A new drug use survey from SAMSHA shows a marked increase in illicit drug use especially by people in the 18-25 yr old range, led by marijuana, while cocaine and meth use has fallen significantly. Also we discuss another substantial increase — of alcohol poisoning, especially in the first few weeks of the new school year – again with attention to the 18-25 yr old range. We ponder how discussions about medical marijuana use may be changing people’s perceptions of its safety, and whether alcohol/energy drink combos may be contributing to the alcohol overdoses.
Transcript (edited):
HOWARD: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions, I am Howard La Mere. The first story I want to talk about is a new story published recently in U.S. News and World Report coming out of SAMHSA, which is the U.S. Substance Abuse and Mental Health Services Administration. It’s a study showing a significant increase in drug use over 2009 and 2010 showing something on the order of a 9% increase overall in the use of illicit drugs, in particular marijuana. Cocaine and methamphetamine showing a decrease by about a half and alcohol continuing as the leading addictive culprit along with tobacco. So, Darryl, I want to check in with you about this survey – in particular about the statement that the largest group of users of marijuana is 18 to 25 year olds – and these people have not been focused on.
DARRYL: First of all the report didnt cite the name of the actual SAMHSA study, but the numbers and percentages of increase correlate well to what we talked about at the beginning of this year regarding the annual national survey on drug use and health. I think thats exactly the study theyre quoting, it did show an increase in marijuana abuse, alcohol, but a decrease in methamphetamine and an increase in ecstasy – which wasnt mentioned in this article. But it is clearly one of the things they do touch on that was vital in SAMHSA’s interpretation of what is going on today after 10 years of decline, that all of a sudden there is an increase in illicit drug abuse – it is a huge thing and has everyone shook up. But it certainly got Gil Kerlikowske, the drug czar and Dr. Tom McLellan and other people as well as Dave Mineta looking at Oregon and California and the initiatives that were on the ballot in November of 2010 – calling for more liberal medical marijuana laws and making marijuana more of an acceptable medical treatment. And the connection is made strongly, Ive actually seen graphs on this that are extremely dramatic – any time there is a public perception that a drug is non-harmful, theres a dramatic increase in the abuse of that drug, legal or illegal. And any time theres an increase in the opposite where drugs are viewed as harmful, theres a dramatic decrease. And when you graph out the actual percentage of people abusing marijuana and public perception of marijuana being harmful and you superimpose those graphs upon each other, those curves cross when the public opinion of marijuana’s harmfulness decreases. Thats an important thing to pay attention to that there is an increase in drug abuse after 10 years. In 2010 there was an increase after 10 years of decline, but as significant was the decline in number of people who believed drugs are harmful. The age group in which use grew most dramatically was the 18 to 25 year olds, the college age group or those just entering the work force. This supports the fact that prevention should be addressed and stressed throughout ones whole lifetime because people are going to be exposed to drugs throughout their lifetime and the potential for developing problems exists pretty much throughout life – even in senior citizens. If youve never had drug problems before, you can develop one late in life. And there hasnt been in the past .our focus has been primarily in prevention and maybe secondary prevention in high schools and middle schools, but we have to get the kids early so we have to teach them about drugs and not to use them in elementary school. The efforts diminish with college age kids – but with the dramatic number of young collegiates experiencing alcohol toxicity and major drug problems, many universities have increased their efforts on their own campuses .not a nationwide effort, but on their own campuses to try and do something to curb the use of drugs and alcohol during the college years. And it was interesting another report I saw where one university – George Washington University, in Washington D.C. – noted a great spike in 2011, of new students entering or students coming back to college at George Washington just in the first week alone, they had over 30 students transported to the emergency room for alcohol poisoning, which was up from 23 calls the previous year, which was up from 13 calls from the year before. And so, theres been dramatic increase in alcohol toxicity reported and I think that is consistent .I would project that thats consistent throughout every college campus. Why is there a dramatic increase? Well, I dont think theres a real increase in drug use, although the national survey on drug use and health seems to indicate otherwise, I think that the reported increase shows a greater awareness and a greater effort by the universities to encourage responsibility in all of their students – making students who are not the heavy drinkers or heavy users, more responsible for helping out their fellow students by calling for help or getting them to the emergency room when they see a fellow student in trouble. So I think that explains the great spike in number. But it doesnt explain why the biggest problems we see in college age drinking and college age drug use occurs within the first week of school.
HOWARD: I mentioned earlier how odd it seems that there is no increase in alcohol potency the way there is in heroin or marijuana. But then I thought about the drinks that mix alcohol and caffeine, which are relatively new and could be attractive to people just entering college for instance and could result in alcohol poisoning.
DARRYL: The study didnt mention that, but thats a good thing to point out because energy drink cocktails are more of a modern phenomenon and we are seeing increased toxicity in young people who arent ready for the speed ball drink combination. After drinking too much alcohol think theyre fine because they had a “caffeine drink”.
HOWARD: It takes like pop, you know, like a soft drink.
DARRYL: Thats another trend – drinks with fruit or sweet flavors. The number of flavored martinis and drinks like Cosmopolitans – you know with lemon drops and things just to sweeten them – is huge. The state alcohol board came down on a local bar for selling jello mixtures – called jello pops – alcohol is substituted for water and mixed with the jello powder and it firms up – like regular jello – you eat it but probably don’t realize it has a full shot of alcohol in it and you get drunk real fast just eating a couple of squares of jello. But you know, thinking about why is it that in the first week of school -…high school, college or whatever people overdose, people get into drugs, need assistance, – probably its the camaraderie or peer influences. Students havent seen each other in 3 months or so, they get back together – they dont have any real school stress at that time – no assignments yet or tests so they’re freer and for college kids, they probably have more money the first week they come back to school and its just, I guess the perfect environment for people to go out and get their ya yas out and end up in the emergency rooms.
HOWARD: Another related story I wanted to mention comes from the American Society of Addiction Medicine. There is a new report that defines addiction as a physical disease rather than a behavioral matter. And what I thought was a little bit different about this article was the mention of addiction as both chronic and a largely genetic underlying disease, brain disease. Is that different than what weve talked about before? I mean, weve talked about genetics here and there, Darryl, but Im wondering if this seems like its a different take on the subject.
DARRYL: No, it doesnt differ from what weve been talking about at all, its actually validating what weve been reporting all along in all of our books and in all of our educational materials. The American Board of Addiction Medicine embraced this much earlier, determining that addiction is such a full scale, chronic, persistent, relapsing disorder that as of July, they have 10 residencies and more residencies planned. So why it has taken the American Society of Addiction Medicine so long to come on board with this, Im not sure but the article mentions that about 50% of addiction is genetic and the rest is a lot of other factors. And what weve always reported based on all the researchers in this field, is that genetics contributes anywhere from 40 to 60% of the persons liability for developing an addictive disorder. Environment and especially trauma and stress early childhood trauma and stress contributing a major portion of someone’s liability to develop addiction and then the toxicology of each addictive substance. So its the same thing that weve been reporting and it should have been embraced by the American Society – and Im sure it was by most of the members – but this is an official announcement of a change in their definition of addiction so this is a major undertaking. They must have had a lot of sessions and meetings and probably a lot of arguments, but its totally consistent with what we and many other people have been saying all along about what addiction is and what its etiology is how a person comes to be addicted. Most important though, is the concept that addiction is like diabetes or heart disease or hypertension or asthma or any other chronic persistent disorder. And what I like best about their new definition, so to speak, is it confirms what weve been saying all along that relapse is a part of this condition. Its a relapsing condition, very much like the other illnesses, diabetes is relapsing, hypertension is a relapsing condition and now this acceptance that relapse is a part of the disease of addiction. It begins then to question the other people in the field saying theres no evidence of treatment success, that you cant show the 12 steps are successful when in fact a lot of research is showing it is. If you look at the overall span of a human lifetime, where a chronic persistent relapsing incurable disorder exists – the person doesn’t get cured, the condition is arrested or treated to mitigate and minimize it through ongoing efforts. And if a person fails to do that, they are likely to experience a major relapse as often happens with diabetes, or hypertension. The trick is to help addicts understand that it is part of their condition and should they relapse, they need to climb right back into treatment as soon as possible so that they dont suffer horrendous, catastrophic major consequences. That helps take the sting out of relapse – addicts feel so guilty and shameful and carry so much stigma when they relapse, because to them, thats the worst thing that can happen – it makes them think that being an addict is preferable to being somebody who chronically relapses in their disease.
HOWARD: Its important to really stress that it is not “my bad” but rather part of the process. Thats all the time we have for today – thanks for listening. If you have comments or questions or suggestions, please do share them with us. Email us at info @ cnsproductions.com Please check back soon for the next in the series and visit our website, www.cnsproductions.com