Posts Tagged ‘addiction’

Excessive playing of video games is now considered a disorder needing medical treatment, World Health Organization (WHO) says

January 14, 2018

 

For the gaming disorder to be diagnosed, WHO said, behavior pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational and occupational functioning for at least 12 months. David Aliaga/Laurel Photo Services via AP

Mayen Jaymalin (The Philippine Star) – January 15, 2018 – 12:01am

MANILA, Philippines — Excessive playing of video games is now considered a disorder needing medical treatment, the World Health Organization (WHO) reported.

The WHO announced recently that it is including “gaming disorder” in its 11th Revision of International Classification of Diseases (ICD-11) used by medical doctors worldwide to diagnose the conditions of patients.

According to the WHO, it is in the process of updating data and will come up with ICD-11 in the middle of this year.

The inclusion of a disorder in ICD-11, the WHO said, allows countries to plan out public health strategies and monitor the trends of disorders.

In the draft ICD-11, gaming disorder is defined as a pattern of digital or video gaming characterized by impaired control over it and giving it priority over other daily activities.

For the gaming disorder to be diagnosed, WHO said, behavior pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational and occupational functioning for at least 12 months.

WHO decided to include gaming disorder in ICD-11 after reviews of available evidence and consensus among experts.

“The inclusion of gaming disorder in ICD-11 follows the development of treatment program for people with such health condition in many parts of the world,” WHO said.

With the new development, WHO expressed hope that health professionals would become more aware of the disorder, be able to come up with appropriate treatment, and help people avoid the condition.

At this time, WHO said, only a small number of people engaged in video gaming have developed the disorder.

However, WHO said, people who play video games should be conscious of the time they spend on such activity as well its effects on their physical and psychological functioning.

Read more at http://beta.philstar.com/headlines/2018/01/15/1777842/who-excessive-video-gaming-disorder#faAJvHYMe4tW5LZE.99

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Federal Judge Seeks Speedy Resolution of Opioid Lawsuits

January 9, 2018

In Cleveland court room, he urges opposing sides to reach an agreement involving the reduction of pills to those who abuse them, rather than just a monetary payment

Ohio Attorney General Mike DeWine is one of several U.S. attorneys general who sued opioid manufacturers and distributors in state courts.
Ohio Attorney General Mike DeWine is one of several U.S. attorneys general who sued opioid manufacturers and distributors in state courts.PHOTO: BROOKE LAVALLEY/THE COLUMBUS DISPATCH/ASSOCIATED PRESS
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A federal judge is pushing for a swift resolution to hundreds of lawsuits filed by cities and counties over the opioid crisis, saying Tuesday that too many people are dying each year from opioid abuse.

“I don’t think anyone in the country is interested in a whole lot of finger pointing at this point, and I’m not either,” U.S. District Judge Dan Polster said Tuesday at the first gathering, in a Cleveland courtroom that was packed, of lawyers involved in the sprawling opioid litigation.

Judge Polster is overseeing the consolidation of more than 200 cases filed in federal court by local governments, hospitals and other parties, all seeking to recoup the costs of opioid addiction from the manufacturers and distributors of the painkillers.

More than a dozen state attorneys general, including those in OhioKentuckyMissouri and New Mexico, have also sued manufacturers and distributors in state courts. New suits are piling up each day as plaintiffs’ lawyers sign up additional clients.

Addiction experts are in wide agreement on the most effective way to help opioid addicts: Medication-assisted treatment. But most inpatient rehab facilities in the U.S. don’t offer this option. WSJ’s Jason Bellini reports on why the medication option is controversial, and in many places, hard to come by. Image: Ryno Eksteen and Thomas Williams

“In my humble opinion, everyone shares some of the responsibility, and no one has done enough to abate it,” said Judge Polster, a former prosecutor nominated to the bench by President Bill Clinton.

He urged both sides to reach an agreement—one that involves the reduction of pills to those who abuse them, rather than just a monetary payment—without enduring the protracted cost and hassle of litigation. “We don’t need briefs and we don’t need trials,” the judge said. “None of those are going to solve what we’ve got.”

If a speedy resolution doesn’t work, he said, the lawyers will have to prepare a test case for trial.

A few early cases show how long litigating such opioid cases can take.

California’s Orange and Santa Clara counties sued five drugmakers, including Purdue Pharma, Johnson & Johnson and Endo International, for deceptive marketing in 2014, and have since revised their state-court complaint four times. One defendant, Teva Pharmaceuticals , agreed last year to pay $1.6 million as part of a pending agreement, while the rest continue to push for its dismissal.

Chicago similarly sued drugmakers for false marketing in 2014. Several of Chicago’s claims have been dismissed, and the case has been hung up in disputes over document discovery. That case is now on hold and part of the multidistrict litigation in front of Judge Polster.

The Ohio judge last week named New York lawyer Paul Hanly, South Carolina lawyer Joseph Rice and West Virginia-based Paul Farrell as co-lead counsel for the plaintiffs in the case. They oversee additional groups of court-appointed plaintiffs’ lawyers working on the litigation.

In court Tuesday, Mr. Rice, a founding partner at Motley Rice LLC, told Judge Polster that the plaintiffs “share your feeling of urgency.”

Attorneys for the drug distributors and manufacturers said in court that they are willing to enter into discussions but have some legal questions they’d like resolved first.

“All of us recognize there are issues in this country [and we] want to be part of the solution,” said Mark Cheffo, a partner at Quinn Emanuel Urquhart & Sullivan LLP representing Purdue. “We welcome the opportunity to sit down with the court, hear your ideas, and try to be as productive as we can.”

Purdue said late last year it was working on an “expedited basis” with more than 30 state attorneys general that hadn’t yet sued but are probing the opioid crisis. That disclosure came in a letter to Ohio Attorney General Mike DeWine urging him to rejoin those talksrather than pursue his own lawsuit.

Judge Polster said Tuesday that he could ask state attorneys general to join the discussions in the multidistrict litigation so defendants wouldn’t be negotiating on several fronts, though he acknowledged he didn’t have power to dictate how state court judges overseeing opioid cases proceed.

Multidistrict litigation, initially meant to streamline pre-trial motions, is increasingly used as leverage to strike a settlement. Volkswagen agreed to a series of deals in 2016 totaling more than $17 billion to resolve civil claims with consumers and others over its diesel-emissions cheating scandal, without the case going to trial.

Judge Polster said his branch of government seemed to be the least likely one to try to resolve the opioid crisis. Ideally, he said, solutions should come from federal and state government. But, he said, “They haven’t seemed to have done a whole lot. So it’s here.”

Write to Sara Randazzo at sara.randazzo@wsj.com

https://www.wsj.com/articles/federal-judge-seeks-speedy-resolution-of-opioid-lawsuits-1515518275

iPhones and Children Are a Toxic Pair, Say Two Big Apple Investors

January 8, 2018

Two activist shareholders want Apple to develop tools and research effects on young people of smartphone overuse and addiction

Teens took a group selfie with a smartphone in New York’s Times Square on Dec. 1.
Teens took a group selfie with a smartphone in New York’s Times Square on Dec. 1. PHOTO: DREW ANGERER/GETTY IMAGES

The iPhone has made Apple Inc. and Wall Street hundreds of billions of dollars. Now some big shareholders are asking at what cost, in an unusual campaign to make the company more socially responsible.

A leading activist investor and a pension fund are saying the smartphone maker needs to respond to what some see as a growing public-health crisis of youth phone addiction.

Jana Partners LLC and the California State Teachers’ Retirement System, or Calstrs, which control about $2 billion of Apple shares, sent a letter to Apple on Saturday urging it to develop new software tools that would help parents control and limit phone use more easily and to study the impact of overuse on mental health.

The Apple push is a preamble to a new several-billion-dollar fund Jana is seeking to raise this year to target companies it believes can be better corporate citizens. It is the first instance of a big Wall Street activist seeking to profit from the kind of social-responsibility campaign typically associated with a small fringe of investors.

Adding splash, rock star Sting and his wife, Trudie Styler, will be on an advisory board along with Sister Patricia A. Daly, a nun who successfully fought Exxon Mobil Corp. over environmental disclosures, and Robert Eccles, an expert on sustainable investing.

The Apple campaign would be unusual for an activist like Jana, which normally urges companies to make financial changes. But the investors believe that Apple’s highflying stock could be hurt in coming decades if it faces a backlash and that proactive moves could generate goodwill and keep consumers loyal to Apple brands.

“Apple can play a defining role in signaling to the industry that paying special attention to the health and development of the next generation is both good business and the right thing to do,” the shareholders wrote in the letter, a copy of which was reviewed by The Wall Street Journal. “There is a developing consensus around the world including Silicon Valley that the potential long-term consequences of new technologies need to be factored in at the outset, and no company can outsource that responsibility.”

Obsessive teenage smartphone usage has sparked a debate among academics, parents and even the people who helped create the iPhone.

Two teenage boys use smartphones in Vail, Colo., in June 2017.
Two teenage boys use smartphones in Vail, Colo., in June 2017. PHOTO: ROBERT ALEXANDER/GETTY IMAGES

Some have raised concerns about increased rates in teen depression and suicide and worry that phones are replacing old-fashioned human interaction. It is part of a broader re-evaluation of the effects on society of technology companies such as Google and Amazon.com Inc. and social-media companies like Facebook Inc. and Snap chat owner Snap Inc., which are facing questions about their reach into everyday life.

Apple hasn’t offered any public guidance to parents on how to manage children’s smartphone use or taken a position on at what age they should begin using iPhones.

Apple and its rivals point to features that give parents some measure of control. Apple, for instance, gives parents the ability to choose which apps, content and services their children can access.

The basic idea behind socially responsible investing is that good corporate citizenship can also be good business. Big investors and banks, including TPG, UBS Group AG and Goldman Sachs Group Inc. are making bets on socially responsible companies, boosting what they see as good actors and avoiding bad ones.

Big-name activists increasingly view bad environmental, social or governance policies as red flags. Jana plans to go further, putting its typical tools to work to drive change that may not immediately pay off.

Apple is an ambitious first target: The combined Jana-Calstrs stake is relatively small given Apple’s nearly $900 billion market value. Still, in recent years Apple has twice faced activists demanding it pare its cash holdings, and both times the company ceded some ground.

Chief Executive Tim Cook has led Apple’s efforts to be a more socially responsible company, for instance on environmental and immigration issues, and said in an interview with the New York Times last year that Apple has a “moral responsibility” to help the U.S. economy.

Apple has shown willingness to use software to address potentially negative consequences of phone usage. Amid rising concerns about distracted driving, the company last year updated its software with a “do not disturb while driving” feature, which enables the iPhone to detect when someone is behind the wheel and automatically silence notifications.

The iPhone is the backbone of a business that generated $48.35 billion in profit in fiscal 2017. It helped turn Apple into the world’s largest publicly listed company by market value, and anticipation of strong sales of its latest model, the iPhone X, helped its stock rise 50% in the past year. Apple phones made up 43% of U.S. smartphones in use in 2016, according to comScore , and an estimated 86 million Americans over age 13 own an iPhone.

Jana and Calstrs are working with Jean M. Twenge of San Diego State University, who chronicled the problem of what she has dubbed the “iGen” in a book that was previewed in a widely discussed article in the Atlantic magazine last fall, and with Michael Rich of Harvard Medical School and Boston Children’s Hospital, known as “the mediatrician” for his work on the impact of media on children.

The investors believe both the content and the amount of time spent on phones need to be tailored to youths, and they are raising concern about the public-health effects of failing to act. They point to research from Ms. Twenge and others about a “growing body of evidence” of “unintentional negative side effects,” including studies showing concerns from teachers. That is one reason Calstrs was eager to support the campaign, according to the letter.

The group wants Apple to help find solutions to questions like what is optimal usage and to be at the forefront of the industry’s response—before regulators or consumers potentially force it to act.

The investors say Apple should make it easier and more intuitive for parents to set up usage limits, which could head off any future moves to proscribe smartphones.

The question is “How can we apply the same kind of public-health science to this that we do to, say, nutrition?” Dr. Rich said in an interview. “We aren’t going to tell you never go to Mickey D’s, but we are going to tell you what a Big Mac will do and what broccoli will do.”

Write to David Benoit at david.benoit@wsj.com

Appeared in the January 8, 2018, print edition as ‘Investors Prod Apple On Child iPhone Use.’

https://www.wsj.com/articles/iphones-and-children-are-a-toxic-pair-say-two-big-apple-investors-1515358834

Addictive gaming to be recognised as disease: WHO

January 5, 2018

AFP

© AFP/File | “Gaming disorder” can lead to computer games taking “precedence over other interests”, according to the current working definition
GENEVA (AFP) – 

“Gaming disorder” will be recognised as a disease later this year following expert consensus over the addictive risks associated with playing electronic games, the World Health Organization said Friday.

The disorder will be listed in the 11th edition of the International Classification of Diseases (ICD), to be published in June, WHO spokesman Tarik Jasarevic told reporters in Geneva.

WHO is leading the process of updating ICD-11, which includes input from global health practitioners.

The current working definition of the disorder is “a pattern of gaming behaviour, that can be digital gaming or video gaming, characterised by impaired control over gaming, increased priority given to gaming over other activities to the extent that gaming takes precedence over other interests,” Jasarevic said.

Other symptoms include “the continuation and escalation of gaming despite the occurrence of negative consequences”.

The provisional guidelines say that an individual should demonstrate an abnormal fixation on gaming for at least a year before being diagnosed with the disorder, which will be classified as an “addictive behaviour”, Jasarevic said.

Anecdotal evidence suggests that the condition disproportionately effects younger people more connected to the ever-expanding online gaming world.

But the WHO spokesman cautioned that it was premature to speculate on the scope of the problem.

“Gaming disorder is a relatively new concept and epidemiological data at the population level are yet to be generated”, he said.

Despite the lack of hard data, “health experts basically agree that there is an issue” and that official inclusion in the ICD is the next appropriate step, Jasarevic said.

“There are people who are asking for help”, he added, noting that formal recognition of the condition will help spur further research and resources committed to combatting the problem.

The U.S. Opioid Crisis: How Can We Remedy? — U.S. has five percent of the world’s population but uses 50 percent of the world’s opioids

January 5, 2018

By 

Forbes

This post was contributed by Gerald McKenna, MD, a board member of the Physicians Foundation and the CEO and Medical Director of his private practice in Addiction Medicine, McKenna Recovery Center.

(Photo credit: Shutterstock)

The United States is in the midst of an opioid crisis unlike anything we have seen in medicine since the HIV epidemic in the 1990s. Imagine, the U.S. has five percent of the world’s population but uses 50 percent of the world’s opioid analgesics. In 2017 alone, an opioid overdose was the cause of more than 60,000 deaths—quadruple the number of deaths since 1999. This death rate continues to increase and shows no signs of slowing.

In order to understand the origins of this opioid epidemic, we need to go back to the early 1990s. New guidelines on analgesic treatment and quality assurance issued by the U. S. government (1995), the American Pain Society (1995), and the World Health Organization (1996) tell the story.

There was a movement to treat pain more adequately than what had been done in prior decades. Pain was to be labeled as the fifth vital sign in medicine, in addition to blood pressure, pulse, respirations, and temperature. As a result, physicians were ordered to adequately evaluate and address pain in their patients. As part of this order, there was a requirement in California to obtain at least ten Continuing Medical Education (CME) credits per year to ensure that all physicians with a California license adhered to the new policy. Physicians who did not comply or who had complaints against them for inadequate pain control were sometimes referred to peer-review committees to have their noncompliance evaluated.

The new recommendations appeared successful and were quickly adopted nationwide.  It was not unreasonable to expect that a trained physician would be able to determine the origins of pain and provide adequate treatment for it. Thus, the production and sale of short-acting opioids increased dramatically.

Unfortunately, the CME courses that were offered to physicians attempted to address the proper prescribing of opioids, but did not necessarily emphasize the use of non-opioid approaches to treating chronic pain.

As the opioid crisis has reached a climax, physicians have been forced to look carefully at their prescribing habits. Physicians’ continuing medical education programs are now deemphasizing the use of opioids in all but acute pain, such as for postsurgical analgesia.

A corollary to this reeducation and reconsideration by physicians is the challenge to help reduce opioid use for patients who have been placed on very high levels of opioid analgesics for years. This is an incredibly important task – to reverse the alarming opioid crisis we find ourselves in today as a country.

The Physicians Foundation, of which I am a board member, was established to aid physicians in dealing with serious emerging problems in our healthcare system. The opioid crisis is an issue the Foundation recognizes as a critical one that must be addressed. That begins with properly educating our physicians, then treating patients using effective and safe means.

There are a series of actions that need to be taken if we are going to affect the opioid crisis.

  • Educate physicians, nurses, pharmacists, medical students, residents and the public on the treatment of acute and chronic pain.
  • Pharmaceutical companies need to recognize their role in creating this crisis and work with the medical profession to address it.
  • Educate patients regarding treatment approaches to both acute and chronic pain.
  • Implement a group model for patients who present to primary pain clinics with complaints of chronic pain. This model is well suited to educate patients regarding the clinic’s approach to the use of opioid analgesics, central and peripheral mechanisms involved in pain, non-medication approaches to pain and empowerment to support each other in dealing with chronic medical conditions involving pain.
  • Encourage physicians to take the online training in the use of buprenorphine, an often lifesaving medication.

In a similar vein, addictionists have come to understand that the physical and emotional reaction to chronic drugs can easily lead to a chemical use disorder, the term used to describe the chronic medical conditions formerly called addiction or drug dependence. There has traditionally been inadequate training in medical schools and residencies regarding the diagnosis and treatment of chemical use disorders, but the American Society of Addiction Medicine has provided many educational opportunities online and in courses around the country to train physicians in the recognition, early treatment, and referral for further intervention of these chronic medical illnesses.

Physicians need to be trained in the early signs and symptoms of chemical use disorders, including drug-seeking behavior, physician manipulation, seeking prescription from multiple physicians, and using emergency rooms and urgent care clinics to obtain opioid analgesics for non-existing or minor injuries.

Our health care system needs to be revamped to provide this equal recognition. Without these changes, chemical use and psychiatric disorders will always be sidelined and will not be recognized as chronic medical problems in need of equal treatment.

The opioid epidemic is vast and increasing. We have the tools at hand to be able to successfully intervene in this serious medical problem. It will take congress and the will of the people in pressuring our congressional leaders to support the readily available solutions to this deadly problem.

https://www.forbes.com/sites/physiciansfoundation/2018/01/03/the-u-s-opioid-crisis-how-can-we-remedy/#25cd65ac3768

Fox News Doctor Spreads Marijuana Propaganda

January 4, 2018

Dr. Marc Siegel appeared on the Fox News Channel morning program on Wednesday, January 3, 2018 and had nothing good to say about California’s new marijuana law. Siegel is convinced that marijuana in a “gateway drug” and poses a danger for many people who are pregnant, driving a motor vehicle, or working in an academic environment. He seemed to say that routine, prolonged use caused brain damage. Peace and Freedom will try to get the video of his remarks Wednesday on “Fox and Friends” because he issued a clear cautionary note to California….

Read more: National Institutes of Health Report Include

The video is athttps://www.youtube.com/watch?v=FxyaehZvU6w

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Talented ... Philip Seymour Hoffman poses for a portrait at Sundance Film Festival in January. Picture: AP.

Talented … Philip Seymour Hoffman poses for a portrait at Sundance Film Festival in January. Picture: AP. Source: AP

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The casket of Philip Seymour Hoffman leaves the Church of St Ignatius in Manhattan on Friday as family and friends mourned the loss of the talented actor

The casket of Philip Seymour Hoffman leaves the Church of St Ignatius in Manhattan as family and friends mourned the loss of the talented actor who died at age 46.

John Belushi

From left to right: Philip Seymour Hoffman; Cory Monteith; Lindsay Lohan and Heath Ledger

“Home Alone” star Macaulay Culkin. Many believe he is addicted to heroin.

 

Angry: Charlie is reportedly furious that his ex has fled rehab

Angry? Charlie Sheen

Alec Baldwin and a member of the paparazzi get into an altercation in New York City, outside of Grey Dog restaurant, in front of the actors wife, Hilaria, on Aug. 27, 2013. - Provided courtesy of Freddie Baez / Startraksphoto.com

Alec Baldwin, paparazzi member scuffle in New York in front of Hilaria

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The Number of Great Entertainers Felled by Drugs and Alcohol Is Staggering

Compiled by Peace and Freedom

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Amy Winehouse predicted that she would join the ghostly ranks of the 27 Club
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One of the greatest tragedies to strike previously was the death of Heath Ledger, who played the Joker in The Dark Knight. The actor was found dead in his Manhattan apartment in January 2008
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Nearly one year after Whitney Houston‘s shocking death, her mom Cissy Houston often asks herself: “Could I have saved her somehow?”

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Fallen star: Mindy McCready reached the peak of her career with her debut single 'Ten Thousand Angels' in 1996

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http://en.wikipedia.org/wiki/Amy_Winehouse

File:Amy Winehouse - Rehab.jpg

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John Belushi

Jim Morrison

Marilyn Monroe

“Stars” that died of drugs and alcohol:

http://www.drugs.com/celebrity_deaths.html

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Brain problems: Junior Seau experienced insomnia and other symptoms of brain trauma after retiring from the NFL - he committed suicide by shooting himself in the chest so his brain could be studied.

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Brain problems: Junior Seau experienced insomnia and  other symptoms of brain trauma after retiring from the NFL – he committed  suicide by shooting himself in the chest so his brain could be studied

United Nations have called for a balanced approach to illegal drug problems by putting people first through care for health and human rights

January 1, 2018
At a joint training program on “Regional Law Enforcement in New Psychoactive Substances” in Singapore, the UN Office on Drugs and Crime said officials from 11 Southeast Asian and Pacific Island countries made the call that reaffirms the emphasis on health and welfare of humankind as the founding purpose of international drug conventions. UN/Released

MANILA, Philippines — Member-states of the United Nations have called for a balanced approach to the world problem on drugs by putting people first through approaches that attend to health and human rights, and promote the safety and security of all societies.

At a joint training program on “Regional Law Enforcement in New Psychoactive Substances” in Singapore, the UN Office on Drugs and Crime (UNODC) said officials from 11 Southeast Asian and Pacific Island countries made the call that reaffirms the emphasis on health and welfare of humankind as the founding purpose of international drug conventions.

Singapore and UNODC teamed up for a pilot initiative to combat the growing and global challenges posed by new psychoactive substances. It is aimed at helping developing countries in the region achieve development goals, including the 2030 Agenda for Sustainable Development.

It also supports the implementation of the relevant operational recommendations outlined in the Outcome Document of the 2016 UN General Assembly Special Session on the World Drug Problem, which called for member states to adopt measures to address the challenges posed by new psychoactive substances (NPS).

“Let us be clear, the threat of NPS is very real. NPS, including fentanyl analogues, continue to multiply and evolve. Fentanyl analogues, for example, are helping to fuel tragic increases in opioid overdoses,” said UNODC executive director Yury Fedotov.

During the training, experts and law enforcement practitioners from Singapore, the US Drug Enforcement Administration and Australian Federal Police shared their expertise on legislative responses, forensic identification, field detection, enforcement and diversion of precursor chemicals.

The course allowed participants to gain a better understanding of the recent trends in the global and regional markets for NPS and to identify best practices in its detection and investigation.

It was conducted under the Singapore Cooperation Program, which is the country’s primary platform in extending technical assistance to the developing world. Over 170 countries and territories have taken part in the program since its inception in 1992.

Meanwhile, UNODC said technology has become a cornerstone of criminality in just two decades, making close cooperation among countries a necessity to succeed against this challenge.

Criminals, after 20 years, are the unintended beneficiaries of technology and globalization as it enables criminals to work across regions, increasing their reach, their crimes and their profits, the group added.

http://www.philstar.com/headlines/2018/01/02/1773869/un-drug-problem-people-first-through-health-rights

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America’s opioid epidemic began more than a century ago – with the civil war

January 1, 2018

By Jessica Glenza
The Guardian
December 30, 2017

An estimated two million people abused opiates during the war, after using drugs disseminated by healthcare providers, doctors and nurses to stem pain

Five Union army officers in a field outside Fairfax, Virginia in June 1863.
 Five Union army officers in a field outside Fairfax, Virginia, in June 1863. Photograph: Alexander Gardner/Getty Images

For many Americans, it was the prescription of a well-meaning physician that sent them down the dark road.

Aggressive marketing and over-prescribing of painkillers touched off a scourge of opiate addiction and Congress, pushed by the destruction it had wrought, introduced a new law to reform painkiller prescribing.

It was 1915 and Congress was considering what would become the first law to criminalize drug use, the Harrison Narcotic Act. By this time, addiction had already touched middle-class housewives, immigrants, veterans and even physicians hoping to soothe their own aches and pains. Between the 1870s and 1880s, America’s per capita consumption of opiates had tripled.

More than a century later, Americans are fighting some of the same demons.

“I freely admit that I did not expect another wave of medical opiate addiction in my lifetime,” said David Courtwright, a professor of history at the University of North Florida, and an expert on the history of drug use in the US.

“It’s similar in the sense that millions of Americans who are suffering from chronic painful conditions have become addicted to opium-based medicines or their synthetic equivalents,” said Courtwright. “But there’s also a difference,” he said. “Medicine today is very sophisticated, pharmaceutical marketing is very sophisticated … There’s nothing like Purdue Pharma in the late 19th century,” Courtwright said.

Courtwright was referring to the maker of Oxycontin. Purdue received Food and Drug Administration approval of Oxycontin in 1995, a move which many believe kicked off the wave of opioid abuse gripping America in the 21st century.

Since 1999, more than half a million Americans have died of drug overdoses. Recent data shows the trend accelerated in 2016, when 63,600 people were killed by overdoses and the rate of Americans dying increased by 21%.

Declaring America’s overdose epidemic a public health crisis, Donald Trump told a White House audience in October: “Nobody has seen anything like what is going on now.” But experts dispute that characterization.

“I think we see history repeat itself,” said Anna Lembke, an addiction expert and behavioral scientist at Stanford University. “Increased opioid use during the civil war was first and foremost disseminated by healthcare providers, nurses and doctors, who were trying to stem the pain of wounded soldiers. That gave way to a pandemic of opioid addiction.”

A pharmacist counts pain medication at a South Portland Pharmacy on 19 February 2014.
Pinterest
 A pharmacist counts pain medication at a South Portland Pharmacy on 19 February 2014. Photograph: Portland Press Herald/Getty Images

Richard Heimer, a professor of epidemiology and pharmacology at the Yale University School, said there were an estimated two million people who abused opiates. “It did come to be called, immediately after the civil war, morphonism or soldier’s disease,” he said.

However, Courtwright warns veterans were not the only people afflicted by addiction in the late 19th century.

“No precise estimate exists for the number of addicted veterans; we can be sure, however, they comprised a minority of overall opiate addicts,” he wrote in the Civil War Veteran: A Historical Reader. With easy access to morphine and syringes, physicians used; white gamblers and sex workers often smoked opium; and respectable white women used laudanum for menstrual cramps.

“There was a massive opioid epidemic after the civil war,” said Robert Heimer, a professor of epidemiology and pharmacology at Yale University School of Public Health. “Except is wasn’t a black market – it was a perfectly legal market filled with patent medicines that contained not just cocaine and opiates, morphine mostly, but also alcohol.”

Laudanum, Heimer said, “was commonly taken as a relief of colds, coughs, and in stronger form was particularly good for lung diseases such as tuberculosis, which was common at the time, in addition to being widely used in combat situations to facilitate amputations”.

Where Purdue Pharma marketed Oxycontin to doctors as a “continuous around-the-clock analgesic” formulation of semi-synthetic oxycodone great for chronic pain, Mrs Winslow’s Soothing Syrup marketed morphine and alcohol to parents as a “perfectly harmless and pleasant” way to produce “quiet sleep, by relieving the child from pain”.

History, Courtwright said, offers some “grounds for optimism”. Beginning in the 1890s, physicians began to criticize colleagues who reached for the prescription pad when patients had aches and pains; pharmacists refused to sell heroin or cocaine (then both legal); and in 1906 muckraking journalists and campaigners successfully argued for reforms to end the sale of patent medicines.

By 1915, Courtwright argues in the New England Journal of Medicine, “the Harrison Act closed the barn door after the horse was back in”. Problematically, the Harrison Act also became the first law to criminalize drug use and opiate maintenance therapies, such as methadone and buprenorphine.

That stigma stuck. Despite double blind clinical trials showing the efficacy of methadone, abstinence-based 12-step programs are still much more common in the US, and politicians have so far failed to find the courage to fund such evidence-based treatments.

Waves of addiction have also hit the US since 19th century – adulterated alcohol killed thousands during the 1920s Prohibition era; barbiturates and amphetamines were abused in the 1930s and 1940s; heroin addiction claimed lives in the 1960s; valium addiction in the 1970s.

“The problems of globalization and loss of prestigious jobs have damaged community wellbeing in areas that were previously spared from the kind of malaise that led to large-scale opioids use in the inner cities in the 60s and 70s,” said Heimer. “The lessons are that community disadvantage and community alienation sets the stage for youthful experimentation to turn into tragedy.”

https://www.theguardian.com/science/2017/dec/30/americas-opioid-epidemic-began-more-than-a-century-ago-with-the-civil-war

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Philippines, Indonesia Kill People in The Name of Ending Drug Abuse — Is It Working?

December 30, 2017

During 2017, Indonesia followed the Philippines in a very aggressive police crackdown policy on illegal drug users and abusers. Human rights groups have said these measures cost too many lives and should be curtailed. Below is the latested editorial from The Jakarta Post.

Jakarta Post
Indonesia

EDITORIAL: Addiction to killing

Chief of the National Drug Agency (BNN), Comr. Gen. Budi Waseso boasted Wednesday, Dec 27, that police and BNN officers had shot and killed 79 suspected drug dealers this year alone. (Shutterstock.com/File)

The death penalty and shooting drug dealers on sight is the most effective way to end drug abuse, according to many Indonesians including President Joko “Jokowi” Widodo and his chief of the National Drug Agency (BNN), Comr. Gen. Budi Waseso.

However, it remains unclear how authorities can close loopholes for organized crime here. Southeast Asia’s illicit drug trade is estimated annually at US$30 billion, quite apart from the lucrative smuggling of people, weapons, timber, wildlife and counterfeit goods across borders, according to the United Nations Office on Drugs and Crime.

What is for certain is that Indonesia is blithely trampling on due process, not to mention human rights, as chief Budi boasted Wednesday that police and BNN officers had shot and killed 79 suspected drug dealers this year alone.

Few who know a drug addict or cured survivor sympathize with those who were shot; but we should not be dependent on trigger-happy sheriffs.

BNN’s Budi has echoed the tough rhetoric of National Police chief Gen. Tito Karnavian and President Jokowi, saying law enforcers had “enough ammunition for 58,000” arrested suspects this year. He jokingly added officers had hoped they would resist so they could be shot, but the suspects immediately surrendered during the raids; not very funny, unfortunately.

Are our leaders seeking to steal the limelight of Philippine President Rodrigo Duterte? Since he took office in mid-2016 the neighboring country’s drug war has left over 6,000 drug pushers, addicts and those associated with them dead; a few infants also died in the crossfire.

At home, of the 79 shot this year including 10 foreigners, it also remains unclear how many were shot because law enforcers’ or others’ lives were in immediate danger — the National Police’s criteria for using firearms. But it’s too easy to pull the trigger when your President has said, “Gun them down. Have no mercy,” regarding suspected drug dealers resisting arrest.

Health advocates question how Indonesia can curb the epidemic of HIV/AIDS, hepatitis and its complications, as addicts hide and avoid treatment for fear of being criminalized. The Health Ministry records nearly 75,000 people in Indonesia inject drugs, including 36.4 percent diagnosed as HIV-positive. In 2011. the BNN and the University of Indonesia estimated the country had 1.1 million non-injecting drug users. The figures suggest lower estimates than the 4.5 million addicts with up to 50 dying daily from drugs — the oft-cited figures by Jokowi, which won him popular support for the national “drug emergency” and the tough action.

Parents are indeed constantly worried about new drugs being offered to their children, while raids indicate Indonesia is becoming a producer of methamphetamine among other drugs, apart from being a major regional market. But dumping addicts into cells close to convicted terrorists and executing them has significantly helped neither the war on drugs nor on terrorism.

Authorities say we are moving toward more stress on prevention and rehabilitation for drug addicts. But measures harking back to the New Order’s “mysterious shootings,” or Petrus, confirm our old addiction to violence instead of rehabilitating anyone.

http://www.thejakartapost.com/academia/2017/12/29/editorial-addiction-to-killing.html

China says US should do more to cut its ‘enormous’ opioid demand

December 29, 2017

 

Yu Haibin of the China National Narcotics Control Commission speaks during a press conference held in Beijing, China, Thursday, Dec. 28, 2017. (AP)

BEIJING: The United States should take action to reduce demand for the drugs fueling its deadly opioid crisis rather than simply accusing China of being the major source, a top Chinese drug control official said.

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“The biggest difficulty China faces in opioid control is that such drugs are in enormous demand in the US,” Yu Haibin of the China National Narcotics Control Commission said at a news briefing, the China Daily reported on Friday.
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US President Donald Trump declared the opioid crisis a public health emergency in October and said he discussed with Chinese President Xi Jinping how to “stop the lethal flow” of the drugs during his visit to China last month.
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Opioids include prescription painkillers, heroin and fentanyl, a highly addictive synthetic drug 50 to 100 times more potent than morphine.
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American law enforcement agencies and drug control experts say most of the fentanyl distributed in the United States, as well as its precursor chemicals, come from China.
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While Chinese officials dispute that assertion, the government has taken steps to crack down on the production and export of them, and has placed fentanyl and other related compounds on its list of controlled substances.
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Yu said the United States should intensify law enforcement and share more police intelligence with Chinese authorities to combat the problem.
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China’s drug control agency said on Thursday that five more precursor chemicals that can be used to produce fentanyl and methamphetamines had been added to its list of controlled substances, the China Daily reported.
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Wei Xiaojun, the deputy secretary-general of China’s National Narcotics Commission, said last month that China did not “deny or reject” that some fentanyl produced in China had made its way to the United States but there was not enough evidence to say most of it originated from China.
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The US Department of Justice indicted two major Chinese drug traffickers in October on charges of making illegal versions of fentanyl and selling the highly addictive drug to Americans over the Internet and through the international mail.