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That is, at least, not among young people, and not when the activity is learning.\u003c/p>\n\u003cp>A study \u003ca href=\"https://www.psychiatrist.com/JCP/article/Pages/2018/v79/17m11977.aspx\" target=\"_blank\" rel=\"noopener\">published Tuesday\u003c/a> in the \u003cem>Journal of Clinical Psychiatry \u003c/em>finds that when adolescents stop using marijuana — even for just one week — their verbal learning and memory improve. The study contributes to growing\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930618/\" target=\"_blank\" rel=\"noopener\"> evidence that marijuana use in adolescents\u003c/a> is associated with reduced neurocognitive functioning.[contextly_sidebar id=\"gapfFkqeMFkKiddjhmrAPnGjnaQfV5tT\"]\u003c/p>\n\u003cp>More than 14 percent of students in middle school and high school reported using marijuana within the past month, finds a \u003ca href=\"http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2017.pdf\" target=\"_blank\" rel=\"noopener\">National Institutes of Health survey\u003c/a> conducted in 2017. And marijuana use has increased among high-schoolers over the past 10 years, according to the\u003ca href=\"https://www.hhs.gov/ash/oah/adolescent-development/substance-use/marijuana/index.html\" target=\"_blank\" rel=\"noopener\"> U.S. Department of Health & Human Services\u003c/a>.\u003c/p>\n\u003cp>At the same time, the percentage of teens who believe that regular marijuana use poses a great risk to their health has\u003ca href=\"http://www.monitoringthefuture.org/pubs/monographs/mtf-vol2_2016.pdf\" target=\"_blank\" rel=\"noopener\"> dropped sharply since the mid-2000s\u003c/a>. And legalization of marijuana may play a part in shaping how young people think about the drug. One study noted that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365078/\" target=\"_blank\" rel=\"noopener\">after 2012, when marijuana was legalized\u003c/a> in Washington state, the number of eighth-graders there that believed marijuana posed risks to their health dropped by 14 percent.\u003c/p>\n\u003cp>Researchers are particularly concerned with marijuana use among the young because THC, the active ingredient in marijuana, most sharply affects the parts of the brain that develop during adolescence.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The adolescent brain is undergoing significant neurodevelopment well into the 20s, and the regions that are last to develop are those regions that are most populated by cannabis receptors and are also very critical to cognitive functioning,\" says \u003ca href=\"http://www.mghaddictionmedicine.com/about/staff/randi-schuster-ph-d/\" target=\"_blank\" rel=\"noopener\">Randi Schuster\u003c/a>. Schuster is the director of neuropsychology at Massachusetts General Hospital's Center for Addiction Medicine and the study's lead author.[contextly_sidebar id=\"lZELc7PUUZvmD5VTorbXygfap5jLk01F\"]\u003c/p>\n\u003cp>Schuster and the team of researchers set out to determine if cognitive functions that are potentially harmed by marijuana use in adolescents — particularly attention and memory — improve when they abstain from marijuana.\u003c/p>\n\u003cp>They recruited 88 pot-using teens and young adults, ages 16 to 25, and got some of them to agree to stop smoking (or otherwise consuming) marijuana for the month.\u003c/p>\n\u003cp>Schuster says the researchers wanted to recruit a range of participants, not just heavy users or those in a treatment program, for example. Some of the young people smoked once per week; some smoked nearly daily.\u003c/p>\n\u003cp>The researchers randomly assigned the volunteers into an abstaining group and a nonabstaining group. They delivered the bad news to those chosen to be abstainers at the end of their first visit, and Schuster says, they took it surprisingly well.\u003c/p>\n\u003cp>\"People were generally fine,\" she says. \"We kind of went through what the next month would look like and helped them come up with strategies for staying abstinent.\"\u003c/p>\n\u003cp>One motivation for the non-tokers to stick with the program? They received increasing amounts of money each week of the month-long study.\u003c/p>\n\u003cp>The researchers urine-tested both groups on a weekly basis to make sure that the THC levels for the abstinent group were going down, and that the levels for the control group were staying consistent as they continued using.\u003c/p>\n\u003cp>Also at each visit, the participants completed a variety of tasks testing their attention and memory through the\u003ca href=\"http://www.cambridgecognition.com/cantab/\" target=\"_blank\" rel=\"noopener\"> Cambridge Neuropsychological Test Automated Battery\u003c/a>, a validated cognitive assessment tool.\u003c/p>\n\u003cp>The researchers found that after four weeks, there was no noticeable difference in attention scores between the marijuana users and the nonusers. But, the memory scores of the nonusers improved, whereas the users' memories mostly stayed the same.[contextly_sidebar id=\"c4SATwAqatlL4R15kRXVJih13AxNqqVR\"]\u003c/p>\n\u003cp>The verbal memory test challenged participants to learn and recall new words, which \"lets us look both at their ability to learn information the first time the words were presented, as well as the number of words that they're able to retrieve from long-term memory storage after a delay,\" Schuster says.\u003c/p>\n\u003cp>Verbal memory is particularly relevant for adolescents and young adults when they're in the classroom, Schuster says.\u003c/p>\n\u003cp>\"For an adolescent sitting in their history class learning new facts for the first time, we're suspecting that active cannabis users might have a difficult time putting that new information into their long-term memory,\" Schuster says.\u003c/p>\n\u003cp>While this study didn't prove that abstaining from cannabis improves adolescents' attention, other studies have found that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930618/\" target=\"_blank\" rel=\"noopener\">marijuana users fare worse in attention tests\u003c/a> than nonusers. Schuster hypothesizes it might take more than four weeks of abstinence for attention levels to improve.\u003c/p>\n\u003cp>Interestingly, most of the memory improvement for the abstinent group happened during the first week of the study, which leaves the researchers feeling hopeful.\u003c/p>\n\u003cp>\"We were pleasantly surprised to see that at least some of the deficits that we think may be caused by cannabis appear to be reversible, and at least some of them are quickly reversible, which is good news,\" Schuster says.\u003c/p>\n\u003cp>One weakness of this study is its lack of a non-marijuana-using control group, says \u003ca href=\"https://uwm.edu/psychology/people/lisdahl-krista-m/\" target=\"_blank\" rel=\"noopener\">Krista Lisdahl\u003c/a>, an associate professor of psychology at the University of Wisconsin Milwaukee who was not involved with the study but also researches the neuroscience of addiction. Because of this, it's difficult to conclude whether the improvements in memory brought the participants back to their baseline levels prior to using marijuana.\u003c/p>\n\u003cp>Also, because the study lasted only four weeks, it's impossible to draw conclusions about the long-term effects of marijuana usage for young people, such as how marijuana directly affects academic performance, sleep patterns or mood.\u003c/p>\n\u003cp>Lisdahl says that longitudinal studies such as the NIH's\u003ca href=\"https://abcdstudy.org/\" target=\"_blank\" rel=\"noopener\"> Adolescent Brain Cognitive Development Study\u003c/a> could provide more information about what marijuana does to the adolescent brain. It might also reveal what happens if adolescents stop using marijuana and if their brain functioning can completely recover.\u003c/p>\n\u003cp>Lisdahl is helping with the NIH study, which has, to date, enrolled more than 11,000 children ages 9 and 10 and will follow them into young adulthood. It's the largest long-term research study on child brain development in the U.S., and it assesses how everything from screen time to concussions to drugs affect adolescents' brains.\u003c/p>\n\u003cp>In the meantime, Lisdahl says the findings from the new study — that abstinence from marijuana is associated with improvements in adolescents' learning and memory — sends a positive message.\u003c/p>\n\u003cp>\"I remain optimistic that we can show recovery of function with sustained abstinence,\" she says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Rachel D. Cohen is an intern on NPR's Science Desk.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+Adolescents+Give+Up+Pot%2C+Their+Cognition+Quickly+Improves&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"When researchers convinced a group of young people to stop smoking pot, their cognition quickly improved. This adds to research warning against teen pot use, despite marijuana's growing acceptance. ","status":"publish","parent":0,"modified":1541016393,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1093},"headData":{"title":"When Adolescents Give Up Pot, Their Cognition Quickly Improves | KQED","description":"When researchers convinced a group of young people to stop smoking pot, their cognition quickly improved. This adds to research warning against teen pot use, despite marijuana's growing acceptance. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"When Adolescents Give Up Pot, Their Cognition Quickly Improves","datePublished":"2018-10-31T20:04:23.000Z","dateModified":"2018-10-31T20:06:33.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445318 https://ww2.kqed.org/futureofyou/?p=445318","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/31/when-adolescents-give-up-pot-their-cognition-quickly-improves/","disqusTitle":"When Adolescents Give Up Pot, Their Cognition Quickly Improves","source":"DIY Health","nprByline":"Rachel D. Cohen, NPR","nprImageAgency":"BURGER/Canopy/Getty Images","nprStoryId":"662127406","nprApiLink":"http://api.npr.org/query?id=662127406&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/10/30/662127406/when-adolescents-give-up-pot-their-cognition-quickly-improves?ft=nprml&f=662127406","nprRetrievedStory":"1","nprPubDate":"Wed, 31 Oct 2018 09:02:00 -0400","nprStoryDate":"Tue, 30 Oct 2018 13:01:25 -0400","nprLastModifiedDate":"Wed, 31 Oct 2018 09:02:03 -0400","path":"/futureofyou/445318/when-adolescents-give-up-pot-their-cognition-quickly-improves","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Marijuana, it seems, is not a performance-enhancing drug. That is, at least, not among young people, and not when the activity is learning.\u003c/p>\n\u003cp>A study \u003ca href=\"https://www.psychiatrist.com/JCP/article/Pages/2018/v79/17m11977.aspx\" target=\"_blank\" rel=\"noopener\">published Tuesday\u003c/a> in the \u003cem>Journal of Clinical Psychiatry \u003c/em>finds that when adolescents stop using marijuana — even for just one week — their verbal learning and memory improve. The study contributes to growing\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930618/\" target=\"_blank\" rel=\"noopener\"> evidence that marijuana use in adolescents\u003c/a> is associated with reduced neurocognitive functioning.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>More than 14 percent of students in middle school and high school reported using marijuana within the past month, finds a \u003ca href=\"http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2017.pdf\" target=\"_blank\" rel=\"noopener\">National Institutes of Health survey\u003c/a> conducted in 2017. And marijuana use has increased among high-schoolers over the past 10 years, according to the\u003ca href=\"https://www.hhs.gov/ash/oah/adolescent-development/substance-use/marijuana/index.html\" target=\"_blank\" rel=\"noopener\"> U.S. Department of Health & Human Services\u003c/a>.\u003c/p>\n\u003cp>At the same time, the percentage of teens who believe that regular marijuana use poses a great risk to their health has\u003ca href=\"http://www.monitoringthefuture.org/pubs/monographs/mtf-vol2_2016.pdf\" target=\"_blank\" rel=\"noopener\"> dropped sharply since the mid-2000s\u003c/a>. And legalization of marijuana may play a part in shaping how young people think about the drug. One study noted that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365078/\" target=\"_blank\" rel=\"noopener\">after 2012, when marijuana was legalized\u003c/a> in Washington state, the number of eighth-graders there that believed marijuana posed risks to their health dropped by 14 percent.\u003c/p>\n\u003cp>Researchers are particularly concerned with marijuana use among the young because THC, the active ingredient in marijuana, most sharply affects the parts of the brain that develop during adolescence.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The adolescent brain is undergoing significant neurodevelopment well into the 20s, and the regions that are last to develop are those regions that are most populated by cannabis receptors and are also very critical to cognitive functioning,\" says \u003ca href=\"http://www.mghaddictionmedicine.com/about/staff/randi-schuster-ph-d/\" target=\"_blank\" rel=\"noopener\">Randi Schuster\u003c/a>. Schuster is the director of neuropsychology at Massachusetts General Hospital's Center for Addiction Medicine and the study's lead author.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Schuster and the team of researchers set out to determine if cognitive functions that are potentially harmed by marijuana use in adolescents — particularly attention and memory — improve when they abstain from marijuana.\u003c/p>\n\u003cp>They recruited 88 pot-using teens and young adults, ages 16 to 25, and got some of them to agree to stop smoking (or otherwise consuming) marijuana for the month.\u003c/p>\n\u003cp>Schuster says the researchers wanted to recruit a range of participants, not just heavy users or those in a treatment program, for example. Some of the young people smoked once per week; some smoked nearly daily.\u003c/p>\n\u003cp>The researchers randomly assigned the volunteers into an abstaining group and a nonabstaining group. They delivered the bad news to those chosen to be abstainers at the end of their first visit, and Schuster says, they took it surprisingly well.\u003c/p>\n\u003cp>\"People were generally fine,\" she says. \"We kind of went through what the next month would look like and helped them come up with strategies for staying abstinent.\"\u003c/p>\n\u003cp>One motivation for the non-tokers to stick with the program? They received increasing amounts of money each week of the month-long study.\u003c/p>\n\u003cp>The researchers urine-tested both groups on a weekly basis to make sure that the THC levels for the abstinent group were going down, and that the levels for the control group were staying consistent as they continued using.\u003c/p>\n\u003cp>Also at each visit, the participants completed a variety of tasks testing their attention and memory through the\u003ca href=\"http://www.cambridgecognition.com/cantab/\" target=\"_blank\" rel=\"noopener\"> Cambridge Neuropsychological Test Automated Battery\u003c/a>, a validated cognitive assessment tool.\u003c/p>\n\u003cp>The researchers found that after four weeks, there was no noticeable difference in attention scores between the marijuana users and the nonusers. But, the memory scores of the nonusers improved, whereas the users' memories mostly stayed the same.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The verbal memory test challenged participants to learn and recall new words, which \"lets us look both at their ability to learn information the first time the words were presented, as well as the number of words that they're able to retrieve from long-term memory storage after a delay,\" Schuster says.\u003c/p>\n\u003cp>Verbal memory is particularly relevant for adolescents and young adults when they're in the classroom, Schuster says.\u003c/p>\n\u003cp>\"For an adolescent sitting in their history class learning new facts for the first time, we're suspecting that active cannabis users might have a difficult time putting that new information into their long-term memory,\" Schuster says.\u003c/p>\n\u003cp>While this study didn't prove that abstaining from cannabis improves adolescents' attention, other studies have found that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930618/\" target=\"_blank\" rel=\"noopener\">marijuana users fare worse in attention tests\u003c/a> than nonusers. Schuster hypothesizes it might take more than four weeks of abstinence for attention levels to improve.\u003c/p>\n\u003cp>Interestingly, most of the memory improvement for the abstinent group happened during the first week of the study, which leaves the researchers feeling hopeful.\u003c/p>\n\u003cp>\"We were pleasantly surprised to see that at least some of the deficits that we think may be caused by cannabis appear to be reversible, and at least some of them are quickly reversible, which is good news,\" Schuster says.\u003c/p>\n\u003cp>One weakness of this study is its lack of a non-marijuana-using control group, says \u003ca href=\"https://uwm.edu/psychology/people/lisdahl-krista-m/\" target=\"_blank\" rel=\"noopener\">Krista Lisdahl\u003c/a>, an associate professor of psychology at the University of Wisconsin Milwaukee who was not involved with the study but also researches the neuroscience of addiction. Because of this, it's difficult to conclude whether the improvements in memory brought the participants back to their baseline levels prior to using marijuana.\u003c/p>\n\u003cp>Also, because the study lasted only four weeks, it's impossible to draw conclusions about the long-term effects of marijuana usage for young people, such as how marijuana directly affects academic performance, sleep patterns or mood.\u003c/p>\n\u003cp>Lisdahl says that longitudinal studies such as the NIH's\u003ca href=\"https://abcdstudy.org/\" target=\"_blank\" rel=\"noopener\"> Adolescent Brain Cognitive Development Study\u003c/a> could provide more information about what marijuana does to the adolescent brain. It might also reveal what happens if adolescents stop using marijuana and if their brain functioning can completely recover.\u003c/p>\n\u003cp>Lisdahl is helping with the NIH study, which has, to date, enrolled more than 11,000 children ages 9 and 10 and will follow them into young adulthood. It's the largest long-term research study on child brain development in the U.S., and it assesses how everything from screen time to concussions to drugs affect adolescents' brains.\u003c/p>\n\u003cp>In the meantime, Lisdahl says the findings from the new study — that abstinence from marijuana is associated with improvements in adolescents' learning and memory — sends a positive message.\u003c/p>\n\u003cp>\"I remain optimistic that we can show recovery of function with sustained abstinence,\" she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachel D. Cohen is an intern on NPR's Science Desk.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+Adolescents+Give+Up+Pot%2C+Their+Cognition+Quickly+Improves&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445318/when-adolescents-give-up-pot-their-cognition-quickly-improves","authors":["byline_futureofyou_445318"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_828","futureofyou_1585","futureofyou_61","futureofyou_1041","futureofyou_872"],"collections":["futureofyou_1093"],"featImg":"futureofyou_445319","label":"source_futureofyou_445318"},"futureofyou_445259":{"type":"posts","id":"futureofyou_445259","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445259","score":null,"sort":[1540839600000]},"guestAuthors":[],"slug":"a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster","title":"A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster","publishDate":1540839600,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>When he was police chief of Stanwood, Wash., population 7,000, Ty Trenary thought rural communities like his were immune from the opioid crisis.\u003c/p>\n\u003cp>Then, one day, a mother walked through his door and said, \"Chief, you have a heroin problem in your community.\"[contextly_sidebar id=\"snF1nVDNKWV8zjCpOVtbCXhNa21X1NeR\"]\u003c/p>\n\u003cp>\"And I remember thinking, 'Well that's not possible,' \" Trenary recalls. \"This is Stanwood and heroin is in big cities with homeless populations. It's not in rural America.\"\u003c/p>\n\u003cp>But heroin addiction and abuse are not just a big city problem, as Trenary had thought. While the bulk of fatal overdoses still happen in urban areas, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/66/ss/ss6619a1.htm?s_cid=ss6619a1_w\" target=\"_blank\" rel=\"noopener\">the rural overdose rate has increased \u003c/a>to slightly surpass that of cities.\u003c/p>\n\u003cp>Rural Americans say drug addiction and abuse are the most urgent health problems facing their local community, according to\u003ca href=\"https://www.npr.org/HARVARD-POLL/rural-health-poll-10-15-18-updated.pdf\" target=\"_blank\" rel=\"noopener\"> a new poll\u003c/a> by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In the poll, 48 percent of people said opioid addiction has gotten worse in their community in the past five years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Trenary now agrees. A few years ago, he was elected sheriff of Snohomish County and got a rude awakening. He toured the jail and found it had become a de facto detox center, full of \"very, very sick, very, very sick people,\" he says.\u003c/p>\n\u003cp>\"Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.\"\u003c/p>\n\u003cp>At any given time, about half the inmates were withdrawing from heroin, making for a \u003ca href=\"https://www.heraldnet.com/news/lawsuit-against-snohomish-county-focuses-on-inmates-death/\" target=\"_blank\" rel=\"noopener\">dangerous\u003c/a> and \u003ca href=\"https://komonews.com/news/local/13m-settlement-in-snohomish-county-jail-death-claim\" target=\"_blank\" rel=\"noopener\">expensive\u003c/a> situation.\u003c/p>\n\u003cp>\"It took becoming the sheriff to see the impacts inside the jail with heroin abuse, to see the impacts in the community across the entire county for me to realize that we had to change a lot about what we were doing,\" Trenary says.\u003c/p>\n\u003cp>\u003cstrong>A Disaster Response Approach\u003c/strong>\u003c/p>\n\u003cp>So they did. Snohomish County in Western Washington is taking a unique approach to tackle the problem.\u003c/p>\n\u003cp>Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.\u003c/p>\n\u003cfigure id=\"attachment_445267\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-full wp-image-445267\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg\" alt=\"\" width=\"800\" height=\"532\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-768x511.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-375x249.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-520x346.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Snohomish County Sheriff Ty Trenary. He wasn't aware of the extent of the opioid epidemic in his county until he became sheriff and realized the jail had become a defacto detox center. \u003ccite>(Leah Nash/Finding Fixes podcast)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Snohomish County is the first county in the country to treat it this way.\u003c/p>\n\u003cp>The idea grew out of their experience with another tremendous disaster in the county: the massive 2014 landslide in Oso, Wash., which killed 43 people.\u003c/p>\n\u003cp>Back then, the director of communications for the sheriff's office, Shari Ireton, took reporters to see the landslide, and she ended up learning something, too.\u003c/p>\n\u003cp>\"It was amazing to see Black Hawk helicopters flying with our helicopter and a fixed wing over the top of that,\" she says. \"All in coordination with each other, all with the same objective, which is life safety.\"[contextly_sidebar id=\"EkK9yT8ARJNlHsaGPy5VTEvcCBTT8MS7\"]\u003c/p>\n\u003cp>Ireton thought, what if they used that same coordinated system, of everyone working together across government agencies, to tackle the opioid epidemic?\u003c/p>\n\u003cp>County leaders took the idea and ran with it.\u003c/p>\n\u003cp>Now, the response to the opioid epidemic is run out of a special emergency operations center, a lot like during the Oso landslide, where representatives from across local government meet every two weeks, including people in charge of everything from firetrucks to the dump.\u003c/p>\n\u003cp>The technical name for this group is the Multi-Agency Coordination group, or MAC group. It comes straight out of FEMA's emergency response playbook.\u003c/p>\n\u003cp>They talk through PowerPoint slides and rattle off numbers like 7.5 and 6.1, which refer to items on their to-do list. Seven big, overarching goals, which include reducing opioid misuse and reducing damage to the community, are broken down into manageable steps, like distributing needle cleanup kits and a project to train schoolteachers to recognize trauma and addiction.\u003c/p>\n\u003cp>This to-do list is over 100 items long.\u003c/p>\n\u003cp>\"Some of these goals are really long term,\" Ireton says. \"I mean they're going to take years, decades.\"[contextly_sidebar id=\"4DNOyEVwXKrhJsxImwngLjd8ofHh3LVo\"]\u003c/p>\n\u003cp>The key is to be realistic, says Ireton, who is also the spokesperson for this group. You are never going to be successful if your goal is just \"end the opioid epidemic,\" she says.\u003c/p>\n\u003cp>\"By breaking it down, it's like eating an elephant. You just can eat one piece at a time. Breaking it down into a piece that you can actually digest.\" Ireton says.\u003c/p>\n\u003cp>The county's program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.[contextly_sidebar id=\"tgGunyxLm8dgF9b7x7IdKyEh7K66M6ez\"]\u003c/p>\n\u003cp>In Marysville, Wash., the woods are full of homeless encampments surrounded by piles of spent syringes and trash. On a recent visit, rain drips through a cedar forest next to a strip mall. Officer Mike Buell is visiting the camp along with social worker Lauren Rainbow. Buell cracks jokes with some illegal campers and introduces himself using his first name.\u003c/p>\n\u003cp>Buell's job isn't to arrest the campers, but to help them get drug treatment and housing. He crouches next to the opening of one tent and explains that he and his colleagues will help the campers with food, coffee and transportation to and from appointments.\u003c/p>\n\u003cp>\"We're basically your Uber,\" Buell says.\u003c/p>\n\u003cp>The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.\u003c/p>\n\u003cp>That's just one item in the county's plan, and problems with opioids are far from solved here.\u003c/p>\n\u003cp>Snohomish County will keep working on its large and small goals, one bite at a time.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was reported by \u003c/em>\u003ca href=\"https://www.findingfixes.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Finding Fixes\u003c/em>\u003c/a>\u003cem>, a podcast about solutions to the opioid epidemic, which is a project of \u003c/em>\u003ca href=\"http://www.invw.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>InvestigateWest\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Rural+Community+Decided+To+Treat+Its+Opioid+Problem+Like+A+Natural+Disaster&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"A rural county in Washington declared the opioid epidemic a life-threatening emergency. It uses a multiagency coordination group straight out of FEMA's playbook to respond to the crisis.","status":"publish","parent":0,"modified":1540834398,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1019},"headData":{"title":"A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster | KQED","description":"A rural county in Washington declared the opioid epidemic a life-threatening emergency. It uses a multiagency coordination group straight out of FEMA's playbook to respond to the crisis.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster","datePublished":"2018-10-29T19:00:00.000Z","dateModified":"2018-10-29T17:33:18.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445259 https://ww2.kqed.org/futureofyou/?p=445259","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/29/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster/","disqusTitle":"A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster","nprByline":"Anna Boiko-Weyrauch, NPR","nprImageAgency":"Leah Nash for Finding Fixes podcast","nprStoryId":"658476111","nprApiLink":"http://api.npr.org/query?id=658476111&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/10/28/658476111/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster?ft=nprml&f=658476111","nprRetrievedStory":"1","nprPubDate":"Mon, 29 Oct 2018 12:55:00 -0400","nprStoryDate":"Sun, 28 Oct 2018 08:17:00 -0400","nprLastModifiedDate":"Mon, 29 Oct 2018 12:55:33 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/wesun/2018/10/20181028_wesun_a_rural_community_decided_to_treat_its_opioid_problem_like_a_natural_disaster.mp3?orgId=1&topicId=1128&aggIds=658276358&d=345&p=10&story=658476111&ft=nprml&f=658476111","nprAudioM3u":"http://api.npr.org/m3u/1661520408-b27296.m3u?orgId=1&topicId=1128&aggIds=658276358&d=345&p=10&story=658476111&ft=nprml&f=658476111","audioTrackLength":346,"path":"/futureofyou/445259/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/wesun/2018/10/20181028_wesun_a_rural_community_decided_to_treat_its_opioid_problem_like_a_natural_disaster.mp3?orgId=1&topicId=1128&aggIds=658276358&d=345&p=10&story=658476111&ft=nprml&f=658476111","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When he was police chief of Stanwood, Wash., population 7,000, Ty Trenary thought rural communities like his were immune from the opioid crisis.\u003c/p>\n\u003cp>Then, one day, a mother walked through his door and said, \"Chief, you have a heroin problem in your community.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"And I remember thinking, 'Well that's not possible,' \" Trenary recalls. \"This is Stanwood and heroin is in big cities with homeless populations. It's not in rural America.\"\u003c/p>\n\u003cp>But heroin addiction and abuse are not just a big city problem, as Trenary had thought. While the bulk of fatal overdoses still happen in urban areas, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/66/ss/ss6619a1.htm?s_cid=ss6619a1_w\" target=\"_blank\" rel=\"noopener\">the rural overdose rate has increased \u003c/a>to slightly surpass that of cities.\u003c/p>\n\u003cp>Rural Americans say drug addiction and abuse are the most urgent health problems facing their local community, according to\u003ca href=\"https://www.npr.org/HARVARD-POLL/rural-health-poll-10-15-18-updated.pdf\" target=\"_blank\" rel=\"noopener\"> a new poll\u003c/a> by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In the poll, 48 percent of people said opioid addiction has gotten worse in their community in the past five years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Trenary now agrees. A few years ago, he was elected sheriff of Snohomish County and got a rude awakening. He toured the jail and found it had become a de facto detox center, full of \"very, very sick, very, very sick people,\" he says.\u003c/p>\n\u003cp>\"Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.\"\u003c/p>\n\u003cp>At any given time, about half the inmates were withdrawing from heroin, making for a \u003ca href=\"https://www.heraldnet.com/news/lawsuit-against-snohomish-county-focuses-on-inmates-death/\" target=\"_blank\" rel=\"noopener\">dangerous\u003c/a> and \u003ca href=\"https://komonews.com/news/local/13m-settlement-in-snohomish-county-jail-death-claim\" target=\"_blank\" rel=\"noopener\">expensive\u003c/a> situation.\u003c/p>\n\u003cp>\"It took becoming the sheriff to see the impacts inside the jail with heroin abuse, to see the impacts in the community across the entire county for me to realize that we had to change a lot about what we were doing,\" Trenary says.\u003c/p>\n\u003cp>\u003cstrong>A Disaster Response Approach\u003c/strong>\u003c/p>\n\u003cp>So they did. Snohomish County in Western Washington is taking a unique approach to tackle the problem.\u003c/p>\n\u003cp>Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.\u003c/p>\n\u003cfigure id=\"attachment_445267\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-full wp-image-445267\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg\" alt=\"\" width=\"800\" height=\"532\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-768x511.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-375x249.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-520x346.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Snohomish County Sheriff Ty Trenary. He wasn't aware of the extent of the opioid epidemic in his county until he became sheriff and realized the jail had become a defacto detox center. \u003ccite>(Leah Nash/Finding Fixes podcast)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Snohomish County is the first county in the country to treat it this way.\u003c/p>\n\u003cp>The idea grew out of their experience with another tremendous disaster in the county: the massive 2014 landslide in Oso, Wash., which killed 43 people.\u003c/p>\n\u003cp>Back then, the director of communications for the sheriff's office, Shari Ireton, took reporters to see the landslide, and she ended up learning something, too.\u003c/p>\n\u003cp>\"It was amazing to see Black Hawk helicopters flying with our helicopter and a fixed wing over the top of that,\" she says. \"All in coordination with each other, all with the same objective, which is life safety.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Ireton thought, what if they used that same coordinated system, of everyone working together across government agencies, to tackle the opioid epidemic?\u003c/p>\n\u003cp>County leaders took the idea and ran with it.\u003c/p>\n\u003cp>Now, the response to the opioid epidemic is run out of a special emergency operations center, a lot like during the Oso landslide, where representatives from across local government meet every two weeks, including people in charge of everything from firetrucks to the dump.\u003c/p>\n\u003cp>The technical name for this group is the Multi-Agency Coordination group, or MAC group. It comes straight out of FEMA's emergency response playbook.\u003c/p>\n\u003cp>They talk through PowerPoint slides and rattle off numbers like 7.5 and 6.1, which refer to items on their to-do list. Seven big, overarching goals, which include reducing opioid misuse and reducing damage to the community, are broken down into manageable steps, like distributing needle cleanup kits and a project to train schoolteachers to recognize trauma and addiction.\u003c/p>\n\u003cp>This to-do list is over 100 items long.\u003c/p>\n\u003cp>\"Some of these goals are really long term,\" Ireton says. \"I mean they're going to take years, decades.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The key is to be realistic, says Ireton, who is also the spokesperson for this group. You are never going to be successful if your goal is just \"end the opioid epidemic,\" she says.\u003c/p>\n\u003cp>\"By breaking it down, it's like eating an elephant. You just can eat one piece at a time. Breaking it down into a piece that you can actually digest.\" Ireton says.\u003c/p>\n\u003cp>The county's program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In Marysville, Wash., the woods are full of homeless encampments surrounded by piles of spent syringes and trash. On a recent visit, rain drips through a cedar forest next to a strip mall. Officer Mike Buell is visiting the camp along with social worker Lauren Rainbow. Buell cracks jokes with some illegal campers and introduces himself using his first name.\u003c/p>\n\u003cp>Buell's job isn't to arrest the campers, but to help them get drug treatment and housing. He crouches next to the opening of one tent and explains that he and his colleagues will help the campers with food, coffee and transportation to and from appointments.\u003c/p>\n\u003cp>\"We're basically your Uber,\" Buell says.\u003c/p>\n\u003cp>The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.\u003c/p>\n\u003cp>That's just one item in the county's plan, and problems with opioids are far from solved here.\u003c/p>\n\u003cp>Snohomish County will keep working on its large and small goals, one bite at a time.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was reported by \u003c/em>\u003ca href=\"https://www.findingfixes.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Finding Fixes\u003c/em>\u003c/a>\u003cem>, a podcast about solutions to the opioid epidemic, which is a project of \u003c/em>\u003ca href=\"http://www.invw.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>InvestigateWest\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Rural+Community+Decided+To+Treat+Its+Opioid+Problem+Like+A+Natural+Disaster&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445259/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster","authors":["byline_futureofyou_445259"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_828","futureofyou_952","futureofyou_1499","futureofyou_1634","futureofyou_198"],"featImg":"futureofyou_445260","label":"futureofyou"},"futureofyou_444318":{"type":"posts","id":"futureofyou_444318","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444318","score":null,"sort":[1536267637000]},"guestAuthors":[],"slug":"a-researcher-battling-cancer-explores-alternatives-to-opioid-treatments","title":"A Researcher Battling Cancer Explores Alternatives To Opioid Treatments","publishDate":1536267637,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The explosion of deaths related to opioid misuse has underscored a pressing need for better ways of treating pain, especially chronic pain.[contextly_sidebar id=\"Lrxhc0PiaxvZNwtQRWNC315GUyNFIRBB\"]\u003c/p>\n\u003cp>Duquesne University pharmacology associate professor Jelena Janjic thinks she's on to one. It involves using a patient's own immune system to deliver non-opioid pain medication to places in the body where there's pain.\u003c/p>\n\u003cp>Janjic's idea, which draws from the field of cancer research, is to insert tiny amounts of over-the-counter pain medications into minute carriers called nanoparticles, and then inject these into pain patients. The medicines would then travel through the body to places where there is inflammation, and relieve the pain.\u003c/p>\n\u003cp>Janjic has a special reason for wanting to develop new medicines for chronic pain: She suffers from it herself.\u003c/p>\n\u003cp>\"As a patient, I want an answer,\" she says. \"I want to figure out this.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There's no question that the need for better, non-addictive medications is real and urgent. Researchers have come up with\u003ca href=\"https://www.painnewsnetwork.org/stories/2018/6/2/new-treatments-on-the-horizon-for-chronic-pain\"> some ideas\u003c/a>, but so far none has made it to market. Finding new treatments is difficult for any disease and it's proving especially difficult for chronic pain because the underlying causes are poorly understood.\u003c/p>\n\u003cp>Attempting to modulate inflammation as way to treat pain \"is an active area of research,\" says \u003ca href=\"https://www.ninds.nih.gov/node/8824\" target=\"_blank\" rel=\"noopener\">Michael L. Oshinsky\u003c/a>, Program Director, Pain and Migraine, at the National Institute of Neurological Disorders and Stroke.[contextly_sidebar id=\"wUYL0s18LxOkY4wdczUfG5sVi8cK5dSj\"]\u003c/p>\n\u003cp>Oshinsky says Janjic's idea of targeting the immune system with nanoparticles carrying pain relievers makes sense, although he cautions that the relationship between inflammation and pain is not well understood.\u003c/p>\n\u003cp>Janjic's path to this research began in 2010. She has a doctorate in medicinal chemistry, and she had recently moved to Duquesne University where she had set up a lab focused on using nanomedicine techniques to treat cancer.\u003c/p>\n\u003cp>What seemed like out of nowhere, of the blue, she started to suffer bouts of severe pain.\u003c/p>\n\u003cp>\"The one that hit me real hard was the whole body, from head to toe,\" she says. \"I've had on and off chronic pain since I was a teenager, but this was different.\"\u003c/p>\n\u003cp>In August that year, just before her students arrived back to school, she ended up in the emergency room with pain that was almost intolerable.\u003c/p>\n\u003cp>The doctors' diagnosis was discouraging. They told her she had a chronic pain syndrome. They said there wasn't much they could do about it, and they said it was for life.\u003c/p>\n\u003cp>The medicines they gave her helped with the pain somewhat, but left her feeling like she was living in a fog. She was having trouble remembering things, trouble taking notes.\u003c/p>\n\u003cp>\"Things were weird. So I decided I am going to do research on myself,\" Janjic says.\u003c/p>\n\u003cp>To control her own pain, she turned to mindfulness meditation and other non-medical interventions, including composing music and playing the piano. It's not as if the pain magically went away, she says, but she was able to carry on with her life. Some days were worse than others.\u003c/p>\n\u003cp>But she also wanted to find a medical solution.\u003c/p>\n\u003cp>She made one important treatment decision early on: She didn't want to take opioids for her pain.[contextly_sidebar id=\"QMwX3Yw6AeYbgPKNOtGQ6rPZrGu4Q9y4\"]\u003c/p>\n\u003cp>\"At the time I could have got them very easily,\" Janjic says. \"I said, 'What are you going to give me when I'm 67, or 87, if I take them now?' I knew they don't work long-term very well. So almost the refusal of opioids precipitated everything else that happened.\"\u003c/p>\n\u003cp>Looking for alternatives to opioids, she dove into the scientific literature, to learn all she could about chronic pain.\u003c/p>\n\u003cp>Chronic pain syndromes are not well understood. With acute pain, it's usually possible to identify the cause—an injury of some sort, or inflammation caused by an infection. Chronic pain may be linked to an initial mishap, but may persist long after the initial cause of the pain has disappeared. Sometimes there's no good explanation of the pain at all, a frustrating circumstance for both doctor and patients.\u003c/p>\n\u003cp>In addition to her research, Janjic started paying close attention to her own condition.\u003c/p>\n\u003cp>\"I started to understand that my body was actually inflamed,\" she says.\u003c/p>\n\u003cp>Inflammation occurs when our bodies' immune system tries to deal with some damage, maybe from an invading virus or bacteria, and sends a barrage of immune cells to the affected area. On the one hand this is a good thing, since the cells fight the infection. But on the other, it can stimulate nerve cells in a particular part of the body, causing pain.\u003c/p>\n\u003cp>Janjic also noticed something important about her pain: it varied both in intensity and in location. Sometimes it was in her knees, sometimes in her shoulders.\u003c/p>\n\u003cp>She says none of the medicines available today responded to pain's \"diversity within the body.\"\u003c/p>\n\u003cp>\"I [started] to understand the fluctuation,\" she says.\u003c/p>\n\u003cp>She realized that the fluctuation meant more immune cells were going to the part of the body where the pain was. She figured if she could get pain medicine into immune cells, that medicine would ride with those cells to where it was needed.[contextly_sidebar id=\"YRLyRHWtPrWD1BScVQCmWanq4QjZQPO0\"]\u003c/p>\n\u003cp>Before she got into pain research, Janjic was working on something called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29230567\" target=\"_blank\" rel=\"noopener\">cancer nanomedicine\u003c/a>. Cancer nanomedicines work by putting anti-cancer drugs into tiny containers called nanoparticles, and then injecting them into cancer patients, where they enter the patients' immune cells.\u003c/p>\n\u003cp>\"So what did I already know how to do? Mess with the immune system with nanomedicines,\" Janjic says. \"And that's how the idea of pain nanomedicine was born.\"\u003c/p>\n\u003cp>After many years of tinkering, she's started to get positive results. In a \u003ca href=\"https://www.jni-journal.com/article/S0165-5728(18)30012-2/fulltext\">recently published study,\u003c/a> she showed that when researchers put a nonsteroidal, anti-inflammatory drug into a nanoparticle, and then injected that into a rat, it reduced the rat's pain.\u003c/p>\n\u003cp>Janjic says her approach doesn't try to disable the immune cells.\u003c/p>\n\u003cp>\"You still want them to fight infection, you still want them to do what they're supposed to do,\" she says. \"But we almost try to stop them from going into override and causing chronic pain.\"\u003c/p>\n\u003cp>Janjic, who is also the founder and co-director of the \u003ca href=\"https://www.duq.edu/about/centers-and-institutes/chronic-pain-research-consortium\" target=\"_blank\" rel=\"noopener\">Chronic Pain Research Consortium\u003c/a> at Duquesne University, is collaborating with several labs to try pairing different pain medications with different kinds of nano-particles to see what works best. So far progress is slow. And if one of the candidates shows real promise it will be years before anything can be tested in human patients and ultimately approved by the FDA.\u003c/p>\n\u003cp>Janjic credits her own experience with pain for helping her gain a better understanding of pain and how to treat it. She thinks researchers would learn a lot from routinely talking to the people they're trying to help.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"My take home message is, 'Ask the patient first,' \" Janjic says. \"Ask the kid who's ten. Ask the grandpa with rheumatoid arthritis what that feels like. This is what I really want to see flourish. Maybe this already happening somewhere. If it is, I want to know. If you are inspiring your research this way, then I want to talk to you.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Inspired+By+Her+Own+Pain%2C+A+Researcher+Explores+Alternatives+To+Opioid+Treatments&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"New options for non-addictive pain treatment are sorely needed. One researcher is borrowing from the field of cancer nanomedicine to test an idea that could bring relief to chronic pain sufferers. ","status":"publish","parent":0,"modified":1536179328,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1225},"headData":{"title":"A Researcher Battling Cancer Explores Alternatives To Opioid Treatments | KQED","description":"New options for non-addictive pain treatment are sorely needed. One researcher is borrowing from the field of cancer nanomedicine to test an idea that could bring relief to chronic pain sufferers. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Researcher Battling Cancer Explores Alternatives To Opioid Treatments","datePublished":"2018-09-06T21:00:37.000Z","dateModified":"2018-09-05T20:28:48.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444318 https://ww2.kqed.org/futureofyou/?p=444318","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/09/06/a-researcher-battling-cancer-explores-alternatives-to-opioid-treatments/","disqusTitle":"A Researcher Battling Cancer Explores Alternatives To Opioid Treatments","source":"DIY Health","nprByline":"Joe Palca, NPR","nprImageAgency":"Jeff Swensen for NPR","nprStoryId":"636860122","nprApiLink":"http://api.npr.org/query?id=636860122&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/09/05/636860122/inspired-by-her-own-pain-a-researcher-explores-alternatives-to-opioid-treatments?ft=nprml&f=636860122","nprRetrievedStory":"1","nprPubDate":"Wed, 05 Sep 2018 15:33:00 -0400","nprStoryDate":"Wed, 05 Sep 2018 15:33:02 -0400","nprLastModifiedDate":"Wed, 05 Sep 2018 15:34:43 -0400","path":"/futureofyou/444318/a-researcher-battling-cancer-explores-alternatives-to-opioid-treatments","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The explosion of deaths related to opioid misuse has underscored a pressing need for better ways of treating pain, especially chronic pain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Duquesne University pharmacology associate professor Jelena Janjic thinks she's on to one. It involves using a patient's own immune system to deliver non-opioid pain medication to places in the body where there's pain.\u003c/p>\n\u003cp>Janjic's idea, which draws from the field of cancer research, is to insert tiny amounts of over-the-counter pain medications into minute carriers called nanoparticles, and then inject these into pain patients. The medicines would then travel through the body to places where there is inflammation, and relieve the pain.\u003c/p>\n\u003cp>Janjic has a special reason for wanting to develop new medicines for chronic pain: She suffers from it herself.\u003c/p>\n\u003cp>\"As a patient, I want an answer,\" she says. \"I want to figure out this.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There's no question that the need for better, non-addictive medications is real and urgent. Researchers have come up with\u003ca href=\"https://www.painnewsnetwork.org/stories/2018/6/2/new-treatments-on-the-horizon-for-chronic-pain\"> some ideas\u003c/a>, but so far none has made it to market. Finding new treatments is difficult for any disease and it's proving especially difficult for chronic pain because the underlying causes are poorly understood.\u003c/p>\n\u003cp>Attempting to modulate inflammation as way to treat pain \"is an active area of research,\" says \u003ca href=\"https://www.ninds.nih.gov/node/8824\" target=\"_blank\" rel=\"noopener\">Michael L. Oshinsky\u003c/a>, Program Director, Pain and Migraine, at the National Institute of Neurological Disorders and Stroke.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Oshinsky says Janjic's idea of targeting the immune system with nanoparticles carrying pain relievers makes sense, although he cautions that the relationship between inflammation and pain is not well understood.\u003c/p>\n\u003cp>Janjic's path to this research began in 2010. She has a doctorate in medicinal chemistry, and she had recently moved to Duquesne University where she had set up a lab focused on using nanomedicine techniques to treat cancer.\u003c/p>\n\u003cp>What seemed like out of nowhere, of the blue, she started to suffer bouts of severe pain.\u003c/p>\n\u003cp>\"The one that hit me real hard was the whole body, from head to toe,\" she says. \"I've had on and off chronic pain since I was a teenager, but this was different.\"\u003c/p>\n\u003cp>In August that year, just before her students arrived back to school, she ended up in the emergency room with pain that was almost intolerable.\u003c/p>\n\u003cp>The doctors' diagnosis was discouraging. They told her she had a chronic pain syndrome. They said there wasn't much they could do about it, and they said it was for life.\u003c/p>\n\u003cp>The medicines they gave her helped with the pain somewhat, but left her feeling like she was living in a fog. She was having trouble remembering things, trouble taking notes.\u003c/p>\n\u003cp>\"Things were weird. So I decided I am going to do research on myself,\" Janjic says.\u003c/p>\n\u003cp>To control her own pain, she turned to mindfulness meditation and other non-medical interventions, including composing music and playing the piano. It's not as if the pain magically went away, she says, but she was able to carry on with her life. Some days were worse than others.\u003c/p>\n\u003cp>But she also wanted to find a medical solution.\u003c/p>\n\u003cp>She made one important treatment decision early on: She didn't want to take opioids for her pain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"At the time I could have got them very easily,\" Janjic says. \"I said, 'What are you going to give me when I'm 67, or 87, if I take them now?' I knew they don't work long-term very well. So almost the refusal of opioids precipitated everything else that happened.\"\u003c/p>\n\u003cp>Looking for alternatives to opioids, she dove into the scientific literature, to learn all she could about chronic pain.\u003c/p>\n\u003cp>Chronic pain syndromes are not well understood. With acute pain, it's usually possible to identify the cause—an injury of some sort, or inflammation caused by an infection. Chronic pain may be linked to an initial mishap, but may persist long after the initial cause of the pain has disappeared. Sometimes there's no good explanation of the pain at all, a frustrating circumstance for both doctor and patients.\u003c/p>\n\u003cp>In addition to her research, Janjic started paying close attention to her own condition.\u003c/p>\n\u003cp>\"I started to understand that my body was actually inflamed,\" she says.\u003c/p>\n\u003cp>Inflammation occurs when our bodies' immune system tries to deal with some damage, maybe from an invading virus or bacteria, and sends a barrage of immune cells to the affected area. On the one hand this is a good thing, since the cells fight the infection. But on the other, it can stimulate nerve cells in a particular part of the body, causing pain.\u003c/p>\n\u003cp>Janjic also noticed something important about her pain: it varied both in intensity and in location. Sometimes it was in her knees, sometimes in her shoulders.\u003c/p>\n\u003cp>She says none of the medicines available today responded to pain's \"diversity within the body.\"\u003c/p>\n\u003cp>\"I [started] to understand the fluctuation,\" she says.\u003c/p>\n\u003cp>She realized that the fluctuation meant more immune cells were going to the part of the body where the pain was. She figured if she could get pain medicine into immune cells, that medicine would ride with those cells to where it was needed.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Before she got into pain research, Janjic was working on something called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29230567\" target=\"_blank\" rel=\"noopener\">cancer nanomedicine\u003c/a>. Cancer nanomedicines work by putting anti-cancer drugs into tiny containers called nanoparticles, and then injecting them into cancer patients, where they enter the patients' immune cells.\u003c/p>\n\u003cp>\"So what did I already know how to do? Mess with the immune system with nanomedicines,\" Janjic says. \"And that's how the idea of pain nanomedicine was born.\"\u003c/p>\n\u003cp>After many years of tinkering, she's started to get positive results. In a \u003ca href=\"https://www.jni-journal.com/article/S0165-5728(18)30012-2/fulltext\">recently published study,\u003c/a> she showed that when researchers put a nonsteroidal, anti-inflammatory drug into a nanoparticle, and then injected that into a rat, it reduced the rat's pain.\u003c/p>\n\u003cp>Janjic says her approach doesn't try to disable the immune cells.\u003c/p>\n\u003cp>\"You still want them to fight infection, you still want them to do what they're supposed to do,\" she says. \"But we almost try to stop them from going into override and causing chronic pain.\"\u003c/p>\n\u003cp>Janjic, who is also the founder and co-director of the \u003ca href=\"https://www.duq.edu/about/centers-and-institutes/chronic-pain-research-consortium\" target=\"_blank\" rel=\"noopener\">Chronic Pain Research Consortium\u003c/a> at Duquesne University, is collaborating with several labs to try pairing different pain medications with different kinds of nano-particles to see what works best. So far progress is slow. And if one of the candidates shows real promise it will be years before anything can be tested in human patients and ultimately approved by the FDA.\u003c/p>\n\u003cp>Janjic credits her own experience with pain for helping her gain a better understanding of pain and how to treat it. She thinks researchers would learn a lot from routinely talking to the people they're trying to help.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"My take home message is, 'Ask the patient first,' \" Janjic says. \"Ask the kid who's ten. Ask the grandpa with rheumatoid arthritis what that feels like. This is what I really want to see flourish. Maybe this already happening somewhere. If it is, I want to know. If you are inspiring your research this way, then I want to talk to you.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Inspired+By+Her+Own+Pain%2C+A+Researcher+Explores+Alternatives+To+Opioid+Treatments&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444318/a-researcher-battling-cancer-explores-alternatives-to-opioid-treatments","authors":["byline_futureofyou_444318"],"programs":["futureofyou_54"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_828","futureofyou_103","futureofyou_61","futureofyou_938","futureofyou_381","futureofyou_198"],"collections":["futureofyou_1093"],"featImg":"futureofyou_444321","label":"source_futureofyou_444318"},"futureofyou_443882":{"type":"posts","id":"futureofyou_443882","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443882","score":null,"sort":[1533917568000]},"guestAuthors":[],"slug":"families-choose-empathy-over-tough-love-to-rescue-loved-ones-from-opioids","title":"Families Choose Empathy Over 'Tough Love' To Rescue Loved Ones From Opioids","publishDate":1533917568,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>It was Bea Duncan who answered the phone at 2 a.m. on a January morning. Her son Jeff had been caught using drugs in a New Hampshire sober home and was being kicked out.[contextly_sidebar id=\"0ueKts5XFYp7vq9GJWLyDaZMcqJC2m7p\"]\u003c/p>\n\u003cp>Bea and her husband, Doug Duncan, drove north that night nine years ago to pick Jeff up. On the ride back home, to Natick, Mass., the parents delivered an ultimatum: Their son had to go back to rehab, or leave home.\u003c/p>\n\u003cp>Jeff chose the latter, Bea says. She remembers a lot of yelling, cursing and tears as they stopped the car, in the dead of night, a few miles from the house.\u003c/p>\n\u003cp>\"It was really, really difficult to actually just drop him off in a parking lot on our way home and say, 'you made the decision — no rehab — so we made the decision, no home,' \" Bea says. \"It was exquisitely difficult.\"\u003c/p>\n\u003cp>Doug Duncan says many parents had told him to expect this moment. He remembers them saying, your son will have to \"hit rock bottom; you're going to have to kick him out of the house.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Two torturous days later, Jeff Duncan came home. Although he returned to rehab, the Duncans decided their approach wasn't working. They sought help, eventually \u003ca href=\"http://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement.aspx\" target=\"_blank\" rel=\"noopener\">connecting with a program\u003c/a> that, instead of tough love, stresses empathy: CRAFT or Community Reinforcement and Family Training.\u003c/p>\n\u003cp>\"There was more compassion and, 'Wow, this is really difficult for you;' more open questions to him instead of dictating what he should and should not behave like,\" says Bea.\u003c/p>\n\u003cp>Many drug users say, in hindsight, they've appreciated being forced into treatment. But studies show that a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394369/\" target=\"_blank\" rel=\"noopener\">compassionate approach\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752879/\">voluntary treatment\u003c/a> are the more effective ways to engage drug users in recovery and keep them alive. That's a critical consideration for families \u003ca href=\"https://www.npr.org/sections/health-shots/2018/03/29/597717402/fentanyl-laced-cocaine-becoming-a-deadly-problem-among-drug-users\" target=\"_blank\" rel=\"noopener\">in this era of fentanyl\u003c/a>, a powerful opioid that can shut down breathing in seconds.[contextly_sidebar id=\"fB1AY6AFnWUf8d4yEfB8hxxzkt7SQlns\"]\u003c/p>\n\u003cp>\"The concept of letting their children hit bottom is not the best strategy,\" says Nora Volkow, director of the National Institute on Drug Abuse. \"Because in hitting bottom they may die.\"\u003c/p>\n\u003cp>After they went through CRAFT training, the Duncans say things started to shift from chaos to calm.\u003c/p>\n\u003cp>\"I started to feel an immense sense of relief,\" Bea says. \"I stopped feeling like I had to be a private investigator and controlling mom. I could kind of walk side-by-side with him on this journey, instead of feeling like I had to take charge of it.\"\u003c/p>\n\u003cp>For the Duncans, the approach meant they could switch from enforcing family consequences, like kicking Jeff out of the house, to supporting him as he faced other challenges, like losing a job because of his drug use.\u003c/p>\n\u003cp>It worked well: Bea and Doug helped Jeff stick to his recovery. He's 28 now and has been sober for nine years.\u003c/p>\n\u003cp>But desperate parents often don't know how to avoid \"hitting bottom\" with their children, as the Duncans did on that dark and frigid January morning.\u003c/p>\n\u003cp>The Duncans have found ways to help others: Doug is a \u003ca href=\"https://drugfree.org/article/parent-coaches/\" target=\"_blank\" rel=\"noopener\">parent coach\u003c/a> through the Partnership for Drug-Free Kids, which is now collaborating with the \u003ca href=\"https://graykenaddictionsupport.org/\" target=\"_blank\" rel=\"noopener\">Grayken Center for Addiction\u003c/a> at Boston Medical Center.\u003c/p>\n\u003cp>The collaboration will close a gap in services for families caught up in the opioid epidemic, says Grayken Center's director, Michael Botticelli, who served as drug czar in the Obama administration.\u003c/p>\n\u003cp>\"They don't call this a family disease for no good reason,\" Botticelli says. \"The whole design of these services [is] to promote tools and information for families, so they know how to approach a situation and can heal.\"\u003c/p>\n\u003cp>There is no uniform path to healing for the drug user or parents, and no widespread agreement on the best approach for families.\u003c/p>\n\u003cp>Joanne Peterson, who founded the parent support network \u003ca href=\"https://www.learn2cope.org/\" target=\"_blank\" rel=\"noopener\">Learn to Cope\u003c/a>, says there are reasons why some parents ask older children to leave the house — if there are younger children at home or if the parents don't feel safe.\u003c/p>\n\u003cp>\"So it depends on what 'tough love' means; it can mean many different things,\" Peterson says.\u003c/p>\n\u003cp>She applauds the Grayken Center for expanding access to parent coaches, but \"we also need more professional help.\" Peterson says she routinely hears from parents who can't find counselors and doctors who understand their daily traumas.\u003c/p>\n\u003cp>Some critics suggest the CRAFT model is too soft, that it enables drug use.\u003c/p>\n\u003cp>\"That's a misconception,\" says \u003ca href=\"https://drugfree.org/newsroom/news-item/fred-muench-named-president-and-ceo-of-partnership-for-drug-free-kids/\" target=\"_blank\" rel=\"noopener\">Fred Muench\u003c/a>, president of the Partnership for Drug-Free Kids. \"CRAFT is authoritative parenting, creating a sense of responsibility in the child, and at the same time saying, 'I am here for you; I love you; I'm going to help you; but I can't help you avoid negative consequences if you're not looking to do that on your own.' \"\u003c/p>\n\u003cp>The parent coaching extends beyond periods of crisis.\u003c/p>\n\u003cp>On a recent afternoon, Doug Duncan was on the phone with Doreen, a mom whose daughter is in recovery. (We're using only Doreen's first name to protect her daughter's privacy.) Doreen was upset about an angry text from her daughter that sounded like the messages the young woman sent when she was using drugs.\u003c/p>\n\u003cp>\"It brings me back there. In two seconds, I am back on that scene thinking she's on the heroin, she's not going to live,\" Doreen told Duncan, expressing a very common fear of a loved one's relapse.\u003c/p>\n\u003cp>In a panic — her daughter had overdosed twice and been rescued — Doreen wanted to ask if she was using heroin again. But she ran it by Duncan first. He encouraged her to talk it through.\u003c/p>\n\u003cp>Doreen paused, then said she could ask her daughter about work — whether it's been stressful — or about her grief after a friend's recent death. There are many reasons, Doreen realized, that her daughter might be angry. Her tone didn't have to signal a relapse.\u003c/p>\n\u003cp>\"You talk yourself off the cliff,\" Duncan told her.\u003c/p>\n\u003cp>\"Oh yes, I know all about that cliff, I've visited a few times before,\" Doreen said, and laughed. \"You know, that ties in with what you said before about focusing less on what your feelings are, and the terror or fear that you're going through, and more on what they're feeling and what they're going through — turn the tables a bit. That's an excellent point.\"\u003c/p>\n\u003cp>\"That's true compassion,\" Duncan told her, \"and oddly enough it's very therapeutic for you, too.\"\u003c/p>\n\u003cp>More compassion in the home fits the shift away from criminalizing addiction — toward accepting and treating it as a chronic medical condition.\u003c/p>\n\u003cp>If a child had cancer, parents \"wouldn't disengage with them or be angry with them,\" says Botticelli. \"So I do think it aligns our scientific understanding that addiction is a disease and not a moral failure.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's partnership with \u003c/em>\u003ca href=\"https://ww2.kqed.org/futureofyou/2018/08/08/can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses/\" target=\"_blank\" rel=\"noopener\">\u003cem>NPR\u003c/em>\u003c/a>\u003cem> and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Families+Choose+Empathy+Over+%27Tough+Love%27+To+Rescue+Loved+Ones+From+Opioids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Families are starting to adopt an approach that stresses compassion instead of harsh consequences for loved ones with addiction. Their goal? Keep them alive long enough to recover.","status":"publish","parent":0,"modified":1533917568,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":1184},"headData":{"title":"Families Choose Empathy Over 'Tough Love' To Rescue Loved Ones From Opioids | KQED","description":"Families are starting to adopt an approach that stresses compassion instead of harsh consequences for loved ones with addiction. Their goal? Keep them alive long enough to recover.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Families Choose Empathy Over 'Tough Love' To Rescue Loved Ones From Opioids","datePublished":"2018-08-10T16:12:48.000Z","dateModified":"2018-08-10T16:12:48.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443882 https://ww2.kqed.org/futureofyou/?p=443882","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/08/10/families-choose-empathy-over-tough-love-to-rescue-loved-ones-from-opioids/","disqusTitle":"Families Choose Empathy Over 'Tough Love' To Rescue Loved Ones From Opioids","source":"Health","nprImageCredit":"Robin Lubbbock","nprByline":"Martha Bebinger, NPR","nprImageAgency":"WBUR","nprStoryId":"636556573","nprApiLink":"http://api.npr.org/query?id=636556573&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/08/10/636556573/families-choose-empathy-over-tough-love-to-rescue-loved-ones-from-opioids?ft=nprml&f=636556573","nprRetrievedStory":"1","nprPubDate":"Fri, 10 Aug 2018 05:01:00 -0400","nprStoryDate":"Fri, 10 Aug 2018 05:01:17 -0400","nprLastModifiedDate":"Fri, 10 Aug 2018 05:01:17 -0400","path":"/futureofyou/443882/families-choose-empathy-over-tough-love-to-rescue-loved-ones-from-opioids","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It was Bea Duncan who answered the phone at 2 a.m. on a January morning. Her son Jeff had been caught using drugs in a New Hampshire sober home and was being kicked out.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Bea and her husband, Doug Duncan, drove north that night nine years ago to pick Jeff up. On the ride back home, to Natick, Mass., the parents delivered an ultimatum: Their son had to go back to rehab, or leave home.\u003c/p>\n\u003cp>Jeff chose the latter, Bea says. She remembers a lot of yelling, cursing and tears as they stopped the car, in the dead of night, a few miles from the house.\u003c/p>\n\u003cp>\"It was really, really difficult to actually just drop him off in a parking lot on our way home and say, 'you made the decision — no rehab — so we made the decision, no home,' \" Bea says. \"It was exquisitely difficult.\"\u003c/p>\n\u003cp>Doug Duncan says many parents had told him to expect this moment. He remembers them saying, your son will have to \"hit rock bottom; you're going to have to kick him out of the house.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Two torturous days later, Jeff Duncan came home. Although he returned to rehab, the Duncans decided their approach wasn't working. They sought help, eventually \u003ca href=\"http://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement.aspx\" target=\"_blank\" rel=\"noopener\">connecting with a program\u003c/a> that, instead of tough love, stresses empathy: CRAFT or Community Reinforcement and Family Training.\u003c/p>\n\u003cp>\"There was more compassion and, 'Wow, this is really difficult for you;' more open questions to him instead of dictating what he should and should not behave like,\" says Bea.\u003c/p>\n\u003cp>Many drug users say, in hindsight, they've appreciated being forced into treatment. But studies show that a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394369/\" target=\"_blank\" rel=\"noopener\">compassionate approach\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752879/\">voluntary treatment\u003c/a> are the more effective ways to engage drug users in recovery and keep them alive. That's a critical consideration for families \u003ca href=\"https://www.npr.org/sections/health-shots/2018/03/29/597717402/fentanyl-laced-cocaine-becoming-a-deadly-problem-among-drug-users\" target=\"_blank\" rel=\"noopener\">in this era of fentanyl\u003c/a>, a powerful opioid that can shut down breathing in seconds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The concept of letting their children hit bottom is not the best strategy,\" says Nora Volkow, director of the National Institute on Drug Abuse. \"Because in hitting bottom they may die.\"\u003c/p>\n\u003cp>After they went through CRAFT training, the Duncans say things started to shift from chaos to calm.\u003c/p>\n\u003cp>\"I started to feel an immense sense of relief,\" Bea says. \"I stopped feeling like I had to be a private investigator and controlling mom. I could kind of walk side-by-side with him on this journey, instead of feeling like I had to take charge of it.\"\u003c/p>\n\u003cp>For the Duncans, the approach meant they could switch from enforcing family consequences, like kicking Jeff out of the house, to supporting him as he faced other challenges, like losing a job because of his drug use.\u003c/p>\n\u003cp>It worked well: Bea and Doug helped Jeff stick to his recovery. He's 28 now and has been sober for nine years.\u003c/p>\n\u003cp>But desperate parents often don't know how to avoid \"hitting bottom\" with their children, as the Duncans did on that dark and frigid January morning.\u003c/p>\n\u003cp>The Duncans have found ways to help others: Doug is a \u003ca href=\"https://drugfree.org/article/parent-coaches/\" target=\"_blank\" rel=\"noopener\">parent coach\u003c/a> through the Partnership for Drug-Free Kids, which is now collaborating with the \u003ca href=\"https://graykenaddictionsupport.org/\" target=\"_blank\" rel=\"noopener\">Grayken Center for Addiction\u003c/a> at Boston Medical Center.\u003c/p>\n\u003cp>The collaboration will close a gap in services for families caught up in the opioid epidemic, says Grayken Center's director, Michael Botticelli, who served as drug czar in the Obama administration.\u003c/p>\n\u003cp>\"They don't call this a family disease for no good reason,\" Botticelli says. \"The whole design of these services [is] to promote tools and information for families, so they know how to approach a situation and can heal.\"\u003c/p>\n\u003cp>There is no uniform path to healing for the drug user or parents, and no widespread agreement on the best approach for families.\u003c/p>\n\u003cp>Joanne Peterson, who founded the parent support network \u003ca href=\"https://www.learn2cope.org/\" target=\"_blank\" rel=\"noopener\">Learn to Cope\u003c/a>, says there are reasons why some parents ask older children to leave the house — if there are younger children at home or if the parents don't feel safe.\u003c/p>\n\u003cp>\"So it depends on what 'tough love' means; it can mean many different things,\" Peterson says.\u003c/p>\n\u003cp>She applauds the Grayken Center for expanding access to parent coaches, but \"we also need more professional help.\" Peterson says she routinely hears from parents who can't find counselors and doctors who understand their daily traumas.\u003c/p>\n\u003cp>Some critics suggest the CRAFT model is too soft, that it enables drug use.\u003c/p>\n\u003cp>\"That's a misconception,\" says \u003ca href=\"https://drugfree.org/newsroom/news-item/fred-muench-named-president-and-ceo-of-partnership-for-drug-free-kids/\" target=\"_blank\" rel=\"noopener\">Fred Muench\u003c/a>, president of the Partnership for Drug-Free Kids. \"CRAFT is authoritative parenting, creating a sense of responsibility in the child, and at the same time saying, 'I am here for you; I love you; I'm going to help you; but I can't help you avoid negative consequences if you're not looking to do that on your own.' \"\u003c/p>\n\u003cp>The parent coaching extends beyond periods of crisis.\u003c/p>\n\u003cp>On a recent afternoon, Doug Duncan was on the phone with Doreen, a mom whose daughter is in recovery. (We're using only Doreen's first name to protect her daughter's privacy.) Doreen was upset about an angry text from her daughter that sounded like the messages the young woman sent when she was using drugs.\u003c/p>\n\u003cp>\"It brings me back there. In two seconds, I am back on that scene thinking she's on the heroin, she's not going to live,\" Doreen told Duncan, expressing a very common fear of a loved one's relapse.\u003c/p>\n\u003cp>In a panic — her daughter had overdosed twice and been rescued — Doreen wanted to ask if she was using heroin again. But she ran it by Duncan first. He encouraged her to talk it through.\u003c/p>\n\u003cp>Doreen paused, then said she could ask her daughter about work — whether it's been stressful — or about her grief after a friend's recent death. There are many reasons, Doreen realized, that her daughter might be angry. Her tone didn't have to signal a relapse.\u003c/p>\n\u003cp>\"You talk yourself off the cliff,\" Duncan told her.\u003c/p>\n\u003cp>\"Oh yes, I know all about that cliff, I've visited a few times before,\" Doreen said, and laughed. \"You know, that ties in with what you said before about focusing less on what your feelings are, and the terror or fear that you're going through, and more on what they're feeling and what they're going through — turn the tables a bit. That's an excellent point.\"\u003c/p>\n\u003cp>\"That's true compassion,\" Duncan told her, \"and oddly enough it's very therapeutic for you, too.\"\u003c/p>\n\u003cp>More compassion in the home fits the shift away from criminalizing addiction — toward accepting and treating it as a chronic medical condition.\u003c/p>\n\u003cp>If a child had cancer, parents \"wouldn't disengage with them or be angry with them,\" says Botticelli. \"So I do think it aligns our scientific understanding that addiction is a disease and not a moral failure.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's partnership with \u003c/em>\u003ca href=\"https://ww2.kqed.org/futureofyou/2018/08/08/can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses/\" target=\"_blank\" rel=\"noopener\">\u003cem>NPR\u003c/em>\u003c/a>\u003cem> and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Families+Choose+Empathy+Over+%27Tough+Love%27+To+Rescue+Loved+Ones+From+Opioids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443882/families-choose-empathy-over-tough-love-to-rescue-loved-ones-from-opioids","authors":["byline_futureofyou_443882"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_828","futureofyou_61","futureofyou_938"],"featImg":"futureofyou_443883","label":"source_futureofyou_443882"},"futureofyou_443844":{"type":"posts","id":"futureofyou_443844","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443844","score":null,"sort":[1533762016000]},"guestAuthors":[],"slug":"can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses","title":"Can an App Warning to Avoid Risky Friends Prevent Opioid Relapses?","publishDate":1533762016,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>You’re in recovery from opioid addiction, and your walk to work takes you down the same streets where you used to buy heroin. The drug’s calling to you, still. Just then, your phone buzzes, with a message that reads like a text from an old friend:\u003c/p>\n\u003cp>“Hey, I know you’re near a risky area. You can do this.”\u003c/p>\n\u003cp>It’s from Hey,Charlie, an app — conceived at a 2016 Massachusetts Institute of Technology health hackathon — that aims to help people avoid environmental triggers that might threaten their recovery from an opioid addiction. The app, now being piloted by several treatment centers in Boston and Framingham, Mass., monitors a user’s contacts and location, and sends pop-up notifications to caution them about risky acquaintances or neighborhoods.[contextly_sidebar id=\"B6m1pmj1KurktxXVtJVATPZuSNjGkhGD\"]\u003c/p>\n\u003cp>“People and places can remind you of using drugs and stress you out,” leading people to relapse, said Emily Lindemer, co-founder of Hey,Charlie.\u003c/p>\n\u003cp>The app chimes in with a different reminder: recovery. “It helps them keep their sobriety at the front of their mind,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There are a sea of addiction apps, many connecting people to treatment or augmenting their outpatient therapy, by counting the number of days in recovery, for example, or recording fluctuations in mood or cravings. Some simply encourage users with inspirational quotes or hypnosis guides. Social apps are increasingly a focus, as well.\u003c/p>\n\u003cp>“Social outlets are critically important,” said Wilson Washington Jr., a senior public health adviser at the federal Substance Abuse and Mental Health Services Administration (SAMHSA). “You need family support, you need community support, you need system support.”\u003c/p>\n\u003cp>One such app, \u003ca href=\"http://www.sobertool.com/about/\" target=\"_blank\" rel=\"noopener\">SoberTool\u003c/a>, offers an anonymous forum for discussion. \u003ca href=\"https://www.sobergrid.com/\" target=\"_blank\" rel=\"noopener\">Sober Grid \u003c/a>is a social network — purported to be the largest for people with a chemical dependency — with a news feed reminiscent of Instagram.\u003c/p>\n\u003cp>But when Lindemer attended the MIT hackathon, she saw a gaping hole among the existing apps — not only could an app foster positive social connections, but it could also help people sever the negative ones.\u003c/p>\n\u003cp>Michael Kidorf, a psychiatrist and associate director of addiction treatment services at Johns Hopkins School of Medicine, told STAT that the social networks of urban drug users tend to include a mix of people who use substances and people who are drug-free.[contextly_sidebar id=\"cwsZEwnwKgEBeLVOmPCSFLGkj8YqHqD4\"]\u003c/p>\n\u003cp>“As you would expect, people who have more network members who use illicit drugs use more drugs [themselves] and engage in more risky behaviors,” he said by email.\u003c/p>\n\u003cp>Opioid users also rely heavily on their contacts to secure heroin and other drugs, Kidorf added. Studies consistently show that regular interaction with other users predicts poorer treatment outcomes.\u003c/p>\n\u003cp>The hard part, he said, is getting people to dismantle and rebuild their social network. “It is relatively easy to tell substance users to ‘change people, places, and things.’ It is much harder to provide a strategy to help them achieve this important goal.”\u003c/p>\n\u003cp>Hey,Charlie is piloting one such strategy.\u003c/p>\n\u003cp>Having watched someone close to her — the namesake for Hey,Charlie — struggle with opioid addiction, Lindemer noticed the obstacles people in recovery face. Even for those who receive \u003ca href=\"https://www.statnews.com/2018/08/06/fda-expands-medication-assisted-treatment/\">medication-assisted treatment\u003c/a>, “you go live your life and in the day-to-day 24/7 doing normal things, you still are in recovery and you still have to battle these constant environmental triggers,” she said.\u003c/p>\n\u003cp>As a then-Ph.D. student in the joint Harvard-MIT Health Sciences and Technology program, Lindemer thought an app could help mediate those urges.\u003c/p>\n\u003cp>Following the hackathon, Lindemer with her co-founder, Vincent Valant, and head developer, Benjamin Pyser, created a company that initially was funded through MIT grants. Now that she has graduated — she has a day job as a scientist at Watson Health in Cambridge, Mass. – the startup is running mostly on funding from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse.\u003c/p>\n\u003cp>Hey,Charlie’s business model is their “Achilles’ heel,” Lindemer said.\u003c/p>\n\u003cp>She wants to ensure that Hey,Charlie is accessible to everybody. “Our goal is that, if we are charging for it, we are not charging the patient. We want it to fit into a treatment program,” which is why the company hopes to eventually demonstrate the app’s clinical efficacy in controlled trials.[contextly_sidebar id=\"dahwcW9QuGAKTVxO8aXeHP8Uk5bpWbni\"]\u003c/p>\n\u003cp>The app is still being refined, but the basics are in place. When sending a text to a “risky” contact, or receiving one, a message from Hey,Charlie will pop up: “Wait a minute, are you sure you want to speak to John Smith right now?” If the user decides against communicating, Hey,Charlie can send an automatic response. The app also shares a handful of affirmative messages with the user throughout the day.\u003c/p>\n\u003cp>For now, Hey,Charlie’s location services simply create a pause (you’re near a risky area). “The idea is that if you are aware of a potentially triggering situation before it arises, you are more mentally primed to handle it effectively,” said Lindemer.\u003c/p>\n\u003cp>But in the future, Lindemer hopes the app can go one step further. She envisions it not only warning people that they’re approaching a risky location, but suggesting an entirely different path as well. Lindemer wants to partner with local businesses so that Hey,Charlie can say, “Hey, there’s a coffee shop with a discount a couple of blocks away if you’re willing to switch up your route!”\u003c/p>\n\u003cp>The app relies on a combination of data actively input by users — a one-time occurrence — and data passively collected as they continue to use their cellphones. The onboarding process asks users a series of questions about their contacts, ranked by frequency of communication, and then calculates the risk each contact poses.\u003c/p>\n\u003cp>Lindemer said that she and her team don’t expect users to be completely upfront and that, especially at the beginning of recovery, relationships can be confusing as they rapidly evolve. Hey,Charlie continues to check in periodically, asking, “Is there anything you want to tell me about this person?”[contextly_sidebar id=\"m4GxEhhH8zjyZ8polANWuf0odOZy5mLJ\"]\u003c/p>\n\u003cp>While the initial version of the app focused on sheltering users from risky contacts, Lindemer and her team are now working to incorporate positive support features as well — letting supportive contacts know when their friend or family member is in a risky place.\u003c/p>\n\u003cp>“One of the things we know really well is that many people in recovery do have somebody — like a really close family member or friend — who wants to help them, and they often just don’t have the tools, and they don’t know when is the right time to reach out, so we’re trying to address that,” Lindemer said.\u003c/p>\n\u003cp>Kidorf stressed the importance of supportive, drug-free contacts. His research focuses on how treatment providers can mobilize drug-free individuals to be active participants in their loved one’s recovery.\u003c/p>\n\u003cp>Hey,Charlie is being piloted at local clinics in and around Boston. Dr. Christopher Shanahan, an internist and professor at Boston University School of Medicine, is leading the effort.\u003c/p>\n\u003cp>Shanahan, who has been studying substance use for nearly 20 years, loved the idea that Hey,Charlie could be there for his patients when he can’t. He said Lindemer pitched it to him and his colleagues during their journal club hour — when researchers typically discuss new papers published in their field.\u003c/p>\n\u003cp>“We have, what, 15 to 20 minutes with a patient in a clinic?” Shanahan said. “We give them some advice, a little bit of coaching, and send them out with some buprenorphine — and then it’s a crapshoot.”\u003c/p>\n\u003cp>The app, he said, is “a very innovative way of addressing the other 23 hours and 15 minutes of the day where doctors aren’t seeing patients.”\u003c/p>\n\u003cp>But he won’t hang his hat on it. An app can help patients cope with triggers and temptations, but it’s far from the perfect solution, he said.\u003c/p>\n\u003cp>Kidorf expressed a similar level-headed optimism, noting that apps can bring users closer to people and organizations that can support their recovery. “Overall, I think it is fair to say that these apps can be helpful for people motivated to use them.”\u003c/p>\n\u003cp>But still, he added, “We have to do better at thinking of opioid use disorder as a severe and often chronic disorder. The best apps in the world will have a hard time competing with it.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/08/07/can-phone-app-prevent-opioid-addiction-relapses/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"A new app aims to help people avoid environmental triggers that might threaten their recovery from an opioid addiction. But will it work?","status":"publish","parent":0,"modified":1533714565,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":37,"wordCount":1512},"headData":{"title":"Can an App Warning to Avoid Risky Friends Prevent Opioid Relapses? | KQED","description":"A new app aims to help people avoid environmental triggers that might threaten their recovery from an opioid addiction. But will it work?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Can an App Warning to Avoid Risky Friends Prevent Opioid Relapses?","datePublished":"2018-08-08T21:00:16.000Z","dateModified":"2018-08-08T07:49:25.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443844 https://ww2.kqed.org/futureofyou/?p=443844","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/08/08/can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses/","disqusTitle":"Can an App Warning to Avoid Risky Friends Prevent Opioid Relapses?","source":"Health","nprByline":"Orly Nadell Farber\u003cbr />STAT","path":"/futureofyou/443844/can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>You’re in recovery from opioid addiction, and your walk to work takes you down the same streets where you used to buy heroin. The drug’s calling to you, still. Just then, your phone buzzes, with a message that reads like a text from an old friend:\u003c/p>\n\u003cp>“Hey, I know you’re near a risky area. You can do this.”\u003c/p>\n\u003cp>It’s from Hey,Charlie, an app — conceived at a 2016 Massachusetts Institute of Technology health hackathon — that aims to help people avoid environmental triggers that might threaten their recovery from an opioid addiction. The app, now being piloted by several treatment centers in Boston and Framingham, Mass., monitors a user’s contacts and location, and sends pop-up notifications to caution them about risky acquaintances or neighborhoods.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“People and places can remind you of using drugs and stress you out,” leading people to relapse, said Emily Lindemer, co-founder of Hey,Charlie.\u003c/p>\n\u003cp>The app chimes in with a different reminder: recovery. “It helps them keep their sobriety at the front of their mind,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There are a sea of addiction apps, many connecting people to treatment or augmenting their outpatient therapy, by counting the number of days in recovery, for example, or recording fluctuations in mood or cravings. Some simply encourage users with inspirational quotes or hypnosis guides. Social apps are increasingly a focus, as well.\u003c/p>\n\u003cp>“Social outlets are critically important,” said Wilson Washington Jr., a senior public health adviser at the federal Substance Abuse and Mental Health Services Administration (SAMHSA). “You need family support, you need community support, you need system support.”\u003c/p>\n\u003cp>One such app, \u003ca href=\"http://www.sobertool.com/about/\" target=\"_blank\" rel=\"noopener\">SoberTool\u003c/a>, offers an anonymous forum for discussion. \u003ca href=\"https://www.sobergrid.com/\" target=\"_blank\" rel=\"noopener\">Sober Grid \u003c/a>is a social network — purported to be the largest for people with a chemical dependency — with a news feed reminiscent of Instagram.\u003c/p>\n\u003cp>But when Lindemer attended the MIT hackathon, she saw a gaping hole among the existing apps — not only could an app foster positive social connections, but it could also help people sever the negative ones.\u003c/p>\n\u003cp>Michael Kidorf, a psychiatrist and associate director of addiction treatment services at Johns Hopkins School of Medicine, told STAT that the social networks of urban drug users tend to include a mix of people who use substances and people who are drug-free.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“As you would expect, people who have more network members who use illicit drugs use more drugs [themselves] and engage in more risky behaviors,” he said by email.\u003c/p>\n\u003cp>Opioid users also rely heavily on their contacts to secure heroin and other drugs, Kidorf added. Studies consistently show that regular interaction with other users predicts poorer treatment outcomes.\u003c/p>\n\u003cp>The hard part, he said, is getting people to dismantle and rebuild their social network. “It is relatively easy to tell substance users to ‘change people, places, and things.’ It is much harder to provide a strategy to help them achieve this important goal.”\u003c/p>\n\u003cp>Hey,Charlie is piloting one such strategy.\u003c/p>\n\u003cp>Having watched someone close to her — the namesake for Hey,Charlie — struggle with opioid addiction, Lindemer noticed the obstacles people in recovery face. Even for those who receive \u003ca href=\"https://www.statnews.com/2018/08/06/fda-expands-medication-assisted-treatment/\">medication-assisted treatment\u003c/a>, “you go live your life and in the day-to-day 24/7 doing normal things, you still are in recovery and you still have to battle these constant environmental triggers,” she said.\u003c/p>\n\u003cp>As a then-Ph.D. student in the joint Harvard-MIT Health Sciences and Technology program, Lindemer thought an app could help mediate those urges.\u003c/p>\n\u003cp>Following the hackathon, Lindemer with her co-founder, Vincent Valant, and head developer, Benjamin Pyser, created a company that initially was funded through MIT grants. Now that she has graduated — she has a day job as a scientist at Watson Health in Cambridge, Mass. – the startup is running mostly on funding from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse.\u003c/p>\n\u003cp>Hey,Charlie’s business model is their “Achilles’ heel,” Lindemer said.\u003c/p>\n\u003cp>She wants to ensure that Hey,Charlie is accessible to everybody. “Our goal is that, if we are charging for it, we are not charging the patient. We want it to fit into a treatment program,” which is why the company hopes to eventually demonstrate the app’s clinical efficacy in controlled trials.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The app is still being refined, but the basics are in place. When sending a text to a “risky” contact, or receiving one, a message from Hey,Charlie will pop up: “Wait a minute, are you sure you want to speak to John Smith right now?” If the user decides against communicating, Hey,Charlie can send an automatic response. The app also shares a handful of affirmative messages with the user throughout the day.\u003c/p>\n\u003cp>For now, Hey,Charlie’s location services simply create a pause (you’re near a risky area). “The idea is that if you are aware of a potentially triggering situation before it arises, you are more mentally primed to handle it effectively,” said Lindemer.\u003c/p>\n\u003cp>But in the future, Lindemer hopes the app can go one step further. She envisions it not only warning people that they’re approaching a risky location, but suggesting an entirely different path as well. Lindemer wants to partner with local businesses so that Hey,Charlie can say, “Hey, there’s a coffee shop with a discount a couple of blocks away if you’re willing to switch up your route!”\u003c/p>\n\u003cp>The app relies on a combination of data actively input by users — a one-time occurrence — and data passively collected as they continue to use their cellphones. The onboarding process asks users a series of questions about their contacts, ranked by frequency of communication, and then calculates the risk each contact poses.\u003c/p>\n\u003cp>Lindemer said that she and her team don’t expect users to be completely upfront and that, especially at the beginning of recovery, relationships can be confusing as they rapidly evolve. Hey,Charlie continues to check in periodically, asking, “Is there anything you want to tell me about this person?”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>While the initial version of the app focused on sheltering users from risky contacts, Lindemer and her team are now working to incorporate positive support features as well — letting supportive contacts know when their friend or family member is in a risky place.\u003c/p>\n\u003cp>“One of the things we know really well is that many people in recovery do have somebody — like a really close family member or friend — who wants to help them, and they often just don’t have the tools, and they don’t know when is the right time to reach out, so we’re trying to address that,” Lindemer said.\u003c/p>\n\u003cp>Kidorf stressed the importance of supportive, drug-free contacts. His research focuses on how treatment providers can mobilize drug-free individuals to be active participants in their loved one’s recovery.\u003c/p>\n\u003cp>Hey,Charlie is being piloted at local clinics in and around Boston. Dr. Christopher Shanahan, an internist and professor at Boston University School of Medicine, is leading the effort.\u003c/p>\n\u003cp>Shanahan, who has been studying substance use for nearly 20 years, loved the idea that Hey,Charlie could be there for his patients when he can’t. He said Lindemer pitched it to him and his colleagues during their journal club hour — when researchers typically discuss new papers published in their field.\u003c/p>\n\u003cp>“We have, what, 15 to 20 minutes with a patient in a clinic?” Shanahan said. “We give them some advice, a little bit of coaching, and send them out with some buprenorphine — and then it’s a crapshoot.”\u003c/p>\n\u003cp>The app, he said, is “a very innovative way of addressing the other 23 hours and 15 minutes of the day where doctors aren’t seeing patients.”\u003c/p>\n\u003cp>But he won’t hang his hat on it. An app can help patients cope with triggers and temptations, but it’s far from the perfect solution, he said.\u003c/p>\n\u003cp>Kidorf expressed a similar level-headed optimism, noting that apps can bring users closer to people and organizations that can support their recovery. “Overall, I think it is fair to say that these apps can be helpful for people motivated to use them.”\u003c/p>\n\u003cp>But still, he added, “We have to do better at thinking of opioid use disorder as a severe and often chronic disorder. The best apps in the world will have a hard time competing with it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/08/07/can-phone-app-prevent-opioid-addiction-relapses/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443844/can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses","authors":["byline_futureofyou_443844"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73","futureofyou_1061"],"tags":["futureofyou_828","futureofyou_542","futureofyou_1593","futureofyou_61","futureofyou_938"],"collections":["futureofyou_1093"],"featImg":"futureofyou_443846","label":"source_futureofyou_443844"},"futureofyou_443288":{"type":"posts","id":"futureofyou_443288","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443288","score":null,"sort":[1531245659000]},"guestAuthors":[],"slug":"news-organizations-push-for-opioid-data-to-be-made-public","title":"News Organizations Push for Opioid Data to be Made Public","publishDate":1531245659,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>News organizations are pushing for the public release of data detailing the distribution of prescription opioids throughout the U.S., information that could show how drug manufacturers and distributors contributed to the nation’s addiction and overdose crisis.[contextly_sidebar id=\"oFkuCyLuHD6r1DtsAM7gwD9CF2vOQObm\"]\u003c/p>\n\u003cp>Attorneys for The Washington Post and HD Media, which owns The Charleston Gazette-Mail in West Virginia, filed requests Monday in federal court in Cleveland. They are advocating for release of records that the federal Drug Enforcement Agency has turned over as part of lawsuits between hundreds of local governments and the drug industry.\u003c/p>\n\u003cp>Other news organizations, including The Associated Press, also have requested information from the federal opioid distribution database.\u003c/p>\n\u003cp>“Where releasing records would merely bring embarrassment or adverse publicity to a corporation or a governmental agency, the records must be disclosed. In this case, disclosure of the (distribution) data would cause no conceivable harm to patients or other innocent individuals,” Washington Post lawyer Karen Lofton wrote in a court filing Monday. “If anything, their interests would be advanced by the public accountability that would be demanded in the wake of such disclosures.”\u003c/p>\n\u003cp>Drug manufacturers, distributors and the federal government object to making the information public. In a court filing last month, lawyers for the federal government argued that doing so would jeopardize the companies’ trade secrets, criminal investigations and violate state public records laws.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The database compiles information from the drug industry about the sales and distribution of controlled substances. The government refers to it for law enforcement purposes, although in legal papers it redacted descriptions of how it’s used.\u003c/p>\n\u003cp>A West Virginia judge made some of the data public in 2016. The Gazette-Mail used it to report that 780 million pills flowed into the state of just 1.8 million residents over a six-year period. During that time, more than 1,700 West Virginians died from opioid overdoses.[contextly_sidebar id=\"xvq6HHGRhbjlidwnKbSMejLZnMvvVApf\"]\u003c/p>\n\u003cp>In their filing, lawyers for the Charleston newspaper pointed to that previous decision and the resulting story as an example of why the national distribution data should be released.\u003c/p>\n\u003cp>The information is likely to be key evidence in the litigation over opioids. It’s the only way to trace opioids from manufacturers to distributors to pharmacies, said Paul Farrell Jr., a lead lawyer for plaintiffs suing the drug industry and an advocate of making the data public.\u003c/p>\n\u003cp>“It will identify every pill mill in the country,” he said.\u003c/p>\n\u003cp>The federal government agreed to provide data from its registry for 2006 through 2014 to the parties in the hundreds of lawsuits over the impact of prescription opioids and related illicit drugs. That deal includes restrictions that it can be used only for litigation and law enforcement.[contextly_sidebar id=\"bhpnTcxjlxotKE6ut4pr90uVJZ0rSHLV\"]\u003c/p>\n\u003cp>Cleveland-based U.S. District Judge Dan Polster is overseeing more than 800 lawsuits, most filed by governments, and is trying to get the sides to forge a settlement.\u003c/p>\n\u003cp>If the cases go to trial, it’s likely the distribution data would be presented as evidence. But if there’s a mass settlement, the information may not be revealed.\u003c/p>\n\u003cp>Combined, opioids killed more than 42,000 Americans in 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"The information could show how drug manufacturers and distributors contributed to the nation’s addiction and overdose crisis.","status":"publish","parent":0,"modified":1531244444,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":540},"headData":{"title":"News Organizations Push for Opioid Data to be Made Public | KQED","description":"The information could show how drug manufacturers and distributors contributed to the nation’s addiction and overdose crisis.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"News Organizations Push for Opioid Data to be Made Public","datePublished":"2018-07-10T18:00:59.000Z","dateModified":"2018-07-10T17:40:44.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443288 https://ww2.kqed.org/futureofyou/?p=443288","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/07/10/news-organizations-push-for-opioid-data-to-be-made-public/","disqusTitle":"News Organizations Push for Opioid Data to be Made Public","source":"Health","nprByline":"Geoff Mulvihill\u003cbr />The Associated Press","path":"/futureofyou/443288/news-organizations-push-for-opioid-data-to-be-made-public","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>News organizations are pushing for the public release of data detailing the distribution of prescription opioids throughout the U.S., information that could show how drug manufacturers and distributors contributed to the nation’s addiction and overdose crisis.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Attorneys for The Washington Post and HD Media, which owns The Charleston Gazette-Mail in West Virginia, filed requests Monday in federal court in Cleveland. They are advocating for release of records that the federal Drug Enforcement Agency has turned over as part of lawsuits between hundreds of local governments and the drug industry.\u003c/p>\n\u003cp>Other news organizations, including The Associated Press, also have requested information from the federal opioid distribution database.\u003c/p>\n\u003cp>“Where releasing records would merely bring embarrassment or adverse publicity to a corporation or a governmental agency, the records must be disclosed. In this case, disclosure of the (distribution) data would cause no conceivable harm to patients or other innocent individuals,” Washington Post lawyer Karen Lofton wrote in a court filing Monday. “If anything, their interests would be advanced by the public accountability that would be demanded in the wake of such disclosures.”\u003c/p>\n\u003cp>Drug manufacturers, distributors and the federal government object to making the information public. In a court filing last month, lawyers for the federal government argued that doing so would jeopardize the companies’ trade secrets, criminal investigations and violate state public records laws.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The database compiles information from the drug industry about the sales and distribution of controlled substances. The government refers to it for law enforcement purposes, although in legal papers it redacted descriptions of how it’s used.\u003c/p>\n\u003cp>A West Virginia judge made some of the data public in 2016. The Gazette-Mail used it to report that 780 million pills flowed into the state of just 1.8 million residents over a six-year period. During that time, more than 1,700 West Virginians died from opioid overdoses.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In their filing, lawyers for the Charleston newspaper pointed to that previous decision and the resulting story as an example of why the national distribution data should be released.\u003c/p>\n\u003cp>The information is likely to be key evidence in the litigation over opioids. It’s the only way to trace opioids from manufacturers to distributors to pharmacies, said Paul Farrell Jr., a lead lawyer for plaintiffs suing the drug industry and an advocate of making the data public.\u003c/p>\n\u003cp>“It will identify every pill mill in the country,” he said.\u003c/p>\n\u003cp>The federal government agreed to provide data from its registry for 2006 through 2014 to the parties in the hundreds of lawsuits over the impact of prescription opioids and related illicit drugs. That deal includes restrictions that it can be used only for litigation and law enforcement.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Cleveland-based U.S. District Judge Dan Polster is overseeing more than 800 lawsuits, most filed by governments, and is trying to get the sides to forge a settlement.\u003c/p>\n\u003cp>If the cases go to trial, it’s likely the distribution data would be presented as evidence. But if there’s a mass settlement, the information may not be revealed.\u003c/p>\n\u003cp>Combined, opioids killed more than 42,000 Americans in 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443288/news-organizations-push-for-opioid-data-to-be-made-public","authors":["byline_futureofyou_443288"],"categories":["futureofyou_73"],"tags":["futureofyou_828","futureofyou_301","futureofyou_1499","futureofyou_61","futureofyou_938"],"featImg":"futureofyou_443290","label":"source_futureofyou_443288"},"futureofyou_442978":{"type":"posts","id":"futureofyou_442978","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442978","score":null,"sort":[1529701221000]},"guestAuthors":[],"slug":"knowing-when-an-activity-becomes-an-unhealthy-addiction","title":"Knowing When An Activity Becomes An Unhealthy Addiction","publishDate":1529701221,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Now that the world’s leading public health group says too much Minecraft can be an addiction, could overindulging in chocolate, exercise, even sex, be next?[contextly_sidebar id=\"01ODny8j1QsQF9gorizQRnBzsbgXPKRY\"]\u003c/p>\n\u003cp>The short answer is probably not.\u003c/p>\n\u003cp>The new “gaming disorder” classification from the World Health Organization revives a debate in the medical community about whether behaviors can cause the same kind of addictive illness as drugs.\u003c/p>\n\u003cp>The strictest definition of addiction refers to a disease resulting from changes in brain chemistry caused by compulsive use of drugs or alcohol. The definition includes excessive use that damages health, relationships, jobs and other parts of normal life. Brain research supports that definition, and some imaging studies have suggested that excessive gaming might affect the brain in similar ways.\u003c/p>\n\u003cp>Under a looser definition, addiction is considered “a disease of extreme behavior. Any behavior carried to extreme that consumes you and keeps you from doing what you should be doing becomes an addiction as far as life is concerned,” said Dr. Walter Ling, a UCLA psychiatrist.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In its widely used manual for diagnosing mental illness, the American Psychiatric Association calls excessive video gaming a “condition” but not a formal diagnosis or disease, and says more research is needed to determine if it qualifies as an addiction.[contextly_sidebar id=\"Wl5OAMpArUdB6zi7q3hdM5GrzcPwa5h3\"]\u003c/p>\n\u003cp>\u003cstrong>Drugs and the Brain\u003c/strong>\u003c/p>\n\u003cp>Certain drugs including opioids and alcohol can over-activate the brain’s reward circuit. That’s the system that under normal circumstances is activated when people engage in “behaviors conducive to survival” including eating and drinking water when thirsty, explained Dr. Andrew Saxon, chairman of the association’s addiction psychiatry council. The brain chemical dopamine regulates these behaviors, but narcotic drugs can flood the brain with dopamine, encouraging repeated use and making drug use more rewarding that healthy behaviors, Saxon said. Eventually increasing amounts are needed to get the same effect, and brain changes lead to an inability to control use.\u003c/p>\n\u003cp>\u003cstrong>What About Other Substances\u003c/strong>\u003c/p>\n\u003cp>Caffeine is a stimulant and also activates the brain’s reward system, but to a much lesser degree than addictive drugs. The “reward” can make people feel more alert, and frequent users can develop mild withdrawal symptoms when they stop, including headaches and tiredness. Caffeine-containing chocolate may produce similar effects. Neither substance causes the kinds of life problems found in drug addiction, although some coffee drinkers develop a tolerance to caffeine and need to drink more to get the same “buzz” or sense of alertness.[contextly_sidebar id=\"mhQtfvihYwLCtDzX98xiu7QDvAtMJa4g\"]\u003c/p>\n\u003cp>The World Health Organization recognizes caffeine “dependence” as a disorder; the American Psychiatric Association does not and says more research is needed.\u003c/p>\n\u003cp>“The term ‘addiction’ is tossed around pretty commonly, like ‘chocoholic’ or saying you’re addicted to reality TV,” said Dr. Ellen Selkie, a University of Michigan physician who studies teens’ use of digital technology. But addiction means an inability to control use “to the point where you’re failing at life,” she said.\u003c/p>\n\u003cp>\u003cstrong>What About Behavior\u003c/strong>\u003c/p>\n\u003cp>The only behavior classified as an addiction in the American Psychiatric Association’s diagnostic manual is compulsive gambling. To be diagnosed, gamblers must have several symptoms including repeatedly gambling increasing amounts of money, lying to hide gambling activity, feeling irritable or restless when trying to stop, and losing jobs or relationships because of gambling. Research suggests excessive gambling can affect the brain in ways similar to addictive drugs. Since the diagnostic manual was last updated, in 2013, studies have bolstered evidence that excessive video gaming may do the same thing, and some experts speculate that it may be added to the next update.\u003c/p>\n\u003cp>The manual doesn’t include sex addiction because there’s little evidence that compulsive sexual behavior has similar effects on the brain.[contextly_sidebar id=\"WREHBIaI0tAVtsrRyKdECjzCVCBZe8oy\"]\u003c/p>\n\u003cp>Many excessive gamblers, gamers and sex “addicts” have other psychiatric conditions, including anxiety, attention deficit disorder and depression, and some mental health specialists believe their compulsive behaviors are merely symptoms of those diseases rather than separate addictions.\u003c/p>\n\u003cp>Excessive use of the internet and smartphones is also absent from the psychiatric manual and World Health Organization’s update. Psychiatrists disagree on whether that is a true addiction — partly because overuse is hard to measure when so many people need to use their smartphones and the internet for their jobs.\u003c/p>\n\u003cp>\u003cstrong>Does the Term Matter?\u003c/strong>\u003c/p>\n\u003cp>The World Health Organization’s decision to classify excessive video gaming as an addiction means “gaming disorder” will be added to this year’s update to the organization’s International Classification of Diseases. Doctors worldwide use that document to diagnose physical and mental illnesses. Insurers, including Medicaid and Medicare, use billing codes listed there to make coverage decisions. The American Psychiatric Association’s manual is widely used for defining and diagnosing mental disorders. If conditions aren’t listed in these documents, insurance coverage for treatment is unlikely.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This Associated Press \u003ca href=\"https://apnews.com/tag/ScienceSays\" target=\"_blank\" rel=\"noopener\">series\u003c/a> was produced in \u003ca href=\"http://bit.ly/2ptoKnW\" target=\"_blank\" rel=\"noopener\">partnership\u003c/a> with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n","blocks":[],"excerpt":"The new “gaming disorder” classification from the World Health Organization revives a debate in the medical community about whether behaviors can cause the same kind of addictive illness as drugs.","status":"publish","parent":0,"modified":1529649746,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":876},"headData":{"title":"Knowing When An Activity Becomes An Unhealthy Addiction | KQED","description":"The new “gaming disorder” classification from the World Health Organization revives a debate in the medical community about whether behaviors can cause the same kind of addictive illness as drugs.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Knowing When An Activity Becomes An Unhealthy Addiction","datePublished":"2018-06-22T21:00:21.000Z","dateModified":"2018-06-22T06:42:26.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442978 https://ww2.kqed.org/futureofyou/?p=442978","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/22/knowing-when-an-activity-becomes-an-unhealthy-addiction/","disqusTitle":"Knowing When An Activity Becomes An Unhealthy Addiction","source":"Health","nprByline":"Lindsey Tanner\u003cbr />The Associated Press","path":"/futureofyou/442978/knowing-when-an-activity-becomes-an-unhealthy-addiction","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Now that the world’s leading public health group says too much Minecraft can be an addiction, could overindulging in chocolate, exercise, even sex, be next?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The short answer is probably not.\u003c/p>\n\u003cp>The new “gaming disorder” classification from the World Health Organization revives a debate in the medical community about whether behaviors can cause the same kind of addictive illness as drugs.\u003c/p>\n\u003cp>The strictest definition of addiction refers to a disease resulting from changes in brain chemistry caused by compulsive use of drugs or alcohol. The definition includes excessive use that damages health, relationships, jobs and other parts of normal life. Brain research supports that definition, and some imaging studies have suggested that excessive gaming might affect the brain in similar ways.\u003c/p>\n\u003cp>Under a looser definition, addiction is considered “a disease of extreme behavior. Any behavior carried to extreme that consumes you and keeps you from doing what you should be doing becomes an addiction as far as life is concerned,” said Dr. Walter Ling, a UCLA psychiatrist.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In its widely used manual for diagnosing mental illness, the American Psychiatric Association calls excessive video gaming a “condition” but not a formal diagnosis or disease, and says more research is needed to determine if it qualifies as an addiction.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Drugs and the Brain\u003c/strong>\u003c/p>\n\u003cp>Certain drugs including opioids and alcohol can over-activate the brain’s reward circuit. That’s the system that under normal circumstances is activated when people engage in “behaviors conducive to survival” including eating and drinking water when thirsty, explained Dr. Andrew Saxon, chairman of the association’s addiction psychiatry council. The brain chemical dopamine regulates these behaviors, but narcotic drugs can flood the brain with dopamine, encouraging repeated use and making drug use more rewarding that healthy behaviors, Saxon said. Eventually increasing amounts are needed to get the same effect, and brain changes lead to an inability to control use.\u003c/p>\n\u003cp>\u003cstrong>What About Other Substances\u003c/strong>\u003c/p>\n\u003cp>Caffeine is a stimulant and also activates the brain’s reward system, but to a much lesser degree than addictive drugs. The “reward” can make people feel more alert, and frequent users can develop mild withdrawal symptoms when they stop, including headaches and tiredness. Caffeine-containing chocolate may produce similar effects. Neither substance causes the kinds of life problems found in drug addiction, although some coffee drinkers develop a tolerance to caffeine and need to drink more to get the same “buzz” or sense of alertness.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The World Health Organization recognizes caffeine “dependence” as a disorder; the American Psychiatric Association does not and says more research is needed.\u003c/p>\n\u003cp>“The term ‘addiction’ is tossed around pretty commonly, like ‘chocoholic’ or saying you’re addicted to reality TV,” said Dr. Ellen Selkie, a University of Michigan physician who studies teens’ use of digital technology. But addiction means an inability to control use “to the point where you’re failing at life,” she said.\u003c/p>\n\u003cp>\u003cstrong>What About Behavior\u003c/strong>\u003c/p>\n\u003cp>The only behavior classified as an addiction in the American Psychiatric Association’s diagnostic manual is compulsive gambling. To be diagnosed, gamblers must have several symptoms including repeatedly gambling increasing amounts of money, lying to hide gambling activity, feeling irritable or restless when trying to stop, and losing jobs or relationships because of gambling. Research suggests excessive gambling can affect the brain in ways similar to addictive drugs. Since the diagnostic manual was last updated, in 2013, studies have bolstered evidence that excessive video gaming may do the same thing, and some experts speculate that it may be added to the next update.\u003c/p>\n\u003cp>The manual doesn’t include sex addiction because there’s little evidence that compulsive sexual behavior has similar effects on the brain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Many excessive gamblers, gamers and sex “addicts” have other psychiatric conditions, including anxiety, attention deficit disorder and depression, and some mental health specialists believe their compulsive behaviors are merely symptoms of those diseases rather than separate addictions.\u003c/p>\n\u003cp>Excessive use of the internet and smartphones is also absent from the psychiatric manual and World Health Organization’s update. Psychiatrists disagree on whether that is a true addiction — partly because overuse is hard to measure when so many people need to use their smartphones and the internet for their jobs.\u003c/p>\n\u003cp>\u003cstrong>Does the Term Matter?\u003c/strong>\u003c/p>\n\u003cp>The World Health Organization’s decision to classify excessive video gaming as an addiction means “gaming disorder” will be added to this year’s update to the organization’s International Classification of Diseases. Doctors worldwide use that document to diagnose physical and mental illnesses. Insurers, including Medicaid and Medicare, use billing codes listed there to make coverage decisions. The American Psychiatric Association’s manual is widely used for defining and diagnosing mental disorders. If conditions aren’t listed in these documents, insurance coverage for treatment is unlikely.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This Associated Press \u003ca href=\"https://apnews.com/tag/ScienceSays\" target=\"_blank\" rel=\"noopener\">series\u003c/a> was produced in \u003ca href=\"http://bit.ly/2ptoKnW\" target=\"_blank\" rel=\"noopener\">partnership\u003c/a> with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442978/knowing-when-an-activity-becomes-an-unhealthy-addiction","authors":["byline_futureofyou_442978"],"categories":["futureofyou_1062","futureofyou_73","futureofyou_1061"],"tags":["futureofyou_828","futureofyou_141","futureofyou_483","futureofyou_61","futureofyou_204"],"collections":["futureofyou_1097","futureofyou_1096"],"featImg":"futureofyou_442981","label":"source_futureofyou_442978"},"futureofyou_442832":{"type":"posts","id":"futureofyou_442832","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442832","score":null,"sort":[1529514210000]},"guestAuthors":[],"slug":"a-new-wave-of-meth-overloads-communities-struggling-with-opioids","title":"A New Wave Of Meth Overloads Communities Struggling With Opioids","publishDate":1529514210,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Principal Mary Ann Hale dreads weekends.[contextly_sidebar id=\"QjIcDJYMtfg5dIJ2tgHtDzucgvS1vkD2\"]\u003c/p>\n\u003cp>By the time Fridays roll around, 74-year-old Hale, a principal at West Elementary School in McArthur, Ohio, is overcome with worry, wondering whether her students will survive the couple of days away from school.\u003c/p>\n\u003cp>Too many children in this part of Ohio's Appalachian country live in unstable homes with a parent facing addiction. For years, the community has struggled with opioids. Ohio had the second-highest number of drug overdose deaths per capita in 2016, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>But in McArthur, a close-knit village of about 2,000 in rural Vinton County, there has been a significant shift in recent months.\u003c/p>\n\u003cp>\"They've moved on from the oxycodone and OxyContin,\" says Hale. \"Right now, the biggest problem is meth.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At the local ER dispatch, paramedics are observing the change firsthand. \"We used to do a lot of pills, but now the problem is meth,\" says Mike, a paramedic who asked to be identified only by his first name so he could speak freely. \"And it's worse because there's no Narcan for meth,\" he says, referring to the antidote that reverses an opioid overdose.\u003c/p>\n\u003cp>Though the opioid crisis endures in Ohio, the problem is now compounded by the resurgence of methamphetamine use, \u003ca href=\"https://www.drugabuse.gov/publications/drugfacts/methamphetamine\" target=\"_blank\" rel=\"noopener\">an addiction that's even harder to treat,\u003c/a> and can lead to troubling, violent behavior. Local officials and law enforcement are neither staffed nor funded to tackle the growing problem. For McArthur's residents, the impact has been devastating for families across generations.\u003c/p>\n\u003cp>In the 2000s, the last time meth use surged across the country, people would often \"cook\" meth in toxic and explosive labs typically set up in bathrooms, kitchens or abandoned buildings. In response, Congress enacted the Combat Methamphetamine Epidemic Act in 2006, which regulated the sale of certain over-the-counter drugs, like pseudoephedrine, used in cooking meth. Meth use declined, seizures by law enforcement fell, and meth labs started to disappear.[contextly_sidebar id=\"YSAN9ZbzPDyOVwYJZ4OFKCtJdGfh99pw\"]\u003c/p>\n\u003cp>Now, meth is back, and not just in Ohio. Communities around the country are raising the alarm.\u003c/p>\n\u003cp>In 2012, 17,846 pounds of the stimulant drug were seized by law enforcement agents in the U.S. or at the border, according to U.S. Customs and Border Control. By 2017, that number had more than tripled, and much of it now comes from Mexico.\u003c/p>\n\u003cp>\"What everybody is doing now is buying the cheap Mexican meth, and not cooking anymore,\" says Vinton County prosecutor Trecia Kimes-Brown.\u003c/p>\n\u003cp>Meth overdoses have been climbing too, though it's harder to overdose on meth than on opioids. Overdoses involving psychostimulants, which include meth, increased from 5 percent of total overdoses in 2010 to 11 percent in 2015.\u003c/p>\n\u003cp>The Drug Enforcement Administration confirms that Mexican drug dealers have taken over the market for meth in the U.S. \"Trafficking and usage trends in places like \u003ca href=\"https://www.dea.gov/divisions/det/2018/det040318.shtml\" target=\"_blank\" rel=\"noopener\">Ohio are on the rise\u003c/a>,\" says Cheryl Davis, a special agent and a spokesperson for the DEA.\u003c/p>\n\u003cp>\u003cstrong>Keeping Up With The Need\u003c/strong>\u003c/p>\n\u003cp>There's only one stoplight in McArthur. A sprinkling of locally-owned shops line main street. The talk of the town in recent months has been the opening of a new grocery store, the first in many years. What they still don't have, anywhere in the county, is a hospital or an in-patient treatment center.[contextly_sidebar id=\"Ouvx6KYMlkZveBSoH3UuiIOe3iyO2dUb\"]\u003c/p>\n\u003cp>Vinton County prosecutor Kimes-Brown says that it's hard to find mental health professionals for users who end up in custody. It's the criminal justice system, she says, that has absorbed the brunt of the drug crisis.\u003c/p>\n\u003cp>People arrested on meth charges are often transported to neighboring counties, and when there are no spaces available at a nearby jail, Kimes-Brown has to triage. She'll call a judge and negotiate a swap: Let out someone with a misdemeanor, a lower risk to society, and let in one of her violent meth arrestees.\u003c/p>\n\u003cp>\"I literally have to put them on the street to put this other, more violent offender in jail,\" says Kimes-Brown. \"That happens at least once a week.\"\u003c/p>\n\u003cp>That has left Vinton County with an enormous bill. In 2017, a sixth of the county's budget went toward the jail bill — about $578,000, according to county records.\u003c/p>\n\u003cp>The surge of meth cases has also been overwhelming for local police. It can be riskier for officers to respond to meth-related calls.\u003c/p>\n\u003cp>\"They are more violent,\" says Ryan Cain, the lead detective on counternarcotics for the county. He says in a rural county with a culture of hunting, it's not uncommon to encounter meth users who are hallucinating — and carrying a gun.[contextly_sidebar id=\"jURV5uNv7tUYtN1vUs6HnvQ1mP05T3xa\"]\u003c/p>\n\u003cp>\"We actually had one guy say that a helicopter was in the backyard and people were repelling down the helicopter,\" he says. \"How strong their hallucinations are is wild.\"\u003c/p>\n\u003cp>Meth can make people agitated and prone to risk-taking, says Andy Chambers, an addiction psychiatrist and researcher at the Indiana University School of Medicine in Indianapolis.\u003c/p>\n\u003cp>\"You can develop dangerous psychotic episodes that can look like schizophrenia,\" says Chambers. \"The psychosis can get dangerously paranoid — hearing stuff, feeling like they're being pursued.\"\u003c/p>\n\u003cp>And it can make people neglectful of their lives, their families — anything but the next high. Cain says he's seen people sell food stamps for 25 or 50 cents on the dollar and steal from family members. \"They spend every dollar they got trying to get the next hit,\" he says.\u003c/p>\n\u003cp>\u003cstrong>Layers of Addiction\u003c/strong>\u003c/p>\n\u003cp>Counselor Amanda Lee of Health Recovery Services rehab center on McArthur's Main Street, regularly treats patients struggling with opioid addiction — and using meth. Sometimes, she says, people turn to meth when they're detoxing from opioids.\u003c/p>\n\u003cp>\"People are going to meth to get off of opiates,\" says Lee, whose patients tell her opioids are less available on the street these days, while meth is everywhere. \"They go through withdrawal from opiates and sickness and they're using meth to get through it.\"\u003c/p>\n\u003cp>Lee also says when staff give patients Vivitrol treatments, one of a handful of FDA-approved medications for opioid addiction, it still leaves users craving other highs. Vivitrol is a monthly injection which blocks opioid receptors.\u003c/p>\n\u003cp>\"The Vivitrol injection does not cover receptors in the brain for methamphetamines, so, they can still get high on meth\" says Lee. She thinks Vivitrol might be driving some patients to meth.\u003c/p>\n\u003cp>The connection is not so clear-cut for Chambers.\u003c/p>\n\u003cp>\"There's a lot of urban legend that Vivitrol is causing meth addiction, but it's not true,\" says Chambers. \"You're getting people who were using meth with opiates beforehand and now the meth is prevalent. But it's not that Vivitrol is causing meth.\"[contextly_sidebar id=\"L0FiTy6YTJl26cw07pUSkjE7elCrqCUj\"]\u003c/p>\n\u003cp>The real problem, Chambers says, is that patients' meth addiction may be going untreated. While some patients can benefit from Vivitrol or other medication-assisted treatment for opioid use disorder, there's not a drug that helps with meth.\u003c/p>\n\u003cp>\"The reality is meth has been with us for many years,\" Chambers says. In fact, he says, it might be better to stop talking about an \"opioid crisis\" or a \"meth crisis\" and admit we have a \"polysubstance epidemic.\"\u003c/p>\n\u003cp>What's underlying it he says, especially in rural areas, is a broken mental health care system.\u003c/p>\n\u003cp>In fact, 56 out of 88 Ohio counties have \u003ca href=\"https://www.odh.ohio.gov/-/media/ODH/ASSETS/Files/chss/Primary-Care-Office/PCO-Needs-Assessment-2015---2016.pdf\" target=\"_blank\" rel=\"noopener\">mental health care provider shortages\u003c/a>, mostly in rural areas. This leaves about 70 percent of the population with unmet mental health care needs in Ohio, and rates are similar throughout much of the Midwest, South and Western U.S., \u003ca href=\"https://ersrs.hrsa.gov/ReportServer?/HGDW_Reports/BCD_HPSA/BCD_HPSA_SCR50_Qtr_Smry_HTML&rc:Toolbar=false\" target=\"_blank\" rel=\"noopener\">according to data from\u003c/a> the department of Health and Human Services.\u003c/p>\n\u003cp>\"I'm concerned about the ongoing shortages,\" says Chambers. \"If you want decent mental healthcare in the U.S. you better live in the big cities.\"\u003c/p>\n\u003cp>\u003cstrong>When Home Is No Longer Safe \u003c/strong>\u003c/p>\n\u003cp>Few have paid a steeper price than the children of Vinton County.\u003c/p>\n\u003cp>\"These kids are living in these environments where they're not being fed, they're not being clothed properly, they're not being sent to school, they're being mistreated,\" says county prosecutor Kimes-Brown. \"They have a front row seat to all of this.\"\u003c/p>\n\u003cp>Teachers and staff at West Elementary are often the first to notice that a child is no longer safe at home.\u003c/p>\n\u003cp>\"They'll just walk into the office and start crying,\" says Hale, principal at West Elementary School. \"They hug you and you sit down and talk with them and find out what's going on in their secret little world.\"\u003c/p>\n\u003cp>The staff at West Elementary School is aware of about 60 students directly affected by the drug crisis — about one sixth of their student body.\u003c/p>\n\u003cp>\"I've had kids describe to me drug use they've seen,\" says Rebecca Smallwood, the school counselor. \"We had one student who performed CPR on her mom when she overdosed. We've had lots of kids see their parents get arrested.\"\u003c/p>\n\u003cp>Hale says teachers must know how to read the signs in the classroom. Sometimes the clues are small but revealing. Shoes that are many sizes too small, or students who come to school without socks or underwear. Just outside the principal's office, staff keep a storage room they refer to as \"Little Walmart\" stocked with underwear, shoes, T-shirts, and pants for their students.[contextly_sidebar id=\"Yl7ULowjEhdxm9U74xHlDIbxHZfkeFd0\"]\u003c/p>\n\u003cp>For other kids at the school, the signs are much less ambiguous.\u003c/p>\n\u003cp>\"[There's] a slide in their academic behaviors, then aggression, crying, or kids talk about suicide,\" says Hale. \"We've been dealing with one of those [cases] this year. Mom's an addict, dad went sideways when mom left, and grandma's raising the little girl.\"\u003c/p>\n\u003cp>This is not uncommon in Vinton County — parents, too consumed with addiction, rely on family members to step in and care for their kids. Usually, it's the child's grandparents.\u003c/p>\n\u003cp>Angela is one of those grandparents.\u003c/p>\n\u003cp>Her grandson, Billy, was exposed to his mother's meth addiction early on.\u003c/p>\n\u003cp>(The grandmother asked NPR to refer to them as Angela and Billy to protect the family's privacy.)\u003c/p>\n\u003cp>\"One day, she brought him to the house. He was in diapers, he was about a year old and he had a smell to him,\" Angela says. \"He was beet red, like he's been out in the sun. She had him in a meth house and the chemicals is what burned his skin, made him red.\"\u003c/p>\n\u003cp>That part of Billy's story is harrowing enough, but it takes an even darker turn.\u003c/p>\n\u003cp>While visiting his grandmother, Billy complained about pain. Angela saw signs on his body that suggested her daughter's boyfriend sexually abused Billy.\u003c/p>\n\u003cp>\"He did things he shouldn't have to [Billy],\" Angela says, through tears. \"It did a heck of a number on him.\"\u003c/p>\n\u003cp>Angela and her husband gained full custody of their grandson in April.\u003c/p>\n\u003cp>It was a difficult transition for Billy. When he started living with his grandparents, Angela says he wouldn't talk to strangers — he wouldn't go near men. \"Even his grandpa,\" Angela says, \"he shied away from.\"\u003c/p>\n\u003cp>Angela says he still won't sleep alone.[contextly_sidebar id=\"P2oeIdpyCHoTNCgCTewBfJB7IbvQyeu9\"]\u003c/p>\n\u003cp>\"He sleeps on the couch and I'm there because I never know when he's going to have his nightmares,\" she says. \"It's harder on the kids than it is on anyone else.\"\u003c/p>\n\u003cp>Smallwood says that the school is starting to see the effects of kids that have been shuffled from home to relatives or foster care. \"That kind of disruption, what it does to a student forever, it's huge. You just can't, you can't use enough adjectives to describe what that does.\"\u003c/p>\n\u003cp>For kids like Billy, school is often the only place they are safe. It is where there is structure and regular meals and people who keep track of their lives from the moment they get off the school bus through the last bell of the day.\u003c/p>\n\u003cp>But it's summer time now, a season most kids and teachers look forward to and relish.\u003c/p>\n\u003cp>At West Elementary it's different.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We worry,\" says Principal Hale.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Wave+Of+Meth+Overloads+Communities+Struggling+With+Opioids+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\n","blocks":[],"excerpt":"Meth has made a resurgence, and in some communities already stressed by opioid addiction it's doubling the burden on first responders, the criminal justice system and schools. ","status":"publish","parent":0,"modified":1529517042,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":66,"wordCount":2068},"headData":{"title":"A New Wave Of Meth Overloads Communities Struggling With Opioids | KQED","description":"Meth has made a resurgence, and in some communities already stressed by opioid addiction it's doubling the burden on first responders, the criminal justice system and schools. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A New Wave Of Meth Overloads Communities Struggling With Opioids","datePublished":"2018-06-20T17:03:30.000Z","dateModified":"2018-06-20T17:50:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442832 https://ww2.kqed.org/futureofyou/?p=442832","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/20/a-new-wave-of-meth-overloads-communities-struggling-with-opioids/","disqusTitle":"A New Wave Of Meth Overloads Communities Struggling With Opioids","source":"Health","nprImageCredit":"Arezou Rezvani","nprByline":"Danny Hajek,NPR","nprImageAgency":"NPR","nprStoryId":"619929939","nprApiLink":"http://api.npr.org/query?id=619929939&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/06/20/619929939/a-new-wave-of-meth-overloads-communities-struggling-with-opioids?ft=nprml&f=619929939","nprRetrievedStory":"1","nprPubDate":"Wed, 20 Jun 2018 05:00:00 -0400","nprStoryDate":"Wed, 20 Jun 2018 05:00:50 -0400","nprLastModifiedDate":"Wed, 20 Jun 2018 05:00:50 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/06/20180608_me_teachers_see_first_hand_the_effects_of_the_opioid_crisis_on_children.mp3?orgId=1&topicId=1128&d=422&story=619929939&ft=nprml&f=619929939,https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/06/20180606_me_in_rural_ohio_an_opioid_crisis_becomes_a_meth_crisis.mp3?orgId=1&topicId=1128&d=436&story=619929939&ft=nprml&f=619929939,https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/06/20180607_me_children_are_the_losers_when_parents_struggle_with_opioid_addiction.mp3?orgId=1&topicId=1128&d=420&story=619929939&ft=nprml&f=619929939","nprAudioM3u":"http://api.npr.org/m3u/1621587361-1fcb06.m3u?orgId=1&topicId=1128&d=422&story=619929939&ft=nprml&f=619929939,http://api.npr.org/m3u/1621587366-3a4549.m3u?orgId=1&topicId=1128&d=436&story=619929939&ft=nprml&f=619929939,http://api.npr.org/m3u/1621587364-a38c56.m3u?orgId=1&topicId=1128&d=420&story=619929939&ft=nprml&f=619929939","path":"/futureofyou/442832/a-new-wave-of-meth-overloads-communities-struggling-with-opioids","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/06/20180608_me_teachers_see_first_hand_the_effects_of_the_opioid_crisis_on_children.mp3?orgId=1&topicId=1128&d=422&story=619929939&ft=nprml&f=619929939,https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/06/20180606_me_in_rural_ohio_an_opioid_crisis_becomes_a_meth_crisis.mp3?orgId=1&topicId=1128&d=436&story=619929939&ft=nprml&f=619929939,https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/06/20180607_me_children_are_the_losers_when_parents_struggle_with_opioid_addiction.mp3?orgId=1&topicId=1128&d=420&story=619929939&ft=nprml&f=619929939","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Principal Mary Ann Hale dreads weekends.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>By the time Fridays roll around, 74-year-old Hale, a principal at West Elementary School in McArthur, Ohio, is overcome with worry, wondering whether her students will survive the couple of days away from school.\u003c/p>\n\u003cp>Too many children in this part of Ohio's Appalachian country live in unstable homes with a parent facing addiction. For years, the community has struggled with opioids. Ohio had the second-highest number of drug overdose deaths per capita in 2016, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>But in McArthur, a close-knit village of about 2,000 in rural Vinton County, there has been a significant shift in recent months.\u003c/p>\n\u003cp>\"They've moved on from the oxycodone and OxyContin,\" says Hale. \"Right now, the biggest problem is meth.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At the local ER dispatch, paramedics are observing the change firsthand. \"We used to do a lot of pills, but now the problem is meth,\" says Mike, a paramedic who asked to be identified only by his first name so he could speak freely. \"And it's worse because there's no Narcan for meth,\" he says, referring to the antidote that reverses an opioid overdose.\u003c/p>\n\u003cp>Though the opioid crisis endures in Ohio, the problem is now compounded by the resurgence of methamphetamine use, \u003ca href=\"https://www.drugabuse.gov/publications/drugfacts/methamphetamine\" target=\"_blank\" rel=\"noopener\">an addiction that's even harder to treat,\u003c/a> and can lead to troubling, violent behavior. Local officials and law enforcement are neither staffed nor funded to tackle the growing problem. For McArthur's residents, the impact has been devastating for families across generations.\u003c/p>\n\u003cp>In the 2000s, the last time meth use surged across the country, people would often \"cook\" meth in toxic and explosive labs typically set up in bathrooms, kitchens or abandoned buildings. In response, Congress enacted the Combat Methamphetamine Epidemic Act in 2006, which regulated the sale of certain over-the-counter drugs, like pseudoephedrine, used in cooking meth. Meth use declined, seizures by law enforcement fell, and meth labs started to disappear.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now, meth is back, and not just in Ohio. Communities around the country are raising the alarm.\u003c/p>\n\u003cp>In 2012, 17,846 pounds of the stimulant drug were seized by law enforcement agents in the U.S. or at the border, according to U.S. Customs and Border Control. By 2017, that number had more than tripled, and much of it now comes from Mexico.\u003c/p>\n\u003cp>\"What everybody is doing now is buying the cheap Mexican meth, and not cooking anymore,\" says Vinton County prosecutor Trecia Kimes-Brown.\u003c/p>\n\u003cp>Meth overdoses have been climbing too, though it's harder to overdose on meth than on opioids. Overdoses involving psychostimulants, which include meth, increased from 5 percent of total overdoses in 2010 to 11 percent in 2015.\u003c/p>\n\u003cp>The Drug Enforcement Administration confirms that Mexican drug dealers have taken over the market for meth in the U.S. \"Trafficking and usage trends in places like \u003ca href=\"https://www.dea.gov/divisions/det/2018/det040318.shtml\" target=\"_blank\" rel=\"noopener\">Ohio are on the rise\u003c/a>,\" says Cheryl Davis, a special agent and a spokesperson for the DEA.\u003c/p>\n\u003cp>\u003cstrong>Keeping Up With The Need\u003c/strong>\u003c/p>\n\u003cp>There's only one stoplight in McArthur. A sprinkling of locally-owned shops line main street. The talk of the town in recent months has been the opening of a new grocery store, the first in many years. What they still don't have, anywhere in the county, is a hospital or an in-patient treatment center.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Vinton County prosecutor Kimes-Brown says that it's hard to find mental health professionals for users who end up in custody. It's the criminal justice system, she says, that has absorbed the brunt of the drug crisis.\u003c/p>\n\u003cp>People arrested on meth charges are often transported to neighboring counties, and when there are no spaces available at a nearby jail, Kimes-Brown has to triage. She'll call a judge and negotiate a swap: Let out someone with a misdemeanor, a lower risk to society, and let in one of her violent meth arrestees.\u003c/p>\n\u003cp>\"I literally have to put them on the street to put this other, more violent offender in jail,\" says Kimes-Brown. \"That happens at least once a week.\"\u003c/p>\n\u003cp>That has left Vinton County with an enormous bill. In 2017, a sixth of the county's budget went toward the jail bill — about $578,000, according to county records.\u003c/p>\n\u003cp>The surge of meth cases has also been overwhelming for local police. It can be riskier for officers to respond to meth-related calls.\u003c/p>\n\u003cp>\"They are more violent,\" says Ryan Cain, the lead detective on counternarcotics for the county. He says in a rural county with a culture of hunting, it's not uncommon to encounter meth users who are hallucinating — and carrying a gun.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"We actually had one guy say that a helicopter was in the backyard and people were repelling down the helicopter,\" he says. \"How strong their hallucinations are is wild.\"\u003c/p>\n\u003cp>Meth can make people agitated and prone to risk-taking, says Andy Chambers, an addiction psychiatrist and researcher at the Indiana University School of Medicine in Indianapolis.\u003c/p>\n\u003cp>\"You can develop dangerous psychotic episodes that can look like schizophrenia,\" says Chambers. \"The psychosis can get dangerously paranoid — hearing stuff, feeling like they're being pursued.\"\u003c/p>\n\u003cp>And it can make people neglectful of their lives, their families — anything but the next high. Cain says he's seen people sell food stamps for 25 or 50 cents on the dollar and steal from family members. \"They spend every dollar they got trying to get the next hit,\" he says.\u003c/p>\n\u003cp>\u003cstrong>Layers of Addiction\u003c/strong>\u003c/p>\n\u003cp>Counselor Amanda Lee of Health Recovery Services rehab center on McArthur's Main Street, regularly treats patients struggling with opioid addiction — and using meth. Sometimes, she says, people turn to meth when they're detoxing from opioids.\u003c/p>\n\u003cp>\"People are going to meth to get off of opiates,\" says Lee, whose patients tell her opioids are less available on the street these days, while meth is everywhere. \"They go through withdrawal from opiates and sickness and they're using meth to get through it.\"\u003c/p>\n\u003cp>Lee also says when staff give patients Vivitrol treatments, one of a handful of FDA-approved medications for opioid addiction, it still leaves users craving other highs. Vivitrol is a monthly injection which blocks opioid receptors.\u003c/p>\n\u003cp>\"The Vivitrol injection does not cover receptors in the brain for methamphetamines, so, they can still get high on meth\" says Lee. She thinks Vivitrol might be driving some patients to meth.\u003c/p>\n\u003cp>The connection is not so clear-cut for Chambers.\u003c/p>\n\u003cp>\"There's a lot of urban legend that Vivitrol is causing meth addiction, but it's not true,\" says Chambers. \"You're getting people who were using meth with opiates beforehand and now the meth is prevalent. But it's not that Vivitrol is causing meth.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The real problem, Chambers says, is that patients' meth addiction may be going untreated. While some patients can benefit from Vivitrol or other medication-assisted treatment for opioid use disorder, there's not a drug that helps with meth.\u003c/p>\n\u003cp>\"The reality is meth has been with us for many years,\" Chambers says. In fact, he says, it might be better to stop talking about an \"opioid crisis\" or a \"meth crisis\" and admit we have a \"polysubstance epidemic.\"\u003c/p>\n\u003cp>What's underlying it he says, especially in rural areas, is a broken mental health care system.\u003c/p>\n\u003cp>In fact, 56 out of 88 Ohio counties have \u003ca href=\"https://www.odh.ohio.gov/-/media/ODH/ASSETS/Files/chss/Primary-Care-Office/PCO-Needs-Assessment-2015---2016.pdf\" target=\"_blank\" rel=\"noopener\">mental health care provider shortages\u003c/a>, mostly in rural areas. This leaves about 70 percent of the population with unmet mental health care needs in Ohio, and rates are similar throughout much of the Midwest, South and Western U.S., \u003ca href=\"https://ersrs.hrsa.gov/ReportServer?/HGDW_Reports/BCD_HPSA/BCD_HPSA_SCR50_Qtr_Smry_HTML&rc:Toolbar=false\" target=\"_blank\" rel=\"noopener\">according to data from\u003c/a> the department of Health and Human Services.\u003c/p>\n\u003cp>\"I'm concerned about the ongoing shortages,\" says Chambers. \"If you want decent mental healthcare in the U.S. you better live in the big cities.\"\u003c/p>\n\u003cp>\u003cstrong>When Home Is No Longer Safe \u003c/strong>\u003c/p>\n\u003cp>Few have paid a steeper price than the children of Vinton County.\u003c/p>\n\u003cp>\"These kids are living in these environments where they're not being fed, they're not being clothed properly, they're not being sent to school, they're being mistreated,\" says county prosecutor Kimes-Brown. \"They have a front row seat to all of this.\"\u003c/p>\n\u003cp>Teachers and staff at West Elementary are often the first to notice that a child is no longer safe at home.\u003c/p>\n\u003cp>\"They'll just walk into the office and start crying,\" says Hale, principal at West Elementary School. \"They hug you and you sit down and talk with them and find out what's going on in their secret little world.\"\u003c/p>\n\u003cp>The staff at West Elementary School is aware of about 60 students directly affected by the drug crisis — about one sixth of their student body.\u003c/p>\n\u003cp>\"I've had kids describe to me drug use they've seen,\" says Rebecca Smallwood, the school counselor. \"We had one student who performed CPR on her mom when she overdosed. We've had lots of kids see their parents get arrested.\"\u003c/p>\n\u003cp>Hale says teachers must know how to read the signs in the classroom. Sometimes the clues are small but revealing. Shoes that are many sizes too small, or students who come to school without socks or underwear. Just outside the principal's office, staff keep a storage room they refer to as \"Little Walmart\" stocked with underwear, shoes, T-shirts, and pants for their students.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>For other kids at the school, the signs are much less ambiguous.\u003c/p>\n\u003cp>\"[There's] a slide in their academic behaviors, then aggression, crying, or kids talk about suicide,\" says Hale. \"We've been dealing with one of those [cases] this year. Mom's an addict, dad went sideways when mom left, and grandma's raising the little girl.\"\u003c/p>\n\u003cp>This is not uncommon in Vinton County — parents, too consumed with addiction, rely on family members to step in and care for their kids. Usually, it's the child's grandparents.\u003c/p>\n\u003cp>Angela is one of those grandparents.\u003c/p>\n\u003cp>Her grandson, Billy, was exposed to his mother's meth addiction early on.\u003c/p>\n\u003cp>(The grandmother asked NPR to refer to them as Angela and Billy to protect the family's privacy.)\u003c/p>\n\u003cp>\"One day, she brought him to the house. He was in diapers, he was about a year old and he had a smell to him,\" Angela says. \"He was beet red, like he's been out in the sun. She had him in a meth house and the chemicals is what burned his skin, made him red.\"\u003c/p>\n\u003cp>That part of Billy's story is harrowing enough, but it takes an even darker turn.\u003c/p>\n\u003cp>While visiting his grandmother, Billy complained about pain. Angela saw signs on his body that suggested her daughter's boyfriend sexually abused Billy.\u003c/p>\n\u003cp>\"He did things he shouldn't have to [Billy],\" Angela says, through tears. \"It did a heck of a number on him.\"\u003c/p>\n\u003cp>Angela and her husband gained full custody of their grandson in April.\u003c/p>\n\u003cp>It was a difficult transition for Billy. When he started living with his grandparents, Angela says he wouldn't talk to strangers — he wouldn't go near men. \"Even his grandpa,\" Angela says, \"he shied away from.\"\u003c/p>\n\u003cp>Angela says he still won't sleep alone.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"He sleeps on the couch and I'm there because I never know when he's going to have his nightmares,\" she says. \"It's harder on the kids than it is on anyone else.\"\u003c/p>\n\u003cp>Smallwood says that the school is starting to see the effects of kids that have been shuffled from home to relatives or foster care. \"That kind of disruption, what it does to a student forever, it's huge. You just can't, you can't use enough adjectives to describe what that does.\"\u003c/p>\n\u003cp>For kids like Billy, school is often the only place they are safe. It is where there is structure and regular meals and people who keep track of their lives from the moment they get off the school bus through the last bell of the day.\u003c/p>\n\u003cp>But it's summer time now, a season most kids and teachers look forward to and relish.\u003c/p>\n\u003cp>At West Elementary it's different.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We worry,\" says Principal Hale.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Wave+Of+Meth+Overloads+Communities+Struggling+With+Opioids+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442832/a-new-wave-of-meth-overloads-communities-struggling-with-opioids","authors":["byline_futureofyou_442832"],"categories":["futureofyou_1"],"tags":["futureofyou_828","futureofyou_952","futureofyou_1056","futureofyou_1524","futureofyou_938"],"featImg":"futureofyou_442833","label":"source_futureofyou_442832"},"futureofyou_442779":{"type":"posts","id":"futureofyou_442779","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442779","score":null,"sort":[1529103606000]},"guestAuthors":[],"slug":"fda-clears-1st-generic-film-strip-of-addiction-drug-suboxone","title":"FDA Clears 1st Generic Film Strip of Addiction Drug Suboxone","publishDate":1529103606,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>U.S. regulators have approved the first generic version of an under-the-tongue film for treating opioid addiction.[contextly_sidebar id=\"0aUmI4gi0W92FnpTgKsDzebI0XydwaN6\"]\u003c/p>\n\u003cp>The Food and Drug Administration on Thursday approved a generic version of Suboxone, a film strip that dissolves under the tongue. Used daily, it reduces withdrawal symptoms, cravings for opioids and the high from abusing them.\u003c/p>\n\u003cp>The medication combines buprenorphine and naloxone. It’s used along with counseling and other behavioral therapy.\u003c/p>\n\u003cp>The generic version will be sold by partners Mylan N.V. and Dr. Reddy’s Laboratories SA. They didn’t immediately respond to questions about when their version will be available or what it will cost.\u003c/p>\n\u003cp>Brand-name Suboxone film costs about $200 a month without insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The FDA said the approval was aimed at making the treatment available to more people.\u003c/p>\n\n","blocks":[],"excerpt":"When used daily, the treatment reduces withdrawal symptoms, cravings for opioids and the high from abusing them.","status":"publish","parent":0,"modified":1529103281,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":8,"wordCount":141},"headData":{"title":"FDA Clears 1st Generic Film Strip of Addiction Drug Suboxone | KQED","description":"When used daily, the treatment reduces withdrawal symptoms, cravings for opioids and the high from abusing them.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"FDA Clears 1st Generic Film Strip of Addiction Drug Suboxone","datePublished":"2018-06-15T23:00:06.000Z","dateModified":"2018-06-15T22:54:41.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442779 https://ww2.kqed.org/futureofyou/?p=442779","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/15/fda-clears-1st-generic-film-strip-of-addiction-drug-suboxone/","disqusTitle":"FDA Clears 1st Generic Film Strip of Addiction Drug Suboxone","source":"Health","nprByline":"Linda A. Johnson\u003cbr />The Associated Press","path":"/futureofyou/442779/fda-clears-1st-generic-film-strip-of-addiction-drug-suboxone","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>U.S. regulators have approved the first generic version of an under-the-tongue film for treating opioid addiction.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Food and Drug Administration on Thursday approved a generic version of Suboxone, a film strip that dissolves under the tongue. Used daily, it reduces withdrawal symptoms, cravings for opioids and the high from abusing them.\u003c/p>\n\u003cp>The medication combines buprenorphine and naloxone. It’s used along with counseling and other behavioral therapy.\u003c/p>\n\u003cp>The generic version will be sold by partners Mylan N.V. and Dr. Reddy’s Laboratories SA. They didn’t immediately respond to questions about when their version will be available or what it will cost.\u003c/p>\n\u003cp>Brand-name Suboxone film costs about $200 a month without insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The FDA said the approval was aimed at making the treatment available to more people.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442779/fda-clears-1st-generic-film-strip-of-addiction-drug-suboxone","authors":["byline_futureofyou_442779"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_828","futureofyou_952","futureofyou_38","futureofyou_938","futureofyou_381"],"collections":["futureofyou_1093"],"featImg":"futureofyou_442781","label":"source_futureofyou_442779"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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