Illicit Drug Use Spikes During Special Events Interview with:
Bikram Subedi, PhD Assistant Professor of Analytical Chemistry Murray State University, Murray KYBikram Subedi, PhD

Assistant Professor of Analytical Chemistry
Murray State University, Murray KY What is the background for this study? What are the main findings?

Response: The USA is one of the major consumers of diverse neuropsychiatric and illegal drugs, and recently declared a national public health emergency on opioid abuse. Law enforcement typically utilized conventional methods of determining drug consumption rate which are based on survey questionnaire, hospital admissions, drug-related crime statistics, and self-reported information. Conventional methods typically underestimate the actual consumption rate of drugs.

Our new approach of determining consumption rates of drugs in community is time and cost effecting and comprehensive. Based on levels of drugs quantified from raw sewage, the per capita consumption rates of several illicit drugs including methamphetamine, amphetamine, cocaine, and THC in two communities of Western Kentucky (similar population and only ~50 miles apart) were significantly different. During special events such as July 4th and 2017 solar eclipse, the consumption rates were found even higher. The consumption rate of methamphetamine was among one of the highest ever reported in the country.  Continue reading

Gene Deficit May Give Immunity to Effects of Cocaine Interview with:
“Cocaine concealed in washing powder” by The National Crime Agency is licensed under CC BY 2.0 What is the background for this study? What are the main findings? 

Response: Drug addiction is a chronically relapsing neuropsychiatric disease that affects 15.5 million people in Europe at a cost of 65.7 billion euros per year. All addictive drugs have in common to cause an artificial increase in the release of a neurotransmitter called dopamine, a very basic effect that can be found in all studied animal species from the fly to the man. The release of dopamine takes place in a region of the brain called the ventral striatum, or Nucleus Accumbens (NAc), which is directly involved in reward and reinforcement processes. An excess of dopamine release by the dopaminergic neurons projecting to the NAc from the Ventral Tegmental Area (VTA) triggers long-term changes in the brain, which can lead to addiction.

Cocaine is a prototypical addictive drug, since it is heavely abused in Western societies and extensively studied in animal models as well as humans.

We discovered that mice lacking the Maged1 gene showed a marked decrease in cocaine-elicited release of dopamine in the NAc and were entirely unresponsive to cocaine at behavioral level. In fact, they did not show any behavioral reaction normally observed after cocaine treatment, such as cocaine-elicited hyperlocomotion, sensitization (an increased effect of the drug following repeated administrations) or addictive behaviors, such as increased preference for places where the animal expects to obtain a cocaine reward or cocaine self-administration.

In a subsequent set of experiments, the researchers tried to identify what brain regions are responsible for Maged1 influence on cocaine effects and found that Maged1 expression is specifically required in the prefrontal cortex, and not in the neurons producing dopamine in the VTA, for the development of cocaine sensitization and dopamine release.  Continue reading

Children with ADHD Found To Abuse Drugs and Alcohol At Early Age Interview with:

Brooke S. G. S Molina, PhD Professor of Psychiatry, Psychology and Pediatrics University of Pittsburgh 

Dr. Molina

Brooke S. G. S Molina, PhD
Professor of Psychiatry, Psychology and Pediatrics
University of Pittsburgh What is the background for this study? What are the main findings?

Response: There has been inconsistency across previous studies of children with ADHD and their risk of substance use in adolescence and in adulthood. This study closely examined substance use by children with and without ADHD over a long period of time, considering that experimenting with some substances, such as alcohol and cigarettes, is typical after teens reach high-school age.

This study found that children with attention deficit hyperactivity disorder (ADHD) engaged in substance use at a younger age than those without ADHD and had a significantly higher prevalence of regular marijuana and cigarette use into adulthood.

We also found that children diagnosed with ADHD had a faster progression of substance use during childhood and adolescence.

We confirmed a finding for the ADHD group that is widely replicated in the general population – that early substance use strongly predicts adult substance use.  However, more of the children with ADHD were found to be early substance users, such as having a drink of alcohol before the age of 15.

We did not find higher rates of binge alcohol consumption among young adults with ADHD.  However, alcohol use is still an important part of the bigger picture.

The amount of alcohol consumption was self-reported in a questionnaire where the average age of all participants was 25. Binge drinking is very common in early adulthood, but given our findings of children with ADHD starting to drink at younger ages, it’s important to continue this research so we know how many young drinkers with ADHD continue to have serious, chronic problems with drinking as they age. What should readers take away from your report?

Response: It’s very important to understand from our findings that substance abuse begins at a young age – often before high school.  Parents and providers need to understand this and continually assess risk.

We are concerned about the long-term consequences of these substance use patterns.  We do not know how many of these individuals will experience painful and expensive middle age outcomes of chronic substance abuse and associated problems such as divorce, employment problems, injuries, poor health and shortened life expectancy.  Some will be resilient and decrease their substance use.  We need to learn what predicts these outcomes. What recommendations do you have for future research as a result of this work? 

Response: The marijuana use finding is also concerning given the increasing availability of cannabis in the United States and the risk and consequences for children with ADHD needs further study. Is there anything else you would like to add?

Response: These results suggest a crucial need for routine clinical practice to include early screening and interventions to prevent early substance use, including cigarette smoking, among children with ADHD.

Many children with ADHD end up being cared for in primary care settings, so pediatricians are the front-line treatment care providers and conversations about substance use need to begin early. When children with ADHD are being treated, we need to start monitoring their potential risk for substance use at a young age, and not only treating with medication, but considering the range of factors that increase their risk for becoming dependent on nicotine and for developing substance use disorders. 


J Child Psychol Psychiatry. 2018 Jan 8. doi: 10.1111/jcpp.12855. [Epub ahead of print]

Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study.

Molina BSG1, Howard AL2, Swanson JM3, Stehli A3, Mitchell JT4, Kennedy TM5, Epstein JN6, Arnold LE7, Hechtman L8, Vitiello B9, Hoza B10. 

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Cocaine Overdoses Rising Especially Among African Americans Interview with:
“Cocaine” by Nightlife Of Revelry is licensed under CC BY 2.0Dr. Dave Thomas PhD

Health Scientist Administrator
National Institute on Drug Abuse What is the background for this study? What are the main findings?

Response: At the National Institute on Drug Abuse, we support research on all forms of drug use, and are aware that cocaine misuse is on the rise.  We are aware that various forms of drug use can have greater prevalence by race, sex, age and other population characteristics.

The main finding of this paper is that cocaine overdose rates are on the rise and that that the group hit hardest is the non-Hispanic black population.

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Inhaling Poppers Associated With Visual Toxicity Interview with:
Dr. Rebecca Rewbury
Sussex Eye Hospital
Brighton and Sussex University Hospitals Trust
Brighton, UK What is the background for this study? What are the main findings?

Response: ‘Poppers’ are recreational drugs which are illegal to sell for human ingestion, but are sold under the guise of household cleaning products. Inhalation leads to a brief sense of euphoria, enhanced sexual arousal and smooth muscle relaxation. The Psychoactive Substances Act 2016 was due to outlaw poppers, but they were excluded on the basis that they do not act directly on the central nervous system.

The main constituent of poppers, isopropyl nitrite, replaced isobutyl nitrite when the latter was classified as a carcinogen in 2006. Since then, there have been several case reports of ‘poppers maculopathy.’

We noted an increase in patients presenting with central visual disturbances after using poppers and describe 12 such cases. They all demonstrated similar disruption of the photoreceptor layer on retinal imaging. Onset of symptoms was frequently linked to specific brands of poppers, with 3 people having used poppers for many years and only developing side effects on changing brand. Chemical analysis showed that these products contained isopropyl nitrite. One brand of poppers, used without side effects by one patient, contained amyl nitrite, 2-methyl butyl nitrite and isobutyl alcohol, but no isopropyl nitrite.

The outcome of poppers maculopathy varied, but following abstention, visual disturbances and retinal damage tended to improve over months, if not fully resolve. Although in some cases, symptoms and/or imaging findings were prolonged. Ongoing use of implicated brands led to persistent, but not worsening maculopathy, whereas one patient that switched back to another brand showed full recovery.

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Fewer African Americans, More Whites Injecting Drugs Interview with:

Cyprian Wejnert, Ph.D. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention CDC

Dr. Cyprian Wejnert

Cyprian Wejnert, Ph.D.
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
CDC What is the background for this study? What are the main findings?

Response: Our country is dealing with a devastating epidemic of opioid misuse and overdose that affects individuals, families and communities. We have long known that sharing needles and syringes is an incredibly efficient route for HIV, hepatitis and other infections to spread.

Yet, about 10% of annual HIV diagnoses in the United States occur among people who inject drugs, and there are clusters of hepatitis C infections across the country. These infections can be prevented when people who inject drugs use sterile needles, syringes and other injection equipment. One of the main findings of this study is that use of syringe services programs (SSPs) has increased substantially during the past decade, but most people who inject drugs still don’t always use sterile needles.

The analysis finds that more than half (54%) of people who inject drugs in 22 cities with a high number of HIV cases reported in 2015 they used an SSP in the past year, compared to only about one-third (36%) in 2005. Although syringe services program use has increased, findings indicate that too few people who inject drugs use only sterile needles. One in three (33%) reported in 2015 that they had shared a needle within the past year – about the same percentage that reported sharing a decade ago (36% in 2005).

The report also highlights some successes in HIV prevention among African Americans and Latinos who inject drugs, as well as concerning trends in whites who inject drugs. From our study of 22 urban areas, it appears that fewer African Americans are injecting drugs. However, it also appears there has been an increase in white Americans injecting drugs.

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US and Columbia Face Generation of Drug Users Becoming Drug Injectors Interview with:

Pedro Mateu-Gelabert, Ph. D. Principal Investigator National Development Research Institutes, Inc. New York, NY 10010

Dr. Pedro Mateu-Gelabert

Pedro Mateu-Gelabert, Ph. D.
Principal Investigator
National Development Research Institutes, Inc.
New York, NY 10010 

Medical Research: What is the background for this study? What are the main findings?

Dr. Mateu-Gelabert: Heroin production in Colombia increased dramatically in recent decades, and some studies point to an increase in local heroin consumption since the mid-1990s. Despite this rapid increase, little is known about the effects of these activities on heroin injection within Colombia. One of the biggest concerns surrounding heroin injection is the potential spread of HIV through drug user networks.

Medical Research: What should clinicians and patients take away from your report?

Dr. Mateu-Gelabert: The key take home message in the paper is that a widespread early implementation of harm reduction services (e.g. opioid substitution therapy, HIV testing, syringe exchange programs)  can prevent HIV among young PWID (People Who Inject Drugs) before it rapidly spreads within drug injection networks. Reducing HIV among young drug injectors could prevent the spread of HIV from PWID to the general population.

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Children of Military Personnel More Likely To Use Drugs and Have Trouble at School Interview with:
Kathrine Sullivan Ph.D. Candidate

University of Southern California
School of Social Work

Medical Research: What is the background for this study? What are the main findings?

Response: Military families and military-connected youth exhibit significant strengths; however, a sizeable proportion of these families appear to be struggling in the face of war-related stressors. Understanding the consequences of war is critical as a public health concern and because additional resources may be needed to support military families. This study used a large, normative, and geographically comprehensive dataset to determine whether military-connected youth are at risk of adverse outcomes, including substance use, victimization, and weapon-carrying, during wartime.  Results indicated that military-connected 7th, 9th and 11th grade students had greater odds of substance use, victimization, and weapon-carrying compared to non-military connected peers. Specifically, more military-connected students reported using alcohol (45 percent vs. 39 percent), being hit, kicked, slapped or pushed (36 percent vs. 27 percent) or bringing a gun to school (10 percent vs. 5 percent) than other students.  Children with parents or a caregiver in the armed forces were also much more likely to have used prescription medications (36 percent vs. 27 percent), brought a knife to school (15 percent vs. 9 percent), been in a fight (27 percent vs. 17 percent) or feared being beaten up (24 percent vs. 18 percent).

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Most Drugs Have Ingredients That Come From Animals Interview with:
Kinesh Patel, Research Fellow
Wolfson Unit for Endoscopy
St Mark’s Hospital, Harrow HA1 3UJ, UK What are the main findings of the study?

Dr. Patel: Most drugs prescribed in primary care have ingredients that come from
animals, but the animals they come from is not always clear and whether the
drugs are suitable for vegetarians is difficult to find out conclusively,
even after looking at information available on packets, information
leaflets and on the internet.
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