Prescription Drug Abuse in Florida: An Epidemic of Deaths

Prescription Drug Abuse in Florida: An Epidemic of Deaths

Did you know:

-An average of 7 persons die everyday in Florida because of lethal overdoses from the illegal, non-medical misuse of one or more prescription drugs.

-An additional 7 persons die daily with at least one prescription drug detected often in combination with alcohol or other drugs. That is a total of 14 deaths per day in Florida related to prescription drug abuse.

-There were 5,275 persons who died in Florida during 2009 and another 2,579 in the first half of 2010 with at least one prescription drug in their system identified as either the cause of death or present in the decedent.

-Most of the deaths were preventable.

-Treatment admissions for prescription opioid addiction increased 5 1/2 times in Florida over the past decade. Among those aged 12 to 30, the number of prescription opioid treatment clients rose from 488 in 1999 to 7,649 in 2009, a 1,467-percent increase.

-The rate of hospital emergency department cases for non-medical oxycodone misuse among those aged 21-25 in South Florida is nearly double the national per capita rate.

-Florida leads nation in sale of oxycodone with over 400,000,000 pills sold annually.

-Benzodiazepines (e.g., Xanax, Klonopin, Valium) and muscle relaxants (e.g., Soma) are also frequently linked to overdose deaths and medical emergencies across Florida.

-As one of only 12 sales without an operating Prescription Drug Monitoring Program, Florida is a source supplier of illegally diverted controlled medications for the nation.

-Among Florida 12th graders in 2010, 11 percent have misused a prescription pain reliever non-medically in their life; 3.4 percent have done so in the last month.

-The number of infants treated for withdrawal symptoms in Florida hospitals increased 173-percent between 2006 and 2009; 635 cases were reported in the first half of 2010.


Published by United Way of Broward County Commission on Substance Abuse

Experts say prescription pill abuse leads N.J. teenagers to heroin addiction

Experts Say Prescription Pill Abuse Leads New Jersey Teenagers to Heroin Addiction
Written By Megan DeMarco/Statehouse Bureau

Published June 15, 2011

TRENTON — The use of prescription pills is becoming more prevalent among teenagers and is leading to heroin addiction, according to several experts currently testifying before the State Commission of Investigation.

The hearing is focusing on how teenagers gain access to prescription drugs, and how that addiction turns into a heroin addiction.
Prescription pills like Xanax are easily accessible to teenagers, and a "gateway drug" to heroin, law enforcement experts say.

Teenagers, more so in suburban areas, are getting pills from their parents' medicine cabinets, experts say. When pills become too expensive and provide an insufficient high, they turn to heroin.

Pills don't carry the same stigma as heroin, so it's not as big of a deal, experts say.

"Because the pills were manufactured for a legitimate medical purpose they don't have the same stigma," said Investigative Agent Rachel Denno.

According to the federal Center for Disease Control, 60 percent of prescription abuse users begin abusing pills before the age of 15.

The recent increase is occurring, in part, because of technological advances, Denno said. Drug dealers and users can use prepaid cell phones, internet sites and smart phone applications to get around law enforcement.

One confidential informant, via videotape, said his addiction began at 12-years-old. He started swallowing pills, which progressed to snorting, then injecting pills such as OxyContin and Xanax. When his body adjusted its tolerance level, and pills became too expensive, he turned to heroin.

"At that point it was desperation, it was complete desperation to the point where, wow I'm not getting high," said the informant, now 21 and clean for almost a year.

"When you start pills, you never touch heroin. That's disgusting, you know," the informant said. "It never crosses your mind until you get to that point."

The hearing, scheduled until 1 p.m., will also include two more confidential informants and several more law enforcement experts.

SCI commissioners hope the hearing and investigation will lead to legislative changes.

"To put it bluntly, today's young Percocet, Vicodin and OxyContin users are becoming tomorrow's heroin junkies," said Commission Chair Patrick Hobbs.
"This hearing is a major first step toward airing these difficult issues."

Who is Abusing Inhalants?

Who is Abusing Inhalants? By Cathy Brownfield When you think about inhalant abuse, who comes to mind? Is it the youth that snatches a butane lighter from the display at the convenience store or chooses the favorite chemical from the array of cleaning products found under the kitchen sink? Or the grown-up who sets the pace as the role model for others? Until now, preteens and teens were primary abusers of inhalants, usually males 13- to 15-years old, and on occasions such as rave parties and during sexual encounters may be used by those into their 20s, advises the American Council for Drug Education. Alcoholics may use inhalants to avoid withdrawal symptoms when they don't have access to alcohol. But a new report from SAMHSA (Substance Abuse and Mental Health Services Administration) released last week says, "Inhalant abuse is now a multi-generational problemA new government study shows that 54 percent of treatment admissions related to inhalants abuse in 2008 involved adults. Of those adult treatment admissions: 52 percent, ages 18-29 32 percent, ages 30-44 16 percent, age 45 or older. An estimated 1.1 million adults over age 18 used inhalants in the past year, more than crack (988,000), LSD (637,000), heroin (571,000) and PCP (75,000). "Just because a product is legal doesn't mean it's safe," said Gil Kerlikowske, director of the White House Office of National Drug Control Policy (ONDCP). "Our homes are increasingly becoming the source of dangerous drugs of abuse for young people. Whether these products are inhalants found under our sinks and in our utility rooms, or dangerous prescription drugs stored in our medicine cabinets, parents need to act today to protect our young people by securing these products and discussing the harms they can cause." A 42-year-old mother of a 16-year-old daughter actually passed out while driving and using. The legal system ordered treatment or she'd still be using. "As much as I don't like dealing with probation and all the money I have to pay out," said Erin Davis, "getting caught probably saved my life. I know I wouldn't have stopped. I couldn't." Said Dr. David Shurtleff, acting deputy director of the National Institute on Drug Abuse (NIDA) which is part of the National Institutes of health, "Most inhalants produce a rapid high that resembles alcohol intoxication. Given the wide availability of these substances and the severe health consequences they can produce, inhalant abuse is a serious problem. Just a single session of repeated inhalations can cause permanent organ damage or death." Inhalants are breathable, chemical vapors that users intentionally inhale because of the chemical's mind-altering effects. The substances inhaled are common household products that contain volatile solvents, aerosols or gases. Street names include whippits, poppers and snappers. NIDA offers the following signs indicative of inhalant abuse: - Chemical odors on breath or clothing. -Paint or other stains on face, hands and clothes. -Hidden empty spray paint or solvent containers and chemical-soaked rags or clothing -Drunk or disoriented appearance -Slurred speech -Nausea or loss of appetite -Inattentiveness, lack of coordination, irritability and depression. To read more about the study, visit online at www.samhsa.gov/newsroom/

Cocaine and Crack Abuse

COCAINE AND CRACK ABUSE

Published by Medicine.net

Cocaine is a powerfully addictive stimulant drug. The powdered hydrochloride salt form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine base that has not been neutralized by an acid to make the hydrochloride salt. This form of cocaine comes in a rock crystal that is heated to produce vapors, which are smoked. The term "crack" refers to the crackling sound produced by the rock as it is heated.

How is Cocaine Abused?

Three routes of administration are commonly used for cocaine: snorting, injecting, and smoking. Snorting is the process of inhaling cocaine powder through the nose, where it is absorbed into the bloodstream through the nasal tissues. Injecting is the use of a needle to release the drug directly into the bloodstream. Smoking involves inhaling cocaine vapor or smoke into the lungs, where absorption into the bloodstream is as rapid as by injection. All three methods of cocaine abuse can lead to addiction and other severe health problems, including increasing the risk of contracting HIV and infectious diseases.

The intensity and duration of cocaine's effects, which include increased energy, reduced fatigue, and mental alertness, depend on the route of drug administration. The faster cocaine is absorbed into the bloodstream and delivered to the brain, the more intense the high. Injecting or smoking cocaine produces a quicker, stronger high than snorting. On the other hand, faster absorption usually means shorter duration of action. The high from snorting cocaine may last 15 to 30 minutes, but the high from smoking may last only 5 to 10 minutes. In order to sustain the high, a cocaine abuser has to administer the drug again. For this reason, cocaine is sometimes abused in binges -- taken repeatedly within a relatively short period of time, at increasingly high doses.

How Does Cocaine Affect the Brain?

Cocaine is a strong central nervous system stimulant that increases levels of dopamine, a brain chemical associated with pleasure and movement, in the brain's reward circuit. Certain brain cells, or neurons, use dopamine to communicate. Normally, dopamine is released by a neuron in response to a pleasurable signal (e.g., the smell of good food), and then recycled back into the cell that released it, shutting off the signal between neurons. Cocaine acts by preventing the dopamine from being recycled, causing excessive amounts of dopamine to build up, amplifying the message, and ultimately disrupting normal communication. It is this excess of dopamine that is responsible for cocaine's euphoric effects. With repeated use, cocaine can cause long-term changes in the brain's reward system and in other brain systems as well, which may eventually lead to addiction. With repeated use, tolerance to the cocaine high also often develops. Many cocaine abusers report that they seek but fail to achieve as much pleasure as they did from their first exposure. Some users will increase their dose in an attempt to intensify and prolong the euphoria, but this can also increase the risk of adverse psychological or physiological effects.

Cocaine Use on the rise in Australia

Cocaine use on the rise in Australia
September 8, 2010
By Dr Ananya Mandal, MD

The number of cocaine abuse related arrests has risen in Sydney's CBD and an increasing number of users of the drug are being treated in hospitals. According to the latest NSW Bureau of Crime Statistics and Research figures arrests for possession and use of the drug have risen by 76.6 per cent in the past two years. In the first six months of this year 412 people were caught with cocaine in NSW - one more arrest than was made in all of 2008. Almost 100 people were caught with the drug in January alone. Five years ago police made 223 arrests in an entire year. Arrests for narcotics use and possession increased by 11.9 per cent over the same period.

This rise is attributed to increased law enforcement, but the bureau director, Don Weatherburn, said figures from hospital emergency departments also indicated an increase in the number of patients being treated for overdoses. Dr Weatherburn said, "The reason we know that it's not just a case of increased police activity is that overdoses on cocaine and overdoses on narcotics are going up and they have nothing to do with police activity… It's simply disingenuous to say this is nothing more than an increase in police activity." He said while the number of arrests for narcotics remained well down from the peak of 350 in one month in the late 1990s, the figure had been "creeping up" over the past two years.

According to the NSW Police Commissioner, Andrew Scipione the rise in drug crime means there is increasing interception on venues where drug use was suspected such as concerts, parties and hotels.

NSW Police Minister Michael Daley said the sharp rise in drug use, particularly cocaine, was a reflection of stronger law enforcement. He said, "Whilst we can speculate about the use of cocaine ... what we do know is that increased incidents of police vigilance and police work are having a marked effect on the amounts of cocaine and the incidents of cocaine apprehension." Mr Daley welcomed the positive outcomes in the report, saying some major crime had fallen as a result of a bigger police force and increased productivity.

According to Premier Kristina Keneally, "We have built up in this state with laws, equipment and conditions, the best-equipped the most professional police force in the country and one of the best police forces in the world." However, opposition police spokesman Mike Gallacher believes that this report reflects rise in drug abuse and sexual assaults that needed to be addressed.

Overall fall in crime rates

According to the NSW Bureau of Crime Statistics and Research figures there is a significant reduction in incidents of domestic violence related assault, break and enter and retail premises, and malicious damage to property. The instances of domestic violence related assaults fell by 29.7 per cent (from 172 to 121). Break and enter offences on retail premises dropped by 32.4 per cent (from 309 to 171), more than double the state wide reduction of 15.3 per cent. The incidents of people maliciously damaging property in the area fell from 806 to 647 over the 24-month period, a reduction of 19.7 per cent - more than double the NSW average of 9.7 per cent.

Inspector Murray Gillett said Clarence police were working hard to achieve a continual reduction of all crimes across the Valley. He said, "These statistics are a result of a collaborative approach between the community and the police. This is the result of some sustained, prolonged direct targeting of offenders using specific strategies that have been tried and proven successful."

Texas Rangers' Josh Hamilton finds strength after misstep in recovery from drug, alcohol addiction

10:38 AM CDT on Sunday, October 3, 2010
By S.C. GWYNNE / The Dallas Morning News
sgwynne@dallasnews.com
On the chilly morning of Jan. 22, 2009, when everything else in her life seemed to be working out perfectly, Katie Hamilton received a phone call at her home outside Raleigh, N.C.


Josh Hamilton It was her husband, Josh, calling from Tempe, Ariz., where he had gone to a boot camp for athletes. Hamilton had become famous the year before for leading the American League in runs batted in and making the All-Star team in his first full season as a major leaguer.

Also Online Link: Triple Play Ministries

Cowlishaw: Impact on winning makes Hamilton the clear MVP pick

Full coverage: Josh Hamilton

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But he was equally famous for beating a harrowing addiction to drugs and liquor, one that had kept a player often compared to Mickey Mantle out of Major League Baseball until he was 26 years old.

And now he was calling his wife to tell her, through choking sobs, that after three years of sobriety, he had relapsed. He had gone out late the previous evening, alone, to a pizza restaurant, which happened to have a bar. He had a vodka and cranberry juice, then another, then went to a bar and had many more. He told her he didn't remember everything that happened, but that there might be "pictures." Katie told him to come home, and then she prayed.

Seven months later, photos appeared on the Internet that revealed a drunken Josh cavorting with three young women in the bar. Whipped cream was involved. The pictures caused a sensation. Hamilton, who had already told the Texas Rangers and Major League Baseball what happened, now confessed to the rest of the world.

Though his relapse only lasted one night, it held critical lessons for Hamilton, his family, and his team. The first was, now that he had become a star, any sins he committed would be instant headline news. Second, and far more important, was the notion that Hamilton had not beaten his addiction at all. While he had made enormous strides in his recovery, he was in some ways still the hair-trigger addict he had been since he started using cocaine and whiskey in 2001.

The result was a change in how Hamilton, 29, handles his own life and how he is handled by others, even as he helps lead the Rangers into the playoffs for the first time in 11 years.

Since he stopped using drugs and liquor in late 2005, he has worked to build a system of checks and balances around him, to fill his idle time and to avoid the "triggers" of his addiction.


Support system

But the relapse caused him to redouble those efforts, and he is now assisted by a complex, multilayered support system of his own design that is probably without precedent at this level of professional sports. It is rooted in his Christian beliefs and his rigorous daily devotions. Its primary components are his wife, his parents, and a host of "accountability partners" that include a Texas Rangers coach, pastors from three churches, his Christian sports agent and his father-in-law. A set of strict rules dictates what he can and can't do.

The system also addresses the way he spends his time away from the game. He increasingly sees virtually everything he does outside of baseball as a ministry, and as such a more permanent way of dealing with his addiction.

He and Katie founded Triple Play Ministries several years ago, and it has become the conduit for the dozens of off-season public appearances they make. He has his own Christian baseball camps, and even a project to build an orphanage in Uganda. It is the success of this intricately balanced life – he has been clean since that night in Tempe – that has allowed him to have an electrifying, MVP-caliber season.

"I don't want to call the relapse in Tempe a blessing in disguise, but you have to look at the positives," says Rangers general manager Jon Daniels. "It was a reminder to Josh that he can't sneak off, that this can't happen privately. It made his system for dealing with it that much stronger."

The foundation of Hamilton's recovery is his religion, which dominates his life and his conversation.

"The biggest thing we want to do is to share Jesus Christ with people," says Hamilton, sitting in the corner of the Rangers dugout, resplendent in yellowish-green mirrored sunglasses, on his second day in the lineup after being out with a rib injury. His trademark blue flame tattoos adorn his massive biceps. "The whole objective of the ministry is to do that, whether by speaking in public or by doing hospital visits to kids during the holidays, or baseball camps."

Josh and Katie are very much a team, and have come a long way since the darkest days of his addiction in 2005, when she went to court to get a restraining order against him. The two of them, with help from their pastor Jimmy Carroll in Raleigh, designed the system that is now in place to keep Josh sober.

The system's core is a network of people – Josh and Katie use the Christian term "accountability partners" when discussing them – with whom Josh keeps in close contact. Carroll is one. Another is Katie's father, Michael "Big Daddy" Chadwick, a former drug user and seller who became a successful homebuilder in Raleigh and who now runs his own Christian youth ministry. There is also James Robison, the televangelist and founder and president of the Christian relief organization Life Outreach International. And there is Hamilton's agent, Mike Moye, who runs a Christ-centered sports agency.

"They are all Josh's good friends," says Katie. "He seeks advice from them, and godly counsel. Pastor Jimmy has been in our lives for many years and is extremely influential. James Robison is someone Josh calls, if not daily, then close to daily."

Says Josh: "It is very important to my recovery and my walk with Christ that I have people like that around me. They always call or text at the right time."

Gender Gap in Prescription Pain Drug Abuse

Gender Gap in Prescription Pain Drug Abuse
Study Shows Men and Women Have Different Risk Factors for Abuse of Prescription Painkillers

By Bill Hendrick
WebMD Health News

Reviewed By Laura J. Martin, MD

April 29, 2010 -- Gender appears to play a role in the risk of abuse of prescription pain drugs, a study shows.

Predictors of such abuse are different in men and women, researchers say, and knowing this could help doctors adopt treatment plans that are less likely to cause misuse of opioid medications.

The finding comes from a study involving 662 chronic noncancer patients taking opioid drugs for pain relief.

Researchers say misuse by women seems to be closely related to psychological distress. Prescription pain drugs are more likely to be misused by men who have social and behavioral problems.

"Since little has been published about gender differences and misuse of prescription pain medication, it is valuable to document whether risk factors for abuse are gender specific to some degree," says study researcher Robert N. Jamison, PhD, a clinical psychologist at Harvard's Brigham and Women's Hospital.

The study shows that men and women have similar frequencies of aberrant drug behavior but different risk factors for abuse of opioids.

Women who misuse pain drugs are more likely "to admit to being sexually or physically abused or have a history of psychiatric or psychological problems," Jamison says.

Women who are being treated for pain not caused by cancer and who exhibit signs of significant stress should be treated for mood disorders and counseled on dangers of relying on pain pills to help them sleep or reduce stress, the researchers say.

Men taking pain pills should be closely monitored for suspected behavioral problems, Jamison says. In addition, their pills should be counted to check adherence, and frequent urine screens also should be done.

Abuse of Opioids Is Growing
Jamison and colleagues write in the study that the use of opioids for chronic pain has been growing, and that between 3% and 16% of the population has a substance use disorder.

Indeed, some pain centers that dispense opioids "are overwhelmed with patients who are known or suspected to be abusing" their medications, the researchers write.

The study involved patients who had been prescribed opioids for chronic noncancer pain; about half the participants were men, half were women.

Five months into the study they were interviewed and had to submit a urine sample. Physicians also completed a substance misuse behavior checklist.

The researchers write that women in the study tended to display signs of emotional issues and affective distress, compared with men.

Men tended to show signs of worrisome behaviors, such as association with other people who abused drugs and alcohol and engaging in criminal behavior.

For women, a history of sexual abuse was an issue in later misuse of prescription drugs. "These results are in agreement with past research that highlighted the importance of sexual and physical abuse history in predicting opioid misuse," the researchers write. "These same studies also showed that women with a significant history of anxiety and depression tend to do less well in properly managing opioids prescribed for pain, possibly because of the tendency to self-medicate a mood disorder using opioids."

The researchers also say that past research has suggested that women may be more open and truthful about behaviors and to seek psychological help than men.

"Given the prominence of sex differences in a variety of pain-related processes, we may eventually arrive at a method for tailoring risk assessment and risk-reducing interventions in part as a function of gender," the researchers say, adding that more research is called for by their study.

The study is published in the April issue of The Journal of Pain.

SOURCES: News release, American Pain Society.

Jamison, R. The Journal of Pain, April 2010; vol 11: pp 312-320.

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