Teenage E-Cigarette Dripping

The e-cigarette conversation continues as more and more teenagers are using the devices. A 2015 survey found that 24 percent of high school students reported using e-cigarettes during the past 30 days, per the Centers for Disease Control and Prevention (CDC). While the Food and Drug Administration (FDA) has finally been given authority to regulate e-cigs, creating age restrictions, the devices are still being used by minors and young adults.

Most experts agree that electronic cigarettes are less harmful than other forms of nicotine delivery. However, nicotine is still addictive and can potentially start young people on the road to harmful behaviors that can lead to addiction. Furthermore, e-cig nicotine juices come in a number of flavors that can keep people coming back for more, where as traditional cigarettes have one flavor—you either like it or you don’t.

There have also been concerns raised about nicotine levels in e-cigarette “juices,” and how the devices are used. A new trend called “dripping,” allows e-cigarette users to get more bang for their buck, HealthDay reports. In fact, a survey shows that 1 in 4 teens have reported having tried dripping. So, what is dripping?

Normally, e-cigs users inhale to gradually draw the e-juice into a heating coil through what are known as “wicks,” creating a vapor, according to lead researcher Suchitra Krishnan-Sarin, a professor of psychiatry at Yale University School of Medicine in New Haven, Conn. "Dripping" is when e-cig users place drops of the nicotine juice directly onto the exposed heating coil and then quickly inhaling the thick vapor cloud produced. Krishnan-Sarin’s survey indicates that 26 percent of student e-cigarette users at eight Connecticut high schools has "dripped."

The immediate or long term health consequences of dripping are not known yet, according to the article. Although, the chief of general pediatrics of Mount Sinai Health System in New York City, Dr. Karen Wilson, says that the more potent nicotine could impact the developing brains of teenagers.

"Adolescents should not be using nicotine at all," Wilson said. "It changes the brain chemistry, and adolescents are uniquely susceptible to the addictive properties of nicotine." 

The findings of the report were published in Pediatrics.

Mary Tyler Moore's Alcoholism

Mary Tyler Moore passed away Wednesday, January 25, 2017, at the age of 80. Often referred to as “America’s Sweetheart,” Tyler Moore's life was nothing short of extraordinary; she starred in both hot movies and television shows, and championed a number of causes. Her life was also extraordinary in a tragic way as well, and is a perfect example of addiction being family disease—affecting multiple generations.

Mary Tyler Moore was born on Dec. 29, 1936, the daughter of two alcoholics, according to The New York Times. Her sister, Elizabeth Moore, died of a drug and alcohol overdose in 1978. Mary Tyler Moore would struggle with addiction as well over the years, and was treated for alcoholism at the Betty Ford Center in 1984. She would open up about her addiction in her memoir and during interviews.

In 2005, Larry King asked her how she beat alcoholism, to which she responded, “I just made up my mind to stop:”

KING: No AA?

MOORE: Well, I went to the Betty Ford Center and got a lot of education there and a lot of spirit and determination. Somebody said something -- it's a

--> cliché, you've heard it a 100 times, but they say if you want to get all the air out of a glass, what do you do? There's no way to do it but fill it with something else. And that something else is joy of living, reading, being creative, know you're doing the right thing. And that got me to thinking.
KING: Why didn't the joy of success work?

MOORE: I don't know.

KING: One doesn't know, does he?

MOORE: No. And, you know, with alcoholism, you tend to drink because you're angry, or you drink because you're sad now, or you drink because you are just so happy you want to celebrate.

There is not just one way to recover from the debilitating disease of addiction. Tyler Moore’s may not be the course another takes, but her story is inspirational to say the least. She came from a line of alcoholics and found a way to not let the disease be her end. The champion of women’s rights and the treatment of diabetes, she died at Greenwich Hospital in Connecticut of cardiopulmonary arrest.

If you or a loved one is struggling with an alcohol use disorder, please contact Celebrate Hope at Hope by The Sea. Our skilled team can show you how to live life without alcohol or any other mind-altering substances.

Cocaine, Heroin and Overdose

For an addict, there is such a thing as “more high.” Even if tolerance says otherwise. With some drugs, such as marijuana, a continued effort to increase one’s euphoria may not be that dangerous. But for drugs like prescription opioids or heroin, riding the line between intoxication and overdose is never in one's best interest—but highly sought after. What is considered to be a good high, can quickly turn into a deadly overdose.

The death toll related to drug abuse is almost always focused on opioid narcotics these days. While such drugs do not need any help with regard to being dangerous, addicts will commonly mix opioids with other narcotics, sometimes “uppers” and sometimes with more “downers.” It is quite common for people who mix opioids with benzodiazepines to experience a fatal overdose. However, there is another trend that has the power to take one’s life, commonly referred to as “speedballing.” That is mixing opioids and cocaine together, to be injected simultaneously. You may be aware that a number of celebrities have lost their life to the admixture, including:

• John Belushi
• Chris Farley
• Philip Seymour Hoffman

The general public almost never hears about cocaine anymore, being overshadowed by drugs like heroin and fentanyl. If you did hear about cocaine, it is likely that it was because somebody famous died using the drug recently. But make no mistake, cocaine abuse is still a very real problem affecting many Americans. And for those with an opioid use disorder, who are finding that their tolerance is making it difficult to experience euphoria, cocaine might be the solution they consider. Anyone who has ever done a speedball will tell you that there is no other high quite like it, or as dangerous.

While cocaine use rates have been down in recent years, the U.S. Drug Enforcement Agency's (DEA) 2016 National Drug Threat Assessment has shown a significant increase in cocaine-related overdose deaths in recent years, according to the U.S. News & World Report. Cocaine can be deadly on its own; but when mixed with opioids the drug becomes exponentially more fatal.

“When there are no opioids involved in cocaine-overdose deaths you see an overall decline in recent years,” says Christopher M. Jones, an acting associate deputy assistant secretary with the Department of Health and Human Services. “But when you look at cocaine and opioids together, we see a more than doubling in the number of overdoses since 2010, with heroin and synthetic opioids increasingly involved in these deaths."

Treating Depression and Anxiety With Marijuana

When looking for a silver lining in the American electorate's ever changing stance on marijuana, two things often come to mind. 1) Medical marijuana and legalized recreational use will keep countless Americans out of jail or prison. 2) The loosening of the legislative grip on marijuana allows for some long awaited (previously impossible) research to be conducted. The findings of which will hopefully lead to more informed decisions regarding the use of cannabis.

Marijuana, like alcohol, is often used as a stress reliever at the end of a long day of work. While the stereotypical “pot” smokers are teenagers and young adults with Bob Marley shirts and healthy appetites, your average pot smoker is often the farthest thing from that picture. In fact, with the lightening of policies related to marijuana, we can now see a more accurate picture of cannabis users, free from what is portrayed in Hollywood. And what is being seen is college freshmen to businessmen partaking in marijuana use.

More American adults than ever can now easily access marijuana, so it is vital that they know the risks. When people think about the risks associated with cannabis use, cognitive and memory problems often come to mind. But, past research has found connections between heavy cannabis use and mental illness, especially among teenagers and young adults. Users beware!

There are also many pot smokers who use marijuana to self-medicate anxiety and depression. However, it has long been uncertain how effective marijuana is for treating mental illness, and it is likely that the drug may actually worsen one’s symptoms. Researchers at Colorado State University conducted a questionnaire-based analysis of 178 college-aged, legal users of cannabis to shed some light on how the drug affects emotional processing, KDVR reports. The findings were published in PeerJ.

The researchers found that people who use cannabis to treat their depressive symptoms, had less anxiety but were more depressed, according to the article. Those who used the drug to lessen anxiety symptoms had fewer symptoms of depression, but were more anxious.

The findings are important, and hopefully will influence some people’s choice to use the drug for alleviating symptoms of depression or anxiety.

Reversing Overdose Has A Heavy Price

In a perfect world, opioid addicts would have free-access to the lifesaving drug naloxone. The drug can reverse the deadly effects of an opioid overdose, and one could argue that doctors should co-prescribe naloxone when they write an opioid prescription and community outreach programs should handout naloxone free to heroin addicts who cannot afford to buy it from a pharmacy. Sadly, that is not the world we live in, but some lawmakers in the United States have been fighting to expand access to the miracle drug, which has proved difficult because of price.

If one were looking to buy naloxone, they can expect to pay upwards of $150 for two doses. Certainly, you cannot put a price tag on life, but if you can’t afford the naloxone kit you may lose yours. Lawmakers have received a lot of pressure from addiction experts to reign in the ever-increasing price of the lifesaving drug. This week, experts called on the government to act in The New England Journal of Medicine, according to HealthDay. The experts write:

“Naloxone’s price increase is part of an overall trend of increasing prescription-drug prices for both new brand-name drugs and old, off-patent generics. Public frustration with rising drug prices has led to a number of recent policy proposals, including Vermont’s new legislation requiring companies to justify price increases, California’s attempt to constrain drug payments, and the recently proposed and bipartisan-supported Fair Accountability and Innovative Research Drug Pricing Act. None of the federal or state initiatives expanding naloxone’s availability, however, address the drug’s rising cost.” 

Part of the issue is that there are limited options. An increase in demand for the drug has the expected effect of drug makers seeing an opportunity to increase profit, regardless of the deadly consequence of people being unable to afford the drug. Here are the numbers:

• Hospira (a Pfizer Inc. company) charges $142 for a 10-pack of naloxone —a 129 percent increase since 2012.
• Amphastar's 1 milligram version of naloxone costs around $40—a 95 percent increase since September 2014.
• A two-dose package of Evzio (naloxone) costs $4,500, a more than 500 percent increase over two years.

“The challenge is as the price goes up for naloxone, it becomes less accessible for patients,” said study lead author, Ravi Gupta, a fourth-year Yale medical student. "Taking action now is essential to ensuring that this lifesaving drug is available to patients and communities."

The Naloxone Yo-Yo Effect

It could easily be argued that naloxone, the lifesaving overdose reversal drug sold under the brand name Narcan, is one of the most important drugs ever produced. If it's administered in a timely manner, the life of an opioid addict can be spared from what would have otherwise resulted in an overdose death.

In the United States, practically every first-responder has been trained to administer the drug, in response to the staggering overdose death rates linked to the epidemic plaguing America. Additionally, a number of states have taken certain actions, making it much easier for addicts and their families to acquire the ever important drug—in many cases a prescription is not required for obtaining the miracle drug.

While the United States has the highest overdose death rates in the world, after decades of over prescribing painkillers and a burgeoning heroin market, our neighbors from the North have hardly been spared. In fact, between November 17-23, there were nearly 500 overdoses that required paramedics in the greater British Columbia (B.C.) area, CTV reports. Situations that would usually be considered routine, involving naloxone treatment. However, it turns out that addicts have begun mixing naloxone with their heroin in an attempt to protect oneself from an overdose.

Obviously, the method is far from the right course of action. The act of using an opioid, followed by naloxone, is being called “yo-yoing” or the “yo-yo” effect, according to the article. Heroin causes feelings of euphoria; naloxone reverses those effects by essentially starting a process of drug withdrawal—a real up and down experience. One that is far from pain-free.

In B.C. paramedics are arriving at the scene of overdoses and seeing empty vials of the overdose reversal drug, the article reports. Addicts are getting a false sense of safety from yo-yoing, but Paramedic Sophia Parkinson says that a person who uses naloxone needs to be followed up with by medical personnel, as the effects of the antidote can be fleeting.

Please take a moment to watch a short video on the Yo-Yo Effect:


If you are having trouble watching, please click here.

Bipolar Disorder Increases Substance Use Disorder Risk

It is well understood that it is of the utmost importance to treat the whole patient in the field of addiction medicine. A significant number of people seeking help for a substance use disorder, also have other mental health issues to contend with; it is common occurrence which can complicate one’s ability to work a program of recovery. Many people will actually develop a problem with drugs and alcohol as a result of using the substance to help cope with untreated mental illness; if substance abuse counselors fail to address a client's co-occurring disorder while in treatment, then there is an increased risk of relapse down the road.

Over the years there has been a plethora of research conducted which indicates that people with a mental illness, such as depression, are at an increased risk of addiction. It might even be fair to say that a mental illness begets mental illness, in some cases. Studies also point out that a person with a co-occurring disorder, otherwise known as dual diagnosis, has a much better chance of long term recovery, if they are treated for the addiction and co-occurring disorder at the same time.

The most common co-occurring mental health disorders that addiction patients have, include:

• Anxiety Disorder
• Bipolar Disorder
• Depression
• Post-Traumatic Stress Disorder (PTSD)

As was mentioned earlier, people with mental illness are often far more likely to have addiction problems, compared to the general public. This was the results of a new study conducted recently that found that adolescents with bipolar disorder are more likely to abuse drugs and alcohol, and develop a substance use disorder later in life, HealthDay reports. The findings were published in the Journal of Clinical Psychiatry.

The study involved 105 adolescents (average age 14) with bipolar disorder and 98 teens without the disorder, according to the article. Of which, 34 percent of the teens that were bipolar also had substance use disorder, compared to only 4 percent in the control group. The researchers followed up five years later with 68 of the participants with bipolar patients and 81 of the control group. The findings revealed that half a decade later, nearly half of those who were bipolar also had substance use disorder, compared to 26 percent of the control group.