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Wednesday, June 29, 2016
Programs to Curb Prescription Drug Abuse Underutilized
A new study reports that programs to prevent prescription abuse are in place, but underutilized. The finding comes at a time when prescription drug abuse is a raging epidemic across America.
Celebrity deaths like that of Prince and Heath Ledger have heightened the sensitivity of Americans on the problem. Moreover, the realization that the addiction is a true public health problem — with addictions across the population from teens to seniors — has led legislators to call for programs to combat the abuse.
The new study is informative in showing that programs already exist for the addiction, yet they are underutilized. The report comes out of Maine, one of the U.S. states hardest hit by the “epidemic” of prescription painkiller and heroin abuse. Researchers say that although there have been some positive trends recently, there are also troubling ones.
The study appears in the Journal of Studies on Alcohol and Drugs.
Investigators report that in 2014, a high percentage of women in their 80s — 38 percent — had prescriptions for powerful painkilling medications known as opioids.
“That’s very concerning,” said researcher Stephanie Nichols, Pharm.D., of Husson University School of Pharmacy in Bangor, Maine.
For one, she explained, elderly people have a higher rate of respiratory conditions, which makes them more susceptible to an accidental opioid overdose.
What’s more, the study found, women in their 80s were also commonly prescribed sedatives known as benzodiazepines. If one of those medications were combined with an opioid, that would also raise the risk of a potentially fatal overdose, Nichols said.
Prescription opioids include medications like hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), codeine, and morphine. Abuse of these substances is common with the U.S. National Institute on Drug Abuse estimating 52 million Americans have abused a prescription drug — with opioid painkillers at the top of the list.
In response, most U.S. states have established prescription-monitoring programs (PMPs) — electronic databases that track prescriptions for opioids and other controlled substances. Health care providers can use the programs to identify possible cases of prescription drug misuse and help patients get treatment for addiction if needed.
But although Maine has had a monitoring program since 2004, Nichols’s team found that in 2014, many pharmacists were not using it. Of 275 pharmacists they surveyed, only 56 percent said they were using the program.
Doctors and other health care providers use the system, but it’s still important for pharmacists to be linked in, too, according to Nichols.
“Often, the pharmacist is the ‘last line of defense,’ for patient safety,” she said.
Based on the state’s PMP, opioids were prescribed to 22 percent of Maine residents in 2014 — enough to supply every person in the state with a 16-day supply.
That figure is down slightly from 2010, Nichols said. “But it’s still a very large number,” she added.
In an encouraging sign, though, prescriptions for oxycodone and hydrocodone were lower in 2014, but prescriptions for buprenorphine were up sharply. Buprenorphine is an opioid, but it’s typically used to treat opioid addiction.
“I think that’s a positive trend, because we interpret that as an increase in treatment of people with an opioid use disorder,” Nichols said.
Still, she added, more can be done. That includes getting health care providers and pharmacists on board with existing programs and increasing the accessibility and usability of those programs.
Maine has not only a PMP, Nichols pointed out, but also a diversion alert program — which allows providers to see whether a patient has a history of drug-related arrests.
“We have resources to help tackle the opioid epidemic,” Nichols said, “but we’re underusing them.”
A second study in the same issue of JSAD looked at another type of program aimed at curbing prescription drug abuse. The program involves drug “take-backs,” that is local events where people can bring their unneeded or expired prescriptions for safe disposal.
In the study, Itzhak Yanovitzky, Ph.D., of Rutgers University in New Jersey, surveyed over 900 New Jersey adults and found that efforts to raise public awareness of local take-back programs seem to work.
People who’d seen media stories on drug take-back — or even just signs at their local drug store — were twice as likely to have used the programs in the past 30 days as other state residents were.
It suggests that if people are aware of local take-back programs, many will actually use them, according to the study.
Source: Journal of Studies on Alcohol and Drugs
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Rat Study: Anti-Anxiety Meds May Lower Empathy
Anti-anxiety medications may lower levels of empathy, according to a new rat study by neuroscientists at the University of Chicago.
Research has shown that rats are often emotionally motivated to help other rats in distress and routinely free their trapped friends. However, the new findings show that rats who were given midazolam, an anti-anxiety medication, were less likely to free their trapped companions.
Midazolam did not affect the rats’ physical ability to open the restrainer door. In fact, rats on this medication routinely opened the door for a piece of chocolate but did not feel motivated enough to open the door for their stressed companions. The findings suggest that motivation to help others relies on emotional reactions, which are dampened by the anti-anxiety medication.
“The rats help each other because they care,” said Peggy Mason, Ph.D., professor of neurobiology at the University of Chicago. “They need to share the affect of the trapped rat in order to help, and that’s a fundamental finding that tells us something about how we operate, because we’re mammals like rats too.”
The researchers used a rat-helping test originally established in a 2011 study published in the journal Science by Mason, Inbal Ben-Ami Bartal, Ph.D., a post-doctoral scholar now at the University of California, Berkeley, and Jean Decety, Ph.D., Irving B. Harris Professor of Psychology and Psychiatry at the University of Chicago.
In those first experiments, one rat was kept in a restrainer — a closed tube with a door that can be nudged open only from the outside. The second rat roamed free in the cage around the restrainer, able to see and hear the trapped cage mate.
In that study, the free rats quickly figured out how to release their trapped cage mates, seen by the researchers as a sign of empathy for their companions in distress. In the latest research, rats injected with midazolam did not free their trapped companions, although they did open the same restrainer when that restrainer contained chocolate chips.
According to the study, stress — such as seeing and hearing a trapped companion — triggers the adrenal gland and sympathetic nervous system and causes physical symptoms such as increased heart rate and high blood pressure.
To determine whether the rats’ helping behavior was driven by these physical changes, the researchers conducted another set of experiments by giving the rats nadolol, a beta-blocker similar to those used to treat high blood pressure. Nadolol prevents the pounding heart and other bodily signs of a stress response. But even those rats who were given nadolol were just as likely to help their companions as those injected with saline or nothing at all.
“What that tells you is that they don’t have to be physiologically, peripherally aroused in order to help. They just have to care inside their brain,” Mason said.
Mason said that this study further confirms the previous research that rats, and by extension other mammals — including humans — are motivated to help others through empathy.
“Helping others could be your new drug. Go help some people and you’ll feel really good,” she said. “I think that’s a mammalian trait that has developed through evolution. Helping another is good for the species.”
The findings are published in the journal Frontiers in Psychology.
Source: University of Chicago Medical Center
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Helicopter Parenting Can Hinder College-Age Kids
A new study finds that parents who are too involved with their college-age kids could indirectly lead to issues such as depression and anxiety.
“Helicopter parents are parents who are overly involved,” said Florida State University doctoral candidate Kayla Reed. “They mean everything with good intentions, but it often goes beyond supportive to intervening in the decisions of emerging adults.”
Reed and Assistant Professor of Family and Child Sciences Dr. Mallory Lucier-Greer explain that what has been called “helicopter parenting” can have a meaningful impact on how young adults see themselves and whether they can meet challenges or handle adverse situations.
Though much attention has been paid to the notion of helicopter parenting, most of the studies have focused on adolescents.
The current study, found online in the Journal of Child and Family Studies, specifically examined emerging adults, or college-aged students navigating the waters of attending college.
Researchers surveyed more than 460 college students, ages 18 to 25, seeking to learn how their mothers influenced their life decisions. Specifically, researchers asked students how their mothers would respond to sample situations. Investigators looked at mothers because they are traditionally in the primary caregiver role.
Researchers also asked students to self-assess their abilities to persist in complicated tasks or adverse situations and then also rate their depression, life satisfaction, anxiety and physical health.
Students who had mothers who allowed them more autonomy reported higher life satisfaction, physical health and self-efficacy. However, students with a so-called helicopter parent were more likely to report low levels of self-efficacy, or the ability to handle some tougher life tasks and decisions.
In turn, those who reported low levels of self-efficacy also reported higher levels of anxiety and depression, and lower life satisfaction and physical health.
“The way your parents interact with you has a lot to do with how you view yourself,” Lucier-Greer said. “If parents are simply being supportive, they are saying things like ‘you can manage your finances, you can pick out your classes.’
“It changes if they are doing that all for you. I think there are good intentions behind those helicopter behaviors, but at the end of the day you need to foster your child’s development.”
Sample scenarios given to students included questions about whether their mothers would encourage them to resolve a conflict with a roommate or friend on his or her own, or whether their mothers would actively intervene in the situation.
Other sample questions probed whether mothers regularly asked students to text or call at given intervals and whether the mothers were controlling their diets.
Researchers hope to continue this line of work in the future by expanding the work to look at both mothers and fathers and also young adults as they enter the workforce.
Source: Florida State University
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