Minnesota Targeting Painkiller Abusers

Facing an epidemic of abuse, Minnesota is now tracking
prescriptions such as Vicodin and OxyContin to prevent doctor-
shopping.

By JOSEPHINE MARCOTTYmarcotty@startribune.
com

Last update: January 6, 2010 – 8:26 PM

It’s a dilemma doctors face all the time. A new patient claims to be in serious pain and
asks for Vicodin or OxyContin. Is the pain  real or is the patient an addict?

Now, a new, controversial statewide database is supposed to help them figure that out.
Starting this week, pharmacies are required to collect patient and doctor information on
every prescription they fill in an effort to address the national epidemic of painkiller
abuse. According to state estimates, 117,000 Minnesota adults abuse prescription drugs
every year.

When it’s fully up and running in March, the database will allow Minnesota doctors and
pharmacists, for the first time, to check whether patients are getting too many
prescriptions for the same narcotics from different providers. Also known as doctor-
shopping, it’s a way for addicts to feed their habit without tipping off individual
physicians or pharmacies.

But Minnesota doctors are divided over the new registry. Some, like emergency room
doctors, are relieved that they now will have a way to be sure they are not simply feeding
someone’s habit. But others say it will scare doctors into writing fewer needed
prescriptions for fear of being investigated by law enforcement or professionally
disciplined.

“Physicians are very squeamish about prescribing and being scrutinized,” said Dr.
Miles Belgrade, a pain specialist at the University of Minnesota Medical Center who
testified against the proposed plan at the Legislature in 2007.

Even drugs for pets

Minnesota is the 34th state to monitor prescriptions for controlled substances such
as amphetamines, barbiturates and even some diet pills. The database, funded with a
$400,000 federal grant, will track more than 1 million prescriptions per year.

Under the law, almost every Minnesota pharmacy that provides controlled
substances now must submit the name and address of the patient — and even the name
of the animal if it’s for a pet — the name of he prescriber and the pharmacy that fills it.

Doctors will be able to check the Minnesota Prescription Monitoring Program database
when they doubt a patient’s story, said Cody Wiberg, executive director of the Minnesota
Board of Pharmacy, which manages it. They can see, for instance, whether the patient has
filled five prescriptions for Vicodin at five different pharmacies in the past two weeks.

That’s the kind of information that Fairview Health System discovered when it looked at
patient charts from several of its hospital emergency departments.

“We would see people going from one hospital to the next on the same day and on
the next day and not telling the second and third doctor about the other visits,” said
Susan Van Pelt, director of quality improvement for Emergency Physicians
Professional Association, a doctor group that staffs some of Fairview’s emergency rooms.

Getting help for abusers

With the database, doctors can make a more informed decision about the patient, Wiberg
said. The main goal, he said, is to help patients, not catch criminals.

“We’re hoping that somewhere along the line, a health professional is going to intervene
and try to get this person the help that they might need,” Wiberg said. Some might be
addicts who need treatment, and some might be people with under-treated chronic pain
who need the help of specialists.

The law that created the database is designed to keep out those who just want to find
wrongdoers. The government is prohibited from using it to check on doctors’ p
rescribing habits for fear of discouraging them from prescribing painkillers to people
who really need them, said Robert Leach, executive director of the Minnesota Board of
Medicine.

“We didn’t want … to have a chilling effect on the treatment of pain,” he said.

But Belgrade says that the chilling effect still could be a problem. “The law may say that,
but that and the psychological effect on physicians are two separate things,” he said.
Other states have found that the number of prescriptions declined after they began
monitoring prescriptions. But no one knows if that’s because it worked as intended or if
doctors simply wrote fewer of them.

The law also states that criminal investigators must have a search warrant or a court-
ordered subpoena to access the database, but that, too, is of little comfort to Belgrade.

“I don’t know how hard it is to get a subpoena,” he said.

Staff writer Maura Lerner and the Associated
Press contributed to this story. Josephine
Marcotty • 612-673-7394

“Social Opiate Use” AKA Casual Using

From time to time I get to talk to young people who have been “experimenting” with Vidodin, OxyContin, or heroin, about a concept they call “social opiate use”, also called “casual using”. What is this concept? It is the belief, a myth really, that over a period of time, maybe a long period of time, you can use pills or heroin recreationally, as long as you’re cautious about how often you use and how much you use. What is the major flaw in this thinking?  This is the flaw: This line of reasoning assumes that the heart of addiction is the physical dependence your body develops on the opiates. This is not true. In point of fact even the most long-term, entrenched opiate habit can be detoxified in 4-6 days. So the issue isn’t the physical habit. The issue is the obsession to use, the single mindedness of thinking; all driven by the emotional dependence you develop on wanting and needing that sense of ease, comfort, and complete release from fear and worry that committed users get from opiate use. This sense of cushion and armor becomes so intractable, that you loose the ability to handle life on life’s terms, and even the daily ups and downs that normal folk are able to handle –that you used to be able to handle-with a littler bit of difficulty, becomes impossible.  It starts to be all you think about. If you have a pattern of using with your friends on Saturday nights, and you never use on Fridays, after 5-6 weeks, comes Thursday night, you start saying to yourself, “hey it would be fun to get high tomorrow night and Saturday too, it’s not that big a deal”. Even if the money is tight, and something inside you says this might not be such a good idea, you’re more then likely to do it, because something else inside you says “don’t worry about it, it’s cool”. And so it goes, until Friday becomes Thursday, and some of your friends get a little scared because it’s all you talk about, and you can’t figure out what they’re so afraid of. Welcome to social opiate use, the fantasy of something that doesn’t, and never has existed. Except in your mind, that is.

US stars are falling victim to prescription drugs // Thousands of Britons are also addicted to painkillers and other pills obtained legally from GPs or on internet

US stars are falling victim to prescription drugs

   The Observer, Sunday 27 December 2009

Thousands of Britons are also addicted to painkillers and other pills obtained legally from GPs or on internet

Aerosmith lead singer Steven Tyler has finally admitted he has a drug problem. Given the rock star’s legendary excesses of the past, such a move might not seem surprising. But there was more to Tyler’s decision last week to check himself into rehab than first meets the eye.

The 61-year-old singer had long ago cleaned up his act and put his years of heavy drink and drug abuse behind him. His current problem is very different. He is addicted to painkillers, he announced in a statement – a dependence that began after taking medication to cope with 10 years of injuries from his performances.

Tyler’s stage antics have left him with severe chronic pain and damage to his knees and feet. During a show this year he fell off a stage and broke a shoulder. Now he is addicted to the medicines he has used to kill the pain.

But the revelation of Tyler’s problem is significant not just for its importance for Aerosmith fans. His is merely the most recent example of a growing US showbiz trend that has seen more and more stars admit prescription drug addiction, while cases of dependence leading to fatal overdoses have soared. Among the deaths linked to prescription drugs are those of Heath Ledger, Anna Nicole Smith and Michael Jackson, a toll that was added to last week with the death of Brittany Murphy, star of 8 Mile and Clueless. The 32-year-old Hollywood actress was pronounced dead at Cedars-Sinai Medical Centre after collapsing at her Hollywood Hills home last Sunday.

Murphy’s husband, Simon Monjack, has vehemently denied that she was addicted to prescription painkillers. Yet notes obtained from a Los Angeles coroner’s office official have indicated that a formidable list of drugs were found in her room. These notes also stressed that “no alcohol containers, paraphernalia or illegal drugs” were discovered there.

Tragedies like these suggest the celebrity habit of pill-popping – sometimes known as pharming – is spreading alarmingly. Early this year Burt Reynolds admitted he was “a prisoner of prescription pain pills” and checked into rehab, following a long list of stars, including Winona Rider, Charlie Sheen, Jamie Lee Curtis and Friends‘ star Matthew Perry, who have admitted addiction to painkillers and other prescription drugs.

Such cases make headlines because they expose the lives of superstars. But they represent only the tip of an iceberg, doctors warn. In 2005 non-medical use of painkillers contributed to more than 8,500 deaths in the US. Overdose deaths involving prescription pain relievers increased 114% from 2001 to 2005, the most recent year for which nationwide data are available, says the Office of National Drug Control Policy.

Prescription drugs are becoming America’s new addiction, studies show. For example, in one survey of teenagers between the ages of 13 and 18 a total of 155 reported abusing prescription drugs obtained through a friend or taken from a medicine cabinet, sometimes by organising “pharming parties” where pills are put in bowls and shared with friends. The practice has become common in rural areas – hence the use of the term “hillbilly heroin” to describe painkillers that are taken recreationally.

But why is this abuse growing? Is it confined mainly to young people, or are older individuals involved as well? And is this wave of addiction likely to spread to Britain? These are key questions that raise controversial issues about attitudes to medicine in the West.

For a start, there is the issue of our faith in the medical profession. Addiction to prescription drugs often arises as an accidental dependence to a drug first taken, and given, in good faith for a real ailment. For example, Michael Jackson is thought to have become addicted to Demerol – or Pethidine, as it is called in Britain – after suffering a serious burn inflicted during the filming of a Pepsi commercial in 1984.

Twenty years later, use had turned to abuse and Jackson was suffering severe dependence, according to subsequent interviews with his staff. They say the singer frequently asked them to get prescription medicines under different names. One said he took Jackson to doctors’ offices in other states and the singer appeared to be “out of it and sedated” after each visit. On top of this Jackson’s physician, Dr Conrad Murray, a cardiologist, has admitted that he gave Jackson 25 milligrams of propofol on the day he died and has told police Jackson was dependent on the drug to sleep.

“I think people of all ages don’t take medication as seriously as street drugs,” says Dr Marvin Seppala, the chief medical officer at Hazelden, a drug and alcohol treatment centre in Minnesota. “There’s sort of a naive belief they’re safer. The truth is pain medications are in the same exact class as heroin, morphine – they’re very addictive.”

This point is backed by examining the list of drugs found in Murphy’s room. These included Topamax, Methylprednisolone, Fluoxetine, Klonopin, Carbamazepine, Ativan, Propranolol, Biaxin, Hydrocodone and miscellaneous vitamins. Many of these are extremely powerful, says Professor Simon Maxwell, chairman of the British Pharmacology Society’s prescribing committee. “Methylprednisolone is a very strong anti-inflammatory drug that should only be used for people suffering from severe inflammatory conditions such as rheumatoid arthritis.”

Other medicines on the list include treatments for epilepsy, such as Topamax, powerful pain relievers like Hydrocodone and Vicoprofen, and anti-depressants such as Fluoxetine. “I cannot see how the prescribing of these medicines can be justified on medical grounds,” added Maxwell, who is based at Edinburgh University.

These points were backed by Munir Pirmohamed, professor of clinical pharmacology at Liverpool University. “This is a horrendous list. Many of these are powerful medicines that are supposed to be prescribed for very specific, serious conditions.”

However, as is clear from the example of Michael Jackson, when a star wants access to drugs, they generally get their way. For his part, Heath Ledger was taking a combination of painkillers, sleeping pills, anti-anxiety medication and tranquillisers when he died. In such cases, official reports often record death as being from a heart attack. “To be frank, that is highly unlikely,” added Maxwell. “These are young people. Their hearts stopped all right, but not because they had a heart attack. They died because of all the powerful drugs they were taking.”

Thus individuals take these drugs – initially – to counter discomfort or to deal with anxiety that is robbing them of sleep or sometimes, using drugs like Adderall, to increase their concentration. They increase their doses as their tolerance rises, but see no worries as the drugs involved were originally prescribed by their physicians. Eventually they end up on regimes of many drugs that lead to breakdown or death.

Another key factor in this accumulation of potent drugs is the internet. Although it is supposed to be rigorously monitored to prevent people buying prescription drugs, reports indicate that these are routinely circumvented. In this way, powerful painkillers and anti-anxiety medication can be purchased in large quantities by significant numbers of people. As to the issue of painkiller addiction spreading to Britain, there is little doubt that this has already happened.

Last year a parliamentary inquiry concluded that British doctors are unwittingly fuelling numbers of people hooked on prescription drugs that include painkillers, sleeping tablets and anti-anxiety pills. For example, the Home Office blames misuse of benzodiazepines for causing 17,000 deaths since their introduction in the 1960s.

MPs said they had been “extremely concerned” to receive many testimonials of people still being negligently prescribed these drugs by their GPs. Dr Brian Iddon, the Labour MP and former chemist, told the Observer: “Some GPs are addicting people by giving them repeat prescriptions without checking to see how long they’ve been on the drugs in the first place. They are not stopping patients from getting any more of them after the set amount of time.”

The MPs’ investigation also claimed that family doctors were contributing to growing problems associated with these substances by not taking seriously enough requests for help from addicts, and by mismanaging patients with chronic pain.

Medical experts told the inquiry that an unknown, but growing, number of people had become addicted to painkillers, often after taking them initially for genuine medical complaints such as a sore back, period pains or bad headaches. Some developed a dependence on over-the-counter drugs as a result. Solpadeine and Nurofen Plus are the two such substances most widely misused, the MPs say, with 4,000 subscribers to one specialist advice website alone hooked on Solpadeine.

“Of course, there is always going to be a subset of people who want to experiment with substances,” said Pirmohamed. “There are also individuals who want to take risks. This is not the case with many of those addicted to painkillers and other prescription drugs, however. Many of these people simply do not realise that all drugs – no matter how beneficial – are poisonous at some level.

“That is the real key for dealing with this issue. We need to educate people to the dangers of all the medicines we consume.”

Assessing Prescription Drug Usage for Dependency

Self assessment for prescription drug dependency starts simply by checking in with yourself in an honest manner. While addiction professionals at private drug rehab may be best suited to interpret your responses, your first steps to healing can begin with honest answers. Find a time when you can reflect on your prescription drug usage, and ask yourself the following questions. Answering “Yes” to any four questions indicates a strong likelihood of prescription drug dependency and the need to enter a drug treatment program.

• Am I experiencing prescription drug withdrawal symptoms?
  Common withdrawal symptoms for prescription drug addiction can being anger flare-ups, depression, anxiety and irritability. Certain prescription medications may also lead to digestive problems, panic attacks or tremors when usage suddenly declines or ceases.
• Has the prescription drug become overly important to me?
  How large of a role has prescription drug usage taken in your life recently? Do you ever avoid social engagements, job duties or family gatherings in order to use prescription medication or because you are in an altered state from it? Do you find yourself planning your next dosage, looking forward to refills, or spending time recovering from the effects of the medication? These all may be indicators that you have a prescription drug dependency and need treatment at a qualified private rehab program.
• Am I using my prescription medication when I do not want to or didn’t intend to?
  Use that is not pre-planned or thought through can often indicate a prescription drug problem. Ask yourself how closely you stick to your intended or prescribed dosage throughout the day.
• Do I feel like I’ve lost control over your medication dosage and frequency levels?
  When you’ve noticed your prescription drug use increasing, and made attempts to cut back or quit, how successful have you been? If you feel that you simply keep using your prescription medicine even when you intend to lower or cease it, it may indicate an addiction that has spun out of control. Holistic rehab programs can help you overcome the prescription drug dependency in your life, as well as find ways to manage pain that do not put your body, lifestyle and well-being at risk.
• Am I always being safe while on my medication?
  Taking prescription medication comes with certain cautionary responsibilities. If you have found yourself driving a vehicle, operating equipment, or caring for children while on medication, you may have a prescription drug addiction and may benefit from seeking out inpatient drug rehab programs.
• Has my mental or physical health suffered as a result of taking my prescription drug?
  Ultimately, our bodies and minds tell us how prescription medication is affecting our lives. Ask yourself if your health has improved or declined since beginning your medication. How have your moods, outlooks and interpersonal relationships fared? Continued prescription drug use despite declines in physical and mental health may indicate a medication addiction.

Related posts:

1. Discussing Dependency With Prescribing Physicians Talking with your doctor about your past dependency can seem…
2. Chronic Pain and Prescription Medication Dependency More than 50 million people deal with chronic pain…
3. Doctor Shopping and Prescription Drug Addiction The practice of “doctor shopping” has emerged as a tactic…
4. The Epidemic of Prescription Drug Abuse Prescription drugs have certainly made our lives easier, allowing people…
5. Pain Management and Prescription Drug Tolerance From physical injuries to chronic conditions, humans can experience high…

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Writers in Treatment: A Creative Outlet for Recovering Addicts

This is a wonderful blog posting I saw on a website called drug addiction treatment. I hope you find it valuable. Happy holidays. Jerry

By LeAnne Bagnall
Writers in Treatment (WIT) is a recovery program unlike any other in that it offers support specifically for writers who are struggling with substance abuse, addiction, or a behavioral disorder.

Founded last fall by former publisher Leonard Buschel, WIT’s mission is to prevent writers from succumbing to substance abuse and depressive disorders while enclosed in their isolated work environments. Most writers work from home or in other solitary, nonsocial conditions, which may cause them to unnoticeably develop certain behavioral conditions such as depression or anxiety disorders, or engage in unmonitored levels of alcohol or drug abuse. Some writers may believe that their substance abuse, which may involve alcohol, narcotics, or a combination of both, may actually fuel their creative spark, like a muse.

The image of the tortured artist has often been romanticized throughout literary history, as in the idolization of Hemingway or Woolf, to the point where these emerging writers may excuse their risky behavior as custom to the lifestyle. However, these writers—ranging from journalists to novelists, playwrights, or screenwriters—do not realize that they are putting themselves in extreme danger. The abuse can carry on for unregulated periods of time, be taken in excessive doses, and lead to self-destructive behavior or overdose. The idea of slowly killing oneself while living and working alone in a dark, isolated state can be quite frightening; if something serious were to go wrong, it would be very hard for the individual to find immediate help.

Substance abuse and addiction may last for years, even after hitting rock bottom one or more times. It often takes a moment of epiphany for artists and writers to “wake up” and finally decide to get help. That’s where WIT steps in, offering a wealth of clinical, medical, and creative resources for writers to help them recover and overcome their addictions. WIT even offers financial options for residents without health insurance to help cover their expenses, such as no-interest loans that are set up to be repaid once the writer is reemployed.

Qualifications for WIT’s program require that the patient be at least 18 years of age and make at least a quarter of their income through writing. The goal is to remove the writer from that solitary struggle and into a group recovery effort. Writers can relate to one another while receiving proper treatment from trained counselors and medical professionals. WIT runs after-care programs, relapse prevention programs, and monthly meetings to help writers maintain sobriety, as well as cultural programming including book clubs, writer’s workshops, film screenings, concerts, networking opportunities, and seminars with celebrities and guest speakers.

This Saturday, December 12, WIT and It’s Perfect Malibu will be hosting a special gala holiday fundraising party called “Festival of Laughs” in Malibu starting at 7:30pm. The event will promote sobriety and creativity for struggling writers during the holiday season and will feature comedic standup and talks from a variety of guest speakers. Also, a new bookstore and 12-step store will be open to the public during the entire event. The Special Honored Guest, Christopher Kennedy Lawford, will be present to discuss and autograph copies of his 2009 success, Moments of Clarity.

WIT is aimed at teaching writers that there are other options available to them when it seems like their profession offers no other choice. The nonprofit organization offers outpatient and residential rehabilitation treatment backed by a strong advisory board of certified psychologists and other clinical professionals. WIT has partnered with other sobriety organizations such as the Betty Ford Foundation and colleges and theaters throughout the greater Los Angeles region.

Founder Leonard Buschel, who also struggled with addiction while living as a writer, sought help through rehabilitation once himself, and was inspired to create Writers in Treatment to help others writers overcome their addictions. Buschel hopes that WIT can help writers rediscover their natural muse and fulfill their writing aspirations through sober living.

New LifeRing Meeting

Reliance Center is making our facility available to a lunchtime meeting of LifeRing. LifeRing is a recovery organization that holds groups where recovering individuals can  discuss their week  in a safe place. It is not AA, or NA. There are no steps or sponsors. there is no need to have a relationship with a “higher power” . The meeting is at noon on Wednesdays in our offices, 450 Sutter Street, Suite 300. San Francisco

Addiction on 2 Fronts: Work and Home

This is a wonderful article that appeared in today’s New York Times. It’s a little long, but wonderful.  Jerry

WASHINGTON — His son had been dead from an overdose only three months when A. Thomas McLellan, among the nation’s leading researchers on addiction, got a call from the office of Vice President Joseph R. Biden Jr. Would he accept the nomination to be the government’s No. 2 drug-control official?

Skip to next paragraph Dr. McLellan, 61, makes no secret of his cynicism about government — “I hate Washington,” as he put it in an interview — and he had no intention of leaving his job as a professor of psychology at the University of Pennsylvania School of Medicine and scientific director of the Treatment Research Institute in Philadelphia.

But the loss of his younger son, who overdosed on anti-anxiety medication and Scotch last year at age 30 while his older son was in residential treatment for alcoholism and cocaine addiction, changed his perspective.

“That’s why I took this job,” said Dr. McLellan, who was sworn in as the deputy director of the Office of National Drug Control Policy in August. “I thought it was some kind of sign, you know. I would never have done it. I loved all the people I’ve worked with, I loved my life. But I thought maybe there’s a way where what I know plus what I feel could make a difference.”

Married to a recovering cocaine addict, Dr. McLellan has been engulfed by addiction in life and work. His own family has been a personal battleground for one of the country’s most complex and entrenched problems, while as an expert he has been a leading voice for the idea that addiction is a chronic illness and not a moral issue.

This view squares with that of his boss, R. Gil Kerlikowske, a former Seattle police chief who declared on taking office as drug czar in May that President Obama’s administration would no longer use the term “war on drugs” — and that the term implied the government was waging a battle against its citizens.

Instead, the two men say the government needs to change its drug-control strategy, redirecting some of the resources into prevention and treatment and away from law enforcement and antitrafficking efforts, which consumed 75 percent to 90 percent of the budget during the Bush administration.

Dr. McLellan said that of the 25 million substance abusers he estimated were in this country, only about 2 million were receiving treatment. He and Mr. Kerlikowske want to triple that number, partly by spending more money and partly through other tactics, like integrating addiction treatment into the primary health care system.

Many veterans of the long and frustrating fight against addiction say it is about time. “This is an extraordinary moment of opportunity,” said Dr. Nora D. Volkow, director of the National Institute on Drug Abuse and one of the colleagues and friends who helped persuade Dr. McLellan to take the job.

Still, even Dr. McLellan’s most ardent supporters say the challenges are formidable. The federal drug-control office can do only so much, and the Obama administration decided the drug czar would no longer be a cabinet-level position. State and local governments, law enforcement agencies, the health care system and schools are all big players. And taxpayers tend to have little sympathy for addicts or for treatment programs with track records that are mixed at best.

“I can tell a state legislator that if you would only provide treatment for these guys, we’d have the greatest reduction in crime,” said Joseph A. Califano Jr., chairman of the National Center on Addiction and Substance Abuse at Columbia University. “But those constituents want computers in the schools, better roads, better sewage systems.”

Mr. Califano, who was been involved with government efforts to combat the drug problem since the days of President Lyndon B. Johnson, said that he had great admiration for the new leaders of the drug-control office but that “you need a presidential commitment here.”

“I think if Obama gave these two guys the spark, they would know how to turn into a fire,” he said.

The office is preparing its drug policy strategy, to be released in February along with Mr. Obama’s budget. “We are going to get the money to do this,” Dr. McLellan insisted. “I can’t tell you the amount or where it’s coming from, but we’re going to get it.”

The drug czar himself, who has made passing reference to his adult stepson’s struggles with drugs but does not discuss it openly, was more cautious, as he tends to be.

“I think for some folks, radical change will be their only measure of success,” Mr. Kerlikowske said in an interview. “I don’t think we’ll see that. I think we’ll make a lot of progress, we’ll slow the freighter down and start turning it in the direction of the more balanced view.”

The two make an interesting pair — the former police chief who has plenty of experience parsing words with reporters, and the plainspoken, quirky and mustachioed psychologist who says “ain’t” and “yeah,” and whose candor can make Washington insiders nervous.

Dr. McLellan, who has written or collaborated on more than 400 papers on addiction, is well known among his colleagues and friends for both his passion for the subject and his bluntness.

In a recent interview in his office here — still sparsely decorated except for a photocopied picture of his family, including his surviving son and two young grandsons (or “grand felons,” as he called them) — Dr. McLellan put his feet up on the coffee table and declared, “I hate this job.” “This is a job that needs scientific background,” he went on. “But if you come to it with the kind of desires to turn everything into a scientific experiment, you will have your poor little heart broken.”

Skip to next paragraph Despite Mr. Kerlikowske’s insistence that putting more resources into prevention and treatment does not mean the government is going soft on crime, such policies are bound to be controversial. Conservatives point out, for example, that drug treatment and detoxification programs have relapse and dropout rates as high as 80 percent or 90 percent.

“I’m not sure the federal government has an obligation to try to rehabilitate addicts,” said Heather Mac Donald, a senior fellow at the Manhattan Institute, a conservative policy research group. “Government has an obligation to provide safe streets to people, and policing has an extremely effective track record in places in like New York City and Los Angeles.”

Dr. McLellan grew up in Mechanicsburg, Pa., and while his family was “riddled” with addiction, he says he wound up in the field almost by accident. He said that while he drank, he was “constitutionally unfit to be an alcoholic,” and therefore did not have what he and many others consider to be a genetic disease.

He earned his doctorate in experimental psychology, with a focus on animal learning, from Bryn Mawr College in 1976.

“You’ve undoubtedly — I think almost every American has read my Ph.D. thesis by now,” he said. “ ‘Negative Autoshaping in the Rat, Cockroach, Pigeon and Crayfish.’ And armed with this kind of knowledge and obvious preparation for the business world, I was shocked to find that there weren’t many jobs available.”

So he went to the veterans’ hospital in Coatesville, Pa., to see what was available. He was offered a job as a technician to evaluate the effectiveness of one of the nation’s first drug and alcohol rehabilitation programs, and that led him and a team of researchers to develop the Addiction Severity Index, now established as a standard assessment tool for drug and alcohol abuse.

In recent years, Dr. McLellan has focused on the lack of addiction screening in primary health care settings like doctors’ offices and emergency rooms. For example, he said, just as with hypertension or diabetes, there is a concrete way to measure whether someone has an alcohol problem.

The measuring stick is known as “3-14” — so if someone is having 3 or more drinks a day, or 14 per week, that should raise a red flag, and physicians should be much better equipped to intervene and offer treatment options if there is a problem. Ideally, Dr. McLellan said, that treatment would be available in the medical system itself, not segregated in rehabilitation and detox programs, with their high failure rates.

He said another goal was to get a better handle on measuring the use of drugs and alcohol by those under 21, the time of highest risk for the onset of addiction. His younger son was in eighth grade when he began to struggle with addiction, and by then Dr. McLellan was a prominent researcher in the field.

“If it has to happen, better it happens to me, I’m an expert, right?” Dr. McLellan said. “I didn’t know what to do and none of my buddies knew what to do, and let me tell you they were experts. So I said, ‘What the hell are we doing?’ ”

That prompted him to start the Treatment Research Institute to evaluate addiction treatment. But both of his sons continued to struggle with addiction.

Dr. Volkow, of the national drug-abuse institute, said the death of the younger son “epitomized how unprotected people who are addicted to drugs are, even with that father.” Of Dr. McLellan, she added, “He’s an absolute true warrior in the best sense of the word.”

The older son is doing well now, and the two enjoy working together to restore houses and sell them. “Maybe when I get out of here, I’ll do more of that,” Dr. McLellan said.

Then he quickly added, “There’s a lot of need for drug-free housing.”

29 Young Rockland Co. Adults Busted In RX Sting

New City, NY (CBS)  On Wednesday, more than two dozen young people were charged with peddling various prescription pills. They range in age from 16 to 34, and many come from affluent families. Most have no prior criminal records.

It is a real education for a community that prides itself on teaching young people about the dangers of drugs. For a year, the Rockland Narcotics Task Force made undercover buys of prescription drugs – everything from the anti-More then 2 dozen young adults were arrested Rockland County charged with illegally selling prescription drugs.
“This follows a national trend, that prescription pain medication in particular is a hot commodity,” said Marge Davitt of the Rockland Health Department.

Police said undercover agents bought the drugs in parks, and even on the ground of the Congers Elementary School.

“We’re very concerned about it as they are nationally. These are very, very addictive drugs,” said Rockland County District Attorney Tom Zugibe.

OxyContin abuse is particularly concerning. It’s a pricey pill that often leads users to try even harder narcotics.

“We were buying 80 gram Oxycontin pills for a dollar a gram – $80. Once that money runs out they satisfy their addiction by buying $5 worth of heroin,” said Zugibe.

From Long Island to the Hudson Valley, it’s a scourge across the suburbs, with young adults raiding the medicine chest for all kinds of prescription pills.

“Because it’s not crack, or heroin, cocaine, selling a prescription pill is innocuous compared to some of the harder drugs, yes. That’s what they think,” said Capt. Joe Tripodo of the Narcotics Task Force.

Officials with the task force urge parents to talk to young adults about the dangers of prescription drug abuse, and to inventory and secure what’s in your medicine cabinet.

This Saturday every local police department in Rockland will be accepting unwanted prescription pills. Everything collected will be safely destroyed

Rising Pain Pill Use Taking Deadly Toll

By Bob Stiles

TRIBUNE-REVIEW
Sunday, November 29, 2009

I know this is long, but its important. JB

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What’s Done Is Done…

What’s done is done.  It cannot be undone.  One of the first things you need to come to terms with when you enter recovery is that the past cannot be remade.  The voices (The Committee-you remember The Committee) would like to pull you down with recriminations, useless remorse (addicts are always remorseful), self-pity, and fantasized “if-onlys”.  If you are fortunate, you will be told by counselors you trust that these energies would best (and must) be spent creating the actions, structures, and personality changes that will be required if we are going to prevent these things from happening again.  Things like lost jobs; failed marriages; alienated children; squandered opportunities; bitter friends; and a record of lying, cheating and stealing from the ones we loved most. Years and years of selfish, self-centered, destructive living cannot be waved aside with a wish to start fresh. [...]