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		<title>Opiods and the cycle of downers continued</title>
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		<pubDate>Tue, 01 Jun 2010 21:49:24 +0000</pubDate>
		<dc:creator>CNS</dc:creator>
				<category><![CDATA[Addiction Education / Prevention]]></category>
		<category><![CDATA[Downers]]></category>
		<category><![CDATA[Dr. Darryl Inaba]]></category>
		<category><![CDATA[Heroin & opiates]]></category>
		<category><![CDATA[History and cycles of drug use]]></category>
		<category><![CDATA[In the News]]></category>
		<category><![CDATA[Podcasts]]></category>
		<category><![CDATA[Prescription/OTC drugs]]></category>
		<category><![CDATA[brown-tar heroin]]></category>
		<category><![CDATA[doctor-shopping]]></category>
		<category><![CDATA[drug-use cycles]]></category>
		<category><![CDATA[heroin]]></category>
		<category><![CDATA[opiates]]></category>

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		<description><![CDATA[Purer heroin causing significant increase in overdose deaths; doctor shopping and ways for Rx management; and the continuing issues of addictions by health care professionals]]></description>
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		<itunes:subtitle>Purer, high potency heroin coming from Mexico is causing significant increases in overdose deaths, also doctor shopping and ways for Rx management, and the continuing ...</itunes:subtitle>
		<itunes:summary>Purer, high potency heroin coming from Mexico is causing significant increases in overdose deaths, also doctor shopping and ways for Rx management, and the continuing issues of addictions by health care professionals
Listen to podcast
Transcript (edited):

CNS:   Heroin and opium are in the news this week.  There is a report about the purity of the current black tar or brown tar heroin coming in mostly from Mexico and how that’s creating a rash of overdoses increasing by many percentages or hundreds of percent the number of deaths occurring from heroin overdose.  In 2000 about 2000 deaths were reported across the U.S. and in 2008 the number is up to 3000, that’s still a significant rise.  And there is another story about pill pushing physicians and more about doctor shopping by drug abusers and the ongoing issue of abuse of prescription drugs by hospital personnel.  So Darryl, how do you view these things and their interactivity?

DARRYL:      It’s fascinating…I’m not sure they have a lot of interactivity, but they’re all timely and they’re all expected.  First of all, the heroin story – we’re kind of overdue for another downer epidemic.  We’ve been on this cocaine and methamphetamine thing for awhile, about 30 years, and that’s the limit of how long an upper or downer fad goes.  So, we’re now ready to turn the corner and go to downers.  We see here in Oregon as well as all over the country a rising abuse of heroin – increased heroin overdoses and also an increase of prescription opiates.  So maybe there is a tie-in with prescription drugs and the health care professionals and general public starting to use more prescription drugs, or abusing more prescription drugs.  But the heroin story is an old one.  In terms of overdoses, they are much more linked to the variations in purity of heroin than it is to anything else.  And when we see…we see rashes of them, you don’t see, you know, a steady number of heroin overdoses every year…when we see rashes of them, especially occurring in any municipality or any state or something, it’s usually linked to a pure form of heroin that’s come in.  The latest story…I think was in Montana or something, it could have very well have been California or Oregon or any place else…actually talks about tar heroin.  Tar heroin has always been a more pure form of heroin in terms of actual milligrams of drugs, but less pure in terms of separating all the adulterants and ingredients and things leftover from the processing of opium from the opium poppy into morphine and then morphine into heroin.  It was a Mexican cartel, a third one, out of 1980’s that learned how to much more easily process the morphine that’s in opium to concentrate it without eliminating all the other adulterants and all the plant materials and everything else in opium and then easily converting the morphine that was in that resultant product into heroin by adding acetic acid to it or concentrated vinegar.  And that really is a simplified process, but it also resulted in a much more potent form of heroin because it was hard to cut.  You know, when it’s a finished product, it looks like tar.  It’s tacky, sometimes has a great sheen, black sheen to it and it’s, you know, it’s very hard, so….

CNS:   What do you mix that with?

DARRYL:      Yeah, maybe tar or something else.  So, as it got to the street and it was sold in smaller quantities.  It’s in gram quantities instead of a bag of heroin, which is like 300, 400 mg of powder.  But powder you can do anything to, so everybody who touched it wanted some profit on it, or wanted to support their own habit, would step on it.  They would add all kinds of things - instant coffee – if you want brown heroin, they add any kind of white powder to it – quinine, lactose or anything to step on it or dilute it.  Well tar was hard to cut, so it comes in anywhere from 60 to 80% pure or 60 to 80% o</itunes:summary>
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		<title>Food-Source Opiates: Therapeutic Positive UA</title>
		<link>http://www.cnsproductions.com/drugeducationblog/treatment-and-drug-testing/132/</link>
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		<pubDate>Fri, 13 Mar 2009 20:00:58 +0000</pubDate>
		<dc:creator>Darryl</dc:creator>
				<category><![CDATA[Treatment & Testing]]></category>
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		<category><![CDATA[amoxicillin]]></category>
		<category><![CDATA[ampicillin]]></category>
		<category><![CDATA[cocaine positive]]></category>
		<category><![CDATA[codeine]]></category>
		<category><![CDATA[Dextromethorphan]]></category>
		<category><![CDATA[drug testing]]></category>
		<category><![CDATA[DUI violation]]></category>
		<category><![CDATA[Ectasy]]></category>
		<category><![CDATA[EtG testing]]></category>
		<category><![CDATA[ethyl glucuronide]]></category>
		<category><![CDATA[false-positive]]></category>
		<category><![CDATA[false-positive ethanol test]]></category>
		<category><![CDATA[food source opiates]]></category>
		<category><![CDATA[Gas Chromatography/Mass Spectrometry]]></category>
		<category><![CDATA[GC/MS]]></category>
		<category><![CDATA[Hemp oil]]></category>
		<category><![CDATA[Ibuprofen false-negative]]></category>
		<category><![CDATA[Ibuprofen false-positive]]></category>
		<category><![CDATA[marijuana]]></category>
		<category><![CDATA[marijuana test]]></category>
		<category><![CDATA[Mate De Coca]]></category>
		<category><![CDATA[methamphetamine]]></category>
		<category><![CDATA[morphine]]></category>
		<category><![CDATA[non-prescription medications]]></category>
		<category><![CDATA[opiate abuse]]></category>
		<category><![CDATA[opiates]]></category>
		<category><![CDATA[poppy seeds]]></category>
		<category><![CDATA[positive ua]]></category>
		<category><![CDATA[prescription medications]]></category>
		<category><![CDATA[THC Positive]]></category>
		<category><![CDATA[Therapeutic Positive]]></category>
		<category><![CDATA[toxicologist]]></category>
		<category><![CDATA[treatment process]]></category>
		<category><![CDATA[urine creatinine]]></category>
		<category><![CDATA[urine tests]]></category>
		<category><![CDATA[Urine toxicology]]></category>

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		<description><![CDATA[Certain foods, medications and even body processses can cause False-Positive results in UA drug testing. Dr. Inaba discusses these and changes in established limits for testing.]]></description>
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