Teens and Steroids: A Dangerous Combo

anabolic-steroidsTeens are particularly at risk for adverse effects associated with anabolic steroids—possible mood swings, aggressive behavior, heart and liver disease, shrinkage of the testes, and menstrual irregularities in women.

Ali Mohamadi, M.D., a medical officer in the Food and Drug Administration’s Division of Metabolism and Endocrinology Products, warns teens and parents about the dangers of steroid use. Teens are particularly at risk for adverse effects associated with anabolic steroids—possible mood swings, aggressive behavior, heart and liver disease, shrinkage of the testes in males, and menstrual irregularities in women.

The abuse of anabolic steroids can cause both temporary and permanent injury to anyone using them. Teenagers, whose bodies are still developing, are at heightened risk.

An alarming number of them are trying steroids in hopes of improving their athletic prowess or their appearance. Ali Mohamadi warns teens and parents about the dangers of steroid use.

Q: What are anabolic steroids and how many teens use them?

A: They are drugs that mimic the actions of the male sex hormone testosterone. This includes promoting the growth of cells, especially in muscle, and maintaining or increasing male physical characteristics. Various studies have been conducted and generally reflect the findings of a Youth Risk and Behavior Surveillance System study, which estimated that among U.S. high school students, 4.9% of males and 2.4% of females have used anabolic steroids at least once in their lives. That’s 375,000 young men and 175,000 young women.

Q. What are the side effects of taking anabolic steroids?

A: They are known to have a range of serious adverse effects on many organ systems, and in many cases the damage is not reversible. They include fertility problems, impotence, high blood pressure and cholesterol, and heart and liver abnormalities. Boys may experience shrinkage of the testes or the development of breast tissue; girls may experience menstrual irregularities and development of masculine qualities such as facial and body hair. Both may experience acne. Both boys and girls may also experience mood swings and aggressive behavior, which can impact the lives not only of those taking steroids, but of everyone around them.

Q: Are prescriptions needed to get steroids?

A: Yes, in fact anabolic steroids are classified as Schedule III Controlled Substances by the U.S. Drug Enforcement Administration with strict regulations, meaning that not only is a prescription required, but there are extra controls. For example, it is illegal to possess them without a prescription in the United States, and in most circumstances the prescription must be in written form and cannot be called in to a pharmacist. Labels on some steroids recommend testing of hormone levels during use.

The number of FDA-approved uses is limited. Most are prescribed as a replacement for sub-normal levels of steroids. They are also prescribed for conditions such as muscle wasting, poor wound healing, and very specific pulmonary or bone marrow disorders.

A health care professional can prescribe steroids off-label, meaning for conditions other than those that are FDA-approved. But children, particularly teens, are getting access to steroids and taking them for reasons far outside of their intended use.

Q: So how are teens getting access?

A: Some get prescriptions from a licensed practitioner for such purposes as introducing puberty to boys who are “late bloomers” or to stimulate growth among teens who are failing to grow. Some may be dealing with unscrupulous clinics or street dealers on the black market. Unfortunately, a number of vendors sell anabolic steroids online without a prescription. Individuals should also be aware that some dietary supplements advertised for body building may unlawfully include steroids or steroid-like substances, and the ingredient statement on the label may not include that information.

Q: What is the FDA doing to prevent those illegal sales?

A: FDA is taking a number of steps to discourage these practices. Action has been taken against illegal online distributors who sell steroids without valid prescriptions, but an ongoing problem is that you can take one site down and another pops up.

The challenge is intensified by the fact that many online providers don’t accurately advertise the contents of the products they sell, they may be operating outside the U.S., and the drugs aren’t prescribed by a licensed practitioner who can help individuals weigh the risks and benefits. In such cases, individuals may have no idea what they are taking, what the appropriate dose should be, or what levels of control and safety went into the manufacturing process. These facts make the risks of taking anabolic steroids bought without a prescription even greater than they otherwise would be.

Q: What would you say to a teen you knew was tempted by steroids?

A: I would emphasize both the short and long-term potential for serious harm to their health. Rather than making you look or perform better, steroids will more likely cause unfavorable results that could affect you for life. I would also remind them that there are a number of ways to increase muscle mass and athletic performance, including a sensible regimen of exercise and diet, without resorting to extreme and dangerous therapies.

Q: What would you like to say to parents?

A: Parents tend not to believe their teens would consider taking anabolic steroids, but the truth is that the frequency of steroid use in this age group is far greater than many would guess.

During this time of year, when children are in school and getting back into their athletic routines, parents should watch for potential signs of abuse. Mood swings are among the first side effects to show up, and steroid use may lead to mania or depression. Acne is also an early side effect and can be followed by breast development in boys or increased body hair in girls. A surprising gain of muscle mass should also raise questions. It’s a problem that is as real as it is surprising.

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm373014.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery

Drugged Drivers more Dangerous

Drugged Drivers Three Times More Likely to Be Involved in Fatal Crash

Smashed car

Drivers who test positive for drugs are three times more likely than those who test negative to be involved in a deadly car accident, a new study finds.

Using drugs and alcohol together dramatically increases the risk of a fatal crash, according to researchers at Columbia University. People who test positive for both alcohol and drugs have a 23-fold increased risk, Health Day reports.

The study analyzed the results of roadside surveys of drug and alcohol use by drivers. The researchers found almost 32 percent of drivers involved in fatal accidents, and about 14 percent of drivers not involved in such accidents, tested positive for at least one drug. Depressants were most likely to be associated with deadly accidents, followed by stimulants, narcotics and marijuana, the article notes.

About 9 percent of drivers overall, and 57 percent of drivers involved in fatal crashes, had elevated blood alcohol levels. Twenty percent of drivers involved in deadly accidents tested positive for alcohol and one or more drugs, compared with 2 percent of drivers overall.

The findings are published in Accident Analysis and Prevention.

“While alcohol-impaired driving remains the greatest threat to traffic safety, these findings about drugged driving are particularly salient in light of the increases in the availability of prescription stimulants and opioids over the past decade,” lead researcher Dr. Guohua Li said in a news release.

http://www.drugfree.org/join-together/alcohol/drugged-drivers-three-times-more-likely-to-be-involved-in-fatal-crash

Students Misuse of Drugs

Students drug useStudy Suggests Parents May Underestimate Teen Misuse of Stimulant Medications

“Parents’ awareness of their teens using ‘study drugs’ does not match self-reported use by teens,” according to a US nationally representative household survey of parents of 13- to 17-year-olds.

Only 1% of parents of teens who have never been prescribed a stimulant medication for ADHD believe that their teens have used such drugs to stay awake to study for an exam or to do homework, and 4% reported that they did not know.

In contrast, recent national data from the Monitoring the Future survey show that 5% of 8th graders, 9% of 10th graders, and 12% of 12th graders report ever using stimulants such as Ritalin® or Adderall® without a prescription (see figures below).

The study also found that only slightly more than one-fourth (27%) of parents of teens reported that they had talked to their teens about using non-prescribed stimulant medications (data not shown).

While Only 1% of Parents Believe Their Teens Have Used a Stimulant to Stay Awake to Study for An Exam or To Do Homework . . . (see below)

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. . . Between 5% and 12% of
8th, 10th, and 12th Grade Teens Say They Have Ever Used Stimulants Without a Prescription (see below)

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June 10, 2013. Vol. 22, Issue 23. CESAR FAX may be copied without permission at www.cesar.umd.edu

Treat, Don’t Blame Addicts

Why We Should Treat, Not Blame Addicts Struggling to Get ‘Clean’

Journalist David Sheff’s son Nic began using marijuana and alcohol at the age of 12, then heroine and crystal meth. Sheff was baffled; his son transformed from an intelligent student and athlete into an addict living on the streets. At first he thought Nic was just being a wild teenager who needed some tough love. But after struggling to find Nic treatment — and keep him alive — Sheff realized that his son was dealing with a serious disease, more similar than different from diabetes, hypertension or even cancer.

With his personal experience and more than 10 years of research, Sheff concluded that addiction is a health crisis with a price tag of US$600 billion in combined medical, economic, criminal and social costs every year.

In a follow-up to his memoir “Beautiful Boy,” David Sheff has written a new book, “Clean: Overcoming Addiction and Ending America’s Greatest Tragedy,” in order to outline a slew of reasons why society and addiction treatments have largely failed to help the 20 million Americans with addictions.

Sheff asserts that the reason that addiction treatments overwhelmingly fail is because of how we view addiction. And he says correcting common misconceptions about the disease can be the first step towards improving the social support and medical treatment systems for those struggling with their addictions.

Below are the top myths about addiction, according to David Sheff.  


Myth No. 1: Good kids don’t use drugs, bad kids do. 

Myth No. 2: It’s impossible to prevent drug use. Kids who are going to use are going to use.

Myth No. 3: People who get addicted are weak and without morals.

Myth No. 4: Addicts must hit bottom before they can be treated.

Myth No. 5: You don’t treat drug problems with drugs.

Myth No. 6: The only way for addicts to stop using is by going to AA meetings.

Myth No. 7: Marijuana is not addictive. No one’s ever died from marijuana. It’s not a gateway drug. Marijuana shouldn’t be legalized.

Myth No. 8: America’s drug problem is unsolvable.

  • We’ve failed at solving America’s drug problem not because it’s impossible to do so, but we’ve been focusing on the wrong things. The main problem is that we’ve treated drug use as a criminal problem and drug users as morally bankrupt.
  • There are several developments that make me optimistic that we can lower drug use, treat addicts and potentially solve many of the problems in America caused by addiction:
  • There’s a growing understanding and acceptance that addiction is a disease and must be treated like we treat other diseases.
  • There are advances in treatment that will dramatically improve the likelihood that addicts will get well. There are also new prevention strategies, early assessment, and brief intervention strategies that work.
  • There is progress toward making sure that people who need treatment will be able to find programs that use evidence-based treatment.
  • There is a new organization founded called Brian’s Wish To End Addiction

The top myths about addiction above were adapted from content from David Sheff’s new book, “Clean: Overcoming Addiction and Ending America’s Greatest Tragedy. The views are his own.

Full story at; http://www.pbs.org/newshour/rundown/2013/04/addiction-mythbusters-understand-what-triggers-addiction-and-how-to-manage-the-disease.html

Drug Addiction Treatment

Principles of Drug Addiction and Alcoholism Treatment: A Research-Based Guide (Third Edition)

Principles of Effective Treatment

1. Addiction is a complex but treatable disease that affects brain function and behavior.  Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences.

2. No single treatment is appropriate for everyone.  Treatment varies depending on the type of drug and the characteristics of the patients. Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society.

3. Treatment needs to be readily available.  Because drug-addicted individuals may be uncertain about entering treatment, taking advantage of available services the moment people are ready for treatment is critical. Potential patients can be lost if treatment is not immediately available or readily accessible. As with other chronic diseases, the earlier treatment is offered in the disease process, the greater the likelihood of positive outcomes.

4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.  To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual’s age, gender, ethnicity, and culture.

5. Remaining in treatment for an adequate period of time is critical.  The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs. Research indicates that most addicted individuals need at least 3 months in treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment. Recovery from drug addiction is a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug abuse can occur and should signal a need for treatment to be reinstated or adjusted. Because individuals often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment.

6. Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment.   Behavioral therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships. Also, participation in group therapy and other peer support programs during and following treatment can help maintain abstinence.

7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.  For example, methadone, buprenorphine, and naltrexone (including a new long-acting formulation) are effective in helping individuals addicted to heroin or other opioids stabilize their lives and reduce their illicit drug use. Acamprosate, disulfiram, and naltrexone are medications approved for treating alcohol dependence. For persons addicted to nicotine, a nicotine replacement product (available as patches, gum, lozenges, or nasal spray) or an oral medication (such as bupropion or varenicline) can be an effective component of treatment when part of a comprehensive behavioral treatment program.

8. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.  A patient may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient may require medication, medical services, family therapy, parenting instruction, vocational rehabilitation, and/or social and legal services. For many patients, a continuing care approach provides the best results, with the treatment intensity varying according to a person’s changing needs.

9. Many drug-addicted individuals also have other mental disorders.  Because drug abuse and addiction—both of which are mental disorders—often co-occur with other mental illnesses, patients presenting with one condition should be assessed for the other(s). And when these problems co-occur, treatment should address both (or all), including the use of medications as appropriate.

10. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.  Although medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and can, for some, pave the way for effective long-term addiction treatment, detoxification alone is rarely sufficient to help addicted individuals achieve long-term abstinence. Thus, patients should be encouraged to continue drug treatment following detoxification. Motivational enhancement and incentive strategies, begun at initial patient intake, can improve treatment engagement.

11. Treatment does not need to be voluntary to be effective.  Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions.

12. Drug use during treatment must be monitored continuously, as lapses during treatment do occur.  Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signaling a possible need to adjust an individual’s treatment plan to better meet his or her needs.

13. Treatment programs should test patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling, linking patients to treatment if necessary.   Typically, drug abuse treatment addresses some of the drug-related behaviors that put people at risk of infectious diseases. Targeted counseling focused on reducing infectious disease risk can help patients further reduce or avoid substance-related and other high-risk behaviors. Counseling can also help those who are already infected to manage their illness. Moreover, engaging in substance abuse treatment can facilitate adherence to other medical treatments. Substance abuse treatment facilities should provide onsite, rapid HIV testing rather than referrals to offsite testing—research shows that doing so increases the likelihood that patients will be tested and receive their test results. Treatment providers should also inform patients that highly active antiretroviral therapy (HAART) has proven effective in combating HIV, including among drug-abusing populations, and help link them to HIV treatment if they test positive.

More at; http://www.drugabuse.gov/publications/principles-drug-addiction-treatment

Marijuana sent 11,000 to Emergency

Synthetic Marijuana Sent 11,000 People to Emergency Rooms in 2010

More than 11,000 people ended up in emergency rooms after using synthetic marijuana in 2010, according to a new government report. Most were teenagers and young adults, USA Today reports.

Synthetic marijuana, commonly known as K2 or Spice, is a mixture of herbs, spices or shredded plant material that is typically sprayed with a synthetic compound chemically similar to THC, the psychoactive ingredient in marijuana. K2 is typically sold in small, silvery plastic bags of dried leaves and marketed as incense that can be smoked. It is said to resemble potpourri.

Short term effects include loss of control, lack of pain response, increased agitation, pale skin, seizures, vomiting, profuse sweating, uncontrolled spastic body movements, elevated blood pressure, heart rate and palpitations. In addition to physical signs of use, users may experience severe paranoia, delusions, hallucinations and increased agitation.

The new report, from the federal government’s Drug Abuse Warning Network, is the first to analyze the impact of synthetic marijuana, the newspaper notes. The report found 12-to-17-year-olds accounted for one-third of the emergency room visits, while young adults ages 18 to 24 accounted for an additional 35 percent.

Among patients ages 12 to 29, the report found 59 percent of those who paid visits to the emergency room for synthetic marijuana use had no evidence of other substances.

In 2010, ordinary marijuana sent 461,028 people to the emergency room.

In July, President Obama signed legislation that bans synthetic drugs. The law bans harmful chemicals in synthetic drugs such as those used to make synthetic marijuana and bath salts.

From Join Together online

Parents and children both affected by substance misuse

Children and teenagers recognised too as perpetrators

A new report has identified parents as sufferers of abuse and violence from substance misusing children. The report by Adfam and Against Violence and Abuse (AVA) explores and documents Child to Parent Violence (CPV) and consulted with 88 parents seeking support from services.

Key findings from the research found:
  • Children as young as 11 and as old as 40 are physically, emotionally and/or mentally abusing their parents
  • There is a significant correlation between substance misuse and perpetrating domestic violence
  • 88% of victims of abuse were female and 12% were male
  • That abuses range from lower grade emotional manipulation to at the extreme end deaths.
  • Metropolitan Police Service records show that in 2009, 6 out of 7 non-partner/ex partner victims were mothers or fathers killed by sons – with substance misuse or mental health problems considered a key factor

The report makes recommendation including calls for better understanding of CPV, how to respond to requests for help and referral mechanisms are needed for front-line workers (such as police, social workers and GPs. It argues family support services are a cost effective resource, providing essential support to parents at a fraction of the cost that other health and social care services.

Children’s Commissioner re-iterates calls for protection of children

A new report from the Children’s Commissioner urges the Government to give as much attention to alcohol abuse among parents as to other drug misuse, and to train the relevant authorities to spot the signs of problem drinking in families earlier. See BBC report.

The Children’s Commissioner exists to promote the best interests of children and young people in England. It’s report suggest more than a fifth of all children in the UK, approximately 2.5 million, are living with a hazardous drinker (risky) drinker. The research also suggests 26,000 babies in England are living with a parent who is a dependent drinker, which is equivalent to 31,000 across the UK.