Addiction Research

Research has shown that heavy alcohol use clearly damages retrospective memory, that is, the learning, retention and retrieval of previously presented materials. Less is known about the effects of alcohol on day-to-day memory function, specifically, prospective memory, remembering to do things at some future point in time, and everyday memory, remembering to complete daily activities.A study in the June 2003 issue of Alcoholism: Clinical & Experimental Research uses internet-based methodology to find that heavy alcohol consumption has a negative impact on day-to-day memory."Prospective memory impairments include things like forgetting to send someone a birthday card on time, or forgetting what you're going to say in the middle of a sentence," said Jonathan Ling, a senior lecturer in psychology at the University of Teesside in the United Kingdom and first author of the paper. "Everyday memory failures include telling someone a story that you've told them before, or forgetting where things are normally kept. Obviously we all forget things from time to time, however, heavy users of alcohol make noticeably more of these mistakes than either non- or low-users of alcohol." Ling added that most of what is known about heavy drinkers' retrospective memory function is based on laboratory research, and even less is known about alcohol's effects on normal memory-related tasks that people perform from day to day.For this study, researchers collected data from 763 participants (465 female, 298 males) using a specially created website on the University of Westminster web server. Memory was assessed using two self-report questionnaires: the Prospective Memory Questionnaire (PMQ), and the Everyday Memory Questionnaire (EMQ). The PMQ has three sub-scales that measure short-term habitual PM, long-term episodic PM, and internally cued PM. Respondents also self-reported their level of use of alcohol and other drugs by responding to the UEL (University of East London) Recreational Drug Use Questionnaire.The results indicate a dose-dependent effect of alcohol use on day-to-day memory function."We found that heavy users of alcohol reported making consistently more errors than those who said that they consumed little or no alcohol," said Ling. "A typical heavy user of alcohol reported over 30 percent more memory-related problems than someone who reportedly did not drink, and almost 25 percent more problems than those who stated they drank only small amounts of alcohol. More specifically, those participants who reported higher levels of alcohol consumption were more likely to miss appointments, forget birthdays and pay bills on time. Deficits in everyday memory included problems with remembering whether they had done something, like locking the door or switching off the lights or oven, or forgetting where they put items like house keys."Colin R. Martin, a lecturer in mental health in the department of health sciences at the University of York, and honorary consultant psychologist to the Addiction Service and National Monitoring and Evaluation Center of the Salvation Army, said these results "contribute to the increasing evidence base that a diverse range of memory impairment is associated with excessive alcohol consumption. This study is important because it extends our knowledge of alcohol-related memory impairment to everyday situations that most people can identify with, in contrast to laboratory-based memory tasks."
"We also found a significant increase in reported memory problems by people who claimed to drink between 10 and 25 units each week in comparison to non-drinkers," added Ling. "This is an important finding, as it indicates that even if people are using alcohol within the limits suggested by U.K. government guidelines, these individuals still report experiencing memory problems."

new study that reports sugar stimulates the same part of the brain that is activated in other addictions. Scientists from Princeton University showed that sugar caused neurochemical changes in the brains of rats in the same way as drugs that are abused. The animals experienced cravings, withdrawal and bingeing, which typifies “addiction”.By feeding the rats sugar water, they round there was a surge of the neurotransmitter dopamine, just like drugs, alcohol and nicotine. When they used an alternating schedule of deprivation and bingeing, the dopamine effect was even stronger and after three weeks the rats showed signs of withdrawal.What I found interesting is that after periods of abstinence, the rats ingested more sugar than before and if sugar was not available, they drank more alcohol. They also deprived the rats of food for 4 hours after they awoke, which duplicates skipping breakfast in the morning. The animals would then eat a larger quantity of food and drink even more sugar solution.So what does all of the mean? Although you cannot extrapolate rat studies to humans, it does suggest that dieting, bingeing on sugar and skipping meals may create biochemical changes in the brain that sabotage our ability to maintain a healthy weight. Since many overweight people do these things, it is not a surprise that the weight increases and it is a viscous cycle.If sugar does, indeed, have addictive like qualities, it would help to explain the obesity/diabetes epidemic that our world is facing. High fructose corn syrup is hidden in so many food products and is the main ingredient in soft drinks. We may be creating unhealthy addictions early in children that go far beyond the increased empty calories.The brain changes in anorexia and bulimia may also be a result of a sugar effect. There are millions of people who classify themselves as “sugar addicts”. These preliminary results may validate some of their proclamations.

Europe now has more than 12 million cocaine users, 1.5 million heroin users and 9.5 million ecstasy users, a conference on the EU's drugs strategy heard today.
Fianna Fáil MEP Eoin Ryan, a former junior minister with responsibility for the national drugs strategy, told the event that fighting drug crime means sharing intelligence to track criminals across borders.“We need to increase our knowledge of all aspects of drug use through more and better co-ordinated research and data, including information on drug related crime and how international drug cartels operate. But to achieve these goals, international co-operation is urgently needed,” Mr Ryan said.“We now live in an internal market of 27 EU member states. No one European country can defeat the international drug barons on their own.”Mr Ryan said the EU is also the largest financial contributor of aid to Afghanistan in an effort to reduce heroin production, “albeit with limited success to date”.A total of 90 per cent of all heroin sold on the streets of Ireland come directly from the poppy fields of Afghanistan, he added."The European Union is to increase the number of information programmes that it is running in Europe to highlight the dangers of illegal drug abuse. Vulnerable groups in our society will be particularly targeted."
“A European Citizens Alliance on Drugs contains principles and commitments to guide people as to how they should deal with drug related issues as they arise within their environment.”The conference entitled How the EU Action Plan for Drugs 2009-2012 can benefit the people of Dublin also heard from Minister of State for Drugs Strategy John Curran, Lord Mayor of Dublin Eibhlin Byrne, Sebastian Saville, an advisor to the European Parliament on EU drug policy issues, and crime journalist Paul Williams.Mr Curran said the Government's own drug strategy included focusing on reducing the demand for drugs and the supply of drugs. It also focused on treatment, including harm reduction, and on prison-based measures and rehabilitation measures, he said.He said he would be organising a working group on drugs later this month.Sebastian Saville, an adviser to the International Drug Policy Consortium, said drugs strategy should help policy makers to reach "informed decisions" based on the best available evidence on drugs.He said the focus in the drugs debate was sometimes exclusively on numbers rather than on the harm done."Would we rather have a million people who smoke cannabis or 50,000 chaotic crack users?"He said there was a "lack of evidence" on interdiction as a means of controlling drugs.Mr Saville said that drug seizures marked only a small percentage of all the drugs reaching the market and it had to be considered whether the actions of policy makers were proportional to the result. Future policy had to be based on "sound evidence" but the issue was complicated, Mr Saville said.Speakers at the conference expressed concern that the EU strategy focused on drugs, without any emphasis on the harm done by alcohol.Prof Joe Barry, public health consultant and former president of the Irish Medical Organisation said: "There seems to be a reluctance in Ireland to link drugs and alcohol in public policy terms. If we don't have an alcohol strategy, our drugs strategy won't be as effective."Lord Mayor of Dublin Councillor Eibhlin Byrne said those who used drugs and those who were pushing drugs and "causing havoc in our communities" needed to be dealt with in different ways.Ms Byrne said she was aware of women on their "second or third credit union loan" to pay off dealers who were threatening to "break legs or to damage their children".She said she was aware children as young as 10 years old were being used to carry drugs around the city for dealers because they were less likely to be challenged by gardai.She said that 20 years ago, she would have advised women and communities being intimidated in this way to undertake marches of protest."I would not advocate that now because I believe it would be dangerous. In the 20 years, human life has become cheaper."Ms Byrne said she was "not a great one" for policies and action plans because "very often the problem is the absence of money in programmes that we feel will address the issues".
She said she was glad that there was an element of funding attached to the EU policy. Although this has yet to be finalised, it is estimated that between €20 million and €25 million will be provided to promote the strategy in local communities throughout the EU.

Cocaine addicts may have brain deficits that predispose them to drug abuse, and abusing drugs appears to make matters worse, U.S. researchers said on Wednesday.
They said images of cocaine addicts' brains reveal abnormalities in the cerebral cortex -- the brain's outer surface -- and these changes relate to dysfunction in areas responsible for attention and decision-making."These data point to a mixture of both drug effects and predisposition underlying the structural alterations we observed," said Dr. Hans Breiter of Massachusetts General Hospital, whose research appears in the journal Neuron.Breiter and colleagues compared magnetic resonance images, or MRIs, of 20 cocaine addicts with 20 carefully matched volunteers to map out cocaine-related differences in the brain.Compared to their healthy counterparts, cocaine addicts had far less overall volume in the cortex, the outer layer that helps plan, execute and control behavior. These differences were especially pronounced in areas regulating reward, attention and decision-making.They also noticed that while the healthy volunteers tended to have thicker areas in some frontal regions on the right side of the brain, this was reversed in the addicts. And overall, the addicts had less variation in the thickness of their cortex.
Differences in the right and left side of the brain are important because they typically suggest a genetic cause, Breiter said.The researchers also found changes in the cingulate -- another reward center -- that appeared to correspond with the length of cocaine use but not nicotine or alcohol use, suggesting that these changes were the result of long-term cocaine exposure."Human studies have shown differences in how addicts make judgments and decisions, but it is not well understood how these differences relate to alterations in the structure of the brains of addicts," Breiter said in a statement.New research findings suggest that structural abnormalities in the brains of cocaine addicts are related in part to drug use and in part to a predisposition toward addiction. The research, published by Cell Press in the 9th October issue of the journal Neuron, maps the topography of the addicted brain and provides new insight into the effect of cocaine on neural systems mediating cognition and motivation.'Human studies have shown differences in how addicts make judgements and decisions, but it is not well understood how these differences relate to alterations in the structure of the brains of addicts. Claims have been made that cocaine, potentially in connection with alcohol or other drugs, may be toxic to brain cells. We sought evidence supporting a hypothesis that brain thickness is reduced in some brain regions in addicts, is related to altered decision-making and cognition, and might to some limited degree, be connected to their exposure to cocaine,' explains senior study author Dr Hans Breiter from Massachusetts General Hospital.Dr Breiter and colleagues found that brain regions involved with regulation of attention and reward, specifically the dorsolateral prefrontal cortex (DLPFC) and insular cortices, were significantly thinner in cocaine addicts when compared with matched controls. Behavioural tests revealed that the thinner cortex was associated with restrictions in preference-based judgement and decision-making, and with less accurate effortful attention. A general reduction in the level of preference and in the range of decisions reflecting these preferences can be considered an example of a fundamental feature of addiction - the loss of interest in many things outside of drug use.Some cortical thickness differences were associated with years of drug use, but the researchers also observed differences in the symmetry of DLPFC thickness between control subjects and cocaine addicts that suggested predisposition to drug abuse. 'In human and animal studies, differences in the structure of the right and left sides of the brain are important for many behaviours, and when these normal differences in brain structure are altered, there may be a genetic basis for the change. We found an altered right/left relationship in a part of the frontal cortex that was also associated with altered judgement and decision-making in addicts. We further found that the overall brain thickness in the cocaine addicts was more uniform across the brain, which is quite different from what is observed in non-drug users. These differences did not correlate with any drug use measure. Together, this set of findings point to predisposing factors being a potential contributing factor to the addiction,' explains Dr Breiter.In total, these observations provide evidence that cortical thickness abnormalities associated with cocaine addiction may be a reflection of both drug use and a preexisting inclination to drug abuse. 'A fundamental component of addiction may involve adaptations and/or developmental predispositions involving brain regions necessary for judgement and decision-making regarding complex rewards and attention towards goal-objects. Addiction thus may represent a complex phenotype with multiple effects necessary for compulsive drug use, and the resulting restriction in the range of behaviours they show,' concludes Dr Breiter.

World Health Organization study published in July of this year noted that 16.2 percent of those surveyed in the United States had tried cocaine at least once. The latest available research from the Substance Abuse and Mental Health Services Administration found cocaine use on the rise and noted that 70 percent of new "initiates" to cocaine "were aged 18 or older." In the Colombian magazine Semana, a recent interview with two female survivors of a paramilitary massacre described being taken to a nearby soccer field and made to watch as the members of their small town of El Salado were alternatively shot at close range or crudely hacked to death by large machetes. And at every death, of which there were sixty six, the paramilitaries, some of whom were said to be in a drugged stupor, banged drums. The members of the unit that committed this act have admitted their culpability but described the victims as "guerrillas." What does this have to do with the broad leafy expanses of our New England campus? Simply this, the paramilitaries, equally culpable Marxist guerrillas, the corrupt judges, bought politicians and systematic violence that plagues the Andean republic of Colombia is financed and supported by the sale of a chalky white powder, the end result of a complicated refining process of that well respected, hardy, native plant, coca. At every stage of its production and transportation from its habitat in the Andes to that great market that is the United States, this product steadily acquires a darker tincture as men and women found inconvenient to its sale and movement are permanently removed or silenced. Thus frictions in the market are lessened and profits made. The reason I write this is that statistics would say, though it is impossible to conclude with any certainty, that there are independent minded students and faculty on this campus that use cocaine. They may in their defense believe that they are merely acting out on a personal freedom that is long cherished in this country, that the harm done is merely to themselves, to their own body to which they are ultimately responsible. In fact it would be easy to say that at whatever price fluctuation, a gram of cocaine is the cheapest way to ensure the most misery across the widest swath of area. With one small exchange one can tingle a malevolent chain that stretches across hemispheres and bloodies by in large the poorest and the most deprived of the Americas. Progress, the miracle of globalization, and something to consider on a Saturday night.

"The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are often unlabeled and few include warnings about the potential health risks of caffeine intoxication," says Roland Griffiths, Ph.D., one of the authors of the article that appears in the journal Drug and Alcohol Dependence (September 2008).Johns Hopkins scientists who have spent decades researching the effects of caffeine report that a slew of caffeinated energy drinks now on the market should carry prominent labels that note caffeine doses and warn of potential health risks for consumers.The market for these drinks stands at an estimated $5.4 billion in the United States and is expanding at a rate of 55 percent annually. Advertising campaigns, which principally target teens and young adults, promote the performance-enhancing and stimulant effects of energy drinks and appear to glorify drug use.
Without adequate, prominent labeling; consumers most likely won't realize whether they are getting a little or a lot of caffeine. "It's like drinking a serving of an alcoholic beverage and not knowing if its beer or scotch," says Griffiths.
Caffeine intoxication, a recognized clinical syndrome included in the Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization's International Classification of Diseases, is marked by nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeats (tachycardia), psychomotor agitation (restlessness and pacing) and in rare cases, death.Reports to U.S. poison control centers of caffeine abuse showed bad reactions to the energy drinks. In a 2007 survey of 496 college students, 51 percent reported consuming at least one energy drink during the last month. Of these energy drink users, 29 percent reported "weekly jolt and crash episodes," and 19 percent reported heart palpitations from drinking energy drinks. This same survey revealed that 27 percent of the students surveyed said they mixed energy drinks and alcohol at least once in the past month. "Alcohol adds another level of danger," says Griffiths, "because caffeine in high doses can give users a false sense of alertness that provides incentive to drive a car or in other ways put themselves in danger."
A regular 12-ounce cola drink has about 35 milligrams of caffeine, and a 6-ounce cup of brewed coffee has 80 to 150 milligrams of caffeine. Because many energy drinks are marketed as "dietary supplements," the limit that the Food and Drug Administration requires on the caffeine content of soft drinks (71 milligrams per 12-ounce can) does not apply. The caffeine content of energy drinks varies from 50 to more than 500 milligrams."It's notable that over-the-counter caffeine-containing products require warning labels, yet energy drinks do not," says Chad Reissig, Ph.D., one of the study's authors.Griffiths notes that most of the drinks advertise their products as performance enhancers and stimulants – a marketing strategy that may put young people at risk for abusing even stronger stimulants such as the prescription drugs amphetamine and methylphenidate (Ritalin). A 2008 study of 1,253 college students found that energy drink consumption significantly predicted subsequent non-medical prescription stimulant use, raising the concern that energy drinks might serve as "gateway" products to more serious drugs of abuse. Potentially feeding that "transition" market, Griffiths says, are other energy drinks with alluring names such as the powdered energy drink additive "Blow" (which is sold in "vials" and resembles cocaine powder) and the "Cocaine" energy drink. Both of these products use the language of the illegal drug trade.Griffiths and colleagues are currently collecting case reports of intoxication from energy drinks in children and adolescents.

Cocaine dependence is presently one of the most common forms of addiction in the US, as shown by increasing number of cocaine-related emergency situations reported around the country. Furthermore, according to the National Institute on Drug Abuse, around 35.3 million Americans aged 12 and older have used cocaine in 2006.Cocaine addiction is hard to treat and overdoses are quite common. These two problem areas are a group of chemists seek to address with the development of a new drug for cocaine addiction treatment.According the said group, they are currently studying what may potentially be the most powerful substance for eliminating all traces and effects of cocaine in the body. This substance, they also believe, could lead to the formulation of an effective medication drug that would treat addiction and overdose of the common illicit drug. An effective drug for treatment of cocaine addiction is yet to be discovered and the implications of the current study may prove to be a breakthrough if they come out successful.This current study led by Chang-Guo Zhan points to the use of a substance similar to butyrylcholinesterase (BChE) to be the most promising approach to treating cocaine addiction and overdose. According to the researchers, BChE is a “natural blood protein that helps break down and inactivate the drug.” The problem, however, is that natural occurrences of the said substance proves to be too weak and inefficient to be used for medical purposes such as addiction treatment.The researchers sought to overcome the said discrepancy by designing and producing a potent and stable form of BChE. Using this substance they were able to effectively breakdown and metabolize cocaine present in an addicts body. Moreover, the substance they produced was able to process cocaine up to 2,000 times faster than natural BchE. The group noted that this is very promising as anti-cocaine medication because the reduction of the drug levels in the blood and body is key to preventing cocaine overdose.The group also observed that their substance was able to prevent convulsion, and consequently death, when they injected it to mice that were overdosed with cocaine.The full text of the study’s findings is published in the September 24 issue of the Journal of the American Chemical Society, a weekly publication.

New research has uncovered a fundamental cellular mechanism that may drive pathological drug-seeking behavior. The study, published by Cell Press in the July 31 issue of the journal Neuron, examines the brain's reward circuitry and details strikingly distinct influences of self-administered cocaine compared to natural rewards or passive cocaine injection. Dopamine (DA) neurons residing within the ventral tegmental area (VTA) of the brain are a key part of the brain's natural reward pathway and have been implicated in mediating many types of motivated behaviors. It is well established that the VTA DA neurons can express plasticity of excitatory glutamate synapses in the form of long-term potentiation (LTP), a widespread form of cellular plasticity thought to underlie learning and memory processes. The VTA DA neurons have also been linked with drug addiction, but the cellular mechanisms underlying this phenomenon are not well understood. "While usurpation of learning and memory processes may support persistent seeking of abused drugs, common synaptic mechanisms of natural and drug reinforcement have not been demonstrated," says study author Dr. Antonello Bonci from the University of California, San Francisco.Dr. Bonci and colleagues demonstrated that self-administration of cocaine produced a potentiation of VTA excitatory synapses that persisted for three months after abstinence and was still present after three weeks of extinction training. This finding may be relevant to relapse in humans as potentiation persisted even when drug-seeking behaviors were extinguished. In contrast to self-administration of cocaine, self-administration of natural rewards, such as food or sugar, induced a potentiation of VTA glutaminergic synapses that was equally potent but quite short-lived.Interestingly, rats that received repeated passive injections of cocaine did not exhibit potentiation of VTA glutamatergic function, suggesting that cocaine-associated changes were due to an associative process and not just to the pharmacological effects of the drug. "We suggest that neuroadaptations induced specifically by drug self-administration may form a powerful 'memory' that can be activated by drug-associated cues," explains coauthor Dr. Billy T. Chen.How self-administration of a drug but not a natural reward can elicit enduring changes within the brain remains a mystery. "Future studies are required to identify the exact mechanisms through which drugs of abuse alter neural circuitry that is normally accessed by naturally reinforcing events but is usurped by cocaine to persistently cement these synaptic adaptations, perhaps ultimately leading to pathological drug-seeking behavior," concludes Dr. Bonci.

Stockholm will this week play host to experts, politicians, police and anti-drug activists from 82 countries to share ideas and devise strategies for stopping drug abuse worldwide."100 years of drug prevention," will be the theme of the first edition of the World Forum Against Drugs (WFAD) conference to be held from Monday to Wednesday with a large range of speakers reflecting on the lessons learned.Featuring such high-profile panelists as John Walters, who heads the US National Drug Control Policy and has been dubbed the "Drug Czar" of Washington, the conference aims to stake out the road "forward to the visionary goal of a world free from drug abuse."
"World Forum regards the non-medicinal use (abuse) of narcotic substances as a severe public health problem and major problem for society," organisers said on the WFAD website.According to Gunnar Aagren, who heads up conference participant the Swedish National Institute of Public Health, the only way to solve the problem of wide-spread drug abuse is through active prevention efforts.
"Limiting the accessibility of drugs is vital in the efforts to eliminate drug abuse, and prevention work is the only long-term solution," he said in a recent statement.Among the issues to be discussed at WFAD are the facts and myths surrounding cannabis, the link between human trafficking and drugs, and the increasing sale of drugs over the Internet.Several experts are also set to detail how the booming drug production in Afghanistan is impacting availability on world markets, while physicians and psychiatrists are scheduled to describe how drug use affects the brain.The conference will also feature testimonies from former drug addicts like a Swede whose narcotics habit landed him in so much debt that he attempted to smuggle cocaine from Bolivia to Sweden to make some fast cash.
He got caught and spent nearly four years in a Bolivian prison.The conference is set to wrap up with the passing of a resolution to be sent to the United Nations in time for a UN General Assembly Special Session on Drugs scheduled for the first half of 2009, organisers said."The resolution will convey the strong popular support that exists all around the world for the UN's narcotics conventions," the WFAD website said, adding that the "World Forum marks the start of a global network of organisations united behind the UN's narcotics conventions."

new study has unravelled some of the mysteries of the cocaine-addicted brain and may pave the way for the design of more effective treatments for drug addiction. The research, published by Cell Press in the 28 August issue of the journal Neuron, identifies specific brain mechanisms that underlie addiction-related structural changes in the brain and provides surprising insight into how these changes may actually defend the brain during excessive drug use.Persistence of drug-seeking behaviours after long periods of abstinence has presented a major challenge for treatment of addiction. It has been hypothesised that long-term physical changes in the brain might underlie enduring behaviours associated with drug abuse. One long-lasting structural correlate that has been observed across many models of addiction is an increase in the density of dendritic spines on medium-sized spiny neurones (MSNs) in the nucleus accumbens (NAc). The spines represent critical points of communication, called excitatory synapses, between brain cells. The density of these inputs could have a major impact on the way information is processed in the brain and may regulate addiction-related behaviours.
'Although several groups have documented that repeated cocaine exposure increases NAc spine density, the precise molecular mechanisms that control this process have remained elusive,' says senior study author Dr Christopher W. Cowan from the Department of Psychiatry at The University of Texas Southwestern Medical Centre. 'Moreover, the cocaine-induced increase in NAc spine density has been hypothesised to contribute to the long-lasting behavioural sensitisation that occurs after repeated cocaine exposure, but direct evidence concerning the functional relationship between these two processes is lacking.'Previous work demonstrated that chronic cocaine exposure increased levels of cyclin-dependent kinase 5 (Cdk5) in the NAc and that inhibition of Cdk5 blocked the cocaine-induced increase in spine density. The myocyte enhancer factor 2 (MEF2) family of transcription factors are Cdk5 targets that are expressed throughout the developing and adult brain and have been implicated in the regulation of excitatory synapses.Dr Cowan and colleagues found that chronic cocaine exposure reduced MEF2-dependent transcription and promoted increased MSN dendritic spine density in the NAc. Unexpectedly, expression of an overactive form of MEF2 in the NAc that blocked cocaine-induced spine density was associated with an enhanced behavioural sensitivity to cocaine whereas reduction of endogenous MEF2 proteins reduced these behaviours. These results suggest that the cocaine-induced increases in dendritic spine density may actually limit behavioural changes associated with drug addiction rather than support them.
'Taken together, our findings implicate MEF2 as a key regulator of structural synapse plasticity and sensitised responses to cocaine and suggest that reducing MEF2 activity, and thereby increasing spine density, in the NAc may be a compensatory mechanism to limit long-lasting maladaptive behavioural responses to cocaine,' concludes Dr Cowan. 'A better understanding of the MEF2-associated molecular mechanisms that regulate cocaine-induced structural and behavioural plasticity could ultimately lead to the development of improved treatments for drug addiction.'

A growing number of children and young adults are being admitted to hospital after taking illegal drugs, including more than 1,200 admissions of under-16s last year, figures show. NHS data for the decade to 2007 reveals a dramatic rise in the number of hospital admissions for people with mental and behavioural problems linked to drug use, as well as for drug poisoning. Admissions of under-16s and those aged 25 to 34 increased by more than half over the period.
Experts said yesterday that the increase was likely to be linked to falls in the price of drugs such as cocaine, heroin and Ecstasy, allowing teenagers to buy them more easily and giving young adults the opportunity to purchase greater quantities.
The figures, from the NHS Information Centre, show that 1,241 under-16s were taken to hospital for drug-related illness in 2006-07, up from 868 in 1996-97. The number of 16 to 24-year-olds receiving hospital treatment increased from 8,518 to 9,657, a rise of 13 per cent over the same period. According to the British Crime Survey, published last October, more than three million people in England aged 16 to 59 admitted having used some kind of illegal drug in the previous year.
Home Office statistics suggest that Class A drug use has remained largely static in recent years, with about a million people taking substances such as heroin, cocaine and Ecstasy in 2006-07. Despite huge efforts to combat the smuggling of drugs into the country, prices have fallen, suggesting that plentiful supplies are still arriving. Overall, admissions peaked among those aged 25 to 34 and nearly doubled over the decade, from 8,229 cases in 1996-97 to 15,330 in 2006-07. This age group were most likely to suffer drug-related mental and behavioural problems, psychiatrists said. Ken Checinski, an addictions psychiatrist at St George's Hospital, in Tooting, southwest London, said that the cheaper cost of drugs was contributing to users “bingeing” on various types. Mental problems included psychosis from cannabis or amphetamine use and depression after cocaine use, he said. “Affordability is at an all-time low and, like with alcohol, that just leads people to use more or stronger drugs, whether it is a student using skunk - a form of cannabis that is ten times stronger than the typical joint - or a City worker's cocaine binge. “The rise in admissions can also be explained by using multiple drugs in greater quantities or purity. All this will have an effect on your health.”
Harry Shapiro, of the charity DrugScope, added: “Overall Class A drug use has stabilised, with the exception of cocaine, which has risen over the past ten years as prices have fallen, and is responsible for increases in hospital admissions for overdoses.” For the first time, more than one in twenty young people (6.1 per cent) admitted to having used cocaine over the past year, according to the Information Centre's report. The estimated size of the illegal drug market in 2003-04 was £5.3billion. In 2005-06 the Government spent £1.5 billion on its drugs strategy.Sandra Gidley, the Liberal Democrat health spokeswoman, said: “These alarming figures reveal a wasted generation. How many more lives will be lost before the Government takes effective action? We need better education and more powers to tackle the dealers who profit from this misery.” The Department of Health said: “The high-quality drug treatment that is being provided is the most effective way of reducing illegal drug misuse, improving the physical and mental health of drug users, as well as reducing the harm they cause to themselves and society.”

Superior Court judge has indicated she will decide later this month whether a Bergen County man accused of coaching his toddler granddaughter to steal a Seaside Heights arcade worker's purse can enter a special program for drug-addicted offenders.
Judge Barbara Ann Villano said she first wanted to review findings of a drug and alcohol evaluation of Daniel Twomey before she decides whether he will be allowed to enter drug court, a form of rigorous probation in lieu of state prison for defendants whose criminal behavior stems from addiction.
Villano indicated she would make a decision on June 19, said Senior Assistant Ocean County Prosecutor John Foti, who handles drug-court cases for the Prosecutor's Office.Foti had rejected Twomey's application to drug court, saying that with 18 prior convictions dating to 1973, mostly for burglaries and thefts, the 52-year-old Teaneck man was not an appropriate candidate. Twomey appealed Foti's decision to Villano, who presides over drug court.Twomey was captured on a videotape last year allegedly coaching his 4-year-old granddaughter to steal an arcade worker's pocketbook on the Seaside Heights boardwalk.He was arrested in Greenwich, Conn., on Sept. 29 after a television station aired the videotape.On it, a man alleged to be Twomey is seen pushing a young girl under a security door at Lucky Leo's Arcade to steal the employee's purse. The incident happened about 12:15 a.m. on Sept. 16.
Twomey was charged in a February indictment with employing a child to commit a crime and two counts of child-endangerment related to the incident at the arcade. Each of the charges carries a five- to 10-year prison term upon conviction.In addition to his granddaughter, Twomey's 8-year-old grandson was with him at the arcade, authorities said.The indictment also charged Twomey with two counts of theft and one count of receiving stolen property, all charges carrying maximum prison terms of five years.Twomey remains in the Ocean County Jail.

Tran Thi Ngoc Dung, 35, was leaving her hotel in Ho Chi Minh City on her way to a flight home on Sunday when she fell unconscious and was rushed to hospital, Tuoi Tre (Youth) newspaper said. Doctors found she had two condoms full of heroin in her stomach and one of them had burst, the paper said. Ms Dung was still in the hospital but had been put under arrest. It was unclear how much heroin she was carrying.
Vietnam has some of the world's harshest drug laws. Possession of 600g or more of heroin is punishable by death. About a dozen Vietnamese-Australians have been in court in Vietnam for heroin trafficking in recent years. At least four have had their death sentences commuted because of lobbying by the Australian Government.
Australia's Department of Foreign Affairs and Trade said yesterday: "The Australian Consulate-General in Ho Chi Minh City is seeking to confirm media reports that the woman will be arrested on drug charges."Australian woman is under police guard in a Vietnam hospital after a bag of heroin she was allegedly trying to smuggle broke inside her body.The woman had been about to return to Australia when she fell ill and was rushed in critical condition to hospital on Wednesday, a hospital official in Ho Chi Minh City said.The 35-year-old had stopped breathing at one point, but her condition had improved to stable today, said Nguyen Van Xuyen, the director of Saigon General Hospital.
"We found two small plastic bags containing heroin in her anus and one of the bags had broken," Xuyen said.
"This is the first case in which we have found heroin in a person's anus. We have treated people having swallowed heroin before."
Xuyen said the woman came to Vietnam to visit relatives and was about to return to Australia when she was taken to hospital.
"She was in critical condition when she arrived at the hospital, and she would have died if she had been admitted a few minutes later," Xuyen said.
"She woke up yesterday and told us about the heroin."Police were guarding the woman at the hospital and would formally arrest her once she was released, Xuyen said.
The city's anti-narcotics police did not respond to requests for comment.
Trafficking or transporting 600 grams or more of heroin is punishable by death in Vietnam.
In March, an appeals court in Ho Chi Minh City sentenced an Australian woman of Vietnamese origin to death for trafficking heroin.Jasmine Luong, 34, was arrested at the city's Tan Son Nhat Airport in February last year with 1.4kg of heroin hidden in her luggage and shoes.
Several Vietnamese-Australians have been sentenced to death in recent years for drug crimes, but so far none has been executed and several have had their sentences commuted to life in prison.Vietnam this year sentenced at least 22 people to death, including nine for drug crimes.

Mark Standen, 51, was charged on Tuesday with conspiracy to import enough pseudoephedrine to manufacture $120 million of the drug methamphetamine, or ice. He also faces a charge of conspiracy to pervert the course of justice.The arrest sent shockwaves through the NSW criminal justice community because of Standen's seniority and his three-decade career investigating narcotics and organised crime.In 1982, Standen gave evidence before the Stewart Royal Commission into Drug Trafficking confirming that he and two colleagues from the Federal Narcotics Bureau had flushed down a toilet 18 foils of hashish.The commission heard that the three agents had raided a Bondi house on May 7, 1979. The occupant, a man called Udy, admitted the drugs were his and later signed a statement confessing possession.Standen told the royal commission he later destroyed the statement as part of efforts to obliterate all traces of the raid."I do not actually specifically remember the incident - I feel fairly certain I would have destroyed it by shredding," Standen recalled under oath.He said he and his fellow officers decided to destroy the drugs and associated paperwork because the amount of drugs was less than 500 grams and charges could not be brought under federal customs laws. The case would have to have been handed to the NSW police.The royal commission was told Standen had been charged under the Public Service Act, a financial penalty had been imposed and that he and a fellow officer were to be barred from joining the federal police when the AFP took over the Federal Narcotics Bureau from the Customs Department.The royal commission later heard that the financial penalty and the charge against Standen and another officer were dropped."I found out to my amazement that that had occurred," the AFP's Detective Chief Superintendent Brian Bates told the commission.He said the charges and fine were dropped after the Commissioner of the AFP, Sir Colin Wood, had determined Standen would not be accepted into the AFP. Chief Superintendent Bates said it was felt that being barred from the AFP was punishment enough.But another senior AFP officer, Chief Superintendent John Reilly, gave a different reason: he told the commission that the charges against Standen weren't pursued because of indecision between two government departments.Standen told the royal commission he had never been punished in any way."When we became part of the federal police in 1979, I was not offered a position in the police field but I was offered a position in the intelligence side … I never actually started in the intelligence area. Before that was due to happen, the decision was changed," he said.The testimony given before the royal commission was enough to raise questions in Federal Parliament.
Labor senator Nick Bolkus asked the Minister for Administrative Services, Senator Tony Messner, "Did Mr Bates say nothing was done about the charges because the two men were to be denied entry to the federal police … and did Mr Bates also say that despite this … they were still transferred to that force? … Was the Government aware of this rather unorthodox series of events?"Senator Messner declined to answer, saying the matters were still under investigation by the Stewart Royal Commission.When Standen was arrested this week, his Crime Commission colleagues voiced disbelief. But claims have emerged since that Standen's alleged gambling problem was well known when he left the AFP in 1996.The NSW Government yesterday announced the state's Police Integrity Commission would oversee the Crime Commission in the wake of the Standen charges.NSW Police Minister David Campbell said the Police Integrity Commission, which has the powers of a royal commission, would oversee all activities of the Crime Commission, effective immediately.
He said the public would expect that past cases involving Standen were "now properly scrutinised".Mr Campbell yesterday also revealed the Independent Commission Against Corruption was first made aware of allegations against Standen in September last year

technology billionaire was a drug fiend who trafficked in cocaine, Ecstasy, and methamphetamine, spiked the drinks of business associates and employees, hired prostitutes for himself and others, and maintained several narcotics dens, including one in an underground lair at his Los Angeles mansion, prosecutors charge. In a remarkable federal indictment unsealed today in Los Angeles, Broadcom co-founder Henry T. Nicholas III is portrayed as an out-of-control wild man who scored drug caches for Super Bowl parties and rock festivals and had his dealer invoice him for these illicit purchases. A copy of the felony drug conspiracy indictment against Nicholas, who is reportedly worth about $2 billion, can be found below. The 48-year-old Nicholas, who was charged with securities fraud in a separate U.S. District Court case, allegedly "used threats of physical violence and death and payments of money to attempt to conceal his unlawful conduct," according to the indictment. Prosecutors allege that, in June 2002, Nicholas and Broadcom entered into a $1 million settlement agreement with an employee who was aware of the executive's "unlawful narcotics activity." The hefty payout, which Broadcom covered, contractually prevented the employee from speaking about Nicholas's drug abuse. The billionaire apparently did little to conceal his drug transactions. On one occasion, in the lobby of Broadcom's southern California headquarters, he directed an employee to provide cash to a courier "in exchange for an envelope containing controlled substances," the indictment charges. On a drug-fueled 2001 private plane flight--during which Nicholas allegedly used and distributed narcotics--the pilot was forced to don an oxygen mask due to the "marijuana smoke and fumes." According to a March 2008 Forbes story, Nicholas, with an estimated net worth of $1.8 billion, is ranked 677 on the list of the world's wealthiest individuals.allegations that the billionaire drugged his business cohorts, hired prostitutes and maintained a drug warehouse that grabbed headlines.A pair of indictments unsealed Thursday charge the 48-year-old with conspiracy and securities fraud in an alleged scheme to backdate stock options that ultimately forced Broadcom to write down $2.2 billion in profits last year. But prosecutors also detailed a litany of drug charges that apparently came as a surprise to Nicholas and his attorneys.The charges threaten to ground a high-flying lifestyle that prosecutors say featured the former CEO jetting around the world in his two private planes, building a secret lair under his house and hiring strippers to party at a private warehouse stocked with cocaine, methamphetamine and ecstasy.Defense attorney Gregory Craig said that Nicholas was innocent and would prevail."It's a kitchen-sink attack on Dr. Nicholas. They're trying to throw everything at him from eight years ago," Craig said.At a court hearing, U.S. Magistrate Arthur Nakazato set Nicholas' bail at $3.3 million. He also ordered random weapons searches and drug tests by the government, home detention, electronic monitoring and the disabling of Nicholas' two private planes. Nicholas, in handcuffs and wearing gray slacks and a white shirt with no tie or belt, nodded vigorously when asked if he agreed to the conditions of release.Nakazato said he was concerned that Nicholas' extreme wealth could allow him to flee at any moment. He indicated that Nicholas' current Newport Coast home, valued at $15 million to $18 million, would be no impediment to flight for "one of the wealthiest men in the world." Nakazato also said he was bothered by government allegations that Nicholas had threatened and hit a grand jury witness last year during an argument on a private jet."If you flee, I will detain you and I will order an arrest warrant and I'll have the marshals and the FBI going on a hunt for you," Nakazato said. "And when they bring you back, I'm not going to show much mercy."
An arraignment hearing was set for June 16. Nicholas did not enter a plea.
Also indicted on the stock-option backdating was Broadcom's former chief financial officer, William J. Ruehle. He was not charged with the drug violations.Ruehle, 66, was released on $2.6 million bail and surrendered his passport, although he will be allowed to take three international trips that were already planned. He will also be arraigned on June 16.Ruehle's attorney, Richard Marmaro, said in a statement, "Bill Ruehle is innocent of the charges in the indictment, and he looks forward to the opportunity to clear his good name in a court of law."Nicholas, who has a Ph.D. in electrical engineering, co-founded Broadcom Corp. in 1991 with Henry Samueli. The company, which makes microchips for cell phones and broadband Internet devices, reported a strong first-quarter profit in April and forecast second-quarter sales of $1.08 billion to $1.13 billion, ahead of Wall Street expectations.The 18-page indictment on drug charges alleges that Nicholas kept four properties in Orange County and Las Vegas, including a warehouse in Laguna Niguel, Calif., where he stashed and distributed cocaine, methamphetamine and ecstasy.He later remodeled the warehouse with private rooms and furnished it with art and high-end electronics.The court documents also claim Nicholas hired prostitutes and escorts for himself, his employees and customers and conspired to get illegal prescriptions for drugs such as Valium.In 2001, Nicholas smoked so much marijuana during a flight on a private jet between Orange County and Las Vegas that the pilot had to put on an oxygen mask, the indictment states.At a July 1999 Woodstock concert in Rome, N.Y., Nicholas gave a technology executive ecstasy without the executive's knowledge, the indictment states. Nicholas also allegedly spiked a technology executive's drink with ecstacy in New Orleans in early 2000.Nicholas required his unnamed co-conspirators to provide detailed invoices for drugs they sold to him, and used code names such as "party favors" and "refreshments" to conceal what was being sold, prosecutors claimed.
The allegations recall two earlier civil lawsuits filed against Nicholas that accused him of rampant drug use and hiring prostitutes. One lawsuit was cited by prosecutors in a motion filed Thursday that sought to deny bail for Nicholas.
That suit was filed by Nicholas' former bodyguard and personal assistant, Kenji Kato. A second lawsuit was filed last year by a construction crew that claimed they were hired to build an underground lair for Nicholas where he could indulge in sex with prostitutes and drug use.The workers claimed Nicholas failed to pay them millions of dollars and used intimidation and death threats to prevent them from leaving the project, which was kept secret from Nicholas' wife and city inspectors.Nicholas faces a total of 21 counts in both indictments. The drug charges carry a maximum combined sentence of 20 years in prison. He could face up to 340 years in prison on the stock backdating charges.Ruehle faces 21 counts in the stock options indictment, which accuses him of filing false statements with the U.S. Securities and Exchange Commission, falsely certified financial reports and committed wire fraud. Ruehle could face up to 370 years if convicted of all counts.Backdating stock options, which often are granted as hiring and retention incentives, is legal. Companies across the company have run into trouble when they failed to account for the true cost that the backdating created because omitting that cost sometimes inflated the companies' income.
Last month, securities regulators cited Nicholas, Samueli and Ruehle in a civil suit alleging they falsified the company's reported income. The SEC also cited Broadcom general counsel David Dull, but Dull and Samueli were not named in Thursday's criminal indictments.Nicholas served as CEO and president from Broadcom's inception until he resigned in 2003. At the time, he said he stepped down to try to repair his relationship with his wife.Nicholas' attorneys said in court Thursday that he has been at a $66,000-a-month Malibu drug rehabilitation center since April.

CASE STUDIES Convicted and jailed for drug possession, Bliek, 20, is on probation. Her felony drug conviction will keep her from social aid such as food stamps, limit her employment options and bar her from certain housing programs.
"I have no idea what I'm going to do," she said. "I'm not ready to be out on my own."
Her situation is common for those leaving the corrections system, more so in South Dakota than most states, according to a recent study. While conditions of parole often require employment and housing, laws and regulations create barriers to achieving that goal. Women, particularly mothers, might be hardest hit in South Dakota.Programs such as food stamps and Temporary Assistance for Needy Families are denied to people with a drug felony in South Dakota. Local rules also limit options for people leaving prison.But there often are legitimate reasons at the root of the problem.For example, Crime-Free Housing in Sioux Falls, which many credit for keeping neighborhoods safe, excludes people who have had a drug conviction in the past five years, said Sioux Falls Police Officer Jim Larson, who oversees the program.The program is meant to reduce crime and eliminate problem tenants, not punish offenders, Larson said."Nobody is saying that if you have a drug conviction that you're a bad person," he said. "What we're saying, and the managers are saying is, 'Show us some good history. Show us that you've been rehabilitated.' "
A study by the national Legal Action Center examined every state's ability to help inmates re-enter society. It found that South Dakota was among the nine states with the most "roadblocks" for inmates re-entering daily life. Most of the 38 barriers in South Dakota were in the categories of employment, public assistance and public housing.Many officials who work with offenders say women, especially mothers, face a difficult journey toward re-entering society."Our system seems to be more geared for men, when you think about it," said Steve Fodness, director of residential services at the Arch Halfway House in Sioux Falls. "We encourage (men) to get a job, get independent, and get a place to live. For women that doesn't seem to work as well."
South Dakota incarcerates 89 women per 100,000, the 10th- highest rate in the country, according to the Women's Prison Association, so the state has its share of women dealing with these issues.Mothers with records often considered unfit
The problems can be complicated by mental illness - which women offenders tend to have at a higher rate than men - and a strong social stigma about women with criminal records, Fodness said.That stigma makes it difficult for women to resume their role as a mother. It can brand them unfit for parenting forever, said Virgena Wieseler, division director for child protection with the state Department of Social Services."It's very difficult," she said. "Some of our staff has seen some of the women struggle because some people don't think they should have a second chance at parenting."Finding a job is one of the first hurdles a woman will face after leaving prison."They only have so much time to get a job or they're sent back, because they're in violation of their parole," said Julie Becker, director of St. Francis House in Sioux Falls. "There's so much pressure on them in such a short amount of time."Fodness said more jobs are available to men, and they often pay better. For example, women have trouble getting jobs that require hard labor, he said.With a criminal conviction, careers in fields such as day care or medicine are impossible to get, he said.Barred from certain jobs such as nursingBliek, once in school for nursing, now is barred from that field because of her conviction. She also is unable to receive federal student aid and many scholarships that could help pay for her return to college, she said."I'm trying to get into school again," Bliek said. "I started going to school for nursing and that got taken away from me. So my one passion in life was taken away."A methamphetamine addiction cost Tracy Kashmarek, 27, her job in 2003 and sent her to jail for a month."I was employed at a bank and was stealing money to support my habit," she said.Now sober, Kashmarek said it was difficult to find a job once released from jail. The job interviews she did get ended abruptly when her felony record came up, she said."The interview would go great, but after that it would go downhill," Kashmarek said.
Employers in South Dakota can ask about arrests that never led to convictions. And unlike some states, there is no opportunity for offenders to obtain certificates of rehabilitation in order to better their chances of being employed.
Housing restrictions impede return to society
Women with felony records, particularly drug convictions, find their housing options limited in Sioux Falls and throughout the state. Housing not only is a critical step in re-entry, but is a condition set by their probation or parole and a requirement to be met before social services will return children to their mothers.
"If they don't have a place to go to, then it's really hard for children to come home to them," Wieseler said.
The study found that public housing authorities can look at a criminal record and make individual decisions about an applicant's eligibility. They also may refuse to admit an applicant based on a criminal charge that never led to a conviction.
Federal law allows landlords in federally supported housing programs to impose stricter prohibitions against certain residents, said Vona Johnson, director of rental housing with the South Dakota Housing Development Authority.
"What you're gong to find is the owners can write their own written screening criteria to determine who they're going to allow to live in there," she said. "Each landlord can set their own rules. But the feds don't tell them how to write it."
Sioux Falls Crime-Free Housing went to a stricter standard for its participating properties including the prohibition against those with drug convictions in the past five years.
"That is a standard Sioux Falls decided to go to," said Larson, the Sioux Falls police officer. "It's not mandatory."
A number of properties in Sioux Falls apply an even stricter standard, Larson said.
"I know some managers that say if you have any felony, you're not welcome," he said.
The difficulty of re-entering society also manifests itself in the number of women who return to jail or prison
At the Arch, Fodness said more than 40 percent of women clients are incarcerated again, and that difficulties in finding housing and employment, and limited social services contribute to the most of that recidivism.
"I would say it's 70 percent of it at least," he said.
Department of Labor Career Center staff do go into the women's prison quarterly and present a job-search assistance class. Job-seeking strategies are taught, such as how to make a resumé and cover letter and how to use the self-service job search system. Many of the women, however, say they need more help.
At the Arch, women talk of how months of job hunts, lack of counseling and other assistance can set women up for failure, said Bobbi Jo Zens, 35, who has been at the Arch for six months.
"I think that's why women relapse here and go back to prison," she said. "You get beaten down a lot."
Zens has had success; she recently got a job at a restaurant.
'They come out with no identification'
In South Dakota, women leaving prison need better access to psychiatric care, treatment options and better education about how to successfully enter society, Fodness said.
Offenders also need help to get proper identification, Becker said.
"They come out with no identification. They come out with their DOC card, and that's it," she said. "They can't get a job with their DOC card. What they need to do is to help these offenders get their ID and social security card before they take one step off those prison grounds."
Michigan has implemented a program in both of its women's prisons to address some of these issues, and that effort has become a model for other states, said Florida Andrews, director of the Michigan Council on Crime & Delinquency.
The same Legal Action Center study ranked Michigan as one of the best states for helping offenders transition from incarceration back into society.
Employers in Michigan cannot ask about arrests that never led to convictions, and occupational-licensing authorities may consider only certain criminal records. The state also has opted out of the federal ban on food stamps and public assistance, which keeps those options open to offenders. Michigan also is more lenient in its public housing application process when considering criminal records.
Andrews' efforts focus on the transition from incarceration to daily life by addressing women's educational, vocational and parenting skills.
"I decided we weren't paying much attention to women while they were incarcerated," Andrews said.
She has 85 women in the program, which requires the mothers to get their GED and allows them to maintain their parenting roles by helping with their children's school work, attend parenting classes and having monitored visits with their children while incarcerated.
"I'm watching the visits; their interaction with their children, and then we discuss what happened with the visit," Andrews said.
The program also has collected a listing of homes and services that accept referrals for female inmates, she said.
There is no such centralized effort in South Dakota, Fodness said.
That worries Alicia Meng, 32, who has been out of prison for less that four weeks. She is uncertain of what awaits her.
She was released with only a few dollars and her prison outfit, and stays at the Arch, she said.
There has been no time to search for a job or a place to stay, and she is unsure of where to look for the help to get herself established and see her son again.
"I'm just trying to save up money and get out of here," Meng said. "I need to get my life straight before I can get my boy back."

An urgent review of the use of naltrexone (including implants) for opioid dependence is needed following reports of severe adverse reactions, according to two articles in the latest Medical Journal of Australia. In its editorial, Associate Professor Robert Ali, Director of the Drug Alcohol Services Council in Adelaide, and his co-authors said that naltrexone is theoretically an attractive treatment for opioid dependence because it is inexpensive, long-acting, and generally well tolerated. Oral naltrexone is used as a treatment for heroin and alcohol dependence. However, the effectiveness and safety of oral treatments is compromised by poor patient adherence to taking regular doses. This has led to the development of long-acting naltrexone implants and depot injections. Naltrexone implants have not been approved for human use in Australia, but these implants are being supplied through some private clinics. Assoc. Prof. Ali says that naltrexone implants are currently obtained through the TGA Special Access Scheme but without the product being subjected to the usual rigorous scrutiny required for new devices in Australia. "It is concerning that the recent research on naltrexone implants in Australia has not followed usual scientific processes," he said. In a related study published in the journal, Dr Paul Haber, Head of Drug Health Services at Royal Prince Alfred Hospital, and his co-authors studied 12 patients who were admitted to hospital soon after receiving naltrexone in oral or implant form.
Eight of the cases were definitely or probably related to the naltrexone implant, including cases of severe opiate withdrawal and dehydration, infection at the implant site requiring surgery, and a psychiatric disorder. The authors said these severe adverse events challenge the notion that naltrexone implants are a safe procedure. "These events suggest a need for careful case selection, careful clinical management, and for closer regulatory monitoring to protect this marginalised and vulnerable population," Dr Haber said. "Patients should be warned of the associated risks, and appropriate procedures planned to respond to any complications."
Dr Haber also emphasises the importance of screening patients for underlying medical or psychiatric conditions and, importantly, coordinating with relevant service providers. "Similarly, a close relationship between naltrexone implant providers and local emergency departments is important." "The widespread and unregulated use of naltrexone implants without appropriate safeguards for patients, their families and service providers should be restricted until this therapeutic product has been assessed for safety and effectiveness," he said.

Heavy drinkers and heavy smokers develop Alzheimer's disease years earlier than people with Alzheimer's who do not drink or smoke heavily, according to research that will be presented at the American Academy of Neurology 60th Anniversary Annual Meeting in Chicago, April 12-19, 2008."These results are significant because it's possible that if we can reduce or eliminate heavy smoking and drinking, we could substantially delay the onset of Alzheimer's disease for people and reduce the number of people who have Alzheimer's at any point in time," said study author Ranjan Duara, MD, of the Wien Center for Alzheimer's Disease at Mount Sinai Medical Center in Miami Beach, FL, and Fellow of the American Academy of Neurology.
"It has been projected that a delay in the onset of the disease by five years would lead to a nearly 50-percent reduction in the total number of Alzheimer's cases," said Duara. "In this study, we found that the combination of heavy drinking and heavy smoking reduced the age of onset of Alzheimer's disease by six to seven years, making these two factors among the most important preventable risk factors for Alzheimer's disease."The study looked at 938 people age 60 and older who were diagnosed with possible or probable Alzheimer's disease. The researchers gathered information from family members on drinking and smoking history and determined whether the participants had the epsilon 4 gene variant of the APOE gene, which increases the risk of Alzheimer's disease. People with the epsilon 4 variant also develop Alzheimer's at an earlier age than those who do not have the gene variant.
Seven percent of the study participants had a history of heavy drinking, which was defined as more than two drinks per day. Twenty percent had a history of heavy smoking, which was defined as smoking one pack of cigarettes or more per day. And 27 percent had the APOE epsilon 4 variant.Researchers found that people who were heavy drinkers developed Alzheimer's 4.8 years earlier than those who were not heavy drinkers. Heavy smokers developed the disease 2.3 years sooner than people who were not heavy smokers. People with APOE epsilon 4 developed the disease three years sooner than those without the gene variant.Adding the risk factors together led to earlier onset of the disease. People who had all three risk factors developed the disease 8.5 years earlier than those with none of the risk factors. The 17 people in the study with all three risk factors developed Alzheimer's at an average age of 68.5 years; the 374 people with none of the three risk factors developed the disease at an average age of 77 years.

The study was supported by the Florida Department of Elder Affairs.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, epilepsy, multiple sclerosis, Parkinson's disease, and stroke. For more information about the American Academy of Neurology, visit http://www.aan.com.

ketamine hydrochloride—the chemical that induces euphoria, triggers off hallucinations and keeps party animals in a trance through the night. Ironically, in India, it is classified as a veterinary drug primarily used to anaesthetise pets—thus available over the counter. However, ketamine has attracted very little attention in this country since its abuse among Indians is limited largely to Goa's trance and techno music crowd.Ketamine can be injected, snorted or imbibed orally. The effect of the drug varies from person to person, and can last up to 24 hours. Its use can result in delirium, amnesia and impaired motor function. While the drug was tried by acid gurus like Timothy Leary in the '60s, its popularity is linked to the dance-trance movement taking wings in the '80s. Called 'Special K' by the rave party crowd, it is taken along with other drugs like cocaine and has suddenly become popular as an alternative to LSD. Long-term abuse can lead to loss of memory and eyesight besides nervous and mental disorders. An overdose can be lethal

In 2005, a joint investigation by the US Drug Enforcement Agency and the Indian Narcotics Control Bureau (NCB) busted a major illicit pharmaceutical drug internet marketing organisation which operated in the US, India, Costa Rica and Australia. Officials seized 108 kg of ketamine (street value $1.62 million) in the operation. In the same year, drug enforcement authorities in Hong Kong—in a joint operation with India, Singapore and Malaysia—launched a massive operation code-named Bayonet. As much as 87.5 kg of ketamine was seized in the raids.But despite the increased trafficking of ketamine, drug enforcement agencies the world over have struggled to curb the trade. The profit involved is huge. One kg of the drug costs Rs 35,000 in India, but roughly retails at Rs 10 lakh abroad. Much of their efforts have been impeded by the drug's non-inclusion in the United Nations' schedule of controlled substances. While the Commission on Narcotic Drugs (CND), a UN body that steers policy on drug-related matters, has repeatedly pushed for its inclusion, it has failed to convince the World Health Organisation's expert committee on drug dependence.M.M. Bhatnagar, a former NCB director general who also did a five-year stint as a member of the International Narcotics Control Board, says several countries have taken up the issue of putting ketamine on the controlled substance schedule. Says he: "The CND in one of its 2007 resolutions requested the UNODC to share its concerns with the WHO's expert committee on drug dependence and looks forward to an updated review of ketamine by them."Sources told Outlook that the Indian government is now actively considering putting ketamine on the scheduled list. This will ensure that any illegal trade of the drug comes under the purview of the stringent Narcotic Drugs and Psychotropic Substances Act. As of now, offenders can only be prosecuted under the milder Customs Act. Drug enforcement and DRI officials hope to curb the illicit production and trafficking of ketamine if the drug is included in the controlled substances list.
Meanwhile, the trade goes on. The latest is to conceal the powdered form of the drug and ship it beside flour or sugar. As for the market abroad, there are enough people lured by the hype of experiencing a "K-hole"—the so-called nirvana induced by a heavy dose of ketamine.

Matching of treatment-resistant heroin-dependent patients to medical prescription of heroin or oral methadone treatment: results from two randomized controlled trials. Blanken P, Hendriks VM, Koeter Matching of treatment-resistant heroin-dependent patients to medical prescription of heroin or oral methadone treatment: results from two randomized controlled trials. Blanken P, Hendriks VM, Koeter MWJ, van Ree JM, van den Brink W. Addiction 2005 100:89-95
Dear Colleagues,
This re-analysis of the Dutch heroin trials* shows that for most patient variables there was no difference in the proportion of ‘responders’. The study randomised complex, ‘resistant’ opioid dependency cases to either standard oral methadone or medical heroin prescription, injected or nasal forms, depending on individual’s usual route of administration. The factors examined included level of education, hospitalisations, psychiatric history, living arrangements, employment, cocaine use and previous abstinence based treatment. Although overall results were significantly better in the heroin groups, only one of these factors was associated with a difference in treatment outcomes when heroin was prescribed. The group reporting a history of abstinence based treatment had a defined ‘response rate’ in those randomised to ‘medical’ heroin of 61% versus 39% in the oral methadone group. This is highly significant both statistically (p=0.0003) and also from a dependency point of view. The finding appears to be corroborated since the response rate to standard methadone treatment was substantially lower in those who gave a history of having any abstinence based treatment (24 vs. 38%).
The authors speculate about this finding but no firm conclusion is reached. Workers in the field will be familiar with a group of ‘failed’ NA/AA subjects who often take methadone reluctantly at low doses and for short periods. Some can be our most frustrating patients, expressing guilt, depression and other negative feelings towards what they consider a poor option, despite the potential and evident benefits.
The study patients all had limited responses to traditional treatments available in Holland, including oral methadone. The mean age was 39; 80% were male and there was a high degree of psychiatric co-morbidity. Overall the ‘response’ rates in this trial*, were 25% for the oral methadone group and 45% for the others using the Addiction Severity Index (ASI) to 40% improvement levels.
It is depressing for outsiders (and possibly embarrassing for our British colleagues) that the UK has had thousands of patients prescribed injected heroin or methadone for decades, yet it is the Dutch who performed the first large randomised trial of this treatment. It is to the credit of the Addiction journal that it was prepared to publish this item despite its traditional avoidance of items of this nature. Maybe we will soon be reading a section on harm reduction!
In a report from Canadian Press dated 9th Feb 2005, a clinical trial has been approved by Health Canada in which 158 Vancouver addicts will be prescribed pharmaceutical-grade heroin for 12 to 15 months. A second site is being readied for the North American Opiate Medication Initiative (NAOMI) in Montreal, expected to open in April, and Toronto will be added shortly after that.
It now appears possible, or even likely, that banning heroin in the 1950s ’sent the wrong message’ to young people. It certainly denied medical patients the benefits of medical heroin in most countries. Far from eliminating heroin problems, the bans have been associated with rampant spread of illicit heroin use. It may be that the bans have contributed to the problems, in part by permitting easy access for minors as well as encouraging hasty and unsupervised use of drugs of uncertain purity. America is still unravelling the mayhem associated with prohibition of alcohol. It is to be hoped that we will be more scientific and methodical in undoing the many problems associated with heroin prohibition in western countries. Although many factors are still uncertain, these trials, injecting rooms, NA and other self help groups, legal diversion, decriminalization and education are all pieces in a larger puzzle of how to reduce drug use as well as reduce the harmful consequences of such use. Australia has scored many successes regarding tobacco and alcohol. Other drugs should follow and society will be the better and more prosperous for it.

Alcohol is behind 40% of all violent crime in Lancashire, figures show today. Almost a quarter of people arrested in Lancashire were drunk at the time of arrest – but at weekends this could be as much as 80%.In the first 10 months of 2007, 21,133 violent crimes were recorded within Lancashire – and police say 8,453 of them were directly linked to alcohol.The figures come two months after Preston city centre's police inspector said Church Street was the most dangerous street in Lancashire, with more recorded violent crime than anywhere else in the county.Today , Chief Insp James Lee of Preston Police, said that binge drinking is the biggest trigger behind crime."Alcohol is a big problem in violent crime and other types of crime, and the biggest factor in alcohol-fuelled violent crime is not underage drinking but binge drinking."We know that offers like two-for-ones, often seen in Preston, can further the problem. We have a particular problem with adults who buy for children and we will be dealing with this issue."Kath Thomas, chief executive of Victim Support Lancashire, said: "People who have gone for a quiet drink and end up being assaulted often lose out on their compensation payout because they have had a drink themselves."A spokesman at Lancashire Teaching Hospitals NHS Foundation Trust, said: "A&E departments are blighted by problems fuelled by drink, including injuries from fights following excessive drinking."Drinking, and in particular binge drinking, is becoming a favourite pastime. Unless people begin to drink more moderately, the NHS will continue to see a rise in admissions resulting from alcohol."In January, Judge Christopher Cornwall said a booze-fuelled attack on prison officer Paul Ely in Preston city cent
re "illustrates the appalling high price the community pays for the free availability of alcohol".Sentencing Lee Campbell for throwing the punch that wrecked Mr Ely's life, the judge said the case highlighted the terrible consequences of drink-fuelled violence.However, police in Preston insist that violent crime is falling. In the three-month period from November 2006 to January 2007, police recorded 254 incidents of violent crime – but in the same period 12 months later, this fell to 234.
The new policing plan, due to be revealed soon, is expected to focus on violent crime issues.

Velvet Revolver frontman Scott Weiland has admitted himself to rehab.
After a show on Wednesday (February 6) in Los Angeles, the singer checked into an undisclosed rehab centre, resulting in the postponement of last night’s show at the House Of Blues in San Diego.
Weiland has been arrested several times in the past few years for drug related incidents, and has done a number of stints in jail.
His most recent arrest was November 21 when he crashed his car while driving under the influence in Los Angeles.
He previously completed a spell in rehab in 2003.

23-year-old man who died in his home last week likely is one of six people to overdose on heroin since December.
Five of the overdoses have been fatal.
New Hanover County Assistant District Attorney Tom Old said bags of the heroin stamped with the name "Hell Razor" were found in William Brandon Walters' house.
That heroin has been linked to at least two or three fatal overdoses in the past months, he said.

Meanwhile, law enforcement authorities are trying to find the source of the fatal heroin, and they announced on Tuesday they made a significant heroin bust unrelated to the recent overdoses.
But authorities may have more than "Hell Razor" to blame for recent deaths.
Heroin by another name was found at the home of a 48-year-old man who overdosed Friday in the 600 block of Orange Street, authorities said.
More than a week ago, Walters' father, Michael Walters, went to his son's house to check on him after his mail had piled up. He found his son dead on the living room floor Jan. 27.
Brandon Walters' father said Tuesday he didn't want to discuss details of his son's death because of an ongoing investigation. He added he didn't know how his son died.
"We want to see the final results for toxicology," Michael Walters said. "There was no foul play involved at this point that I am aware of."
Incidentally, right after his son died, Michael Walters reported two Samsung flat-screen TVs - worth a total of $4,000 - stolen from his son's house on White Road.
He said they were stolen after he found his son dead.
For now, Michael Walters is just trying to cope with his son's death.
"It takes a little while to cope with it and deal with the loss," he said. Brandon Walters, who was unemployed, was living off his maternal grandfather's inheritance and enjoying automobiles. He liked to buy and trade vehicles like BMWs, Cadillacs and Hummers, his father said.

"I accused him of trading them before the 30-day tag expired on them," he said.

Brandon Walters, who was born in Wilmington and spent most of his life here, was a fisherman and deer hunter who enjoyed going to the shooting range.

At one point, Brandon Walters also was involved with a Baptist church.

"He was a very lovable person," his father said. "He had a heart of gold."

To date, four other men ranging in age from 16 to 48 have died from heroin overdoses since Dec. 6, 2007.

Also, a 19-year-old woman nearly died from a heroin overdose at a McDonald's in the 2500 block of Carolina Beach Road.

Addiction afflicts people of all backgrounds, Old said.

"You find addiction throughout professionals and everyone throughout society," said Old, a drug prosecutor. "I don't know that anyone ever starts using drugs or alcohol with the thought they'll become an addict. Everyone always likes to think they'll be in control of their lives, never anticipating how addictive drugs are."

Drug addiction is not new to China. At one time it was estimated that 27% of the male population was addicted to opium. However, this figure dropped significantly from its peak in 1906 to the establishment of the People’s Republic in 1949. Changes in Chinese society in recent years have meant new freedoms and new choices. As a result, drug addiction is again on the rise and, although seemingly insignificant when compared to the epidemic of the early 1900s, reports indicate there were 1.16 million Chinese addicted to heroin in 2005. Currently the number of beds available for those dependent on alcohol or drugs is quite small, especially when considering the vast number of those who could benefit from treatment. In Beijing alone, a city of more than 10 million, only a few hospitals with a handful of beds currently treat patients addicted to alcohol or drugs. While effective treatment for addiction is being recognized in China, the nation is merely scratching the surface when it comes to treatment availability.
In China today, addiction is severely stigmatized, and is grouped with prostitution and gambling as a negative behavior. Chinese society today generally views drug dependence as a moral weakness and sees the addicted individual as having a character flaw. While this view is prevalent in U.S. society as well, there is little distinction in China between the views of the public and those of medical professionals, who often use punitive approaches to treatment. This goes along with a pervasive attitude in China that individuals must be held responsible for their own actions and must learn from their own mistaken behavior.

The stigma associated with addiction has created a major challenge in addressing treatment needs in China. In a recent survey, only about half of the medical professionals who responded viewed addiction as a treatable brain disease. With an apparent lack of understanding of addiction by the medical community, much of the treatment in China is limited to acute care for withdrawal. Without ongoing treatment opportunities, drug- or alcohol-dependent individuals are not given the opportunity to strengthen their recovery from long-term substance use.Fortunately, 12-Step programs may be playing a major role in changing views, among both addicts and treatment professionals, about the prospects of successful recovery. The success of those in recovery through AA has apparently been evident to treatment professionals who are beginning to see that long-term sobriety is possible but cannot always be accomplished by merely offering acute care to the dependent.

Would-be Counselors
With a growing number of people in recovery who are enthusiastic about providing care to those in need, China now has an increasing number of potentially effective counselors. Along with Mr. H., these are individuals with genuine enthusiasm and an interest in learning from faculty who can assist them in expanding their understanding of treatment. During our time together, we had great discussions, role-played group sessions with individuals volunteering to be the leaders, and talked about some of the challenges addicts face in developing successful recovery programs. We also laughed, cried, joked and, despite the language barrier, experienced a bond that brought us together as fellow warriors, struggling to make treatment effective for the addict. I learned a thing or two from the true pioneers of drug and alcohol treatment in China. I learned that challenges faced by those in recovery in societies outside the U.S. are enormous in comparison to those in our country. I learned that one’s level of passion can help overcome seemingly insurmountable barriers. And I learned that those who have the commitment to help others in any society truly speak the same language.

The British prison service once more shows how out of control the problem of drugs in U.K. Prisons has become.
Between November 2004 and 2007, there were 443 incidents in which drugs - both illegal substances and unlawfully held prescriptions - were discovered at Holme House Prison, Stockton.
In 2005, there were 191 drug discoveries at Holme House, compared to 98 in 2006 and 142 between January 1 and November 6 last year.
The figures, revealed under the Freedom of Information Act, include all drug discoveries made in the prison - on prisoners, visitors or in cells.
Recently fears were raised over the growing use of drugs such as heroin substitute Subutex as a recreational drug in jails.
One 30-year-old former Holme House prisoner, a recovering heroin addict from Stockton, claimed more than half of inmates used drugs.
He said: "At the moment the main thing is a thing called Subutex. For one tiny tablet they go for £50. People get cut up for them and slashed for them."
The former inmate, who does not wish to be named, claimed tennis balls containing drugs would also get thrown over the wall.
Governor of Holme House, Matt Spencer, said his staff used a string of measures in a bid to banish drugs.
He said: "Stopping drugs coming into Holme House is a constant problem and we do have systems in place to stop drugs coming in. Quite obviously, we are not 100 per cent successful in that.
"There are also measures in place to seize and confiscate drugs when they are found in prison.
"We have a regular system of searching prisoners and their cells. Prisoners take part in drug tests, both mandatory and voluntary."

AN electronic cigarette that gives smokers their nicotine hit without the other harmful ingredients in tobacco smoke might help them beat their addiction, scientists say.
Auckland University researchers are recruiting 48 smokers who want to quit to take part in a world-first trial of the "e-cigarette".
Hayden McRobbie, from the university's clinical trials research unit, said the e-cigarette, which is sold over the Internet by a Chinese company for $200, is marketed at present as an alternative to smoking rather than a tool to stop smoking.
"But we think it might actually prove more effective than currently available nicotine-replacement treatments, such as patches and gum, because smoking is not just a chemical addiction - it's behavioural."
The device is "smoked" like a normal cigarette, and even glows at the tip when the smoker draws on it.
A vaporiser device delivers a measured dose of nicotine in a mist.
"Ex-smokers often say they miss the ritual of smoking; the e-cigarette gives them something to do with their hands."
Dr McRobbie said the "quit or die" message was not working for many smokers, who knew the dangers but were powerless against their craving.

Actor Christian Slater says that watching his own films makes him miserable because they flash him back to the days when he was addicted to drugs.
The 'True Romance' star was jailed in 1997 following accusations of assaulting his then girlfriend, Michelle Jonas, and several policemen in a state of inebriation.
Although Slater has been sober for a number of years, he insists that watching his own films reintroduces him to his torturous memories.

The mayor of Victoria even advocated establishing several "Insite" safe injection sites around the island, about which no further mention has been made after many letters of objection.
Apparently crack pipes are widely used, are not issued by the Island Health Authority, but must be condoned and encouraged if the Health Authority is considering issuing in the new year, "safer crack kits" of sleeves and screens that fit over pipes to reduce the chance of spreading Hepatitis C and other diseases, instead of tackling the real problem of drug addiction head on.
Crack cocaine is a highly addictive, relatively cheap and prevalent street drug used across Canada. It can be heated, smoked through a pipe, injected and sniffed. Why, oh why, would anyone encourage the use of addictive drugs when there is such a universal sickness permeating society worldwide. There is only one solution--treat drug addiction properly, eradicate the drugs and prosecute those importing and selling it, before it spreads any further.
Addicts feed their addiction through theft, encouraging dealers and the importation of the supply by drug lords and all sorts of criminals, enriching themselves and their families, making the addicts criminals as well. To condone and encourage the use of crack pipes plus the attachments in the new year, is only increasing the problem at the taxpayers' expense, just to prevent a few cases of Hepatitis C.
If this disease is estimated to cost the Canadian health care system billions of dollars a year, this money could be spent more wisely in treating drug addicts in a residential detoxification and rehabilitation centre or clinic, where they can be educated and taught trades, while being treated, then returned to society as healthy contributing citizens, instead of living a permanent hell, without any hope for the future.
Note should be made of such a community, opening mid-January near Prince George by MLA Lorne Mayencourt, who has had the courage, vision and understanding of how drug addiction should be treated and is pursuing this dream.
Cocaine especially, according to Australian 2006 research results, prevents the up-take of the necessary precursors, dopamine and probably, serotonin, which stimulate the brain's neuro-transmitters.
The tunnel vision regarding the correct treatment of drug addiction needs revision, more attention and understanding. It could take from two to three years for an addict to be rehabilitated after treatment and training, including plenty of fresh fruit, vegetables, minerals, vitamins, rest, fresh air, exercise, encouragement and hope, in the country somewhere away from temptation and big city influences. Such a residential detoxification and rehabilitation community is now being made available near Prince George

Chinese experts, this drug addiction is somehow related to a person's genetic makeup.
According to Chinese scientists, they have identified around 400 genes that seem to make some people more addicted to drugs compared to others.
Furthermore, the results show that the environment factor consisting of peer pressure, neighborhood and the likes only comprise 40% of a person's vulnerability to drugs, while the remaining 60% is attributed to the said genes.
The scientists used four addictive substances in the study namely cocaine, opiate, alcohol and nicotine and mapped out five molecular pathways that trigger addiction. The genes in question turned up more frequently in the determined pathways.
"These common pathways may underlie shared rewarding and response mechanisms and may be targets for effective treatments for a wide range of addictive disorders," commented the scientists.

video game addiction has fallen off the radar ever since the American Medical Association declined to classify it as an official diagnosis last summer.
However a local Canadian TV station revived the topic for a recent segment. Weighing in were Liz Woolley, founder of Online Gamers Anonymous (and occasional GamePolitics visitor), Mark Ouellette, professor of pop culture at Ontario’s McMaster University, and Faith from Destructoid, who writes:
It really bothers me that the con side of the conversation got more air time… especially when I had the academic on my side… Games may be the stuff of peoples’ addictions sometimes, but they are never the cause…
Liz Woolley, of course, got into the game addiction topic following the death of her 21-year-old son Shawn, who committed suicide in 2001 while playing Everquest