Addiction Research Highlights

Clinical studies in 2008.

Alcohol, Other Drugs, and Health: Current Evidence—a free online newsletter from the Boston Medical Center—offers summaries of relevant clinical research on drugs of abuse and related drug issues.

In the November-December 2008 issue, the editors present “a comprehensive guide to all the clinically relevant research articles published by the newsletter in 2008.”

Herewith, a brief sampling:

Topiramate Reduces Drinking in Adults With Alcohol Dependence

“Topiramate may decrease alcohol consumption among people with alcohol dependence by reducing the release of dopamine.”

Treatment for Alcohol Withdrawal Is Poor Despite Proven Therapies

“Evidence-based practice guidelines are clear that patients at risk for alcohol withdrawal should be monitored and treated with benzodiazepines if the risk is high enough or symptoms are substantial.”

Oral Naltrexone Decreases Use and Extends Time to Relapse in Amphetamine Dependent Patients

“Currently, no medications are FDA-approved to treat amphetamine dependence. Naltrexone, an opioid antagonist, has shown efficacy in reducing relapse among subjects with opioid or alcohol dependence.”

Alcohol Counseling Can Reduce Blood Pressure

“Unhealthy alcohol use is associated with hypertension. Two recent articles examined whether reductions in drinking can decrease blood pressure among hypertensive heavy drinkers.”

Levetiracetam (Keppra) Shows Promise in Treating Alcohol Dependence

“Anticonvulsants have shown promise as pharmacologic agents in the treatment of alcohol dependence, although none are yet approved by the Food and Drug Administration for this indication.”

Are Myocardial Infarction Survivors Who Smoke Marijuana at Higher Risk of Death?

“Although a previous study demonstrated an increased risk of myocardial infarction (MI) within 1hour of smoking marijuana compared with periods of nonuse, the net impact of marijuana use on mortality has not been established.”

American Heart Association Releases Guidelines on Treatment of Cocaine-Associated Chest Pain

“There are approximately 500,000 cocaine-associated emergency department visits annually, and it is estimated that 40% involve chest pain.”

Opioid Maintenance Therapy Saves Lives

“Opioid-dependent patients are 13 times more likely to die than their age- and sex-matched peers in the general population.”

Bupropion Added to Nicotine Replacement for Patients in Alcohol Treatment

“The effectiveness of bupropion, an antidepressant approved for smoking cessation in the general population, has not been studied in people being treated for alcoholism.”


Photo Credit: Brief-TSF.com

Safe Drug Injection Sites

Will San Francisco follow Vancouver’s lead?

San Francisco is on the brink of agreeing to open what would officially be the nation’s first medically supervised injection facility for addicts--despite mixed feelings about the program in the Bay Area.

The Safer Injection Facility is likely to be located in San Francisco’s Tenderloin District, where drug abuse is rampant. If it moves forward, the site will be modeled after an equally controversial Canadian program, the Insite injection facility, established in Vancouver in 2003.

“None of us want to shoot out here in front of kids,” a homeless drug user told the Oakland Tribune. “If we had a place to shoot, then we’d also have a place to put our dirty needles, which is a problem out there.” However, there has been considerable community resistance to the idea, say police, with more affluent areas declaring, in essence, “not in my neighborhood.”

The Harm Reduction Coalition (HRC) maintains that the Vancouver safe injection facility has resulted in fewer fatal overdoses, lower disease rates, and more addicts in recovery. HRC defines Safe Injection Facilities as “legally protected places where drug users consume pre-obtained drugs in a non-judgmental environment and receive health care, counseling, and referrals to other health and social services, including drug treatment.

In San Francisco, an injection facility has been an idea in search of a political sponsor for some time. Moreover, advocates can expect no help whatsoever from the federal government. Last year, the Office of National Drug Control Policy said it found preliminary plans for a safe injection site “disconcerting” and called it “poor public policy." An AP/Google report from last year reported that overdoses from injected drugs represented one of every seven emergency calls handled by paramedics in San Francisco.

Last year, Sarah Evans of Vancouver’s Insite center, told the San Francisco Chronicle: “The evidence is really clear that we’re achieving our goals for the users and the community. The more you look into it, the more you realize it’s crazy not to do it.” Not all Canadian politicians agree, however, even though the majority of physicians in the Canadian Medical Association appear to support safe injection sites. Recently, as reported in the Drug War Chronicle, Canadian Health Minister Tony Clement said he would question the ethics of doctors who support the use of safe injection sites for drug addicts.

HRC’s petition for a safer injection facility in San Francisco can be found online at Democracy in Action.


Photo Credit: Inky Circus

States Unleash New Ignition Lock Laws

The brave new world of DUI enforcement.

Starting this month, drivers convicted of driving while intoxicated in at least six new states will face a hi-tech hurdle to repeat offenses: ignition interlocks. After a high profile national campaign, Mothers Against Drunk Driving and other organizations convinced several state legislatures to pass laws mandating the dashboard installation of small ignition interlock device activated by a breathalyzer.

“It’s amazingly inconvenient, “ David Malham of the Illinois MADD group told Associated Press. “But the flip side of the inconvenience is death.”

Will high technology really help keep drunk drivers off the streets and highways? Malham, quoted in the Chicago Tribune, insisted that “it’s not about changing human nature, it’s about science interfering and preventing reckless behavior.” Maltham also said he is looking forward to technology that will be able to sniff a car’s interior, scan the eyes of drivers, and test sweat on the steering wheel before allowing the driver to turn the key.

In addition to Illinois, states that passed laws requiring the use of ignition locks for drunken driving convictions of varying degrees include Nebraska, Colorado, Washington, and Alaska. Other states with similar but unevenly enforced laws on the books include South Carolina, Arizona, New Mexico, and Louisiana.

Illinois is attempting to work around the program’s most obvious flaws—the convicted drinker could drive someone else’s car, or get someone else to blow into the breath-monitoring device—by instituting heavy penalties for non-compliance if the driver is caught cheating.

Lined up in opposition to ignition lock legislation, thus far, is the American Beverage Institute, a lobby group for restaurant owners. In the AP article, the Institute’s Sarah Longwell objected to the fact that states might decide to apply the laws to people other than repeat offenders—to anyone who, on any given night, blows a 0.08 or a 0.10, the common denominators of alcohol intoxication in most states.

Sounding a bit more like the National Rifle Association (NRA) than perhaps it intended, the Beverage Institute offered a dire vision of a slippery slope: “We foresee a country in which you’re no longer able to have a glass of wine, drink a beer at a ball game or enjoy a champagne toast at a wedding. There will be a de facto zero tolerance policy imposed on people by their cars.”

My modest prediction: A tangle of state lawsuits and questions over civil liberties, the more so since many of the laws are first-pass efforts and subject to interpretation.

Photo Credit: HTB

alcoholics anonymous

Recovery in 2009

Some resolutions for the New Year.

The SoberRecovery site has put up a forum entitled: "Anybody up for New Year Resolutions?" You can read the thread at the link above. There are old ones, new ones, and in-between ones.

From the practical...

“i will buy an accordion folder (if santa doesn't bring me one)--and i will organize my recipes”.

To the whimsical...

“I want a *real* accordion."

From the personal...

“To practice the golden rule even in heavy traffic.”

To the profound...

“My New Year's Resolution is to embrace life--to fully come out of the tiny, insular, self-absorbed world that drinking kept me in for so long and live to my full potential!

And organize my garage!”

Happy New Year to All.

Dirk Hanson
Site editor, Addiction Inbox


Graphic Credit: Vox Sacramento

Tobacco Settlement Turned Upside Down

“Tobacco bonds” link state budgets to cigarette sales.

Bob Sullivan of MSNBC reports that ten years after a group of states wrestled Big Tobacco to its knees in a $200 billion settlement, the creation of “tobacco bonds” by Wall Street has allowed investors and state governments to borrow against their future tobacco settlement payments. The result? Money that was to be paid out over the next thirty years for smoking cessation programs is being redirected into infrastructure projects and shoring up municipal credit.

“A review of 660 leading bond funds covered by the investment research firm Morningstar Inc., conducted at msnbc.com’s request, showed that more than 260 are invested in tobacco bonds,” Sullivan writes on his blog, The Red Tape Chronicles.

What, you may well ask, are tobacco bonds, and where did they come from? “Perhaps from you,” Sullivan writes. “When Wall Street talked 25 states into borrowing against future tobacco payments—a process known as ‘securitization’—it sold bonds to individual investors and mutual funds that buy municipal bonds.”

The irony of that approach, says Sullivan, is that “because these states have essentially borrowed against future payments from the tobacco industry, they are now dependent on the continued vitality of cigarette sales. If Big Tobacco stumbles, states will be on the hook for these massive, billion-dollar loans.” As a lawyer involved in litigation over the tobacco settlement put it to Sullivan: “Now [the states] have an incentive not to put tobacco out of business.” More than that, any significant failure by the tobacco industry to make its payments would be “catastrophic both to state budgets and individual investors.”

It wasn’t supposed to be this way. But the settlement from the lawsuit designed to blow up Big Tobacco was just too attractive to investment bankers. Sullivan notes that Oppenheimer’s Rochester family of bond funds includes funds with up to 20 per cent of assets held in tobacco bonds. The lure to the states was that, rather than waiting for the money, they could opt for an attractive lump sum payment up front. And many states did just that.

The problem, according to a tobacco policy researcher quoted on Sullivan’s blog, is that “the states have this horribly naive view that they will outsmart Wall Street. Wall Street always gets the better deal.” Many states have settled for a payout of 50 cents on the dollar, plus additional insurance fees against the risk of tobacco companies going out of business.

Eric Lindblom, a director of the Campaign for Tobacco-Free Kids, told Sullivan: “There is a horrible failure of the states to invest even a minuscule amount of the funds for tobacco control. It’s a real tragedy for our country.”

Roughly 3 per cent of tobacco settlement money has been paid out for smoking cessation efforts over the decade since the settlement, Sullivan writes.

Photo Credit: www.treasury.state.la.us

addiction smoking

[Guest Post] Food For Thought--Are You Addicted?

Can you eat your way to happiness?

(This article is contributed by Sarah Scrafford, who regularly writes on the topic of Becoming an Ultrasound Technician. She invites your questions, comments and freelancing job inquiries at her email address: sarah.scrafford25@gmail.com.)


Food is essential for life, but there are times when it becomes the reason for death. If you’ve heard of addictions, you’ll know what I’m talking about – addictions and substance dependence extend beyond the realm of drugs, nicotine and alcohol. There are times when it can become as simple, and as complicated, as being addicted to food. Some people have a sweet tooth and get their rush from sugar; others limit themselves to chocolate; but there are a few people who need to eat all the time – they eat when they’re sad and when they’re happy; they eat because food is available; they eat because they’re bored; they eat because they’re stressed; in short, they eat all possible reasons and for no reason at all.

Too much of anything is bad for you, and so you have food and eating related disorders. The compulsive eaters are beset with various medical problems, all of which begin and end with obesity. Large people with fat deposits on various parts of their body are prone to illnesses like diabetes, hypertension, stroke and cardiac diseases. They’re also bound to be in poor general health because of their low level of fitness and sedentary lifestyle that comes about automatically when you’re fat and unable to move around without difficulty. Besides these, they’re also plagued by knee and back pains because of their weight – their knees are unable to support their body weight and become weak as time goes by.

On the other end of the spectrum are those obsessed with thinness – they love to eat too, but they do it on the sly. And when they’re done, they make themselves throw up either by retching or by using emetics. This disease, called bulimia, is characteristic of food addicts who feel guilty that they eat so much, and who are scared of the weight they’re going to put on because of the amount they’ve consumed. Bulimics are prone to binge eating, where they eat much more than normal amounts.

The best cure to an eating disorder or food addiction is self-control, and if you cannot control yourself, then get someone to help you do so. De-addiction from alcohol, tobacco or any other drug happens when you avoid the substance altogether, but it’s not that easy to overcome an addiction to something that’s a basic necessity for life. The trick is to learn to count your calories or to get someone to do it for you. You could also begin a sensible exercise routine where you concentrate on losing weigh in a healthy manner. A more active lifestyle gives you less time to sit around doing nothing, and so frequenting the path between your couch and your refrigerator.

Food addiction, like all other addictions, is a psychological problem that can be cured if treated at an early stage. All you need is a lot of will power and a little determination.

The Seasonal Addiction: Christmas Lights

Do you or a loved one suffer from CLA?

In 2004, psychologist John M. Grohol wrote a satirical piece for The Psych Central Report. It seems appropriate to excerpt it here:

"It is an age-old question that has haunted people since the first string of lights was strung in the 20th century," Grohol wrote. "Why do some people seem to go a little crazy with the amount of lights and displays they put on their homes and lawns? What makes some people think that this is a good idea? This growing phenomenon has turned into a full-blown behavioral addiction for some."

Indeed it has; one with its very own WebRing. It’s the time of year when afflicted people manifest CLA—Christmas Lights Addiction.
"It is an extreme behavior of an otherwise normal expression of a celebration of the holidays,” Grohol continues. “If you're one of these folks who can't live without their million-light holiday display, seek help. Imagine how much better your gift to the world would be if you donated your electricity costs to a local charity or homeless shelter.

"Leave the holiday lighting spectaculars to Radio City Music Hall or professional displays found in most communities done in formal gardens or the like. Let's try and get back to celebrating Christmas in a way that honors the heart of the tradition without turning it into some sort of glitzy and tacky sideshow of lighting horror.

Merry Christmas, Happy Chanukah, and Happy New Years to you All!"

Photo Credit: Gizmodo