In addition to the drug charges he now faces in Mexico, Edgar Valdez Villarreal, also called “La Barbie” due to his blond hair and blue eyes, is facing charges in the United States for cocaine smuggling; it is alleged that Valdez is responsible for importing thousands of pounds of cocaine into the US. Mexican sources claim that federal police captured Valdez near Mexico City and that he is currently incarcerated at a secure location near the capital.

Valdez began his drug smuggling career in the Sinaloa Cartel, but left when one of the higher-level operators established his own drug trafficking ring. When the leader of the new cartel, Arturo Beltran Leyva, died in a conflict with members of Mexico’s military in late ’09, Valdez was elevated to a top position. Unfortunately for Valdez, the promotion has been disputed by both members of his own cartel and members of rival drug gangs. Hector Levya, the former leader’s brother, fought Valdez for control of the operation. This rivalry evolved into an all-out gang war, with tactics of beheading among the more heinous methods of killing. Valdez is also accused of killing rivals in other cartels, who once challenged his ascension by hanging and torturing members of Valdez’s cartel.

US prosecutors recently indicted Valdez in Atlanta on federal drug trafficking charges for activities that took place between 2004 and 2006. The government attorneys claimed that Valdez smuggled the drugs through Texas before delivering them to drug dealers in Atlanta. Atlanta currently stands as the center of drug trafficking in the south east of the US. Once the drugs were sold, however, the profits were returned to Mexico via the reverse route.

Valdez was born and raised in Laredo, Texas where he was a star football player. La Barbie is represented in the US by Houston criminal defense attorney Kent Schaffer, who indicated that his recent capture was not at all unexpected. Schaffer has expressed concern that Valdez will be tortured by Mexican authorities before he can be extradited back to America for his criminal trial. The lawyer’s concern for his client’s safety is growing, as he is currently unable to locate Valdez. However, US government sources are confident that La Barbie will be returned home unharmed given his notoriety – all eyes will be on Mexican law enforcement authorities and how they handle his incarceration and extradition proceedings.

Although Americans do not typically serve in the higher-level posts of Mexican drug cartels, La Barbie is not the only US citizen who has climbed this unique career ladder. Another Texan, Juan Garcia Abrego, ascended to the head of the Gulf Cartel in the 90’s, but was eventually extradited back to Houston to stand trial for drug smuggling crimes. He was convicted and is currently serving multiple life sentences.

http://www.chron.com/disp/story.mpl/metropolitan/7178804.html
 

The case brings up challenging questions about the proper method of conducting a patient exam to identify addictive or drug-seeking behavior, how and when to prescribe drugs for new and existing patients, and whether a doctor has a duty to ensure that a patient complies with dosage instructions. Unlike when apprehending a drug dealer on the streets, where evidence of criminal activity is relatively obvious, law enforcement officials encounter obstacles when trying to build a criminal case against a doctor for negligence or intentional wronging in writing prescriptions. Given that much of the information doctors rely on to determine the proper course of treatment is actually communicated directly by the patient, holding doctors liable for abuse and misuse of prescription drugs continues to be a gray area of the law.

Dr. Tseng, age forty, is a graduate of Michigan State University. She received an osteopathic degree from its College of Human Medicine in 1996. Despite claims that she is responsible for the deaths of several of her patients, Dr. Tseng’s license to practice medicine in the State of California remains active; she has had no malpractice judgments against her and has not yet been charged with any crimes.  However, officials now must determine whether Tseng is a medical professional or a prescription drug dealer, not such an easy task.

Unbeknownst to Dr. Tseng, the US Drug Enforcement Administration (DEA) embarked on a three-year investigation of her prescription-writing practices after receiving several complaints from pharmacists and loved ones of her patients. At the conclusion of the investigation, investigators determined that Dr. Tseng poses an imminent danger to public health and safety and they are in the process of initiating criminal proceedings against her. As a result, the DEA terminated her ability to prescribe addictive drugs, such as OxyContin, indefinitely.  After going public with Dr. Tseng’s case, law enforcement officials have received additional complaints from parents who claim that their kids overdosed on drugs prescribed by Dr. Tseng.

Tseng has been forthcoming about the way she practices medicine and claims that she receives complaints from parents of her patients daily. Tseng claims that these parents call her names, such as “drug doctor”. However, Tseng strongly defends herself and her prescription-writing practices, claiming that she prescribes meds based on what patients tell her their symptoms are and what she is able to discern from a physical exam. New patients pose particular difficulties, Tseng claims, as she has no way of knowing whether or not they are telling the truth.  Instead of acknowledging her role in the deaths of several young people under her care, Tseng blames the patients for not precisely following her dosing instructions.

Government officials, however, claim that Tseng is prescribing dangerous narcotics, such as OxyContin, without evidence that a patient has a bona fide need for the drug. Under the law, a physician can prescribe addictive painkillers, anti-anxiety drugs, and sleep aids after she has diagnosed the patient and determined that the drug will help alleviate the symptoms or the medical problem. The law does require, however, that the doctor conduct a physical evaluation and keep detailed medical records.

If carried out correctly, medical authorities claim that a physical and history-taking should help doctors identify addicts who are doctor shopping in order to obtain a new supply of drugs. Among the things that should warn the doctor that a patient is drug seeking are patients who are willing to travel a long way for a medical appointment; those who already know what they need and take it upon themselves to ask for a specific medication; and patients who claim that they “lost” their current bottle of pills. Another indictor of addiction, although not necessarily something a doctor would be aware of, is when a patient fills narcotic prescriptions at different pharmacies (in order to avoid detection).

Tseng readily admits that several of her patients drove long distances for an appointment with her but says that when she questioned them, they indicated that they had been referred by her other patients. Tseng believed that a personal referral was a plausible reason for someone to drive incredibly long distances to be seen for a bad back.

Although she suspected that some of the patients she was treating were using her to obtain prescription drugs that were not clinically indicated, the first real alarm started to sound when she became aware that pharmacies where questioning her prescriptions or even declining to fill her prescriptions. Combined with the public outcry surrounding the recent overdoses of high-profile celebrities such as Michael Jackson and Corey Haim in 2009, this negative feedback from pharmacies prompted Tseng to cease prescribing OxyContin. For her part, Tseng feels that her refusal to write prescriptions for OxyContin successfully deterred drug seekers from continuing to come to see her.

The Patients of Dr. Tseng and Their Stories

Sadly, for those with legitimate chronic or acute pain, the ease with which patients can transform from a legitimate user of prescription pain medication to a prescription drug addict is horrifyingly easy. These drugs are so powerful that those pre-disposed to compulsive or addictive behaviors need to be monitored closely in order to prevent addiction from taking hold. When allowed to progress unchecked, however, prescription drug addiction can turn deadly. Dr. Lisa Tseng has discovered this the hard way.

Tseng is a general practitioner in Los Angeles County whose patient roster inexplicably includes people from as far away as south Orange County, Palm Springs, and beyond. Many of her patients are young white males in their early 20’s.

In December 2009, twenty-one year old Arizona State University student Joey Rovera and a couple of friends from school drove from Arizona to Tseng’s medical clinic located in a mini-mall just off the 60 Freeway in Roland Heights; Tseng wrote several prescriptions for the men. Just over a week later, Rovera died of a drug overdose.

Rovera was not the first patient to die while under Dr. Tseng’s care. Since 2007, at least six young men have died of drug overdoses after visiting Dr. Tseng. Two additional young men died after obtaining prescription drugs from other patients of Dr. Tseng. Officials now believe that these “patients” were drug dealers. The victims were all athletic, had a history of playing sports from an early age and came from good homes and loving families. Unfortunately, these young men also had a history of experimental drug use. Some had become full-blown addicts, causing sporting injuries in order to obtain prescription-grade painkillers.

Dr. Tseng was known throughout the southwest for being a medical practitioner who did not inquire too deeply into the veracity of a patient’s claim of chronic or acute pain, anxiety, or sleep problems. She readily prescribed painkillers such as OxyContin and Vicodin, as well as muscle relaxers, anti-anxiety meds, and sleep aids such as Soma and Xanax. All of these medications are known for their addictive properties and are largely responsible for the recent increase in prescription drug-related addiction and overdoses in teen and young adults.

Another of Tseng’s patients, Matthew, was a dirt bike racer from San Clemente, California who started on the path to prescription drug addiction when he was just thirteen years old. After breaking his leg during a race, doctors in the hospital prescribed morphine for pain and he quickly become addicted. Throughout his teen and young adult years, Matthew entered various addiction treatment centers in an attempt to treat his painkiller addiction.  His parents often wondered whether he was intentionally injuring himself during bike races so that he could obtain more painkillers from medical professionals.

Then, a few years ago, things started looking up for Matthew. It seemed as if one of his various stints in rehab had worked; he managed to stay off prescription painkillers for ninety days and got engaged.  However, then his girlfriend fractured her cervical vertebrae and needed his help. Instead of continuing drug treatment, he dropped out and returned home to care for her. The 24-year-old lasted only about two weeks before relapsing; his mother found him dead on the bathroom floor surrounded by prescription drugs (maximum-strength OxyContin, Soma, and Xanax).

In a confusing twist for Matthew’s parents, the pills were traced back to an unfamiliar Dr. Tseng, who practiced roughly fifty miles from where Matthew lived. Tseng had prescribed OxyContin just 48 hours before Matthew died – only four pills remained in the bottle out of the original thirty. His parents had never even heard of Tseng and still have no idea how Matthew had come under her care.

Ryan Latham, a twenty-one year old man who died of a prescription drug overdose in 2008, is another young patient who traveled to see Tseng. Officials claim that Latham’s system contained Vicodin, Xanax, and Soma when he died, pills prescribed by Tseng just one week prior. Although he had a history of drug abuse, Ryan had been clean for at least six months before he started seeing Tseng. Sadly, before he died, Ryan informed his mother that Tseng would prescribe painkillers to a patient based solely on past history of a painful condition.
 

http://www.latimes.com/news/local/la-me-overdose-new-20100829,0,6188118,full.story
 

Lead researcher Dr. Peter Snyder from The Warren Alpert Medical School of Brown University and colleagues conducted a 2-day experiment measuring the participants’ rising and declining BAC levels during intoxication and the impacts on their executive cognitive functions. Previously, similar alcohol studies had only measured the impact of alcohol on basic functions such as motor speed and information processing speed, yet Snyder’s study became the first to consider executive functions. In the study, 20 participating college students consumed alcoholic beverages over an 8-hour period in order to bring their BAC near 0.10 percent and then down to normal levels.

During their varying rising and falling BAC levels, participants were required to complete on-screen computer maze learning exams. For sober, healthy young adults (whom served as the placebo group), the hidden maze exam was completed with few errors. However, the participants displayed progressively higher rates of error while following simple directions during the exam with increasing BAC levels. Regardless of their self-reported feelings of sobriety, the participants’ likelihood to commit errors did not decline as progressively as their subjective feeling of drunkenness. The researchers conclude that the participants’ executive functions were not recovering as quickly as the participants believed, but were instead more closely related to their actual BAC levels, putting them at greater risk of committing error.

While basic functions are able to recover in a shorter time span following drunkenness, executive functions—the cognitive functioning involved in driving skills and making judgments regarding traveling through intersections or changing lanes—are not able to recover as quickly. According to the study, the perception of recovery from drunkenness progressed more rapidly than the drinker’s actual cognitive recovery, which may explain why many drunk drivers make the erroneous conclusion that they are fit to drive.

With an average of 17,000 deaths caused by alcohol-impaired vehicular accidents every year in the U.S., too many drunk drivers get behind the wheel believing they are more sober than they really are. Sixteen to 20-year-old male drivers face a twofold chance of a vehicular accident after raising their BAC by 0.02 percent; even further, their risk increases 52 times when their BAC becomes 0.08–0.10 percent. The researchers hope that their findings will influence alcohol education programs for college-aged adults to help better inform these drivers of the risks involving drinking and driving.

The study is published in the August 2010 issue of Experimental and Clinical Psychopharmacology, a publication of the American Psychological Association.

The Drug Abuse Warning Network is a public health surveillance system that monitors emergency department visits that involve drugs, including methamphetamine. In order for an emergency department visit to be a DAWN case, the emergency department visit must have involved a drug, either as the direct cause of the visit or as a contributing factor.

DAWN recently released a report that offers important information about the emergency department visits involving methamphetamine between 2004 and 2008.

In 2004, there were 132,576 visits (8.2 percent of all visits) to the emergency department that involved methamphetamine but by 2008 that number had been reduced to 66,308 visits (3.3 percent). The trend was consistent among both males and females, showing a significant decline between 2004 and 2008 (a decrease of 39 percent and 37 percent, respectively).

In 2008, the report showed that methamphetamine-related visits to the emergency department varied by age. 34.7 percent of the visits were made by individuals aged 25 to 34. 24.5 percent of the visits were made by individuals 35 to 44, and 23.7 percent were made by individuals 18 to 24.

Most of the visits to the emergency department that involved methamphetamine also involved other drugs or alcohol. More than a quarter involved methamphetamine and another drug, and 34.2 percent involved methamphetamine combined with two or more other drugs.

Almost a quarter of methamphetamine-related visits to the emergency department also involved alcohol or marijuana. Nearly one in five methamphetamine-related visits involved cocaine or opiates.

The majority of methamphetamine-related visits to the emergency department resulted in the patient being treated and released (60.0 percent). Almost a quarter of the emergency department visits ended in the patient being admitted to a hospital, and 15.8 percent ended in another type of discharge (e.g., patient transfers, death, or some other type of discharge).

Emergency room visits involving methamphetamine provide an opportunity for medical staff to intervene in a situation where someone is abusing methamphetamine, often along with other drugs. The patient can be warned and educated about the dangers of mixing multiple substances and assist them in obtaining treatment for drug withdrawal, if necessary.
 

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Still, there is merit in considering whether clinical trials may prove efficacious in the prevention, treatment, or recovery from substance abuse or addiction. For many people, however, the whole arena of clinical research and trials remains a mystery. What are clinical trials? What actually happens during one? How do you apply, or do you have to be referred? How do you even find clinical trials in your area?

These are all good questions and will be dealt with shortly. The reason it’s important to understand more about clinical trials and how they may benefit individuals with substance abuse or dependence is that it’s only with full knowledge can anyone make an informed decision on whether or not participating in a clinical trial is right for them.

What are Clinical Trials?

In the basic sense, it’s fairly easy to figure out what clinical trials are just by examining the words. Clinical is an adjective that refers to medical treatment, practice, observation or diagnosis. Trial is a noun whose third accepted definition says that it is a test or experiment to determine the quality, safety, usefulness, performance, and public acceptance of the thing or process being tested. So, in this case, a clinical trial is a test of a medical treatment, practice, observation or diagnosis as to its quality, safety, usefulness, performance and public acceptance.

Fair enough – but this isn’t sufficient to give a full picture of clinical trials.

The National Library of Medicine (http://www.nlm.nih.gov/services/ctclintrial.html), of the National Institutes of Health (NIH), publishes this definition of a clinical trial:

“A clinical trial (also clinical research) is a research study in human volunteers to answer specific health questions. Carefully conducted clinical trials are the fastest and safest ways to find treatments that work in people and ways to improve health. Interventional trials determine whether experimental treatments or new ways of using known therapies are safe and effective under controlled environments. Observational trials address health issues in large groups of people of populations in natural settings.”

What Actually Happens During a Clinical Trial?

What happens during a clinical trial depends on the kind of trial being conducted. In brief, there are the following types of clinical trials:

• Treatment Trials – These test experimental treatments, new combinations of drugs, or new approaches to surgery or radiation therapy.

• Prevention Trials – As the name implies, prevention trials look for better ways to prevent disease in people who have never had it or to keep it from returning. These trial approaches may include medicines, vaccines, minerals, vitamins, and/or lifestyle changes.

• Diagnostic Trials – These trials are conducted to find better procedures or tests for diagnosing a particular condition or disease.

• Screening Trials – In a screening trial, the purpose is to test the best way to detect certain health conditions or diseases.

• Quality of Life Trials – Also known as Supportive Care trials, these explore ways to improve the quality and comfort of life for those with a chronic illness.

The clinical trial consists of a team of doctors and nurses as well as social workers and other health care professionals. These team members check the participant’s health at the beginning of the trial, give specific instructions for participation in the trial, carefully monitor the participant during the course of the trial, and remain in touch after the trial’s completion.

There are some clinical trials that involve more tests, doctor visits, procedures than an individual would normally have for a condition or illness. For all trial types, however, the participant works with a research team. Participation in a clinical trial is most successful when the protocol (study plan) is followed carefully and there is frequent contact with the research staff.

Clinical Trial Phases

There are four phases of clinical trials. In effect, these are stages of clinical trials where researchers seek answers to different questions.

• Phase I – In Phase I clinical trials, researchers test an experimental treatment or drug in a small group of people (20 to 80) for the first time in order to evaluate safety, determine a safe dosage range, and identify side effects.

• Phase II – In Phase II clinical trials, the experimental treatment or drug is given to a larger group of people (100 to 300) to see if it is effective and to further evaluate its safety.

• Phase III – In Phase III clinical trials, the experimental treatment or drug is given to an even larger group of people (1,000 to 3,000) to: confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information to allow the experimental treatment or drug to be used safely.

• Phase IV – In Phase IV clinical trials, post-marketing studies delineate additional information on the experimental treatment or drug, including potential benefits, risks, and optimal use.

How to Find a Clinical Trial in your Area

The best way to find clinical trials being conducted in the area of substance abuse or dependence is by using a comprehensive website such as ClinicalTrials.gov (http://www.clinicaltrials.gov/). ClinicalTrials.gov is a registry of federally and privately supported clinical trials that are conducted in the United States and around the world. Using the resources of ClinicalTrials.gov, interested parties can obtain information about a particular trial’s purpose, who may participate, locations, and phone numbers for more information.

The website currently contains nearly 94,500 trials sponsored by the NIH, other federal agencies, and private industry. Studies listed in its database are conducted in all 50 states and in 173 countries.

Use the website’s search tool to look for clinical trials by condition and area. For example, enter “Substance Abuse AND Los Angeles” to find clinical trials being conducted on this condition and in this geographic area. One recent search using these criteria resulted in listings for 90 studies. Included are clinical trials that are recruiting, not yet recruiting, active but not recruiting, and completed.

Such a search may show several clinical trials for methamphetamine dependence, for example. Research trials involving tests of various medications for the treatment of methamphetamine dependence – such as Varenicline, Bupropion, Atomoxetine, and Methylphenidate, and one trial using behavior therapy are either recruiting or not yet recruiting participants. Separate trials for the drugs Modafinil, Prometa and Perindopril in connection with methamphetamine dependence have been completed.

There is also a trial for exercise to improve the outcomes of treatment for methamphetamine users.

The fact that there are numerous trials active, recruiting, not yet recruiting, or completed for methamphetamine dependence is encouraging. Since the crystal meth scourge is sweeping America with 70 percent of the meth from Mexican drug labs being distributed within our borders, and the ravages of meth addiction are so potentially deadly, effective means of treating meth dependence are desperately needed.

But meth is just one example of clinical trials. There are clinical trials for marijuana dependency among adolescents, trials for alcoholism, opioid dependence, cocaine and alcohol dependence, schizophrenia and comorbid cannabis use disorder, mental illness and substance abuse, gender-responsive treatment for women offenders with substance dependence, alcohol and drug intervention for middle school youth, and many more.

Drill down further by clicking on the study to find out who’s conducting and sponsoring the study, the purpose, type, and design of the study, as well as further study details (primary and secondary outcome measures), enrollment number, study start date and estimated study completion date, eligibility criteria, contacts, locations, and links for more information.
For further help on how to search for clinical trials, see the ClinicalTrials.gov help topics page (http://clinicaltrials.gov/ct2/help/help) for basic search, advanced search, refine search and search expressions.

How to Get Involved in a Clinical Trial

In order to be considered for a clinical trial, or to ask questions about a particular trial, interested parties should get in touch with the contact person listed for the study on ClinicalTrials.gov. It is important to note that you cannot sign up for any clinical trial on the ClinicalTrials.gov site, since this is strictly a clinical trial database.

But the larger question is whether a particular clinical trial – or any clinical trial – is right for you or for your loved one with substance abuse or dependence. Your first conversation should be with your doctor or health care provider. He or she knows your medical history, is conversant with developments in the field – especially if this is a substance abuse treatment provider, and can give you valuable insight into the merits or potential downside of such a trial in your case.
Even if your doctor or health care provider recommends a particular clinical trial, there are still inclusion and exclusion criteria and eligibility requirements that need to be satisfied. These are based on age, gender, type and stage of a disease, previous treatment history, and other medical conditions. Note that some studies are looking for individuals with particular addictions or conditions, while others are looking for healthy participants.

Either look up the clinical trial to begin with to try to determine if you meet the requirements and then talk with your doctor about the advisability of pursuing it further, or talk with your doctor first and then search the particular trial online to find out more about the study’s eligibility requirements.

In the event that you are eligible for a particular trial, you still need to meet with the trial coordinator. Be sure to write down all the questions you have so you can ask them during the meeting. It’s also recommended that you bring a friend or relative along and tape record the meeting so that you can play the recording back later. Many times, it’s easy to forget information you’ve heard, including important facts, dates, and requirements.

Questions to Ask

You need to be as informed as possible in order to make your decision to participate in a clinical trial. While you may have other questions, here are some to definitely get answers to. Even though some of the answers may appear on the website listing, you need to hear the specifics from the study’s coordinator.

• What is the purpose of the study?
• Who will be in the study?
• Why do you (researchers) believe the experimental treatment being tested in the study will be effective? Has it been tested before? What were the results?
• What kind of tests and/or experimental treatments will be involved?
• Tell me about the possible risks, side effects, and benefits in the study compared with my current treatment.
• Tell me how this clinical trial may affect my daily life.
• How long will the trial last?
• Will hospitalization be required?
• Who pays for the experimental treatment?
• Will I receive reimbursement for any other expenses?
• What kind of long-term or follow-up care is part of this study, if any?
• How will I know if the experimental treatment is working? Will I be provided with the results of the trial?
• Who will be in charge of my care during the trial?

Informed Consent

An informed consent document will be provided by the research team to the eligible participant. In the informed consent document, the research team includes details about the study, such as its purpose, length, required procedures, and key contacts. In addition, the trials potential risks and benefits are spelled out. The potential participant can then make the decision to sign the document or not, to participate in the trial or not. The informed consent document, however, is not a legal contract. The participant may withdraw from the trial at any time.

One of your key questions that you want answered concerns the results of the clinical trial. In most informed consent documents, researchers pledge to share with you the results of the trial. In other words, they will share with you what they learned from the trial. This includes a summary of the responses of all study participants. In addition, the researcher will discuss with you results that relate to your diagnosis or that may be beneficial to you as you decide on the best treatment for your disorder or addiction.

Make Your Decision Weighing All Factors

The decision to participate in a clinical trial goes beyond meeting eligibility requirements, recommendations from doctors, family, or friends. It’s a very personal decision for most people. Although it is true that there are some individuals for whom others need to make the decision (in the instance that a person is severely impaired due to mental illness, perhaps in conjunction with substance abuse), most make the decision after weighing all the possible risks and benefits and whether they feel in their gut that this is the right choice for them.

Should you or shouldn’t you? Your best course of action is to gather as much information as you can, ask all the pertinent questions (at any time they occur to you, whether prior to or during the trial), confer with your doctor, family, and close friends, and then allow the information to sink in. Don’t rush to jump into the trial. Give it careful thought. If you are desperate for something to help you avoid recurring relapse for opioid dependence, or can’t get off meth by any other means, or alcoholism and drug use has resulted in your inability to adhere to your recovery program, perhaps participating in a clinical trial may be of benefit.

Remember, however, that there are no guarantees in clinical trials, just as there is no sure-fire outcome to any addiction treatment. If, however, you’ve weighed all the risks against the potential benefits and still feel that you want to go through with it, and are accepted, by all means go for it.

How do you think any new medication or treatment for substance abuse or dependence ever gets approved in the first place? Without clinical trials, there wouldn’t be any hope of finding more effective ways of prevention, treatment, and recovery for substance abuse and dependence.

There’s one more thing to think about in making your decision to participate in a clinical trial. This is one more example of you taking action to manage your disease, to learn how to overcome it and live a full and productive life that’s free of drugs and/or alcohol. Isn’t that worth a lot? Even if you’re long into recovery and still having recurring symptoms or difficulties, there may be a clinical trial that you can become part of that will further the research into addiction recovery. In the end, however, it has to be right for you.

In addition to such crimes, there are other addicts who prefer to take a less violent approach to securing their fix. A recent news report focuses on the efforts of the Dorset and Somerset Counter Fraud and Security Management Service (DAS) to reduce the number of individuals able to commit prescription fraud.

One woman has admitted to providing false names in three surgery incidents in order to gain access to codeine-based painkillers. She consumed as many as 150 tablets a day to feed her addiction.

This individual was jailed for a year and 28 days as a result of her actions. A fraud specialist with the NHS noted that catching the individual and putting her away so quickly helped to save the NHS money and resources in terms of lost appointments for genuine patients who truly need help.

The woman accused also faced 17 similar offenses which reportedly took place across Hampshire and Dorset. The judge in this case referred to the defendant as a ‘sad spectacle’ for abusing a system designed to help those in need of medical care.

For this offense, she was sentenced to 12 months. The 28-day sentence was for a shoplifting offense and the judge ordered that it be served consecutively with the 12 month sentence.
 

The state of Massachusetts will soon determine just how effect such a program can be as a new detection system has been approved. According to a recent Boston Globe report, a physician anywhere in the state will soon be able to easily identify those patients who engage in doctor shopping activities.

Regulators with the Public Health Council have approved a new detection system that could help to address a problem affecting at least 9,000 Massachusetts residents suspected of doctor shopping every year. The online database will show previous prescriptions filled by patients for powerful painkillers.

Physicians will also be able to use the database to better determine which patients truly need help and which ones are simply craving another hit. A successful system will ensure those truly in pain can receive the help they need.

This focus is an important one in Massachusetts as the state experienced a dramatic increase in the number of substance abuse deaths in the past 10 years. While some of the more than 600 deaths can be attributed to those injecting heroin and other street narcotics, the rise has also been driven by prescription medications.
A previous prescription monitoring program was put in place in the state in 1992, but covered only one category of drugs, including OxyCotin, Percocet and morphine. This system does not provide direct access for health providers.

With the expanded system, physicians are expected to have access and pharmacists have to alert state officials when they fill a prescription for a broad range of medications. The changes are expected to make an impact on the state. The success or failure of the system can provide keen insight for other states considering such a program.
Violators could face substantial fines and other penalties, Bonner said.
The state is spending about $1 million to strengthen prescription monitoring and will commit $400,000 annually to maintain the initiative. Health authorities said they expect the state’s health insurance program for the poor will save $2 million a year by spotting abusers.
“You look at these people, and you see their faces and you hear their stories, and it’s very compelling,’’ Bonner said. “And the million dollars it has cost to get this program up and running is a drop in the bucket compared to the devastation that has been caused.’’
 

Breast cancer can occur in different parts of the breast, including the milk ducts, lobules, or (rarely) connective tissues, and cancers can be either invasive or noninvasive. Ductal cancer is the most common type of breast cancer, attributing to almost 70% of all breast cancer cases. Lobular cancer, on the other hand, affects approximately 10–15% of breast cancer cases. Furthermore, some cancer cells obtain their energy from women’s naturally occurring hormones—estrogen and progesterone. Breast cancers can be estrogen receptor-positive (cancer cells use estrogen to grow), progesterone receptor-positive (cancer cells use progesterone to grow), or hormone receptor-negative (the cancer does not grow using hormonal cells).

Using the Women’s Health Initiative Observational Study, lead researcher Dr. Christopher Li and colleagues observed 87,724 postmenopausal women in their study to measure their likelihood of developing breast cancer subtypes. Women were between the ages of 50 and 79 years from 1993 to 1998, were cancer-free, and had self-reported on their alcohol consumption at the time of their initial consultation. Women were classified as nondrinkers, prior drinkers, or current drinkers. Women who were considered current drinkers were grouped into six categories, depending on how much alcohol they consumed. Alcohol consumption ranged from a maximum of 1 drink per week to at least 14 drinks per week.

Then, the researchers followed up with the women in September 2005 to assess the prevalence of various breast cancer types. A total of 2,944 cases of invasive breast cancer were diagnosed among the study’s sample. Researchers evaluated this group’s tumor subtype status, hormone status, family medical history, reproductive history, demographics, alcohol consumption, and lifestyle. As a result, alcohol consumption shared a positive relationship with invasive breast cancer overall, as well as invasive lobular cancer and hormone receptor-positive tumors. Compared to nondrinkers, women who were current drinkers and consumed an average of seven or more drinks per week had a doubled risk of hormone receptor-positive invasive lobular breast cancer. However, the researchers did not find a significant disparity among drinkers and nondrinkers’ risk when it came to ductal type breast cancer, the most common subtype.

The researchers’ study affirms the findings of previous research that have linked alcohol consumption with an increased risk of hormone receptor-positive subtypes than hormone receptor-negative subtypes, as well as increased risk of lobular cancer. Although the researchers note that alcohol consumption levels of the study’s diagnosed women were not reevaluated following their initial report, they suggest that a distinct relationship exists between alcohol use and breast cancer risk. These women did not appear to have heightened levels of risk based on their varying levels of alcohol consumption, but being current alcohol consumers alone put them at a twofold risk of these specific breast cancer subtypes.

Source: Medical News Today, Alcohol Consumption Linked To Subtypes Of Breast Cancer, But Not All, August 24, 2010

If You’ve Done Nothing About Getting Over Your Addiction

Think about it. When you’re steeped in your addiction, all you think about is using, when you’re going to use next, how you’ll get the money to buy your drug of choice, then using, recovering from using, and beginning the cycle all over again. Over a period of time, this pattern of self-destructive behavior wreaks havoc on not only you but everyone around you. The people you hurt the most are the ones closest to you – your family.

Although you probably don’t give it much thought, especially if you’re in a drug-induced euphoric state, your loved ones are the last people you should be alienating. They’re the ones to always have your back, to support your hopes and dreams and stand by you in tough times.

When you’re constantly messed up, not thinking clearly, getting into fights and arguments and trouble with the law, losing your job, being evicted, unable to pay the bills or take care of your family responsibilities – what do you think happens to the family? They suffer. And it’s not of their doing. They didn’t force you to drink or do drugs or engage in other addictive behavior. If you are an alcoholic, you may also have other addictions, or even suffer from a mental health disorder.
In short, because of your addiction and your actions, you’ve made it increasingly difficult – if not impossible – for your family members to tolerate the situation. They may have decided it’s best for all concerned to remove you from their lives.
But just because they have taken this course of action doesn’t mean that it’s forever. This may be the wake-up call you need to do something to get them back.

Now, the all-important question: What can you do about it? Here are some suggestions:

• Take stock – Before you can determine where you’ll go from here, you need to take stock of your current situation. How bad is it? Do you still have a job and possibly health insurance coverage? If so, this is very important and can serve you well as you consider your options. If not, you’ll need to explore other alternatives to getting the help you need. And, whether you like it or not, help is definitely what you need. Help, in this respect, is assistance to overcome your addiction.

Taking stock also means looking at how you’re currently living. Do you have shelter? Are you able to buy food? Are you taking medications that are prescribed for you or have you let your physical health deteriorate as a result of your addiction? If you’re on the street, homeless, you’re likely in the full-on addictive state. Your first priority should be to take care of your food and shelter needs, get any necessary medical assistance that may be available to you.

It may not be a pretty picture, but the reality of your situation is something that you have to address – if you want to regain your family and your life.

• Decide what you want – How much do you want your family back? Are you willing to do whatever it takes to have them welcome you back? This is a tough decision for some long-term addicts who are so wedded to their drug of choice that they can’t see past the next fix. You may tell yourself that you like your life as it is, and that you don’t need to change. If that’s really what you believe in your heart, you are deep in denial. Your drug-using lifestyle will continue to drag you downward until the consequences are so dire that you may wind up in jail, in a mental institution, or dead.

When you look at your future, is that what you really want for yourself? It’s true that no one chooses to become an addict, but you do need to choose to overcome your addiction once you are hooked. Make no mistake about it. The decision to overcome addiction is a tough one. It requires courage and determination. It’s more than just willpower. If that was all there is to it, every addict who expressed a desire to get clean would be able to overcome addiction.

But wanting to get clean is a step in the right direction. In fact, if you want to turn your life around and get your family back, it’s the only thing that makes sense for your future.

• Get into treatment – If you’ve taken stock and then decided that you want to change your life, make the effort to find treatment that can help you overcome your addiction. Believe it or not, treatment is available to those who need it – and it doesn’t need to depend on whether or not you have money or can afford it, or even if you have insurance coverage. The truth is that it’s in everyone’s best interest for addicts to receive treatment and learn how to manage their disease. It’s less cost to society in terms of medical care, incarceration, lost productivity, housing subsidies and other economic and non-economic costs. Society, as a whole, benefits when its members are fully productive – or marginally more productive – and capable of being self-sufficient.

But beyond the broad societal benefits of addicts receiving treatment, diving down to the personal level, how it benefits you is what you really care about. Why not give yourself a chance to live life without the yoke of drug addiction? Allow yourself to think about being free of the constant drug-using lifestyle? Then, do something about it.

Finding treatment needn’t be that difficult. Use the Treatment Facility Locator (http://dasis3.samhsa.gov/), maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA), or call their toll-free treatment referral helpline at 1-800-662-HELP. Using the search tool on the Internet or talking to consultants via the helpline, you’ll be able to find treatment facilities in your area or get information or referrals to state or local agencies that may be of assistance.
Listings in the Treatment Facility Locator go by state. You can find out:

o Facility name, address, phone numbers (including intake number and toll-free hotlines, if available), map, distance from your location, and website URL (if available)

o Services provided, such as substance abuse treatment, detoxification, buprenorphine services

o Type of care: outpatient, residential short-term treatment (30 days or less), residential long-term treatment (more than 30 days)

o Special programs/groups: persons with co-occurring substance abuse and mental health disorders, persons with HIV/AIDS, gays and lesbians, women, men, adolescents, seniors, criminal justice clients, pregnant/post-partum women, DUI/DWI offenders, etc.

o Forms of payment accepted: self-payment, state-financed insurance (other than Medicaid), Medicaid, private health insurance, military insurance (e.g. VA, TRICARE), etc.

o Payment assistance: if available, sliding-fee scale (with payment based on income and other factors), or payment assistance (check with facility for details)

o Special language services: if available

Once you’ve identified one or more treatment facilities, contact them – or go through federal, state, or local agencies to get things rolling – and get yourself admitted to treatment.

• Stick it out – Prepare for the long haul, with respect to overcoming your addiction and getting into recovery. It won’t happen overnight. You will need to stick it out in treatment, learning about the disease of addiction, how to identify and recognize triggers to using, learning and practicing coping strategies and techniques, and changing your behaviors to ones that are healthier. You will be in recovery the rest of your life, but you can manage your disease and create the kind of future you want.

Once you successfully complete treatment and are in the early stages of recovery, say the first 90 days, expect some good days and days that are not so good. Rely on your support system, the network of allies and your sponsor in your 12-step group (the concept and process you became acquainted with during treatment).

Over time, if you are sincere about your commitment to recovery, your family members may come around. After all, they only wanted the best for you and may be heartened by the turnaround in your life. If they do welcome you back, they will be an invaluable support to your ongoing recovery. If they do not, you can’t internalize the guilt. You’ve done your part – and you will undoubtedly need to make amends, if not in person, then through writing about it or indirect amends. You need to live your new life, clean and sober, and with the new-found hope that you can make your goals and work toward achieving them.

You’ve Already Gone Through Treatment and are in Early Recovery

If you’ve completed treatment for your addiction and are in the early (first 90 days) of recovery, first of all, congratulations. What you have accomplished is a very big deal. You have taken the difficult and scary step of looking your addiction in the face and making the determination that you are not defined by your disease. You have accumulated effective tools and strategies to help you maintain your sobriety, developed a support network in your 12-step group members and sponsor, worked to re-establish yourself in society, gone back to work, and changed your behavior to reflect your healthier lifestyle.
But, as you know, it’s not always easy. There are times when you feel lonely, depressed, anxious, and fearful of making a mistake, of falling into relapse. Sometimes the cravings and urges become overwhelming and you’re afraid you won’t be able to stop yourself from giving in. What should you do when these feelings overcome you? Turn to your support network: Call your sponsor, go to a meeting or meetings (there are meetings all day, every day, even meetings available online and via telephone), or talk with close friends who understand your situation.

Other ways to help yourself in recovery include:

• Take it one day at a time – Who says you need to have everything perfect the day you get out of treatment? That’s not only unrealistic, it’s self-defeating. No one expects that you’ll have all the answers just because you’ve gone through treatment. In fact, treatment just sets the stage for you to be able to put what you’ve learned into practice. Granted it’s a little frightening to be on your own again after being in a structured environment where what you do and when you do it is monitored at all times. Even if you went to outpatient treatment, you had to adhere to certain schedules and rules and recommendations, not to mention urine and other tests to ascertain compliance with abstinence.

Cut yourself a little slack. Give it time for you to settle into your new routine – your daily maintenance schedule of taking proper care of your basic requirements (nutrition, adequate rest), going to 12-step meetings, counseling, keeping any required medical appointments, taking medications as prescribed (if appropriate). Know that it will get easier as time goes on. You will know the times and circumstances that cause you stress, and have more practice in dealing with cravings and urges that surface from time to time.

Never take recovery for granted. Work hard at maintaining your sobriety, but do so in the present. Do for you what’s best for your recovery today. Tomorrow, you will do the same.

• Work on your recovery plan – During treatment, toward the end of your formal or active treatment phase, you learned about relapse prevention. You also began to create your recovery plan. Now that you’re out of treatment and in recovery, you need to continue to work on your recovery plan, refining it, adjusting it, and modifying it as new opportunities and goals present themselves.

What happens in our lives constantly changes. Nothing stays the same forever. You may have an initial goal of maintaining sobriety for a week, then a month, then three months, six months, nine months, and a year.

Along with actively working to sustain your sobriety, you’ll undoubtedly create other goals. You may want to go back to school to start or finish a degree, learn a trade or gain a skill, pursue recreational or leisure activities, widen your social sphere to include new friends that are clean and sober, get a new job or work to advance yourself in your present job. What you will find is that once you reach one goal, what you previously set for yourself as the next step on your recovery plan may have changed. You may now see a new opportunity taking its place, either as a short-term or long-term goal.
Be flexible enough and open to the possibilities so that you can recognize them when they occur. You want to be able to take advantage of the gifts that life presents to you. Now that you’re in recovery, you have the ability to chart your own course and choose the kind of life you want to live.

Work your recovery plan. Do so on a weekly basis, or as often as needed.

• Reconnect with your family – If you haven’t done so already, or if you have tried and been rebuffed, you may wish to take this opportunity to re-establish ties with your family. At first, things may be awkward. Accept that. At least, if they are willing to communicate with you – even on a distant basis (as in, not in person) – it is progress.

On the other hand, it may turn out that they’re still too hurt or unable to forgive you for what happened because of your addiction. Again, you need to accept this. Sometimes it takes longer for family members to come around. Every person’s situation is different. There is no blame or shame attached to any of this. It just is.

What can you do if your family members continue to shun you? First of all, don’t internalize feelings of guilt or remorse. There are some families that will never accept a loved one back for reasons that may no longer even make sense. This doesn’t mean that you are doomed to a life of no caring individuals. It does mean that you will possibly need to create a new circle of loving persons who will, in effect, become your new family. Of course, it goes without saying that you only have one mother and father, or you may not wish to become involved in a new romantic relationship anytime soon. With respect to new potential partners, addiction recovery experts caution that you shouldn’t become involved romantically with new partners for at least the first year. But that doesn’t mean you can’t make new friends. In fact, you need to do this as part of your overall recovery.

Most of all, since your family is important to you, you need to forgive yourself for whatever has happened. Make amends to the extent that you can, even if this means that you do so indirectly. Your 12-step group sponsor and allies can help you with this, since all of them have the same goal of working the steps. They may be of invaluable assistance in this regard, perhaps by relating how they took this step, or what worked for them may be useful to you. You may write out your feelings, ask for forgiveness, and keep the letter (or destroy it). By expressing your thoughts, committing to your changed lifestyle, you are reinforcing that you have overcome your addiction and are managing your recovery in a healthy manner.

This is the best that you can do – until and if your family has a change of heart and softens to the extent that you can again be welcomed back.

Never Give Up

Finally, whether you’ve done nothing about your addiction or are already in recovery, always keep hope alive that your family members will again be supportive. It may take a short time or it may take a very long time, much longer than you think it should or could even plan for.

Instead of obsessing over things that you cannot control, concentrate on living every day to the best of your ability. Keep focused on your goals while actively working your recovery plan, taking care of you and reaching out to give to others as you are able. In the end, the measure of a man or woman is not what has happened to them in the form of tragedy or misfortune or fame or success, but what he or she does with the gifts and opportunities and challenges that life presents.