They Inhaled

The "Nice People Take Drugs" campaign.

From the UK charity Release comes the project called Nice People Take Drugs. The publicity campaign has caused significant controversy in Britain, as reported by the UK Guardian. Release says on its web site that its charter is to "campaign for changes to UK drug policy to bring about a fairer and more compassionate legal framework to manage drug use in our society."

An earlier, similar campaign, using the same slogan and photos of well-known people on bus advertisements, ended when the bus company removed the ads, fearing a public backlash.

1 in 25 Global Deaths Linked to Alcohol

Vodka kills more Russians than war, Lancet reports.

A team of researchers at the University of Toronto reported in Lancet that 3.8 % of global deaths could be attributed to alcohol. In Europe, the report stated, the rate of premature death from alcohol was 1 in 10 during 2004, the year studied. And in a related study, more than half of all premature deaths among adult males in Russia were attributable to booze.

The world health care burden, as spelled out by Dr. Jurgen Rehm and others at the University of Toronto, is staggering: “The costs associated with alcohol amount to more than 1% of the gross national product in high-income and middle-income countries, with the costs of social harm constituting a major proportion in addition to health costs.”

In a BBC News report,the study authors warned that the worldwide effect of alcohol-related disease was similar to that of smoking in prior decades. The report takes note of prior research indicating a health benefit from moderate drinking, stressing that any purported benefit is “far outweighed by the detrimental effects of alcohol on disease and injury.”

The Lancet study concludes that the overall mortality figures are “not surprising since global consumption is increasing, especially in the most populous countries of India and China.”

Professor Ian Gilmore of the Royal College of Physicians, quoted by the BBC, called the report “a global wake-up call,” and urged the adoption of “evidence-based measures” for reducing alcohol-related harm, such as price increases and advertising bans. “Many countries are investigating new ways to cut deaths and disease and reduce the burden on health services by using the price of alcohol to lower consumption,” Gilmore said. Pricing strategies have been used effectively in the past to lower cigarette consumption, researchers have noted.

In one of the Russian studies, Professor Richard Peto of the University of Oxford led a statistical analyses, concluding: “If current Russian death rates continue, then about 5% of all young women and 25% of all young men will die before age 55 years from the direct or indirect effects of drinking.” The Russian figures are also affected by the high rate of associated smoking in the former Soviet Union.

Peto added: “When Russian alcohol sales decreased by about a quarter, overall mortality of people of working age immediately decreased by nearly a quarter. This shows that when people who are at high risk of death from alcohol do change their habits, they immediately avoid most of the risk.”

Photo Credit: www.adaweb.net

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Friday File

Book and blog recommendations for the weekend.

Books

I just finished reading a splendid book, Barbara Oakley’s Evil Genes: Why Rome Fell, Hitler Rose, Enron Failed, and My Sister Stole My Mother’s Boyfriend. Oakley, a systems engineer at Oakland University in Michigan, has done a great service for interested non-scientists by picking apart the intricate genetics of psychopathy and antisocial behavior.

Primarily a history of borderline personality disorder and the “great men” who suffered from it, Oakley takes the “nature-nurture” debate to the next level, asserting that bad behavior is a genetic propensity triggered by environmental influences—precisely the argument I make about addiction in my book, The Chemical Carousel: What Science Tells Us About Beating Addiction.

Oakley deftly beats back the usual panoply of objections to genomic research—that it is a slippery slope leading to eugenics, or that it is an excuse for bad behavior. Even worse, for many people, Evil Genes suggests that individual ethics are largely biochemically determined. The “successfully sinister,” as she calls them, have a baffling ability to charm their way to the top, and the author suggests some evolutionary reasons why this might be so.

Overall, Oakley makes a strong, eye-opening case for the importance of modern neuroscience in the quest to understand human behavior. This book should come as a serious shock to a generation of lawyers, judges and forensic psychologists who have spent a lifetime adhering to the “blank slate” view of human nature, when the “bad seed” analogy appears to be closer to the truth.

Blogs

Check out Brain Blogger for a look at “Topics from Multidimensional BioPsychoSocial Perspectives,” as the site is subtitled. Recent posts include articles about antibiotic overuse, gender reassignment, autism, torture, proprioception, neural plasticity, and my own article on marijuana withdrawal, which has drawn a panoply of heated responses.

A fascinating site with a multidisciplinary perspective.

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Should I Tell My Boss?

Health help in the workplace.

It’s no secret: Times are tough. The situation at work is uncertain at best, downright Machiavellian at worst. According to a recent survey by the American Psychological Association (APA), the primary source of stress for 80 % of Americans is—you guessed it—money.

Health Matters at Work, a program developed by Community Health Charities, is offering a four-part video podcast series on addiction, depression, and stress in the workplace. The goal of the Health Matters at Work program is to enhance the ability of “employers, employees, and their loved ones to connect to credible information and resources to improve their health and their lives.”

The podcast series focuses on work-related resources available through Mental Health America, the Depression and Bipolar Support Alliance, and the National Council on Alcoholism and Drug Dependence.

“The message we hope people hear,” said Robert Lindsey of the National Council on Alcoholism and Drug Dependence, “is that together we offer a broad network of support to people in communities across America, and we are all here for people that need our help.”

David Shern of Mental Health America said: “Mental Health is fundamental to health in every way. Increased levels of stress, depression, and anxiety all raise the risk of cardiovascular disease.”

Community Health Charities of America, located in Arlington, Virginia, is a consortium dedicated to assisting “people affected by a disability or chronic disease by uniting caring donors in the workplace with health issues and causes important to them and their families.”

A list of the group’s member charities can be found here.

Corporate partners include AARP, McDonalds, Exxon, HP, Siemens, and USA Today.


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Obama Comes Clean

Signs nicotine control act, admits he still lights up.

The new anti-smoking legislation, the Family Smoking Prevention and Tobacco Control Act, prevents the advertising of tobacco to children and puts tobacco under the purview of the Food and Drug Administration for the first time.

In signing the bill, Obama was compelled by reporters to admit to his nicotine addiction during a press conference. "Look, I've said before that as a former smoker I constantly struggle with it. Have I fallen off the wagon sometimes? Yes," Obama said in an article about the news conference by Sheldon Alberts of Canwest News Service.

Typically, for a smoker who can’t quite quit, Obama defended himself by saying, "I don't do it in front of my kids. I don't do it in front of my family."

Obama was said to have convinced his wife to support his bid for the presidency by agreeing to give up cigarettes—a campaign pledge he has not been able to keep, by his own admission.

During the Tuesday press conference Obama compared his addiction to nicotine to an alcoholic's need for a drink. "I don't know what to tell you, other than the fact that, you know, like folks who go to (Alcoholics Anonymous) you know, once you've gone down this path, then, you know, it's something you continually struggle with, which is precisely why the legislation we signed was so important, because what we don't want is kids going down that path in the first place."

During the press conference, an exasperated Obama sought to turn the questions away from his own lingering addiction. "First of all, the new law that was put in place is not about me. It's about the next generation of kids coming up," he said. "So I think it's fair . . . to just say that you just think it's neat to ask me about my smoking, as opposed to it being relevant to my new law. But that's fine. I understand. It's an interesting human interest story."

Graphics Credit: obamasmoking.com

addiction drugs smoking nicotine

The Dapsone Analogy

Another way of looking at addiction.

Medical science tells us that there are diseases called “pharmacogenetic disorders.” A common one is known as glucose-6-phosphate dehydrogenase deficiency. This disorder is a human enzyme deficiency that reduces the ability of red blood cells to carry oxygen, resulting in severe anemia. Its origin is genetic, and it is found predominantly in Jews and African-Americans. People who have this disease don’t necessarily know it. They don’t get into trouble until they are exposed to a very particular kind of environmental insult: an oxidative agent. Like eating fava beans, for example. If a person suffering this disorder eats fava beans, as one addiction expert told me, sparing the technical details, “their red blood cells go to hell.”

Okay. But how can something be a disease if the people who supposedly have it are perfectly normal until they start messing with fava beans—or alcohol or heroin? To some people, that just does not sound like a disease. And there are, in addition, obvious environmental influences on the course of addiction. However, there are also strong environmental causes and impacts related to diabetes, hypertension, and a host of other common diseases.

As it happened, African Americans who served in Viet Nam who suffered from glucose-6-phosphate dehydrogenase deficiency found out about it fast, whenever they took an anti-malarial medication called Dapsone, a drug now used to treat certain skin diseases similar to leprosy.

Blacks with glucose-6-phosphate dehydrogenase deficiency would take Dapsone, which pulled the environmental trigger on their disease, and they would suffer acute hemolysis—the complete breakdown of their red blood cells. If they didn’t take Dapsone, or eat fava beans, they were fine—you couldn’t tell them from anyone else. (The same thing happened in Korea when service personnel suffering this deficiency encountered a different environmental trigger—the antimalarial drug primaquine.)

Now try this: What if eating fava beans for the very first time didn’t make certain people sick—it made them feel incredibly good; better than they had ever felt in their life? Better than they ever thought possible. What if that first experience felt like a life truly worth living; a surcease from years of sadness, a miracle drug, the healing hand of God? What if certain people, for reasons of abnormal biochemistry, had never experienced the typical feelings of happiness and contentment most people take for granted—until they ate fava beans. And then, for the first time in their lives, they felt better than okay.

If fava beans were a rewarding stimuli instead of aversive, the disease would still be a pharmacogenetic disorder, hidden from view in the absence of the environmental trigger. Once having tasted the bean, however, a stubborn minority of people would be drawn to eat it repeatedly. And the more they ate the beans, the more their bodies would become dependent upon the artificial reward the beans provided—until they reached a point where they simply could not function unless they had their beans.

Photo Credit: Astragen LLC

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Addiction Touches Almost Everyone

75% of Americans know someone who is addicted.

A new survey by Lake Research Partners, sponsored by George Soros’s Open Society Institute and presented at the June 16 Conference of Mayors meeting in Providence, R.I., reveals that three of every four people surveyed said that they personally knew someone who has been addicted to alcohol or drugs.

More ominously, half of Americans “say they could not afford treatment if they or a family member needed it. They are also concerned that people addicted to alcohol or drugs may not be able to get treatment because of cost or lack of insurance coverage – a concern likely heightened by the current economic recession.” Moreover, financial concerns about treatment are highest among Americans with incomes less than $50,000. 67% of that income group said they would not be able to afford addiction treatment.

Among the survey’s other findings:

--Three‐quarters (75%) of Americans are concerned that people who are addicted to alcohol or drugs may not be able to get treatment because they lack insurance coverage or cannot afford it. Concerns about the affordability of and access to addiction treatment emerge throughout the survey results. Four in ten (41%) are very concerned.

--Nearly three‐quarters (73%) support including alcohol and drug addiction treatment as part of national health care reform to make it more accessible and affordable. This support cuts across all demographic groups. Lake Research Partners notes that this figure is quite high, “given the current economic climate and public concerns about government spending." One‐quarter (26%) oppose increased funding.

--Two‐thirds of Americans (68%) also support increasing federal and state funding for alcohol and drug prevention, treatment, and recovery services.

--Finally, more than nine in ten (96%) support providing specialized prevention, treatment, and recovery support to veterans and military returning from active duty (78% strongly support this effort).

The poll was sponsored by Closing the Addiction Treatment Gap , a program of the Open Society Institute. This program seeks to raise awareness around alcohol and drug addiction and its effects on family and communities. The telephone survey was conducted May 29-June 1, 2009 among a nationally‐representative sample of N = 1,001 adults 18 and older. The margin of sampling error is + 3.1 percentage points.

Graphics Credit: http://naturalpatriot.org/category/education/

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Smoke Alarm

The Cannabis and Tobacco Education Initiative.

My British friend James Langton, author of No Need For Weed, who maintains the excellent web site Clearhead for people with marijuana abuse problems, has launched a new site called Smoke Alarm.

The new venture is a non-profit company dedicated to the proposition of “offering credible information to the estimated 3 million people who regularly smoke tobacco joints here in the UK. We do this by directly educating through schools and colleges as well as indirectly through tobacco cessation professionals, drug agencies, and youth services.”

James Langton is in a unique position to help smokers in Europe, where the preferred drug delivery method for nicotine and marijuana is a joint of marijuana and tobacco rolled together—a smoking method that has never really caught on in the U.S. This preference for combining the two smokes into a “tobacco joint” creates “a powerfully addictive carcinogenic cocktail,” Langton writes on the new site. “Cannabis and tobacco are intimately connected and although the science of nicotine addiction is well understood, much less is known about how to help cannabis smokers with the psychological and physiological aspects of their dependency, and how the two substances interrelate to compound the difficulties in quitting either or both, together or separately.”

Langton’s book, No Need For Weed: Understanding and Breaking Cannabis Dependency, published by Hindsight Press, chronicles the author’s 30 years of experience as an addicted marijuana smoker, and explores the thoughts and difficulties of others who have suffered various degrees of marijuana dependency (See my support site on Marijuana Withdrawal).

“Cannabis continues to be an extremely popular drug with young people in the United Kingdom, and the fact that 44% of fifteen and sixteen year olds admitted to using the drug at some point in their lives when questioned for the 2008 United Nations International Narcotics Control Board report should not come as a surprise,” Langton writes. “Many young cannabis smokers do not consider themselves to be nicotine addicted simply because they mix their cannabis with tobacco. However, it's when the supply of cannabis is curtailed or they make an attempt to quit the drug that the nicotine pull gains dominance. This dynamic can set up a life-time nicotine cannabis relationship that remains one of the hardest for adult drug users to break.”

addiction drugs smoking nicotine

Allergies and Addiction

Is there a connection?

Most medical scientists agree that the primary cause of allergies is the unregulated release of histamine from mast cells, mostly likely caused by genetic malfunctions in the immune system.

What connection could that mechanism have to addiction? For starters, real toxins like drugs, and mistaken toxins like dust and ragweed, are both dealt with by the immune system, which attempts to cleanse the system of the “poisons.”

On a more mundane level, Alcoholics Anonymous has from the beginning referred to alcoholism as an “allergy of the body and an obsession of the mind.” More and more frequently, references are made to “allergy-induced addictions,” which supposedly include cravings for high-carbohydrate foods, sodas, and sugar foods in general, in addition to alcohol.

Joan Mathews-Larson and Mark Mathews, in “The Role of Allergies in Addictions and Mental Illness,” from the 2009 Praeger International Collection on Addictions, concentrate on food allergies, and argue that abstaining alcoholics turn instinctively to “allergy-provoking foods” like grains, sugars, and yeast—not coincidentally the basic ingredients of alcoholic beverages. This same basic class of foods—wheat, milk, barley and corn (from which we derive corn syrup) are capable of forming peptides that can bind to endorphin receptors.

Combining these trigger foods with alcohol can be a bad idea, the authors claim. “The starting point of most diseases is in the gut. Allergy foods factor heavily in the etiology of diseases because they damage the GI tract, and impair digestion.... Furthermore, combining allergy foods with alcohol heaps more stress on the immune system by doing more damage to the gut.” Thus, allergic alcoholics risks compounding the digestive damage unless they work to clear their diet of allergens.

The authors further allege that “If the allergic addictive person is deprived of the offending allergen long enough, he or she will go into withdrawal,” concluding that addiction and allergies “are the same problem based on similar molecules, following the same etiology.” Needless to say, this is a controversial theory. As one commentator on a health site described it, “This is counter intuitive on so many levels.”

While the research is controversial, and represents an unusual view of the etiology of addiction, there are plenty of addicts and alcoholics who suffer from allergies, and the extent to which this represents a double whammy to the immune is a question that remains largely unanswered.

Photo Credit: Allergy Asthma Zone

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A High Old Time in Washington, D.C.

Feds release state-by-state drug use figures.

It’s that time of year again: the season for publishing the annual SAMHSA drug sweepstakes. SAMHSA, the Substance Abuse & Mental Health Services Administration, a unit of the Department of Health and Human Services, has released its latest national report, covering 2007.

The map to the right shows illicit drug use in the past month among persons aged 12 or older, by state--------------------->

Which states exhibited the most felonious behavior when it comes to illegal drugs?

This year, the big all-around champion—especially in the cocaine category—was the nation’s capital. Washington, D.C. outpaced the rest of the country in almost everything, ranking number one for cocaine, number one for alcohol, and number three for marijuana, according to the study.

The Washington area, writes Maria Schmitt in the Washington Examiner, “has had a troubling association with drugs and alcohol, from the overdose death of University of Maryland basketball star Len Bias to the undercover bust of then-Mayor Mario Barry to last year’s DUI arrest of Rep. Vito Fossella of New York.”

Meanwhile, Vermont stubbornly holds onto the title of pot-smoking capital of the country. Freedom and Unity, as the state motto would have it. Utah retains its title as the most unstoned state in the union. It also ranks dead last in alcohol abuse. Meanwhile, North Dakota leads the nation in underage drinking.

The Midwestern plains states, by and large, don’t seem to be showing any latent signs of picking up a serious illegal drug habit. For abstaining addicts looking for the least environmental drug cues, Iowa and Nebraska are probably the best bets. Although if you talk to residents of those two states, they will tell you about vastly underreported alcohol and methamphetamine problems.

What inevitably strikes the outside observer is the bewildering range of use from state to state. To use one example, Iowa, my home state, recorded half the illegal drug use of Rhode Island—yet Iowa’s alcohol abuse levels were pegged at 9.2 per cent, which places it among the nation’s major drinking states.

As states beg for various kinds of funding, SAMHSA’s figures have come under fire in the past, their accuracy and political neutrality questioned. So take them with a grain of salt. Nevertheless, the figures likely represent certain broad trends with relative fidelity. “This report shows that while every state faces its own unique pattern of public health problems,” said SAMHSA acting administrator Eric Broderick in a press release, “these problems confront every state.”

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A Drug for Kleptomania?

Naltrexone curbs shoplifting.

It seems like such an unlikely finding: In a University of Minnesota study of kleptomania—the compulsion to steal—a popular medicine used to treat both heroin addiction and alcoholism drastically reduced stealing among a group of 25 shoplifters. The drug, naltrexone, blocks brain receptors for opiates. It is one of the few drugs available for the treatment of alcoholism, and continues to gain momentum as a treatment for opiate addiction.

In an article for the April issue of Biological Psychiatry, Jon Grant and colleagues at the University of Minnesota School of Medicine record the results of their work with 25 kleptomaniacs, most of them women. All of the participants had been arrested for shoplifting at least once, and spent at least one hour per week stealing. The 8-week study is believed to be the first placebo-controlled trial of a drug for the treatment of shoplifting.

In the April 10 issue of Science, Grant said that “Two-thirds of those on naltrexone had complete remission of their symptoms.” According to Samuel Chamberlain, a psychiatrist at the University of Cambridge in the U.K., the study strongly suggests that “the brain circuits involved in compulsive stealing overlap with those involved in addictions more broadly.” The study, in short, strengthens the hypothesis that the shoplifting “high” may have much in common with the high produced by heroin or alcohol.

Researchers are also working with the drug memantine as a treatment for compulsive stealing.

The finding lends additional evidence to the theory that shoplifting is a dopamine- and serotonin-driven disorder under the same medical umbrella as drug addiction and alcoholism. Preliminary research has shown that naltrexone may also have an effect on gambling behavior.

If so-called “behavioral addictions” continue to display biochemical similarities with “chemical addictions,” the move to broaden the working definition of addiction will continue to intensify. And the same sorts of questions that plague addiction research will be replayed in the behavioral sphere: What level of shoplifting constitutes the disorder called kleptomania? Isn’t the medicalization of shoplifting just a way to excuse bad behavior? Is medical treatment more effective than jail time? From a legal point of view, what is the the difference between kleptomania and burglary?

In his book, America Anonymous, Benoit Denizet-Lewis quotes lead study author Jon Grant: “With all addictions, a person’s free will is greatly impaired, but the law doesn’t want to entertain that.... Why shouldn’t someone’s addiction be considered as a mitigating factor, especially in sentencing?”

Photo Credit: Napo Hampshire Branch

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Addiction: Gwyneth Puts the Question

Is "chemical dependency" too narrow a concept?

Ordinarily, a post on this blog would not begin: "Addiction: What does Gwyneth have to say about it?"

But today, it does.

Addiction: What does Gwyneth have to say about it?

Well, I'll tell you. That came up recently on Ms. Paltrow's new health web site, Goop.com. Specifically, Paltrow set before a group of "sages" the following questions:

"Have you ever loved somebody who drinks until their usually charming personality is usurped by a monster? Or discovered that someone you adore is throwing up after every meal? Or wondered if you are stuck in a feedback loop of tension and unrest because you need the adrenaline of stress to function? How do we become enslaved by addiction? What is addiction?"

Here are some excerpts from the responses, which were many and varied, but overall quite fascinating:

Episcopal Priest Cynthia Bourgeault:

“As recent neuroscience has demonstrated, every habit lays down its own neural pathway i.e., it carves its own rut track in the brain--and the inertia around these pathways is considerable. The disruption of ANY happy pathway brings with it considerable discomfort and resistance. So you’re quite right in lumping together habits and addictions; the difference between them is more one of degree than of kind. One can be addicted to coffee, alcohol, porridge for breakfast, endorphins, heroin, meditation, exercise, sex or God! The difference is only that the classic ‘chemical dependency addictions’ add to our already full plate of cognitive and emotional distress and at the interruption of a habit, physiological distress as well.”

Deepak Chopra:

“Human beings become addicted because we are complex. Addictions are like a jigsaw puzzle where all the pieces are on the table but no one quite knows what the whole picture should be. Here are the main pieces:

1. The addictive substance or behavior
2. Brain chemistry
3. Social pressure for and against addiction
4. A vulnerable psyche
5. The X factor

Drugs change the brain by affecting receptors in your brain cells that exist for pleasure and the cessation of pain. If you take any substance long enough, the brain adapts by altering its receptors, and then the trouble begins. The burned-out addict is actually a burned-out brain.... Addicts can be brought to healing and self-knowledge. They can be weaned off substances and their brains (slowly) returned to a more balanced chemical state. Yet there remains the X factor. Call it a predisposition, karma, the unconscious or a perverse urge to self-destruction. For some addicts, the journey of addiction is existential."

Kabbalist Michael Berg:

"There is a saying, 'if today I have one then tomorrow I want two, and if today I have 100, then tomorrow I will want 200.' The addiction battles many of us fight are here to push us toward finding a deeper fulfillment, which comes from connecting to the real things in life: love, compassion, sharing and revealing our true essence.”

Psychologist Karen Binder-Brynes:

“I tend to gravitate toward a multi-leveled, biopsychosocial model as a theorem for explaining addiction. Although historically addictions were usually regarded in terms of psychoactive substances, such as drugs, that when ingested caused chemical alterations in the brain, the current thinking has broadened to include other compulsive behaviors such as pathological gambling, shopping, eating, etc....Why some people become more prone to addictions than others is a matter of great debate. The arguments range from a strict “disease” model suggesting a biochemistry of addiction, perhaps with genetic basis, to a “choice” model (Szasz, 1973) suggesting that the addict is a person who chooses a taboo substance or behavior to a low-risk lifestyle.... Denial and shame are often deterrents to seeking assistance. Never lose hope that you or a loved one can get help and beat an addiction. People can make miraculous recoveries from the powerful grip of addiction. I have seen it!”

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If You’ve Seen One Drug Czar....

The language of drug politics.

In a May 29 post on his Salon blog, Drug WarRant, Peter Guither deftly deconstructs the language of drug czarism, and its corrosive effect on rational dialog over drug policy:

--So far, there has been little or no discussion of marijuana from the newest drug czar, Obama’s man Gil Kerlikowske, now director of the White House Office of National Drug Control Policy. “I've got to admit that it's a nice change from the reefer madness reign of Walters,” Guither writes. “Maybe Kerlikowske is following my mother's age-old advice... If you can't say something nice (and he can't by law), then don't say anything at all.”

--Prescription drugs are “the new crack.” To his credit, Guither worries about this new emphasis, and where it is likely to lead: “The prescription drug "epidemic" will be an excuse to further crack down on diversion, which will end up continuing the focus on pain doctors who prescribe large amounts of pain medication, with DEA agents deciding they know more than doctors. The result will be even more people suffering, unable to get the pain medication that actually makes life possible for thousands of people.”

--Drugs cause crime. As proof, Kerlikowske cites the statistic that half the men arrested in ten major U.S. cities tested positive for some sort of illegal drug, as reported by USA Today. From this data, Kerlikowske concludes that there is “a clear link between drugs and crime.” Guither notes that “There's a lot of reasons that people who have been arrested would tend to test positive for illicit drug use than the general population..... A very large percentage of arrests are for drug crimes, which naturally skews the population. Then there are socio-economic factors and a lot more.”

However, what the new drug czar is implying, writes Guither, is that drugs cause crime. “But implying that drugs cause crime is a lie. And that's what drug czars do.”

Kerlikowske has also come out in favor of greater use of drug courts as an alternative to prison sentences. Bill Piper, director of national affairs for the Drug Policy Alliance Network, told USA Today he agreed that drug use should be seen as a public health issue, but that “people shouldn't have to get arrested to get treatment."

Photo Credit: Lifehype Magazine

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Cocaine Treatment Drug Flunks the Test

Vigabatrin fails in clinical trials.

It wasn’t the Last Best Hope, or the Holy Grail, but it had stirred up great excitement as possibly the first effective treatment medication for cocaine addicts. So it was nobody’s idea of happy corporate news when Catalyst Pharmaceutical Partners of Coral Gables, Florida, announced last Friday that its drug Vigabatrin, known as CPP-109, had failed as a cocaine treatment in Phase II clinical trials.

Brian Bandell of the South Florida Business Journal reported that during the 12-week study, the drug did not help drug addicts stay cocaine-free, compared to a placebo group.

In a press release, CEO Patrick McEnany said “we are not ready to abandon our view that CPP-109 has the potential for use in treating cocaine addiction, which still represents a significant unmet medical need.” Vigabatrin is sold overseas as Sabril by a Belgian company, but is not approved for use in the United States. Earlier animal testing and two limited early-stage studies on human addicts in the 2003-2004 had convinced the company that Sabril diminishes cravings for stimulants. It may also blunt the euphoric effect of meth and cocaine.

Catalyst’s stock, traded on NASDAQ, fell 57 percent to 90 cents a share on the news. The company started operations in 2006. According to the Miami Herald, Catalyst raised $21 million in its initial public offering on a single drug “with huge potential.” McEnany told the Herald he was uncertain why the drug had failed, but added that “cocaine addicts are a very unpredictable group.” He said the company would be analyzing the data over the next few months. “The data is immense. We’re trying to get our arms around it.”

Ovation Pharmaceuticals (now Lundbeck, Inc.), which hopes to market the drug under the trade name Sabril in the U.S., had also promised to push forward with clinical trials.

Edward H. Nash of Merriman Curhan Ford, a San Francisco financial research firm, downgraded Catalyst’s stock on Friday. “Unfortunately, we do not believe Catalyst has the opportunity and the right technology in hand,” he said, adding that the firm “no longer represents a viable biotech investment.”

Vigabatrin attracted initial interest because of its ability to dampen neuronal responses to excess amounts of dopamine produced by chronic cocaine use. As noted earlier (FDA Puts Coke/Meth Treatment on Fast Track), the U.S. Food and Drug Administration (FDA) had given “Fast Track” designation to vigabatrin, an anticonvulsant, for evaluation as an anti-craving drug for cocaine and methamphetamine addiction.

However, potential side effects threatened to derail the trials almost before they started. The FDA was already on record with its concern about reports of retinal damage in patients overseas. (See “Drug For Cocaine Addicts Causes Weight Loss”).

Graphic Credit: Addiction Treatment Forum

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