You Can Help Reduce the Opioid Crisis

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You’ve probably heard a lot about our country’s opioid crisis. Stories about it are everywhere: online, in the news, and on social media. You may even personally know a friend or a family member who has been affected.

In the past, when it came to drug deals, the media painted a picture of drug abusers getting an opioid “fix,” during shady transactions. But it’s become clear that very often, people get opioids in a far less ominous way: They take them from someone’s house. The fact is, there’s a staggering amount of prescription opioids in the medicine cabinets and other storage places in households all over America.

When initially taking these drugs, some people may think of this as a form of innocent experimenting, but sadly, many of the next victims you’ll read or hear about—or even know personally—will have died from an overdose of opioids they took from someone else’s prescription bottle.

You can help reduce the impact of this opioid crisis. Here’s how:

  • Tell your friends who may want to experiment in this way that prescription opioids can be just as dangerous as heroin.
  • Tell your parents and family members that it’s not a good idea to keep unused, unwanted, or expired opioids around the house “just in case” they’re needed for pain. The risk is just way too high!

How many prescription opioids are out there? In 2016, retail pharmacies dispensed more than 214 million first-time or refill opioid prescriptions. As many as 9 out of every 10 of these patients report not finishing what has been prescribed to them. That’s a lot of leftover opioid prescription bottles—and every one of them has the potential to kill.

The U.S. Food and Drug Administration (FDA) has developed a simple infographic to walk through the process step by step for drug disposal. Contrary to what a lot of people think, it’s okay to flush the opioids on the FDA’s “flush list” down the toilet. We need to get them out of our homes.

Today, teens are taking on important new leadership roles when it comes to public health topics. Use that same energy to step up and lead another way: Make sure your house is free of unwanted, unused, and expired opioids. Encourage your friends to do the same and let them know that using other people’s opioids can be deadly.

Teens can play a big role in this effort. We, and especially your friends and family, need your help!

Study shows effects of ‘secondhand drinking’ hurt 53 million Americans.

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Forget secondhand smoke. Now you have to worry about the secondhand drinking.

One fifth of adults — or an estimated 53 million people in the United States — suffer from other people’s boozing annually, making this “a significant public health issue,” according to a new study published in the Journal of Studies on Alcohol and Drugs.

“One thing to think about with the 1 in 5 number is that it is only limited to a snapshot in time of about a year. So, probably more people have actually been harmed by someone else’s drinking at other times in their life,” study author Katherine Karriker-Jaffe, a senior scientist with the Alcohol Research Group at the Public Health Institute in Emeryville, Calif., said.

Researchers analyzed responses from 8,750 adults interviewed in 2015 for the National Alcohol’s Harm to Others Survey and the National Alcohol Survey. Subjects were asked whether they experienced any of the 10 types of harms — caused by someone who had been drinking alcohol — in a 12-month period. The damages included everything from traffic accidents, physical abuse, marital problems, property damage and financial issues.

The current research, funded by the National Institute on Alcohol Abuse and Alcoholism, analyzed the data to provide insight for potential alcohol control policies, such as taxation and pricing to reduce alcohol’s harm to persons other than the drinker.

Researchers said that 21% of women and 23% of men experienced at least one negative impact. The most common type of harm reported was threats or harassment.

“For women, the most prevalent [types of harm, after harassment] are family and marital problems or financial problems due to someone else’s drinking and a close third runner-up would be driving-related harms — so riding with a drunk driver or actually having a crash caused by someone who had been drinking,” says Karriker-Jaffe. “For men, [after harassment,] the driving-related harms were the most common, followed by property damage and vandalism.”

Adults under the age of 25 were at a higher risk to experience a broader range of issues from other people’s drinking.

The study also found that women were more likely to report harm caused by a spouse or family member who was hitting the sauce. Men were more likely to report issues that were caused by a stranger.

The Opioid Epidemic’s Untold Story

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Last year, more Americans died of opioid overdoses than of many cancers, gunshot wounds, or even car crashes. In fact, by at least one metric, the epidemic is more dire for Americans than was the Vietnam War: while an average of 11 Americans died per day during the 14 years the U.S. was involved in Vietnam, nearly 120 Americans died per day of opioid overdoses in 2018 alone.

As families write obituaries, death notices are printed, and flowers are delivered to grieving loved ones, an important part of the story has gone largely untold. At some point, if they survive, most opioid abusers end up in court. Perhaps they have been arrested for stealing to feed their habits or perhaps an agency has deemed them unfit parents. Whatever the reason, one fact remains: the state court justice system is now the primary referral source for addiction treatment in the country.

This reality has put enormous strain on our nation’s state courts, many of which have been overwhelmed by growing dockets and shrinking resources. In a recent survey of chief justices and state court administrators, 55 percent ranked the opioid epidemic’s impact on the courts as severe. The survey results are unsurprising, given the complexity of opioid cases: it takes an enormous amount of time to figure out what’s best for people who are addicted, how to care for their children, and what resources are available for them. And those who are placed in a treatment program with court oversight may remain involved with the court for years.

While Congress has responded with appropriation increases in targeted funding for the states, almost none of it has been directed to the court system. Court leaders quickly realized the stress this epidemic brought to the courts as a “crisis within a crisis.”

This led to the establishment of the National Judicial Opioid Task Force in 2017 by the Conference of Chief Justices and the Conference of State Court Administrators to examine current efforts and to find solutions to address the epidemic. The task force started by developing five principles for state courts to use as a point of reference in addressing the crisis:

  • The justice system is in the middle of this crisis and should lead the way in delivering solutions.
  • Judges should use their positions to bring together leaders of government agencies and other groups to address the epidemic.
  • Courts should ensure that opioid abusers get the treatment they need.
  • Interventions should be comprehensive and should include initial proper treatment, recovery services, and appropriate placement of children.
  • The courts should use data whenever possible to help them make good decisions.

With these principles in place, the task force has developed—and will continue to develop—practical information, tools, and best practice recommendations for state court judges and court administrators. It recently released a comprehensive resource center to provide information to help courts understand the unique aspects of opioid-use disorder and to handle opioid-related cases more effectively.

To be sure, this isn’t just a serious problem where we live in Indiana and Tennessee. Opioid addiction has rocked states throughout the country. In nine states, the number of prescriptions exceeds the number of residents. And a 2017 White House report estimated that the opioid crisis resulted in economic costs exceeding $504 billion in the U.S. in a single year.

But there are examples of hope. The task force is working with court leaders across the country to identify promising state and local court programs that address the crisis. For example, a New York state court judge has developed an opioid intervention court that, within hours of arrest, links participants with treatment services. Kentucky has created treatment and recovery teams that combine best practices in courts, child welfare, treatment, and peer recovery. In Indiana, the Supreme Court hosted a statewide opioid summit bringing together almost 1000 community stakeholders from every one of the state’s counties. Montana judges are using new technologies to address the complications of providing services in remote communities. And courts in Tennessee are focusing on the needs of pregnant women with addiction and have already seen a reduction in the number of babies born with neonatal abstinence syndrome.

Much work remains. But the National Judicial Opioid Task Force is dedicated to building on the successes of other courts and working collaboratively with local, state, and federal partners to craft the responses and solutions that are required to combat this serious and complicated epidemic.

What Are the Current Drug Trends Among Teens and Young Adults?

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Drug trends among teens and young adults today are “not your father’s Oldsmobile,” so to speak. The whole scene has changed. We continue to have problems with commonly-used mind-altering substances that have been around for a long time such as opiates, marijuana and hallucinogens. Today, however, we add to this list increasingly bizarre practices such as consuming embalming fluid, along with numerous synthetic drugs and organic drugs that are unstudied and often untraceable. Here is an overview of the major drug trends we are seeing nationwide.


Today, Kratom has become a hotly-debated drug, often touted as an organic pain-reliever and recently classified as an opioid by the Food and Drug Administration. Despite its widespread use and ease of online ordering, little clinical research has been conducted on this drug making it a risky substance, especially as it becomes increasingly popular with teen and young adults. Though this drug was officially made illegal in Alabama, Arkansas, Indiana, Tennessee, Vermont, and Wisconsin in 2016, Kratom is still legal in many states. Its effects can be severe with more severe side effects including respiratory depression and psychosis. It is also highly addictive.

Synthetic Drugs

Synthetic drugs have become increasingly popular with younger people, and the effects of these drugs can be deadly.

Synthetic drugs include synthetic cannabinoids such as Spice and K2. These drugs are manufactured chemicals that are often sprayed on dried plant material. This allows them to be smoked in a method similar to marijuana. Synthetic cannabinoids are also sold as liquids which can be vaporized in e-cigarettes. Often, these products are labeled as incense and do not come up on standard drug tests, thereby making them dubious to many parents. Common street names include Spice, K2, Genie, Red Magic and Fake Weed.

Synthetic cathinones, commonly referred to as “bath salts,” are similar in that they are manufactured substances and are often labeled as “not for human consumption” despite their widespread use as a drug. These mind-altering substances are unregulated stimulants often used as a substitute for cocaine or amphetamines. They can be swallowed, snorted, smoked, or injected and remain popular among teens young adults. Common names include Flakka, Ivory Wave, Stardust, Cloud Nine, Meow Meow, Vanilla Sky, and White Knight or White Lightning.

Since synthetic drugs are largely unregulated and can be highly dangerous and unpredictable, it is imperative that parents familiarize themselves with these substances, which are often mistaken for benign incenses and can be purchased at many local gas stations and paraphernalia shops.


In recent years, we have seen a resurgence of hallucinogens among young people. These include more commonly known substances such as lysergic acid diethylamide (LSD). LSD is often taken as a tablet or “blotter.” Its effects may be intense and include both visual and auditory hallucinations, altered perceptions, delusions and time distortions. Psilocybin, also known as “Magic Mushrooms,” is a naturally-produced psychedelic compound found in species of mushrooms. Dried or fresh mushrooms are often ingested, prepared as a tea or consumed with other foods. Other substances include marijuana cigarettes, which are dipped in solutions to enhance the hallucinogenic effects of THC, with embalming fluid is among the substances used. As one might imagine, this solution can produce disastrous effects, such as decreased lung function and an increased risk of cancer when used recreationally.


Opioids continue to be popular among all age groups, including young adults. Young adults consume more prescription medications recreationally than any other age group, sometimes in combination with alcohol, placing them at increased risk for respiratory failure. They are also at high risk for addiction and dependence. Often, physicians find these drugs were illegally and unknowingly obtained from a family member or friend. These addictive substances can lead to heroin and fentanyl use. Opioid use can cause permanent neuropathy among people who overdose or become unconscious from opioids. In a residential treatment setting, it is unfortunately common to see at least one or two patients at any given time with a permanent disability as a result of an overdose.

The Role of the Internet in Drug Use

Today, the internet continues to be a primary source of information about drugs from many young people, with entire sites devoted to explaining drug use. Additionally, young people often report obtaining drugs from site on the “Dark Web,” a part of the internet that requires special software or authorization to access and is not found on regular search engines, making them largely untraceable. These drugs are sent via mail, sometimes to a P.O. Box where they can be received without a parent’s knowledge. Cryptocurrencies like Bitcoin may also be a source of payment, creating a largely anonymous purchase experience.

What Can Parents Do?

  • Pay attention to unexplained changes in your child’s behavior including school/work performance, general mood, sleeping patterns, etc. These changes may be signs of substance use.
  • Pay attention to what is happening on computers in your home. Check browsing history regularly and do not ignore unexplained software on your computer. Check for deleted browsing histories and ask questions.
  • If you discover your child is experimenting with drugs, consider consulting a professional as opposed to trying to figure out the problem yourself.
  • The most significant thing a parent can do to help kids is to spend time with them. This is just as true with adolescents and young adults as it is for young children. Communicating with your kids and being clear about expectations are a parent’s best tools for guiding kids to make healthier choices.

Family Involvement Key to Success of Teen Substance Use Treatment

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Family involvement is a key component to success in treatment for teen substance use disorder, according to a review of recent research by an expert at the Center on Addiction.

“Our review has shown that programs that involve families are the most effective,” said Aaron Hogue, Ph.D., Director of Adolescent and Family Research at the Center on Addiction. He recently spoke about treatment for adolescent substance use at the National Academy of Sciences, Engineering, and Medicine in Washington, D.C.

As the opioid epidemic grows, there is great demand for treatment for opioid use disorder for teens and young adults, Hogue noted. “We know the most effective treatment is medication-assisted treatment, which combines medications with behavioral interventions,” he said. “This review helps treatment providers know which types of behavioral interventions will have the greatest impact.”

He noted that more than 90 percent of teens who meet diagnostic criteria for a substance use disorder do not receive appropriate treatment.

Hogue conducted a cumulative review of experimental studies on outpatient behavioral treatment adolescent substance use. He reported in the Journal of Clinical Child and Adolescent Psychology that ecological family-based treatment is the most effective. This type of treatment targets multiple systems—family, school, peers, juvenile justice—within which teens develop.

As with other types of family therapy, ecological family-based treatment engages teens and families to make long-term changes, addresses individual, family, peer and community-level influences, and reduces problem behaviors.

The ecological model of family therapy aims to change relationships, Hogue explained. “It looks to change the meanings in how behaviors are interpreted. For instance, if a teen were to say, ‘My mom doesn’t trust me – she’s always asking me where I’m going,’ a therapist might reframe it by saying, ‘It sounds like your mom cares about what you’re doing and is worried about you hanging out with the people or going places that will lead to negative outcomes.’ It helps shift how the teen understands the behavior, from being inappropriately controlling to being worried and showing concern.” This doesn’t mean one interpretation is truer than another, but it broadens the understanding of meanings and relationships, Hogue said.

Other types of treatment that were found to be effective included individual cognitive-behavioral therapy and group cognitive-behavioral therapy. These types of therapy help identify, recognize and avoid thought processes, behaviors and situations associated of alcohol or other drugs, and develop better problem-solving and coping skills.

The review found behavioral family-based treatment was “probably” effective. This type of therapy works to improve communication and support and reduces conflict between families that have a member with addiction. Behavioral-based family treatment is focused on increasing the communication and coping skills of family members, Hogue said.

Motivational interviewing was also found to be “probably” effective. This approach bolsters motivation to change substance use behaviors and encourages planning for change and then making and maintaining changes in behavior.

Families looking for therapy should ask how much family involvement there is, Hogue advised. “Am I expected to attend a few sessions at the beginning or end of treatment? Should I be in the building for every session and come in periodically for review and updates? Or am I expected to attend most or all sessions because the focus in on the entire family as a team?” he said. “One approach isn’t necessarily preferable to another, but whichever approach you take, you need to be fully committed to it in order to maximize its effectiveness.”

For more information on types of addiction therapy, read the Center on Addiction’s “Guide to Finding Quality Addiction Treatment.”

Brain Damage from Alcohol Continues After Abstinence

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Damage to the brain caused by alcohol continues during the first few weeks of abstinence, a finding that refutes the notion that the brain begins to normalize immediately after individuals stop drinking.

“Until now, nobody could believe that in the absence of alcohol the damage in the brain would progress,” study investigator Santiago Canals, PhD, of the Institute of Neuroscience of Alicante, Consejo Superior de Investigaciones Científicas–Universidad Miguel Hernández, Spain, said in a news release.

The study was published online April 3 in JAMA Psychiatry.

A Look Inside the Brain

Using diffusion tensor imaging, the researchers assessed microstructural alterations in white matter after long-term alcohol exposure and during early abstinence in 91 men (mean age, 46) who had alcohol use disorder (AUD).

The men were hospitalized and were undergoing detoxification treatment, which guaranteed that they did not drink alcohol. Thirty-six healthy men of similar age who did not have AUD served as control persons.

The researchers found diffuse microstructural changes in white matter in the men with AUD compared with the control persons. These changes primarily affected the right hemisphere and the frontal region of the brain. These changes progressed during 2 to 6 weeks of abstinence.

“The study was not designed to look further in time, also due to the fact that our results were unexpected,” study coinvestigator Wolfgang Sommer, MD, PhD, of the University of Heidelberg, Germany, said.

“Other studies looked at a longer time horizon and typically found signs of recovery, both of the brain structure and its function. Nevertheless, we need more research to understand what is going on here and what are the temporal aspects of the underlying phenomena,” said Sommer.

The researchers replicated their observations in an established rat model of excessive alcohol consumption.

“The fact that the findings in humans mirror those in rats may establish a relationship between the observed changes and alcohol consumption, which is difficult to verify based on human results only, given the large heterogeneity of the abuse patterns, medication for relief of withdrawal symptoms, and comorbidities among patients with AUD,” the researchers write.

“This result establishes the utility of diffusion imaging for monitoring the brain status as a possible noninvasive biomarker of AUD progression and, potentially, of treatment response,” they add.

Important Translational Study

“These types of translational studies are crucial to help fill in gaps in addiction research,” Marisa Silveri, PhD, director of the Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, Massachusetts, and associate professor of psychiatry at Harvard Medical School, Boston, said.

“The findings do fly a little in the face of what we know, because when people become abstinent, it usually doesn’t take them long for things like brain chemistry and cognition to improve, somewhat after abstinence. But it’s studies like these that uncover some more micro level cellular indicators that tell us that just because you can recover some function, it doesn’t necessarily mean the brain is returned to a healthy state,” said Silveri.

“That’s an important message because people often think that when they no longer feel the acute intoxicating effects of alcohol, that it’s not still having an effect, and we do know from many studies that there are residual effects of alcohol intoxication on neurobiology.

“The brain is a fantastic orchestra of networks, and understanding some of the subtler changes and what they mean is work that is most needed,” she added.