Spice, K2, Other “Fake Pot” Illegal as of March 1

DEA makes synthetic marijuana a Schedule 1 drug.

The U.S. Drug Enforcement Administration (DEA) exercised its emergency scheduling authority yesterday to outlaw the use of “fake pot” products.

Sixteen states have already passed a mishmash of legislation outlawing one or more of the drugs in question, which are typically sold as Spice, K2 or Red X.

The DEA had already announced its intention to put 5 new drugs--JWH-018, JWH-073, JWH-200, CP-47, 497, and cannabicyclohexanol--on the official list of scheduled substances. “These products consist of plant material that has been coated with research chemicals that claim to mimic THC, the active ingredient in marijuana, and are sold at a variety of retail outlets, in head shops, and over the Internet,” the DEA said in a prepared statement. “The temporary scheduling action will remain in effect for at least one year while the DEA and the United States Department of Health and Human Services (DHHS) further study whether these chemicals should be permanently controlled."

According to the DEA, “Emergency room physicians report that individuals that use these types of products experience serious side effects which include: convulsions, anxiety attacks, dangerously elevated heart rates, increased blood pressure, vomiting, and disorientation.”

The smokable herbal products were designated as Schedule 1 substances, the federal government’s most restrictive category, ostensibly reserved for drugs with “no accepted medical use for treatment in the United States and a lack of accepted safety for use of the drug under medical supervision.” Marijuana is also a Schedule 1 drug, along with heroin, Ecstasy, and LSD. The supposedly less dangerous Schedule 2 drugs, bizarrely, contain the most problematic drugs of all in terms of human health and addictive potential: methamphetamine, oxycontin, and cocaine. Schedule 3 is so confusing as to defy coherent description, while Schedule 4 is the valium category and Schedule 5 is the Robitusson category.

One problem with the whack-a-mole approach to drug enforcement is that developers of designer drugs can easily stay one jump ahead of the law. What many drug officials and agencies, including the International Narcotics Control Board, want to see is sweeping, generic bans on whole categories of chemicals, in order to win the game of leapfrog.

However, as reported by Maia Szalavitz at Time Healthland, broad-spectrum drug bans “could have the unintended effect of keeping potential cures for diseases like Alzheimer’s out of the pharmaceutical pipeline.” As Szalavitz notes, “getting a drug out of Schedule 1 is much harder than getting it into that legal category, as supporters of medical marijuana and MDMA have discovered.”

And if clinical researchers wish, say, to pursue JWH-133--a chemical compound closely related to the newly banned drugs—for its ability to reduce the inflammation associated with plaque buildup in the brains of people with Alzheimer’s, they are going to find that research almost impossible to do, as more and more chemicals escape the lab or emerge from the work of underground chemists and ultimately become illegal substances.

Notice of Intent to Temporarily Control Five Synthetic Cannabinoids

Graphics Credit: http://newsbythesecond.com/

Smoking and Adolescent Attention Deficit

Are young smokers risking cognitive impairment as adults?

 Call it “nicolescence.” It’s that time of life when certain 18-and-unders discover cigarettes. Most adult smokers begin their habit before the age of 19, and a majority of adolescents have tried cigarettes at least once. But for some of them—those who were “born to smoke,” in a sense—early exposure to nicotine may influence adolescent cognitive performance in ways that adult exposure to nicotine does not. Furthermore, early exposure may result in “cognitive impairments in later life.”

These provocative notions are raised by a group of researchers at VU University, Amsterdam, The Netherlands, in a paper for Nature Neuroscience. And while the specifics of glutamate activity they have documented are fascinating, the leaps back and forth between adolescent humans and adolescent lab mice are dizzying. Nonetheless, the bold claims made in the paper prompted the scientists “to reconsider our views on the etiology of attention deficits.”

That may be more than many addiction researchers are willing to countenance, but the study makes an intriguing case for long-term effects on attentional processing. The Dutch researchers exposed adolescent rats to nicotine, assessed visuospatial attention and other markers associated with synaptic activity in the prefrontal cortex, and found impaired measures of attention and signs of increased impulsivity in adulthood after five weeks of abstinence. Adult rats exposed to nicotine for the first time did not show similar long-term consequences.

The molecular underpinnings for this phenomenon appear to be reduced glutamate receptor protein levels in the prefrontal cortex. Glutamate is a neurotransmitter involved in attention, among other cortical tasks. Glutamate levels were “altered specifically by adolescent and not adult nicotine exposure” in the lab animals, the researchers found.

The glutamate receptor mGluR2 is the likely culprit.  The researchers report that “a lasting downregulation of mGluR2 on presynaptic terminals of glutamatergic synapses in the prefrontal cortex persists into adulthood causing disturbances in attention…. Restoring mGluR2 activity in vivo in the prefrontal cortex of adult rats exposed to nicotine during adolescence remediated the attention deficit.”

The study concludes: “Not only from a behavioral, but also from a molecular point of view, the adolescent brain is more susceptible to consequences of nicotinic receptor activation.” In other words, there is at least some evidence that the neurotoxic effects of nicotine are potentially more severe in the early developmental stage called adolescence.

The Dutch study is not the only one of its kind. In 2005, Biological Psychiatry published a report on cognition in which adolescent smokers “were found to have impairments in accuracy of working memory performance irrespective of recency of smoking. Performance decrements were more severe with earlier age of onset of smoking.”

And a 2007 study published in Neuropsychopharmocology, based on testing and fMRI scans of 181 male and female adolescent smokers, concluded that “in humans, prenatal and adolescent exposure to nicotine exerts gender-specific deleterious effects on auditory and visual attention…” Boys were more sensitive than girls to attention deficits involving auditory processing, while girls tended to show equal deficits in both auditory and visual attention tasks. 

Counotte, D., Goriounova, N., Li, K., Loos, M., van der Schors, R., Schetters, D., Schoffelmeer, A., Smit, A., Mansvelder, H., Pattij, T., & Spijker, S. (2011). Lasting synaptic changes underlie attention deficits caused by nicotine exposure during adolescence Nature Neuroscience DOI: 10.1038/nn.2770

Photo Credit: http://smoking-quit.info/

From NINA to NSNA: No Smokers Need Apply

 Smoke-free workplace or job discrimination?

It started with hospitals and medical businesses. As more and more states adopted strict policies about smoking, state courts began to bump up against a vexing question—the legal system is being called upon to adjudicate the legality of refusing to hire smokers.

The issue has split the anti-smoking world into two camps, and shines light on the fundamental question: Is it legal to discriminate against tobacco consumers, usually known as smokers, for the use of a lawful product? Will courts uphold cases where employees have been fired for “smelling of smoke”?

20% of Americans continue to smoke. As the New York Times puts it, a shift from “smoke-free” to “smoker-free” workplaces reflects the general feeling that “softer efforts—like banning smoking on company grounds, offering cessation programs and increasing health care premiums for smokers—have not been powerful-enough incentives to quit.”

Join Together reports that under new “tobacco-free” hiring policies, “applicants can be turned away for smoking, or if they are caught smoking after hire. Policies differ by company, but some require applicants to take urine tests for nicotine.”

The chief executive of St. Francis Medical center in Cape Girardeau, Missouri, which recently stopped hiring smokers, said that it was “unfair for employees who maintained healthy lifestyles to have to subsidize those who do not. Essentially that’s what happens.”

The American Lung Association, the American Cancer Society, and the World Health Organization (WHO) do not hire smokers. However, the American Legacy Group, an anti-smoking advocacy organization that does hire tobacco users, argues that “smokers are not the enemy.” In the words of Ellen Vargyas, the group’s chief counsel,  “the best thing we can do is help them quit, not condition employment on whether they quit.”

As Dr. Michael Siegel of  the Boston University School of Public Health told the New York Times: “Unemployment is also bad for health.”

The issue has broader implications, as yet imperfectly explored. Will it become legal to discriminate against alcohol and drug users in general? How about junk food? Should a company be forced to saddle itself with the likely health costs associated with a junk food junkie?

And so on. This one bears watching.

Love, Loss, and Addiction

Review of “This River” by James Brown.

James Brown, author of “The L.A. Diaries,” has offered up another candid and courageous memoir in his new book, “This River.” In a series of related vignettes, the book amplifies and extends the basic story of Brown’s life as chronicled in “L.A. Diaries,”--a harrowing tale of genetic fate and social failure; a dysfunctional family riven by alcoholism and drug addiction, culminating in the suicide of the author’s brother, followed by the suicide of his  sister.

Throughout his descents into hard drug use, his ups and downs along the alcoholic’s rehab trail, Brown remains a fierce observer of his own behavior, and, heartbreakingly, its effect on those around him: “Worrying, damaging, terrorizing those closest to us, intentionally or not, is what alcoholics, addicts, and the mentally ill do best.” As was true of “The L.A. Diaries,” Brown writes in a spare, direct, unflinching style—a bracing antidote to the Stuart Smalleys of the world.  His observations on A.A., anti-craving medications, and antipsychotic drugs are those of a man unwilling to let prior prejudices and built-in excuses deter him from a search for the true nuts and bolts of his condition.

Reaching that point of understanding, and comprehending the need for action—none of it typically comes fast, cheap, or easy. Brown, who teaches in the MFA program at Cal State San Bernardino, masterfully captures the internal monologues of the addictive mind:

"Getting hooked is for weaklings, the idiots who can’t control themselves, those losers who end up broke and penniless, wandering the streets at night like zombies, like the walking dead…. For the budding addict, the supply is never enough, but your only regret, at least to date, is that you didn’t come across this miracle potion sooner."

The internal dialog eventually becomes an existential struggle: “True or not, I resist the idea that mental illness and alcoholism are somehow inborn. Accepting that premise means embracing the notion of fate, and I don’t. I prefer to believe that I’m in full control.”

As who among us does not. And although none of us are truly in full control—we are all a conflicting welter of “I”s, of shifting identities and roles—it is through the dissociations characteristic of addictive illness that the Jekyll and Hyde nature of these changes, which are somehow “in the blood,” sometimes manifest themselves most graphically.

Does the author prevail? He does, for now, and that is how we must leave it:

Things are changing deep inside you and have been for some time: hormones, genes, brain chemistry, all of it adapts to the alcohol and drugs you continually dump into your body. The cells habituate. The cells literally mutate to accommodate your cravings and now they crave too. Now your addiction has more to do with physiology than psychology. Now it’s the body that robs the mind of its power to choose, and it’s not long before you’ll wish you never came across that miracle potion, those powders and pills.

With suberb jacket reviews from the likes of Tim O’Brien, Robert Olmstead, and Duff Brenna, “This River” is a short read that will lodge itself firmly in your memory.  I read it in one sitting, and I bet you do, too.

Photo Credit: http://radaris.com/p/James/Rivers/

What’s the Best Valentine’s Day Present of All?

Answer: a healthy heart.

Valentine’s Day is all about hearts, so it’s not surprising that February was picked as American Heart Month almost 50 years ago.

The Office on Smoking and Health at the U.S. Centers for Disease Control (CDC) wants you to know that, if you smoke, “the cells that line your body's blood vessels react to the poisons in tobacco smoke almost immediately. Your heart rate and blood pressure go up. Your blood vessels grow narrower. Chemical changes caused by smoking also make blood more likely to clot."

Furthermore: “Plaque clogs and narrows your arteries. This can trigger chest pain, weakness, heart attack, or stroke. Plaque can rupture and cause clots that block arteries. Completely blocked arteries can cause sudden death. Smoking is not the only cause of these problems, but it makes them much worse.”

Worse like this---------------------------------------------->

The 2010 Surgeon General's Report, "How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease," documents the crucial importance to heart health of being smoke-free.

Okay, don’t quit for yourself. Because face it, you don’t want to. But how about quitting for someone else? As the CDC reminds us, “because secondhand smoke also affects others and can increase their risk for heart attack and death, quitting smoking can help protect your loved ones.”

And here are some CDC resources for supporting a stop-smoking program:

For support to quit, call 1-800-QUIT-NOW (1-800-784-8669; TTY 1-800-332-8615). This service provides free support and advice from experienced counselors, a personalized quit plan, self-help materials, the latest information about cessation medications, and more. 

Online cessation services and resources are also available online at www.smokefree.gov. This Web site provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.

Photo Credit: http://inventorspot.com/

Drinking on Television

  

Does alcohol on TV make you bend the elbow?

I have a guest post at All About Addiction covering a journal article in Alcohol and Alcoholism with the unambiguous title: “Alcohol Portrayal on Television Affects Actual Drinking Behaviour.”

It is an easy and familiar accusation. Over time, it has been levied at violent video games, drug use in the movies and alcohol advertising of every stripe. But what is the actual evidence for it? Leave it to a group of Dutch scientists to design a practical experiment to test the proposition when it comes to drinking.... More.

Photo credit: http://josh-wyxl.itmblog.com/page/14/

Sign of the Times

Epidemic of Oxycontin theft at Walgreens.

ROCHESTER, NH — Police are looking for a suspect who robbed the Walgreens Pharmacy on South Main Street early Sunday morning. According to Sgt. Gary Boudreau, police responded around 2 a.m. to the Walgreens at 104 South Main Street for a reported robbery. Boudreau said a single male entered the store, proceeded to the pharmacy counter and passed a note demanding certain prescription medications. The suspect left the store with an undisclosed amount of OxyContin, Oxycodone and Xanax.

COLORADO SPRINGS, CO--The Colorado Springs Police Department's Robbery Unit is seeking assistance identifying the suspect in the Aggravated Robbery of the Walgreens located at 4713 Flintridge Dr in Colorado Springs on January 4, 2011 at 4:22 pm. During the robbery the suspect approached a pharmacist, threatened he had a weapon and demanded Oxycontin. The suspect fled the store with an undisclosed amount of Oxycontin.

WESTBROOK, CT--State Police are investigating strong armed robbery at a Walgreens in Westbrook. State Police say a man entered the Walgreens and demanded narcotics from the pharmacist around noon on Thursday. Police say he made off with more than 100 OxyContin pills.

TIGARD, OR--The Tigard Police Department is investigating a robbery that occurred Monday afternoon at the Walgreens store at 13939 S.W. Pacific Highway. An employee called 9-1-1 to report the incident at approximately 5:10 p.m.  Police officers arrived and began searching for the robber, who had  demanded OxyContin from an employee at the prescription counter. The robber displayed and threatened the employee with a black handgun, police said.

POST FALLS, ID -- Investigators hope surveillance footage will help them catch a pair of Oxycontin robbers who hit a Post Falls Walgreens Sunday. Police say two men walked into the Walgreens at 706 E. Seltice Way at about 11:00 a.m. and approached the pharmacy counter. One of the men handed an employee a "threatening note", demanding the powerful painkiller. The clerk complied with the note and handed over an unknown amount of pills.

LEXINGTON, KY--Police are looking for a man who stole more than 700 prescription pain pills at gunpoint from a Lexington pharmacy early Monday morning. Witnesses said a man wearing blue jeans and a gray hooded sweatshirt with the hood up entered the store, displayed a handgun and demanded OxyContin tablets. He appeared to be about 6 feet 3 inches tall and about 180 pounds. He drove away in a brown pickup truck after bagging 772 pills, according to a police report.

SPOKANE, WA--OxyContin robberies in Washington have prompted an unprecedented response from one of the nation’s largest pharmacy chains. New time-delayed safes have been installed in Walgreens pharmacies across the state to hold supplies of the powerful painkiller. The timed locks take several minutes to open, halting immediate access to a prescription drug that’s prompted about a dozen robberies at Spokane County Walgreens stores since last fall, often at gunpoint or knifepoint.

Photo Credit: http://localspice.blogspot.com