FDA Updates Label for Stop Smoking Drug Chantix (Varenicline) to Include Potential Alcohol Interaction, Rare Risk of Seizures, and Studies of Side Effects on Mood, Behavior, or Thinking US Food and Drug Administration Varenicline (Chantix) is a nicotinic acetylcholine receptor partial agonist, believed to exert its effect of reducing tobacco consumption by blocking nicotine effects on dopaminergic neurons of the ventral tegmental area (VTA). As such, the US Food and Drug Administration (FDA) is warning that varenicline can change the way people react to alcohol. Rare accounts of seizures in patients treated with Chantix have been reported. The FDA has approved changes to the Chantix label to warn about these risks, which warrant communicating to all patients being so treated.
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FROM JOURNAL OF ADDICTION MEDICINE
Prevalent Intravenous Abuse of Methylphenidate Among Treatment-Seeking Patients With Substance Abuse Disorders: A Descriptive Population-Based Study Journal of Addiction Medicine (free ASAM member resource) Operating against common assumptions among those in both the pediatric and addiction treatment communities, the findings of this first Icelandic nationwide study on IV abuse of methylphenidate (MPH) shows that it is common among treatment-seeking IV abusers and suggests that MPH has high abuse potential. It concludes that both the use and possible abuse of MPH in those with high abuse potential should be monitored, especially in countries where MPH prescriptions rates are on the rise.
Krokodil: From Russia with Love JAMA Dermatology This is a brief descriptive piece about Krokodil (from the Russian кpoкoдил, or “crocodile”). Popular in Russia since 2003, it is desomorphine admixed with production contaminants. This injectable heroin analogue is synthesized from codeine (available over the counter in Russia) and other easily obtained materials. Over the years, krokodil has slowly spread across Europe, and has been sensationalized in various media reports as a drug that allegedly “turns people into zombies” and “eats junkies alive.” Indeed, krokodil can leave abusers disfigured, with scaling and green-black skin discoloration secondary to cutaneous infection, necrosis, and gangrene.
Markey, Ayotte Introduce Bipartisan Legislation to Help Prevent Heroin and Prescription Drug Overdoses Sen. Ed Markey This political press release from Senator Markey’s office describes pending legislation that has received endorsement from ASAM. On March 11, Senators Edward J. Markey (D-Mass.), Kelly Ayotte (R-N.H.) and Tim Kaine (D-Va.) introduced the Opioid Overdose Reduction Act to protect first responders, health professionals and family members who are educated in administering an opioid overdose prevention drug, such as naloxone, in an emergency situation of overdose. Rep. Richard Neal (D-Mass.) plans to introduce companion legislation in the House of Representatives in the coming weeks.
NCCN Publishes New Guidelines for Smoking Cessation National Comprehensive Cancer Network To meet the needs of patients who are smokers at the time of a cancer diagnosis, the National Comprehensive Cancer Network® (NCCN®) has published the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Smoking Cessation. The NCCN Guidelines® for Smoking Cessation were presented on March 13, 2015, at the NCCN 20th Annual Conference: Advancing the Standard of Cancer Care™.
NPY Signaling Inhibits Extended Amygdala CRF Neurons to Suppress Binge Alcohol Drinking Nature Neuroscience Binge alcohol drinking is a tremendous public health problem because it leads to the development of numerous behavioral pathologies. It is thought to do so by hijacking brain systems that regulate stress and reward, including neuropeptide Y (NPY) and corticotropin-releasing factor (CRF). The central actions of NPY and CRF have opposing functions in the regulation of emotional and reward-seeking behaviors; thus, dysfunctional interactions between these peptidergic systems could be involved in the development of these pathologies. This study examines an animal model of binge drinking employing multiple assay techniques.
The Impact of Friends on Young Adults’ Drinking Over the Course of the Evening—An Event-Level Analysis Addiction (Full text article) This article develops several important points relating to social drinking behavior and rate of consumption, among young adults. It is a refinement of an earlier study. One observation may be summarized facetiously as, “More peers, more beers.” ...Investigating patterns of weekend drinking, a previous publication found that young adults accelerated their drinking pace, with participants drinking more per hour as the evening progressed. This was particularly the case during the course of Saturday evenings. However, information on situational factors that influence alcohol consumption during the course of the evening is still lacking, as the previous study did not consider situational predictors of drinking that may vary from one hour to the next. The present study therefore aimed to illuminate the impact of the
number of friends present on young adults’ weekend drinking behaviors in real time.
Primary Health Care Utilization for Alcohol-Attributed Diseases in British Columbia, Canada 2001–2011 BMC Family Practice This abstract suggests a relationship over time between unstated regulatory changes in alcohol access and visits to physicians, in Canada. From 2001 to 2011 there were significant increases in the number of persons presenting to general practitioners with alcohol-attributed diseases in British Columbia. The authors conclude that there is a need to provide enhanced support to general practitioners in the treatment of patients with substance use disorders given the increasing number of primary health care patients with alcohol-attributed diseases.
Most Painkiller Users Don’t Know Opioid Sharing Is Felony Bloomberg US patients on prescription opioids underestimate the risks of the medication, with a majority failing to realize that it’s a felony to share their drugs, a survey from a safety group shows. About one in seven believe it’s appropriate to share the medication with friends and family, according to the National Safety Council.
Alcohol Decreases Baseline Brain Glucose Metabolism More in Heavy Drinkers than Controls But Has No Effect on Stimulation-Induced Metabolic Increases The Journal of Neuroscience During alcohol intoxication, the human brain increases metabolism of acetate and decreases metabolism of glucose as energy substrate. Here, the authors hypothesized that chronic heavy drinking facilitates this energy substrate shift both for baseline and stimulation conditions. To test this hypothesis, they compared the effects of alcohol intoxication (0.75 g/kg alcohol vs placebo) on brain glucose metabolism during video stimulation (VS) versus when given with no stimulation (NS), in 25 heavy drinkers (HDs) and 23 healthy controls, each of whom underwent four PET-18FDG scans. The study’s findings may bear on the origins of patients’ complaints, of fatigue and lack of energy during withdrawal and early abstinence.
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The views and positions of any content published in ASAM Weekly are not necessarily endorsed by ASAM nor a reflection of ASAM's beliefs and policies. The features are presented as a summary of the contemporary issues being represented and expressed in scientific, governmental, commercial, and media sources across the specialty field of addiction medicine. Contact ASAM Weekly with any comments or feedback.