drink too much. Many studies have found that women who suffered childhood sexual abuse are more likely to have drinking problems. Depression is closely linked to heavy drinking in women, and women who drink at home alone are more likely than others to have later drinking problems.”

Drinking for women is also particularly dangerous because social conventions don’t allow for the open and heavy use of alcohol among women. For that reason, women are more likely to hide their drinking or drink alone, both contributing to and characteristic of alcoholism.

Poppy power by prescription

My last entry focused on the prevalence of stimulant usage by college students without a prescription. But the problem of prescription drug abuse in fact stretches well beyond that single class of substance and well beyond college campuses.

When I was in high school, the son of a teacher of mine, with whom I was very close, died of an overdose of Oxycontin. Multiple classmates from my childhood and at UMass have also struggled with addiction and abuse issues related to prescription drug use, especially of opiates, a class of painkillers similar to heroin.

The term, opiate, derives from the word opium as the substances are very similar in make-up. Many painkillers in fact contain chemicals derived from the poppy plant, from which both opium and heroin are produced. Related prescription medications include Morphine, Oxycodone, Codeine, Hydrocodone, Vicodin, and Thebaine.

Recently, the director of the National Institute of Drug Abuse came forward to address the issue of the widespread use of painkillers by individuals without a prescription. Dr. Nora D. Volkow writes, ” Painkillers such as Vicodin and OxyContin are opiates and are very powerful medications against pain, but they need to be taken under close supervision of a doctor. These same medications when taken inappropriately can cause addiction for they act on the same places in the brain as does heroin.”

She also cautions consumers that, “even though prescription drugs are medications, their improper use can have serious consequences.” It seems that in our culture, we seem to believe that having a prescription legitimizes the use or over use of strong substances.

Whether with or without a prescription, getting high is getting high.

As someone who’s life has been affected by others’ abuse and in some cases, overdose of prescription drugs, please, take only medications prescribed to you as directed by your doctor. And remember that even though it’s legal, prescription drug use can still be dangerous.

Midterm Miracle

Courtesy girlstyle, Flickr

As midterms roll around once again, I’ve become more aware  of an issue that has persisted throughout my college career. Student reliance on a range of prescription drugs, from anti-anxiety meds to stimulant study aids, is rampant. On college campuses across the country students use prescription ADD drugs to increase academic performance, both with and without a prescription.

A 2005 New York Times article focuses on the illegal trading of prescription study aids during midterms. The author describes a scene at Columbia University, where students cluster outside the library chain smoking cigarettes, drinking coffee and exchanging pills during study breaks. The scene could have easily taken place at any university across the country and in fact seems reminiscent of the collection of students the chat on the concrete wall in front of the electric sliding doors of the DuBois library at all hours of the night.

The article cites the fact that 20% of college students have used Ritalin or Adderall as a study aid. Both drugs are also commonly used as an appetite suppressant or for recreational purposes. While from 1992-2003 the number of members of the general population who admit to abusing prescription drugs doubled, the number of teenagers who admit to abusing prescription medications across the same time span has tripled.

Students on college campuses can get pills from other students who have been prescribed the drugs and don’t take the full dose, and therein lies the true danger. When these strong drugs are taken without the supervision of a medical doctor, users don’t abide by dosing tables or take precautions to use them safely. Many illegal users may crush and snort the pills. Illegal users may also be more likely to use them on a binge-like basis, taking high doses for days at a time to handle large academic work loads leaving them vulnerable to a number of health risks.

Adderall can lead to a number of health complications including cardiac strain, drug dependance, nausea, decreased appetite, headache, insomnia, anxiety or depression and sudden death. In response to 20 instances of sudden death among Adderall users, the Canadian government suspended sales of the drug. The FDA issued a statement denying any serious risk associated with the use of the medication.

Homecoming Ho-down

Each year, UMass students and alumni look forward to Homecoming weekend. The sports games coincide with alumni events, fall tourist type attractions etc. But the weekend also provides all attendees the opportunity to drink heavily at nighttime parties, as well as during the day while tailgating before the big game.

While it is fantastic to show some school spirit, the significance of homecoming should not be so closely linked to drug and alcohol use and abuse. The Amherst Police Blog made a number of arrests in relation to Homecoming festivities including, 4 disorderly conduct charges, 5 under age liquor possession charges, and 3 operating under the influence charges.