September 29, 2017

Feds to Begin Testing Employees for Oxy

New federal mandatory guidelines for workplace drug testing will become effective on October 1, 2017, and will include the authority to test for four semi-synthetic opioids: oxycodone, oxymorphone, hydrocodone, and hydromorphone. These are prescription opioid pain medications that have commonly known names such as OxyContin, Vicodin, Percocet, Dilaudid, etc.

These four prescription pain medications were added to the standard testing panel because data indicates that although they are prescribed, they are the prescription pain medications that are most frequently used without medical authority.

However, under the revised Mandatory Guidelines, positive drug testing results that have a legitimate medical explanation (e.g., supported by a valid prescription), as determined by a Medical Review Officer (MRO), will not be reported to federal agencies.

Affects All Federal Employees

These revised Mandatory Guidelines for Federal Workplace Drug Testing Programs using Urine (UrMG) affect all federal employees in a testing designated position, which is defined by each agency’s Drug-Free Workplace Program.

In 1986, the Federal Drug-Free Workplace Program was initiated by Executive Order 12564 to establish the goal of a drug-free federal workplace. The Program made it a condition of employment for all federal employees to refrain from using illegal drugs on or off duty.

“Revising the Mandatory Guidelines has taken a tremendous amount of coordination across stakeholders and agencies, over a period of several years,” said Dr. Elinore McCance-Katz, the Assistant Secretary for Mental Health and Substance Use at the Substance Abuse and Mental Health Services Administration (SAMHSA). “We felt it necessary to make these revisions because of advances in science and technology and because of the increased misuse of prescription opioids.”

Combating the Opioid Addiction Crisis

The Interagency Coordinating Group Executive Committee composed of the Department of Health and Human Services (HHS), the Department of Justice, the Office of National Drug Control Policy, and the Office of Personnel Management, provides policy oversight of the Federal Drug-Free Workplace Program.

SAMHSA administers the Program and also provides oversight for the National Laboratory Certification Program, which certifies laboratories to conduct forensic drug testing for federal agencies and federally-regulated industries.

By implementing workplace drug testing for four semi-synthetic opioids, HHS is continuing its efforts to prevent opioid addiction in support of President Trump’s commitment to combat the opioid crisis. The long-term impact of implementing these revised guidelines will help ensure safety in the workplace, especially in national security, public health, and public safety occupations that interact directly with the public.

Other Drug-Testing Changes

Other changes in the revised UrMG include making methylenedioxyamphetamine an initial test analyte; removing methylenedioxyethylamphetamine from the standard drug testing panel; raising the lower pH cutoff from three to four for identifying specimens as adulterated; and requiring MRO requalification training and re-examination at least every five years after initial MRO certification.

Changes to the UrMG were also made to, among other things, enhance clarity, incorporate current scientific terminology, and ensure consistency with the proposed Mandatory Guidelines for Federal Workplace Drug Testing Program for Oral Fluid once authorized.

Additional information, including frequently asked questions, is at http://www.samhsa.gov/workplace.

For more information, contact the SAMHSA Press Office at 240-276-2130.

Posted by Webmaster at 04:53 PM


September 18, 2017

Young Binge Drinkers Show Altered Brain Activity

Researchers have studied the brain activity of young binge-drinking college students in Spain, and found distinctive changes in brain activity, which may indicate delayed brain development and be an early sign of brain damage.

For many students, college involves a lot of socializing at parties and at bars, and alcohol is a common factor in these social environments. Excessive alcohol use, in the form of binge drinking, is extremely common among college students, and one study has estimated that as many as one third of young North Americans and Europeans binge drink.

The National Institute of Alcohol Abuse and Alcoholism describes a binge as drinking five or more drinks for men and four or more for women within a two-hour period, and for many college students, these limits wouldn't equate to a particularly heavy night.

Alcohol Changes the Brain

Previous research has linked binge drinking to a variety of negative consequences including neurocognitive deficits, poor academic performance, and risky sexual behavior.

While numerous studies have shown that the brains of chronic alcoholics have altered brain activity, there is also evidence that bingeing can change adolescents' brains. Eduardo López-Caneda, of the University of Minho in Portugal, investigates this phenomenon.

"A number of studies have assessed the effects of binge drinking in young adults during different tasks involving cognitive processes such as attention or working memory," says López-Caneda. "However, there are hardly any studies assessing if the brains of binge drinkers show differences when they are at rest, and not focused on a task."

Binge-Drinking College Students

In a recent study published in Frontiers in Behavioral Neuroscience, López-Caneda and colleagues set out to see if the resting brains of binge-drinking college students showed any differences compared with those of their non-bingeing counterparts.

The researchers recruited first year college students from a university in Spain, and asked them to complete a questionnaire about their drinking habits. Students that had participated in at least one binge within the previous month were considered to be binge drinkers, whereas non-bingers had never binged before. By attaching electrodes to the students' scalps, the scientists could assess electrical activity in various brain regions.

Compared with the non-bingers, the binge drinkers demonstrated altered brain activity at rest. They showed significantly higher measurements of specific electrophysiological parameters, known as beta and theta oscillations, in brain regions called the right temporal lobe and bilateral occipital cortex.

Brains Similar to Chronic Alcoholics

Surprisingly, previous studies have found very similar alterations in the brains of adult chronic alcoholics. While the young bingers in this study might occasionally consume alcohol to excess, they did not fit the criteria for alcoholism. So, what does this mean?

The changes might indicate a decreased ability to respond to external stimuli and potential difficulties in information processing capacity in young binge drinkers, and may represent some of the first signs of alcohol-induced brain damage.

The brains of adolescents are still developing, meaning that they might be more vulnerable to the effects of alcohol abuse. "These features might be down to the particularly harmful effects of alcohol on young brains that are still in development, perhaps by delaying neuromaturational processes," says López-Caneda.

The results suggest that bingeing has tangible effects on the young brain, comparable with some of those seen in chronic alcoholics. "It would be a positive outcome if educational and health institutions used these results to try to reduce alcohol consumption in risky drinkers," says López-Caneda.

Posted by Webmaster at 07:01 AM


September 08, 2017

Daily Marijuana Use Raises Concerns

Health officials are concerned that the rates of daily marijuana use by college-age Americans have returned or exceeded previously high levels seen in the early 1980s, especially among a population whose brains are still not completely developed.

The National Institute on Drug Abuse (NIDA) announced that the latest Monitoring the Future (MTF) national survey results of drug use among full-time college students and their non-college peers are now available online, highlighting that daily marijuana use is at the highest level since the early 1980s for this age group.

Below are the highlights from the 2016 MTF survey results on drug use among college students compared to their peers not attending college (ages 19-22).

  • Daily marijuana use is at the highest level since the early 1980s for this age group (7.8%), reaching the highest level seen for non-college youth (12.8%) and among the highest for full-time college students (4.9%).

  • Non-college peers appear to be drinking less alcohol than their college counterparts with respect to binge drinking (28.7% vs. 32.4%) and intoxication (30.4% vs 40.8%). Binge drinking is defined as five or more drinks in a row in the past two weeks and intoxication is defined as having been drunk in the last month.

  • Past year amphetamine use without medical supervision appears to be higher in college students than their non-college peers. Ritalin use is 2.4% vs. 1.6% and Adderall use is 9.9% vs. 6.2%, respectively.

  • Past year hookah use appears to be lower in college students and their non-college peers (16.9% and 19.8%) and is trending down in college students (27.9% in 2011 vs. 16.9% in 2016).

  • For both cigarettes and e-vaporizers*, past month use for college students and their non-college peers went down.

It is important to note that the Food and Drug Administration began regulating e-cigarettes and hookahs in August 2016, which could have affected marketplace availability. *E-vaporizers may include nicotine, other drugs or no drug at all (i.e., flavoring only).

Posted by Webmaster at 12:20 PM


September 07, 2017

About 137 Million Americans Drink Alcohol

The National Survey on Drug Use and Health (NSDUH) results for 2016 have been release by the Substance Abuse and Mental Health Services Administration indicating that 136.7 million American report themselves to be current alcohol drinkers.




In addition, 7.3 million American under the age of 21 reported past-month alcohol use and 4.5 million of those underage drinkers reported that they binge drink.

NSDUH asks respondents aged 12 or older about their alcohol use in the 30 days before the interview. Current alcohol use is defined as any use of alcohol in the past 30 days.

In addition to asking about any alcohol use, NSDUH collects information on binge alcohol use and heavy alcohol use. Until the 2015 NSDUH, the threshold for binge drinking was defined the same for male and females. Consistent with federal definitions and other federal data collections, the NSDUH definition for binge alcohol use since 2015 differs for males and females.

Binge drinking for males is defined as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days, which is unchanged from the threshold prior to 2015.

Since 2015, binge alcohol use for females has been defined as drinking four or more drinks on the same occasion on at least 1 day in the past 30 days. Heavy alcohol use is defined as binge drinking on 5 or more days in the past 30 days based on the thresholds that were described previously for males and females.

136.7 Million Americans Drink Alcohol

Any alcohol use, binge drinking, and heavy drinking are not mutually exclusive categories of use; heavy use is included in estimates of binge and current use, and binge use is included in estimates of current use.

Because of the 2015 changes to the definition of binge alcohol use in NSDUH, overall estimates of binge and heavy alcohol use in 2016 are presented in this report, but these 2016 estimates are not comparable with estimates prior to 2015.

In 2016, 136.7 million Americans aged 12 or older reported current use of alcohol, 65.3 million reported binge alcohol use in the past month, and 16.3 million reported heavy alcohol use in the past month. Thus, nearly half of current alcohol users reported binge alcohol use (47.8 percent), and 1 in 8 current alcohol users reported heavy alcohol use (11.9 percent). Among binge alcohol users, about 1 in 4 (24.9 percent) were heavy users.

Any Alcohol Use

The estimate of 136.7 million current alcohol users aged 12 or older in 2016 (Figure 9) corresponds to alcohol use in the past month by slightly more than half (50.7 percent) of people aged 12 or older. The 2016 estimate of past month alcohol use was similar to the estimates in most years between 2002 and 2008, but it was lower than the estimates in 2009 to 2015.

Aged 12 to 17

The percentage of adolescents aged 12 to 17 who were current alcohol users was 9.2 percent in 2016, which corresponds to 2.3 million adolescents in 2016 who drank alcohol in the past month. The percentage of adolescents who were current alcohol users in 2016 was lower than the percentages in 2002 through 2014, but it was similar to the percentage in 2015.

Although the estimate of current alcohol use among adolescents decreased between 2002 and 2016, about 1 in 11 adolescents were current alcohol users in 2016.

Aged 18 to 25

In 2016, 57.1 percent of young adults aged 18 to 25 were current alcohol users, which corresponds to about 19.8 million young adults. The percentage of young adults in 2016 who drank alcohol in the past month was similar to the percentage in 2015.

Although the 2016 estimate was lower than the estimates in 2002 through 2014, about three fifths of young adults were current alcohol users in each year between 2002 and 2016 (ranging from 57.1 to 62.0 percent).

Aged 26 or Older

More than half (54.6 percent) of adults aged 26 or older in 2016 were current alcohol users. This percentage corresponds to about 114.7 million adults in this age group who drank alcohol in the past month.

The percentage of adults aged 26 or older in 2016 who were current alcohol users was similar to the percentages in most years from 2002 to 2015. In each year between 2002 and 2016, slightly more than half of adults aged 26 or older were current alcohol users (ranging from 52.5 to 56.5 percent).

Binge Alcohol Use

In 2016, an estimated 65.3 million people aged 12 or older were binge alcohol users in the past 30 days. This number of people who were current binge drinkers corresponds to about 1 in 4 people aged 12 or older (24.2 percent).

About 1.2 million adolescents aged 12 to 17 were past month binge alcohol users, which corresponds to 4.9 percent of adolescents. Thus, about 1 in 20 adolescents aged 12 to 17 in 2016 were current binge drinkers.

An estimated 38.4 percent of young adults aged 18 to 25 were binge alcohol users in the past month, which corresponds to about 13.3 million young adults. Stated another way, about 2 out of 5 young adults in 2016 were current binge alcohol users.

About a quarter (24.2 percent) of adults aged 26 or older were current binge alcohol users. This percentage corresponds to about 50.9 million adults in this age group who were binge drinkers.

Heavy Alcohol Use

The estimate of 16.3 million people aged 12 or older in 2016 who were heavy alcohol users in the past month represents 6.0 percent of the population aged 12 or older.

In 2016, 191,000 adolescents aged 12 to 17 were current heavy alcohol users. Stated another way, about 1 out of 125 adolescents (0.8 percent) engaged in binge drinking on 5 or more days in the past 30 days.

About 1 out of every 10 young adults aged 18 to 25 (10.1 percent) were heavy alcohol users in the past month, which corresponds to 3.5 million young adults.

An estimated 6.0 percent of adults aged 26 or older in 2016 were current heavy alcohol users. This percentage corresponds to about 12.6 million adults aged 26 or older who were heavy alcohol users in the past month.

Underage Alcohol Use

All 50 states and the District of Columbia currently prohibit possession of alcoholic beverages by individuals younger than 21, and most prohibit underage consumption (i.e., consumption of alcoholic beverages prior to the age of 21).

In 2016, about 7.3 million people aged 12 to 20 reported drinking alcohol in the past month, including 4.5 million who reported binge alcohol use and 1.1 million who reported heavy alcohol use. Thus, about three fifths of underage current drinkers (62.5 percent) were binge alcohol users, and about 1 in 7 were heavy alcohol users (14.7 percent).

About one fourth of underage binge alcohol users (23.5 percent) were heavy drinkers.

The estimate of 7.3 million underage people in 2016 who reported current alcohol use represents 19.3 percent of 12 to 20 year olds. Among people aged 12 to 20 in 2016, 12.1 percent were binge drinkers, and 2.8 percent were heavy drinkers.

The percentage of underage individuals who reported current alcohol use in 2016 was lower than the percentages in 2002 through 2014, but it was similar to the percentage in 2015 (Figure 14). Despite these declines over time, about 1 in 5 individuals aged 12 to 20 in 2016 drank alcohol in the past month.

Posted by Webmaster at 02:21 PM


September 06, 2017

Opioid Abuse Can Be Treated in Primary Care

A new model of collaborative care - combining substance abuse treatment with regular medical care - has been found to be more accessible, more effective and at a lower cost that traditional speciality care methods, according to a new RAND Corporation study.

Patients who enrolled in a program that combined substance abuse treatment with primary medical care were more than twice as likely to receive treatment for opioid or alcohol abuse, as compared to peers who received usual primary care services, according to the study.

The patients in the collaborative care model also were significantly more likely to report abstinence from opioids or alcohol six month after beginning care, a key marker to successful recovery. The findings are published online by the journal JAMA Internal Medicine.

Increasing Access to Treatment

"This new model of integrating treatment for substance use disorders with a patient's primary medical care could expand access to drug treatment at a lower cost and in a more accessible fashion," said Dr. Katherine E. Watkins, the study's lead author and a senior physician scientist at RAND, a nonprofit research organization. "This is a way to increase access to evidence-based substance use treatment, without having to convince patients to go to a specialized drug treatment center."

Deaths in the United States are rising from increases in drug overdoses and alcohol-related liver disease, yet many substance use disorders continue to be under identified and undertreated.

While treatment in specialty care settings is important for people who have severe dependence, researchers say that access to such care is limited and the stigma associated with drug treatment means that specialty care alone is insufficient to address the nation's treatment needs.

Collaborative Care System

The RAND study involved 377 people with opioid or alcohol abuse disorders who received medical care at two locations operated by a safety-net medical provider in the Los Angeles area. The clinics were part of a federally qualified health center.

Participants were randomly assigned to receive their medical care from either the clinics' usual primary care providers or from providers who were partnered with therapists and care coordinators who received special training to provide evidence-based substance use treatment.

The collaborative care system was designed to increase delivery of a six-session brief psychotherapy treatment and/or medication-assisted treatment to reduce cravings for opioids or alcohol. Patients receiving usual care were told the clinic provided substance use treatment and were given a phone number to schedule an appointment, as well as a list of community referrals.

Works Better Than Specialty Care

Most of the patients in the study had challenges that were viewed as an obstacle to receiving successful treatment, with nearly half of the group being homeless at the time of enrollment.

Among those treated in the collaborative care model, 39 percent received some type of substance abuse treatment, compared to 16.8 percent among those treated in the usual primary care system.

After six months, 32.8 of the participants in the collaborative care model reported that they had abstained from opioids or alcohol in the previous month, compared to 22.3 percent treated in the usual primary care system. Researchers say that among people with substance abuse problems, abstinence is linked to a lower likelihood of relapse compared with nonproblem use.

"Our findings suggest that it is possible to successfully treat people who are addicted to opioids or alcohol in a primary care setting," Watkins said. "The collaborative care model can be a lower-cost and more-accessible way to treat opioid addiction than expanding the nation's supply of specialty care clinics."

Posted by Webmaster at 07:45 PM