A new study takes a look at the prevalence of alcohol use disorder among U.S. adults.

Nearly one-third of adults in the U.S. engage in problem drinking — also known as an alcohol use disorder — at some point in their lives, a new study shows.

The study, published in JAMA Psychiatry, also shows that a startlingly low number of people actually receive treatment — 19.8 percent.

“These findings underscore that alcohol problems are deeply entrenched and significantly under-treated in our society,” George F. Koob, director of the National Institute on Alcohol Abuse and Alcoholism, said in a statement.

The study included in-person interviews with 36,000 people who were part of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III.

Researchers asked the study participants about their alcohol use, drug use, and psychiatric conditions. They also assessed whether any of the participants’ answers qualified them for a diagnosis of alcohol problems based on the Diagnostic and Statistical Manual of Mental Disorders (DSM). They analyzed whether the participants’ answers would qualify them for either alcohol abuse or alcohol dependence, which were considered two distinct disorders in the fourth edition of the DSM, or for the single disorder called alcohol use disorder (which has mild, moderate, and severe subclassifications), which is in the fifth and current edition of the DSM.

The results? Nearly 14 percent of adults met the criteria in the past year for alcohol abuse disorder, while 29.1 percent of adults met the criteria for alcohol abuse disorder at some point in their lives.

Researchers also noticed the rates of alcohol use disorders increasing over the last decade. Prevalence was higher among men, younger people, people who were previously or never married, white people, and Native American people.

The findings highlight “the urgency of educating the public and policy makers about AUD [alcohol use disorder] and its treatments, destigmatizing the disorder and encouraging those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment,” the researchers wrote in the study.

According to the Centers for Disease Control and Prevention, women should keep alcohol consumption to up to one drink per day and men should keep their consumption to up to two drinks per day. Alcohol abuse has a number of dangerous effects on the body — it can damage the heart, liver, and pancreas and is known to increase the risk of developing certain cancers.

To be diagnosed with alcohol abuse disorder, you must meet at least 2 of 11 criteria in the same 12-month period (the more criteria met, the more severe the disorder). To determine how many of the criteria you meet, according to the NIAAA, ask yourself if you have:

Had times when you ended up drinking more or longer than you intended?
More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
Spent a lot of time drinking? Or being sick or getting over the aftereffects?
Experienced craving — a strong need, or urge, to drink?
Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
Continued to drink even though it was causing trouble with your family or friends?
Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

Overdose Death Risk Rises Dramatically as Opioid Users Age

As users of heroin and other opioids get older, their risk for overdose death increases dramatically, a new study of age trends in excess deaths shows.

Although male users had almost double the rate of drug-related poisoning in early adulthood compared with female drug users, the difference narrowed considerably with age, the study found.

“Our analysis provides the first demonstration of a highly significant, age-related increase in opioid users’ drug-related poisoning mortality rate that persists beyond 45 years of age,” the authors, led by Matthias Pierce, Institute of Brain Behavior and Mental Health, Faculty of Medical and Human Sciences, University of Manchester, United Kingdom, write.

The study was published in Drug and Alcohol Dependence.

Suicide, Homicide

Researchers extracted data from the Drug Data Warehouse, an anonymous, case-linked collection of secondary datasets about substance users in England and Wales. The Warehouse includes data from drug treatment services, prison and probation services, and criminal justice referrals.

The study cohort included 198,247 men and women actively using or being treated for opioid use in England from April 1, 2005, to March 31, 2009. Their median age at cohort assessment was 32.1 years, and 72% were male. Most (93%) were identified as heroin users.

For the analysis, researchers used crude mortality rate (CMR); a CMR of 73 per 10,000 person-years translates to 73 deaths occurring among 10,000 people during a period of 1 year or to 73 deaths among 20,000 people during a period of 6 months. They also compared observed deaths to sex- and age-appropriate expected mortality to derive standardized mortality ratios (SMRs).

During a median follow-up period of 3.1 years and through linkages with national mortality records, researchers determined that there were 3974 deaths from all causes, more than 5.5 times the number of deaths than would be expected in the age- and sex-appropriate general population.

Drug-related poisonings were the most common cause of mortality, accounting for 43% of deaths. Next were “external causes” (excluding drug-related poisonings), which accounted for 21% of all deaths, notably, suicide (5%) and homicide (2%).

The rate of suicide, when it was not also classified as drug-related poisoning, was 3 times higher (SMR, 2.9) than expected. With drug-related poisonings included, the SMR for suicides was 4.3 (95% confidence interval [CI], 3.9 – 4.8).

Sex Differences

The study uncovered some sex differences. The all-cause CMR for men was higher than that for women, reflecting lower female mortality in the general population. For men, the drug-related poisoning CMR was substantially higher than for women.

And they noted differences across ages. For both sexes, drug-related poisoning CMR increased markedly with age, from 19 (95% CI, 16 – 23) for persons aged 18-34 years to 45 (95% CI, 40 – 50) for persons aged 45-64 years (P < .001) and was higher for those aged 45-64 years than for those aged 35-44 years (P = .04). The sex difference was considerably more marked among those younger than 35 years. Men had almost double the drug-related poisoning CMR than women at ages 18-34 (29 vs 15), but this difference narrowed considerably with increased age. “These findings underline the importance for public health policy and treatment providers of delivering effective addiction treatment for older age groups, who are characterised by multiple and complex health problems,” the authors write. National targets need to be adjusted for age to effectively monitor the impact of policies, with the aim of reducing drug related poisoning deaths, they said. The study also found that other major causes of death, including circulatory, respiratory, and liver diseases, were much more common among opioid users than in the general population. The analysis may include some misclassifications, and the use of self-reports may lead to underestimations of levels of behavioral risks. Other potential study limitations were that factors contributing to excess mortality that are common in opioid users, for example, high rates of smoking, alcohol consumption, and depression and low socioeconomic status, were not measured, and that treatment effects on mortality risk were not considered.

Marijuana vs Alcohol: What to say to your Teens

Marijuana vs. Alcohol: What to Say to Your Teen When it comes to talking to your teen about marijuana (and alcohol), it’s not always easy to know what to say.

While there is no exact “script” for talking with your teen about marijuana, our new Marijuana Talk Kit explores common teen questions and arguments – and offers tips for what you can say in response.

For example, what should you say if your teen asked you, “Would you rather I drink alcohol? Weed is so much safer.”

First, instead of getting rattled by your teen’s question, try posing a question back. (This acts as a buffer while you think about your answer.) Try something like: “What is going on in your life that makes you feel like you want to do either?”

Your teen may likely mumble back, “Nothing” (or another one-word answer), but keep in mind that even the word “nothing” is an opportunity to lead to another supportive statement from you.

You can then try, “I’m glad to hear there isn’t anything going on in your life that makes you want to drink or smoke.”

Lastly, it’s a good idea to say something along these lines: “Honestly, I don’t want you to be doing anything that can harm you — whether that’s smoking pot, cigarettes, drinking or behaving recklessly. I’m interested in knowing why you think weed is safer than alcohol.”

This type of sentiment reminds your teen that you care deeply about his health and well-being, and expresses genuine curiosity about his thought process, is going to help him open up.

And that’s what it’s all about. Engaging your teen so you can have ongoing, open and positive conversations. That’s how you’ll better understand the pressures he or she may be facing. And that’s how you can express your concern and support and love. And while your teen may not admit it, deep down that’s something all teenagers want.

Learn more about what to say to your teen about marijuana. Download your free Marijuana Talk Kit

Drug Guide for Parents now Available as a mobile app

The Drug Guide for Parents is now available as a mobile app for Android and iPhones. This guide provides information on drugs most commonly abused by teens and includes photos, slang terms, and short- and long-term effects. It features quick links to connect to a parent support specialist through the Helpline, and other valuable resources to prevent teen drug and alcohol abuse.

Get the app here

Feds Move to Stop Opioid- and Heroin-Related Overdose, Death

A targeted initiative aimed at reducing prescription opioid- and heroin-related overdose, dependence, and death has been announced by the US Health and Human Services (HHS).

“Opioid drug abuse is a devastating epidemic facing our nation,” HHS Secretary Sylvia Burwell said in a statement.

“I have seen firsthand in my home state of West Virginia, a state struggling with this very real crisis, the impact of opioid addiction,” she added.

“That’s why I’m taking a targeted approach to tackling this issue, focused on prevention, treatment, and intervention.”

HHS efforts are aimed at three priority areas. They include training and educational resources to help healthcare professionals make informed prescribing decisions to address opioid overprescribing.

These resources will include updated guidelines for prescribers and will establish new opioid prescribing guidelines for chronic pain.

Efforts will also be directed toward facilitating prescription drug monitoring programs to support data sharing for safe prescribing.

These efforts will be supported by increasing investment in state-level prevention interventions that will help track opioid prescribing and support appropriate pain management.

Secretary Burwell also plans to increase the use of naloxone and to support the development of other lifesaving drugs to reduce the number of deaths associated with prescription opioid and heroin overdose.

These efforts will include the implementation of a prescription drug overdose grant program for states to buy naloxone and train first responders on its use.

Plans are also in place to expand the use of medication-assisted treatment, or MAT.

MAT is a comprehensive effort that combines the use of medication with counseling and behavioral therapies to treat substance use disorders.

A grant program is also planned to improve access to MAT through education, training, and purchase of MAT medications for the treatment of prescription opioid and heroin addiction.

These investments are all part of the President’s FY 2016 budget to intensify efforts to reduce opioid misuse and abuse, including $133 million in new funding.

Deaths from drug overdose have risen steadily during the past 2 decades and currently outnumber deaths from motor vehicle accidents in the United States.

Among drug overdose deaths recorded in 2013, approximately 37% involved prescription opioids.

Deaths related to heroin use have also risen sharply since 2010, with a 39% increase between 2012 and 2013.

Heroin use is a public health emergency that calls for legislative solutions

MORE PEOPLE are killed now by drug overdoses than by homicides in many states, prompting alarmed state lawmakers and attorneys general to search for legislative fixes. The sense of urgency, impelled especially by a spike in lethal heroin overdoses, is justified. Some of the measures proposed to address the problem may not be.

The new focus on heroin use coincides with very sharp increases nationally in overdose deaths in middle-class and predominantly white communities. It’s a shame that that’s what it took to rally the authorities to action; still, better late than never.

About 20 states, including Maryland, and the District have enacted bills to ensure that first-responders carry naloxone, a prescription drug also known by the brand name Narcan, which can save the lives of opiate users who have overdosed. Unfortunately, the spike in demand for the antidote has driven up its cost, which is proving a burden for some states and localities. Nonetheless, more states need to step up and recognize heroin use as a public health emergency.

Virginia is a case in point. Heroin-related deaths more than doubled in the commonwealth from 2011 to 2013 and increased at an even faster rate in Northern Virginia. Yet no law requires emergency medical personnel to carry Narcan; some do and some don’t. Worse, some lawmakers apparently believe that making the antidote more accessible will encourage heroin addiction, as if the availability of treatment somehow enables disease.

There are other sensible steps that states can take. They include enacting so-called good Samaritan laws (in place in Maryland and the District but not yet in Virginia) that shield witnesses from prosecution — even if they abuse or sell drugs themselves — if they promptly report and help overdose victims.

States should also consider measures that crack down on unscrupulous doctors and pharmacists who illegally or inappropriately prescribe and dispense opiate pills like OxyContin, which can be a gateway to heroin . And it’s also worth tracking the results of legislation adopted in New York that allows addicts to remain in treatment programs while they appeal decisions by insurance companies that have denied coverage.

However, we are skeptical that some measures to further criminalize already illegal drugs such as heroin will be effective. One idea, pushed by some prosecutors, is to expose drug dealers to homicide charges if they sell what turns out to be a lethal overdose. The experience of the federal war on drugs suggests that harsher penalties fill up jails and prisons without doing much to extinguish the sale of illegal narcotics.

A wiser tack is to treat heroin addiction as a public health emergency. That means establishing more readily available long-term treatment programs, preferably in residential settings that can help shield users from dealers. Such programs cost money. That in itself will be a test for leaders like Maryland Gov.-elect Larry Hogan (R), who has rightly proclaimed that the spike in heroin overdoses is an emergency. In the face of Mr. Hogan’s promise to slash state spending, will he be able to fulfill his promise to come to grips with this epidemic