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30th August 2016

Egypt: when the addict becomes a "hen that lays golden eggs', exciting secrets on non-accredited drug treatment centers

"Torture ... ... suicide death" a tragic end awaits the person that has fallen in the addiction trap and decided to undergo treatment, but whose conditions did not allow him admission in one of the reputable and respectable treatment centers to pull him out of this vicious circle. The addict is found in this case victim in unauthorized addiction treatment centers.

Indeed, the addicted person, who decided voluntarily or under pressure from his family to undergo treatment, has before him three options: public hospitals that usually display the slogan "there is no room, return the month next"; hospitals and reputable licensed centers that require sums ranging from 6000 to 9000 pounds per month for a treatment that last more than than six months; or unlicensed institutions.

Dr. Ihab Hindi, specialist in psychology and addiction at the hospital "Omm El-Masriyin" says that many families are turning to unauthorized institutions for the treatment of addiction for the sole purpose of getting rid of their addicted son at the lowest cost. The treatment does not exceed 2000 pounds per month, but these centers do not rely on a treatment protocol and are not managed by specialists, doctors or nurses but by an ex-addicted who cured from addiction since a period not exceeding two years and who often lack professional qualifications.

Doctor Hindi revealed that the number of deaths in these centers is very high, reaching up to six patients per month. Indeed, the person who comes as a "healer" administers injections to patients without knowing their medical history; hence many of them have lost their life in vain. He noted that a patient in one of these institutions committed suicide, because they refused to let him go to see his family and they continued to give him injections to keep him as long as possible and increase thus the bill.

Hindi also pointed out that some agencies tie up and torture the patients physically for refusing to continue treatment in the center. The patient represents for them "a hen that lays golden eggs" and they do not want to lose him. He said that the majority of patients either fail to heal or they relapse soon after.

Dr. Ihab Hindi added that the solution is not also in public hospitals that are managed by a group of employees, noting that drug treatment is indeed very difficult. Furthermore, he explained that there are two types of non-accredited institutions; those headed by non-specialists, and other specialists headed by the highest scientific and professional level, but failed to obtain a license given that the state requires a set of complicated procedures and huge money for the license and the doctor at the end finds himself in front of a single solution, according to Ihab Hindi.

It is known that the "tying up" procedure is practiced with patients in hospitals and specialized centers, but it is on a bed and using a belt or a special strap that does not harm to the patient. For his part, Ahmed Raouf, a volunteer at the hotline for the treatment of addiction, warned that most centers tie up patients for the purpose of extortion. Indeed, they proceed accordingly to prevent the patient from leaving the clinic. The volunteer called families not to put their children in those centers where there is not a single physician who oversees patients’treatment.

He stressed that the number of deaths caused by these centers exceeds by far the number of cases of complete recovery, explaining that the injections administered to patients in these suspicious places must be given with other medicines to avoid secondary effects like convulsions, but these centers’ injections are administered to punish the patient rather than to cure him.

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29th August 2016

Northland - USA: Drug Abuse by Numbers

Despite a focus by state and local officials on heroin, it's only one of the substances being abused in the Northland.

In the first four months of 2016, there were 742 detox admissions in the Twin Ports — 531 were primarily alcohol-related, 59 involved heroin or opioid abuse, 38 were meth- or amphetamine-related, four were for cocaine and seven for marijuana.

The misuse of alcohol causes more deaths than heroin.

Drugs like heroin and meth bring violence associated with the black market and drain local resources.

In 2015, the Douglas County Department of Health and Human services received 55 alcohol and drug referrals — people looking for treatment, seeking case management or referred from hospitals.

"At least 50 percent of referrals are alcohol based," said Dave Longsdorf, manager of mental health, alcohol and other drug abuse, and adult protection services with the Douglas County Health and Human Services Department. "In the grand scheme of addiction, alcohol is still No. 1 by a significant amount."

Typically, about 15 to 20 percent of referrals each year are for the current trending drug — at one point, that was meth; today it's heroin followed by meth.

There were five overdose deaths in Douglas County last year — one was directly linked to heroin, one to a mix of heroin with other drugs — according to Douglas County Medical. The others were attributed to a mixture of meth and a seizure medication called clonazapam, the nasal decongestant diphenhydramine and the prescription drug gabapentin, which is used to treat nerve pain and seizures.

To date in 2016, there have been two overdose deaths in the county — one from heroin, one from mixed prescription drugs.

Each of the big three in the area — alcohol, heroin and meth — have their own effects and treatment needs.

Long-term effects of alcohol can include liver damage, high blood pressure and irregular heartbeat, as well as a higher risk of developing certain cancers and a weakened immune system.

Meth damages the user's ability to be happy, leading for depression that persists for up to a year after they stop using, according to Betsy Byler, mental health therapist and chemical dependency counselor with the Human Development Center.

"That's what's really driving them back to using," she said. "Everything is boring, flat."

For people high on meth, Byler said, detox can mean sleeping for days. But it's the craving when they wake up that gets them using again.

"We need a longer detox," she said, to combat that craving.

While meth can kill you, Byler said, it will most likely bankrupt your life first and you'll go to jail.

"Heroin can kill you tonight," she said.                           

When people stop drinking alcohol, they begin to sober up. That's not the case for heroin, which can continue to pump into the system even when the user stops taking it. That is what can lead to overdose deaths for heroin users.

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28th August 2016

A US magazine warns: "Banjo" causes erosion of the jaw

Many people are aware of the damage caused by marijuana on health. In the same context, a recent scientific study found a new damage associated with the consumption of this narcotic substance which seems to also cause a serious gum disease. The new study - published recently by the American magazine "JAMA" in the psychiatry section - showed that prolonged use of marijuana damages the gums, causing as well other physical health problems.

On the other hand and according to a survey conducted in 2014 by the National Institute on Drug Abuse, 22.2 million US citizens have used drugs in the last month, especially adolescents and young adults. After analyzing data pertinent to 1037 adults, scientists found during their research led by Dr. Madeleine Meyer of the University of Arizona, that continued use of marijuana for 20 years increases the risk of gums disease and bone loss around the teeth at the age of 38 years.

Researchers added that the short term effects of smoking marijuana include: an increased feeling of fear, anxiety, delusions, psychosis and hallucinations.

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27th August 2016

KSA: "The Anti-drug" offers residents the opportunity to undergo treatment in the Kingdom

The Secretary General of the National Commission for the fight against drugs, AbduIlah Al-Sharif, said that addicted residents are not punished or expelled at any stage of treatment, stressing that every addict who come voluntarily will receive treatment and rehabilitation confidentially and decently. Abdullah Al-Sharif noted that the purpose of these procedures is reform and rehabilitation.

Al-Sharif said that many companies are currently working on the establishment of clinics and special centers for the treatment of addiction, like for instance "SABIC" company which called its project the "halfway house" in the city of Riyadh. A decision was also taken to the creation of an addiction treatment hospital in Riyadh in coordination with the Department of health at a cost of 300 million riyals. There is also a coordination between the Commission and the real estate company "Kayan" to benefit from the endowments of the University of "King Saud" by setting up a private hospital for the treatment of addiction.

On the other hand, Al-Sharif said that "the governor of Al-Majmaa has donated a piece of land to the National Commission for Drug Control for the creation of a number of special treatment clinics to drug addicts funded by some businessmen”, noting that there are no pieces of land granted by businessmen for the purpose of establishing rehabilitation hospitals because private hospitals are considered investment projects whose profits are high and are compliant to the Ministry of "health."

Al-Sharif said the system currently in place in "Al-Amal" hospitals does not include the treatment of non-Saudis patients, but residents who have the desire to follow a treatment are received in private clinics in confidence explaining that these clinics receive calls via the number "1955" from people interested in going into treatment or from their parents then the Commission gathers information on patients and transfers them to private clinics of the Commission for the fight against drugs.

He also added that the treatment in the private sector is payable but the treatment of some patients is supported by volunteers in charities, stressing that the current situation does not require the creation of a rehabilitation hospital for treatment of drug addicts in every city, as the cases of addiction are still limited. However, there is an urgent need for the establishment of specialized institutions for addicted people because "Al-Amal" hospitals  are no longer able to accommodate a large number of patients, the total capacity of these hospitals does not exceed 2200 beds, in addition to other common psychiatric hospitals in all regions of the Kingdom. Al-Sharif said that the establishment of three new hospitals in some regions will be sufficient to accommodate drug users.

Moreover, he said that the private sector plays a vital and important role in the stages of recovery from addiction, noting that the National Narcotics Control Commission has adopted regulations for the establishment of addiction and rehabilitation hospitals in the private sector. He mentioned that "the Commission is coordinating with a number of businessmen and enterprises in order to create addiction treatment and rehabilitation centers and private hospitals. The task of the Commission is only to provide the necessary authorizations for these companies, in coordination with the Ministry of Health."

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25th August 2016

US: Doctors unprepared for treating drug addiction, some health experts say

Americans are overdosing at epidemic rates on opioids such as heroin and prescribed painkillers, and the nation’s doctors are inadequately prepared to help, according to some public health experts. They say the shortfall begins in medical school.

A report in 2012 by the National Center on Addiction and Substance Abuse revealed that medical schools devoted little time to teaching addiction medicine — only a few hours over four years. Since then, the number of Americans overdosing from prescribed opioids has surpassed 14,000 per year, quadrupling from 1999 to 2014.

Schools have been so slow to change that some medical students, like the ones at Harvard University, have started conducting their own training on how to buy and administer drugs that reverse the effects of an overdose, according to Kelly Thibert, the national president of the American Medical Student Association. The students organized to educate themselves about these medications because it was not part of the school’s curriculum.

Now, Stanford’s medical school may offer an example of what faculty-driven change can look like.

The school began retooling its curriculum after the director of its addiction medicine fellowship, Dr. Anna Lembke, expressed concern about its meager offerings in that field.

Lectures on addiction will no longer be folded into the psychiatry series as a side note, but instead will be presented as a separate unit, relevant to future doctors in any subspecialty, Lembke said. And that training will continue when the students leave the classrooms for clinical rotations.

“We’re at the very bottom of a very long uphill road,” said Lembke.

Medical faculties have traditionally eschewed teaching about addiction, in part because many physicians viewed the subject as a personal vice, not a disease. Some consider it difficult – sometimes impossible – to treat in a medical setting.

In March, the American Board of Medical Specialties officially recognized addiction medicine as a subspecialty.

But many medical schools resist outside direction with regard to their curriculum. More than 60 medical schools signed a pledge, issued in February by the Obama Administration, promising to teach their students about responsible opioid prescription. However, several prestigious medical schools, including Harvard and Stanford, did not sign the pledge.

Stanford and Harvard signed an alternative, nonbinding statement issued by the Association of American Medical Colleges that acknowledges the role of medical schools in treating the epidemic.

Some challenges remain, even if training at medical schools dramatically improves. As of 2013, only 1,200 of the roughly 1 million active physicians in the United States had pursued a certificate in addiction medicine — the highest level of training available prior to the topic’s designation as a subspecialty.

One of the challenges in getting doctors interested in the field, is the low insurance reimbursement rates as a deterrent to young physicians. And the patients can be difficult to work with, since addiction is a disease that affects the brain, and can make people angry.

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24th August 2016

US: Drug addicted newborns are the most vulnerable victims of narcotics abuse

Amid the conversations about methadone clinics and a rising drug abuse epidemic, the region’s most vulnerable population has become tangled in the complex web of opioid addiction.

According to data from tn.gov, 485 Tennessee newborns have been diagnosed with neonatal abstinence syndrome so far this year. NAS is what medical professionals call a cluster of symptoms a newborn shows when it is born withdrawing from drugs that the mother used during pregnancy.

Dr. Des Bharti, a neonatal specialist at Niswonger Children’s Hospital, said infants who are born withdrawing could be addicted to any number of drugs, from narcotics to antidepressants and anxiety medication, and the syndrome can sometimes be difficult to treat after birth.

Newborns have to be monitored around the clock, and their withdrawal symptoms include: a shrill, high-pitched cry, irritability, loose watery stool, bad diaper rash and insomnia. Some NAS babies suffer from seizures.

A typical hospital stay for a NAS baby can last as long as three weeks. Treatment starts by giving the newborn a small dose of medicine — typically 0.1 milligram for every kilogram of weight, Bharti says — and slowly weaning the baby off the drugs.

But some cases are harder to treat than others.

Ideally, Bharti said, a NAS newborn would receive treatment with the same medication it was used to, but that’s not always possible. Suboxone, also known by its generic name buprenorphine, is not approved for use in newborns, so those babies are typically treated with morphine – which doesn’t always work. Babies addicted to drugs like an anti-anxiety medication usually receive a concoction of drugs as treatment.

Treating hundreds of NAS babies per year isn’t something Bharti did on a regular basis when he started working at the hospital 25 years ago. In 1990, the hospital treated just a couple of babies with NAS, but Bharti said he noticed the numbers begin climbing in the early 2000s, soaring at alarming rates — about 200 NAS babies out of 568 neonatal ICU admissions this year.

So what can be done to fix it?

Women’s health nurse practitioner Joy McLain, who works with the Sullivan County Health Department in one of the most heavily affected counties in Tennessee, said that the medical community has been shifting to high gear to try to combat the growing epidemic within the last couple of years.

Indeed, the medical community is educating the public on handling their prescription medications by locking them up and disposing of excess medication at one of the health department’s drop boxes around the area.

“Knowing those tidbits of how to handle your narcotics at home are really going to make a difference, because over 55 percent of people who are struggling with addiction get their opioids free from a family member or a friend,” McLain said.

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