By Linda Hepler

Alcohol affects every organ in the body, and chronic heavy use of alcohol may cause some of the following problems:

Central Nervous System

Long-term effects of alcohol on the brain and nervous system can cause problems with intellectual functioning (memory loss), disturbances in sensory and motor control, and emotional and behavioral instability.

Circulatory system

Heavy alcohol use can cause the red cells to clump together, resulting in the constriction of small blood vessels and a loss of oxygen delivery to cells to all areas of the body, including the brain. It may also cause a decrease in the number of red and white blood cells, leaving the body at risk for infection and unable to fight off infections when they occur.

Endocrine system

The endocrine system is responsible for producing hormones. Heavy alcohol use depresses this production, causing a number of problems - including impaired sexual functioning.

Gastrointestinal system

Alcohol use increases stomach acids, which can lead to irritation and ulcers. It can also impair the function of the pancreas, an organ that helps to regulate the amount of sugar in the blood, which may result in diabetes.

Liver

The liver has many functions, including the production of bile that helps to digest fatty foods; the storage and release of sugar; and the removal of poisons and toxins from the body. Regular heavy use of alcohol can upset the balance of the liver and disrupt these functions.

One serious alcohol-related problem is a build-up of fat, called "fatty liver." If alcohol use continues, the liver cells can become inflamed (alcoholic hepatitis) and eventually die, causing a hardened, scarred - and nonfunctional - liver. This condition is called cirrhosis, and may lead to death.

Muscular system

Alcohol reduces the amount of blood that reaches the muscles, including the heart. This reduced blood flow can cause heart weakness and, eventually, failure.

Labels: alcohol, alcoholism

In the National Drug Threat Assessment 2005 Summary Report, the United States Department of Justice (DOJ) states that although demand for heroin is markedly lower that for comparable illicit drugs (including cocaine, meth, and marijuana), the risks and outcomes associated with heroin abuse are so severe that it continues to represent a substantial threat.

Heroin is the most widely used opiate (drugs derived from opium). The report also indicates that demand for heroin has remained fairly stable over the past few years, ever since a significant increase in demand in the late 1990s. However, data from the National Survey on Drug Use and Health indicates a recent increase in the number of current heroin users.

According to the 2006 Treatment Episode Data Set, collected by the states and reported to the federal Substance Abuse and Mental Health Services administration, the percentage of people admitted to drug rehab programs with a primary addiction to heroin has remained stable over the past decade. Heroin addicts tend to seek treatment after using for several years. This is a factor that makes it extremely difficult to treat heroin addicts.

The most recent national Survey on Drug Use and Health (2006) indicates that the number of current heroin users (those who have used within the past 30 days) increased from approximately 136,000 in 2005 to 338,000 in 2006. The prevalence rate for use increased from 0.06% to 0.14%. The survey supports the assertion by the Department of Justice that demand for heroin is relatively low.

By comparison, the survey reported much higher numbers for current users of other drugs: 14.8 million for marijuana, 5.2 million for prescription pain medicine, and 2.4 million for cocaine. Only PCP (approximately 100,000) and LSD (fewer than 100,000) showed lower numbers of users than heroin. According to the survey, a relatively low number of people (approximately 91,000) first tried heroin in the past year, and the mean age for first use was relatively high (20.7 years). By comparison, approximately 2.1 million people first tried marijuana in the last year, and the mean age for use was 17.4.

Although heroin users account for only a small percentage of drug users in the United States (less than 2%), they consistently comprise a notable segment of those admitted to drug treatment programs. According to 2006 TEDS data, the percentage of people admitted to substance abuse programs with a primary addiction to heroin has remained stable over the past decade. Between 1995 and 2005, heroin admissions comprised 14-15% of all admissions to public substance abuse treatment facilities. According to the National Survey on Drug Use and Health, 446,000 people reported receiving treatment for substance abuse in the past year, compared to 1.2 million for marijuana.

The TEDS data also indicates that heroin addicts tend to use for many years before seeking treatment. Users who inject heroin abuse the drug for an average of 12 years before seeking treatment, and users who snort heroin abuse the drug for an average of 11 years before seeking treatment. Because heroin addiction is usually obtained at a later age than most other illicit drugs, users wait so long to seek treatment, a high percentage of heroin addicts are intravenous users, and because heroin is one of the most potent illicit substances, heroin addicts usually arrive in treatment with serious health problems and are typically more difficult to treat than other addicts. According to TEDS data, approximately 64% of current heroin users are intravenous users.

Long-term intravenous drug use, in particular, carries serious health risks. Intravenous drug users are exposed to and contract diseases such as HIV, Hepatitis C, and bacterial pneumonia at significantly higher rates than other segments of the general population. In 1999, the National Institute on Drug Abuse reported that 36% of new Hepatitis C infections in the past year were related to intravenous drug use.

Labels: addiction, opiates

By Linda Hepler

Despite tough anti-drug laws, the United States continues to have the highest level of illegal drug use in the world.

The history of drug law in the United States dates to 1914, when a ban was enacted on the production and distribution of substances containing opiates.

In 1970 the U. S. Congress passed the Controlled Substances Act and soon afterward, a national Drug Enforcement Administration was formed. DEA funds were used to enforce laws related to drug production, distribution, and abuse, as well as for addiction treatment.

As the opportunities escalated for drugs to be smuggled into the United States, the Office of National Drug Control Policy (ONDCP) was established to coordinate drug-related legislation, research, and policy.

Despite increasingly punitive measures for drug offenses, and billions of dollars spent to fight the spread of illegal drugs, the battle has yet to be won.

In 2001, the National Research Council Committee on Data and Research for Policy on Illegal Drugs published a study suggesting that despite U.S efforts to address drug smuggling and usage, an estimated 16 million persons in the U.S. were drug abusers.

Four years later, the federally funded Monitoring the Future survey reported that about 85 percent of high school seniors found marijuana "easy to obtain," a figure that has remained steady since 1975, shortly after then-president Richard M. Nixon declared the "War on Drugs."

Critics of the war on drugs have suggested that attacks on drug suppliers, such as the recent U. S. efforts to eradicate coca production in Colombia, only drive production efforts into more remote areas. And, critics argue, punitive measures such as long prison sentences for drug offenders don't appear to decrease the demand for drugs - in fact, some believe that they increase the appeal of illegal drugs, just as Prohibition made alcohol more exciting to many.

Economists have speculated that reducing the supply of drugs without reducing demand causes the price of drugs (and thus the profits of drug sellers) to escalate, further encouraging the production of drugs despite the risks.

There has been increasing interest in drug law reform, such as a recent proposal by several lawmakers to end federal penalties for possession and use of small amounts of marijuana.
Such measures may decrease the price of certain drugs, but it is not likely to decrease demand – especially among teens – without better drug prevention and early intervention programs.

According to the Drug Enforcement Administration (DEA), "doctor shopping" is one of the primary ways that addicts obtain prescription drugs for non-medical use. "Doctor shopping" refers to when an individual visits several different doctors to obtain prescriptions for the same medications, and then has the prescriptions filled at different pharmacies. This allows the individual to obtain more of the prescribed substance than any one physician or pharmacist would allow. Legally, doctor shopping is not a minor matter; it is prosecuted as a felony and is punishable by up to five years in prison.

At a 2006 hearing, a high-ranking official from the DEA testified before the House Government Reform Committee Subcommittee on Criminal Justice, Drug Policy, and Human Resources regarding current efforts to address prescription drug abuse in the United States. According to Mr. Rannazzisi's testimony, doctor shopping is a growing problem in this country and is a primary means for addicts to obtain prescription medication for illicit use. Mr. Rannazzisi referred to prescription drug abuse as an "epidemic."

Other illegal activities associated with doctor shopping may include the forgery of prescriptions or the sale or transfer of the drug to others. To address this situation, PDMPs (prescription drug monitoring programs) are being introduced in many states. These programs are designed to allow physicians and pharmacists to cross-check prescriptions with each other and identify individuals who may be doctor shopping.

Abuse of prescribed medicines often begins with legitimate use. Because of this, individuals who otherwise would not abuse substances find themselves addicted when it is already too late. They begin doctor shopping to feed their addiction, but rationalize this behavior as being necessary to manage the pain and maintain the façade of being in control. Pain medication, prescribed for a variety of common reasons, including back pain or surgery, caesarian sections, or even dental procedures, carries the highest risk for dependence.

One Ohio mom recently posted her story on a public message board. She related having had three back surgeries and a herniated disk in her neck. She started on pain medication after her daughter was born by C-section. Soon, the medication from her pain management physician wasn't enough. She went to see another physician, and then another.

She was finally caught when a doctor's office, where she had called to schedule an appointment, asked for her social security number. Apparently, the office participated in a PDMP and had access to a list of all the physicians and pharmacies she had used. The office contacted her husband and provided him with a copy of the list. Now she is enrolled in a treatment program.

This story is typical of many pain medication abusers – middle- and upper-class individuals who lead otherwise respectable lives.

In 2006, one of the most famous doctor shopping and prescription drug abuse stories came to light. Conservative talk show host Rush Limbaugh turned himself in to Palm Beach authorities for doctor shopping. From 1998 to 2006, Limbaugh obtained massive amounts of the painkiller OxyContin, both through multiple prescriptions from different health care providers and through illegal channels. Limbaugh began taking painkillers in the late 1990s after an unsuccessful back surgery. By the time he turned himself in to police, he was rumored to be taking up to 30 pills per day. His drug abuse was severe enough to damage his hearing.

According to a 2004 statement from the White House's Drug Czar John Walter, "The non-medical use of prescription drugs has become an increasingly widespread and serious problem in this country; one that calls for immediate action. The Federal government is embarking on a comprehensive effort to ensure that potentially addictive medications are dispensed and used safely and effectively."

A study completed by the Boston University School of Medicine in 2006 reported that more than 10 million Americans are taking opioid medications to treat pain, and more than 40% of those use potent painkillers on a regular basis. The study consisted of random telephone surveys of 19,000 adults from 1998 through 2006. With such a jump in use and abuse of pain medication by Americans, it's no surprise that associated behaviors such as doctor shopping and prescription fraud are also on the rise.

Labels: addiction, medication

By Linda Hepler

Many people think that addiction is a problem primarily among the young, but elderly individuals are not immune to drug dependence. In fact, older people are especially vulnerable to addiction, as they consume a third of all prescription drugs ordered in the United States.

There are many reasons that older persons become addicted to medications. One cause is that doctors often prescribe medications such as tranquilizers in doses that are too high for an older person who doesn't metabolize drugs as efficiently as a young patient would. Also, some older patients have several doctors (for example, a regular physician plus a variety of specialists) and may ask all of them for the same or similar prescriptions.

Many drugs that older people commonly use, such as tranquilizers and sleeping pills, are meant for short term use - but elderly persons may have difficulty stopping a medication that helps them to sleep better or feel calmer. Over time they become dependent upon the medication. They may be unaware of their addiction, or simply too ashamed to admit it.

Elderly people can become addicted to alcohol, too, even if they've never been heavy drinkers in the past. Retirement and subsequent boredom, grief over a spouse's death, a change of social status, or lack of social structure may result in an escalation from social drinking into an addictive problem.

Of particular concern is the potentially lethal habit of some seniors to combine their medications with alcohol.

Labels: addiction

A study published earlier this year by the University of Chicago Medical Center found that nicotine and opiates have similar effects on the brain's reward system. Naturally rewarding experiences such as eating, sex, and exercise cause the brain to release the neurotransmitter dopamine. Dopamine stimulates the pleasure centers in key areas of the brain. Researchers found that although opiates and nicotine are very different substances, the end result as far as dopamine signaling is very much the same.

Daniel McGehee, Associate Professor in Anesthesia & Critical Care at the University of Chicago Medical Center commented on the findings:

"There is a specific part of the nucleus accumbens [a pleasure center] where opiates have been shown to affect behavior, and when we tested nicotine in that area, the effects on dopamine are almost identical."

The study provides support for the physiological nature of addiction, as well as the seriousness of nicotine addiction. If nicotine ultimately affects the brain in the same way as opiates, how can it be less serious (Source: ScienceDaily.com)

Labels: dopamine, nicotine, opiates

Recent research by the University of Minnesota indicates that a drug used to treat alcoholism may also be effective at curbing the urges of compulsive gamblers. Seventy-seven people participated in the double-blind, placebo-controlled study. Approximately 40 percent of those who took the medication and completed the study reduced their gambling behaviors for at least one month. Results were similar among men and women. Dosage did not appear to have an effect, and the drug was well-tolerated by participants.

Principal investigator Jon Grant, M.D., J.D., M.P.H., a University of Minnesota associate professor of psychiatry, commented, "This is good news for people who have a gambling problem. ... This is the first time people have a proven medication that can help them get their behavior under control."

Grant estimates that approximately 1 to 3 percent of the population suffers from compulsive gambling. With regard to the use of medication, however, he cautions, "Medication can be helpful, but people with gambling addiction often have multiple other issues that should be addressed through therapy."

The medication, Naltrexone, is sold under the brand names Revia and Depade. An extended-release formulation is sold under the name Vivitrol. (Sources: ScienceDaily.com)

Labels: alcoholism, gambling, medication