Breitbart reports

A bill that would reduce drug felonies to misdemeanors for first-time possessions of small amounts of heroin, cocaine, methamphetamine, and other hard drugs passed through the Oregon state legislature on Thursday and is likely to be signed into law by Governor Kate Brown.

House Bill 2355 which reduces convictions for first-time possessions of such illicit drugs passed through the state’s house of representatives by 36-23 on July 4. The state senate voted in favor of it by 20-9.

The bill’s proponents argued that it was the most effective way of addressing growing drug abuse in the state.

Rep. Mitch Greenlick (D.) told the Washington Free Beacon, “We’ve got to treat people, not put them in prison. It would be like putting them in the state penitentiary for having diabetes…This is a chronic brain disorder and it needs to be treated this way.”


Modern reports

The head of the Food and Drug Administration said he does not know how legislation to replace the Affordable Care Act will affect access to addiction treatment as the nation faces an overdose epidemic.

During a Senate appropriations hearing on Tuesday, Dr. Scott Gottlieb called the crisis one of the “biggest challenges” facing his agency and said the FDA was addressing the problem through a number of avenues, including approving opioids with better abuse deterrents.

But when pressed about the potential loss of access to treatment if Medicaid was cut by $800 billion as proposed by the House bill, Gottlieb deflected.

The president’s 2018 budget proposal for the FDA calls for a $854 million cut, down 31% compared with 2017. To offset the loss, the budget proposes a $1.3 billion increase in user fees, paid by drug and device makers and used to support staff that assesses new products. But the chair of the Senate Appropriations Committee recently announced they will not move forward with that proposal.

“I have not focused a lot of attention on the various legislation moving through with respect to the ACA,” Gottlieb said. “I am very focused on what I’m doing at FDA right now, which is more than a full-time job.”

Experts say any rollback of Medicaid expansion will surely and significantly impact millions who were able to get treatment for addiction.

More than 2 million people with substance abuse disorders, including more than 200,000 with opioid use disorders, have Medicaid coverage, according to the Center on Budget and Policy Priorities. And more than 50,000 Americans died from drug overdoses in 2015, according to data from the Centers for Disease Control and Prevention.

Earlier this month the FDA took steps to address the problem with an unprecedented move. The agency asked Endo Pharmaceuticals, maker of the extended-release pain reliever opioid Opana ER, to remove it from the market amid reports that the drug was being abused.

Gottlieb said the FDA is also addressing clinical prescribing practices.

“We know that most people who are going to become addicted to opioids are first exposed to opioid drugs in the clinical setting through legitimate prescription,” Gottlieb said. “It’s incumbent upon all of us to make sure that only properly indicated patients are being prescribed opioids.”

Gottlieb also wants to expand medication-assisted treatments by expediting the clinical trial process to get new therapies into patients’ hands more quickly.

Fewer areas of society have experienced the full impact of the opioid epidemic more than in healthcare, where opioid-related cases were responsible for more than 1.2 million emergency department visits or inpatient stays in 2014, according to a report released Tuesday by the Agency for Healthcare Research and Quality, with the number of hospitalizations increasing by 64% between 2005 and 2014.

Despite the rise, the percentage of people receiving help for their addiction has not changed over the past decade, with only about 20% in treatment between 2004 and 2013, according to a 2015 research letter featured in JAMA.

Access to drug treatment has proven difficult for all ages. In a study published Monday in JAMA Pediatrics, only 1 in 4 youth between the ages of 13 and 25 with an opioid use disorder had access to medication-assisted treatments such as buprenorphine and naltrexone.


DA Now writes

Prescription opioids are most commonly used and abused orally, but some people alter their medications and use non-oral methods of administration to experience enhanced effects. When opioid-based medications are crushed and snorted or injected, death is two times more likely to occur, a new study shows.

The study, published in the international journal Drug and Alcohol Dependence, showed that the risks associated with prescription opioid abuse via oral and non-oral routes vary.

The researchers analyzed acute health data collected by the Researched Abuse, Diversion and Addiction-Related Surveillance System Poison Center Program, a nationwide monitoring system that gathers location-specific information on prescription drug use and misuse through regional poison centers.

A total of 243,477 cases of drug exposure that occurred from 2006 to 2014 were analyzed. There were 25,338 cases of intentional prescription opioid abuse exposure included, most of which (61 percent) involved men.

A total of 10,327 of the intentional cases of opioid abuse involved a single substance, and 15,011 cases involved more than one drug. The drugs that were used the most were hydrocodone instant release (48 percent), oxycodone instant release tablets (23.8 percent), oxycodone extended release (7.9 percent) and morphine extended release (4.1 percent).

The researchers looked at the cases of intentional exposure to prescription drugs and found that ingestion was the most common method of abuse, which was reported in 64 percent (3,906) of the cases. Non-oral routes were used in 14.6 percent (892) of the cases and unknown routes were reported in more than 21 percent.

Of the 3,906 cases of oral drug ingestion, 220 (5.6 percent) resulted… (continue reading)


DAN writes

Scientists have broken new ground with a vaccine that stops the high of heroin. The experts from the Virginia Commonwealth University and the Scripps Research Center discovered that the vaccine — the first of its kind to reach this phase of preclinical testing — was effective on rhesus macaques, a species of monkeys.

“Essentially we have discovered a universal drug vaccine platform that can be customized to target virtually any drug or a predetermined combination of drugs,” said first author Paul Bremer of the Scripps Research Institute. “Emerging research has shown that single drug vaccines can be combined with other single drug vaccines without loss of efficacy.”

Looking to develop more pharmacotherapy options for disorders related to opioid use, the scientists created the vaccine through an assessment of hapten structure — molecules that evoke an immune response through protein — and carrier proteins, which help in the migration of substances.

“We paid careful attention to the chemical structure of heroin and used an accurate mimic of it in the vaccine, known as a hapten,” he said. “This hapten provides a blueprint for which molecule the antibodies should recognize. Previous clinical trials have not used vaccines in which the hapten is properly designed to mimic the target drug.”

The scientists found that the anti-heroin vaccine demonstrated durability and effectiveness over eight months. It also sustained and generated anti-drug IgG titers, a calculation of how much antibody an organism has yielded.

“Theoretically, a heroin user immunized with our vaccine would face increased difficulty in getting high, which may help in achieving drug abstinence,” Bremer said. “Because of the high selectivity of the vaccine for heroin, drugs like buprenorphine could be used as an adjunct pharmacotherapy to help with cravings.”

Bremer explained that the anti-heroin vaccine, which is an immunotherapy, is different from buprenorphine or naltrexone, which are pharmacological therapies.

“[The vaccine] generates antibodies that neutralize heroin’s psychoactive metabolite (6-acetylmorphine) and prevents it from acting on the (opioid) receptors in the brain,” he said. “Pharmacotherapies, in contrast, also act on the same receptors as heroin and can, therefore, have side-effects. Antibodies from the vaccine are much longer lasting and do not penetrate the brain, so they are much safer.”

Rhesus monkeys are ideal subject models because… (continue reading)


Science Daily reports

Use of marijuana in combination with alcohol by drivers is especially dangerous, according to a latest study conducted at Columbia University’s Mailman School of Public Health. Drivers who used alcohol, marijuana, or both were significantly more likely to be responsible for causing fatal two-vehicle crashes compared to drivers who were involved in the same crashes but used neither of the substances. The findings are published in the journal, Annals of Epidemiology.

“The risk of crash initiation from concurrent use of alcohol and marijuana among drivers increases by more than fivefold when compared with drivers who used neither of the substances,” said Guohua Li, MD, DrPH, professor of Epidemiology at the Mailman School of Public Health. The study also indicates that when used in isolation, alcohol and marijuana increase crash culpability by 437 percent and 62 percent, respectively.

The researchers analyzed data for 14,742 fatal two-vehicle crashes between 1993 and 2014 recorded in the Fatality Analysis Reporting System, a database containing information on crashes that resulted in at least one fatality within 30 days and that occurred on U.S. public roads. Included in the study were 14,742 drivers who were responsible for causing the fatal crashes and 14,742 non-culpable drivers who were involved in the same crashes. Crashes involving single vehicles, more than two vehicles, commercial trucks, and two-vehicle crashes in which both drivers were responsible were excluded from the analysis.

Drivers who were responsible for the crashes were significantly more likely than non-culpable drivers to test positive for alcohol (28 percent vs. 10 percent), marijuana (10 percent vs. 6 percent), and both alcohol and marijuana (4 percent vs. 1 percent). Drivers who tested positive for alcohol, marijuana, or both were more likely than those who tested negative to be male, aged 25 to 44 years, and to have had a positive crash and violation history within the previous three years.

The three most common driving errors that led to these fatal crashes were failure to keep in proper lane (43 percent), failure to yield right of way (22 percent), and speeding (21 percent).

Since the mid-1990s, the prevalence of marijuana detected in fatally injured drivers has increased markedly. During the same time period, 28 states and the District of Columbia have enacted legislation to decriminalize marijuana for medical use, including eight states that have further decriminalized possession of small amounts for adult recreational use. Although toxicological testing data indicate a continuing increase in marijuana use among drivers, a positive test does not necessarily infer marijuana-induced impairment.

“While alcohol-impaired driving remains a leading cause of traffic fatalities in the United States, driving under the influence of marijuana and other drugs has become more prevalent in the past two decades,” said Dr. Li, who is also the founding director of Columbia University’s Center for Injury Epidemiology and Prevention. “Countermeasures targeting both drunk driving and drugged driving are needed to improve traffic safety.”