Category: Overdose

Are alcohol and drugs addictions genetically linked? A new paper out now


 What is the role of genetic determinants in development of concurrent alcohol and opioid dependence? The current evidence base is inconclusive; we found 33 studies, but most of them studied each dependency separately.

Check out our new critical review (https://www.oapublishinglondon.com/abstract/978)

The truth about drugs found in a cornershop

Our local corner shop sells alcohol. They also sell groceries, such as garlic, which I went to buy last week. I noticed a booklet by the cash register just as I was paying: The truth about drugs. It looked unattractive – dark colors, scary statements – but I took it to learn more about the drug free world as promised on the cover.
The brochure was full of mistakes, contradictions and misrepresentations of drugs. Most of them were myths which are not supported by the evidence and have been perpetuated for decades:
1) MYTH: Drugs have been part of our culture since the middle of the last century.
                FACT: Drugs have been here since ever. They are at least as old as the humankind.
2) MYTH: Young people today are exposed earlier than ever to drugs.
                FACT: This is a favorite headline of most prevention programs. Finding increased rates of drug use among the youths is not difficult. Finding reasons for this increase is difficult and requires knowledge of drug markets. Young people may be using drugs as much as before. They may be using different drugs than in the past, but that’s a matter of drug availability and supply.
3) MYTH: People take drugs because they want to change something about their lives. [] They think drugs are a solution.
                FACT: People take drugs for all sorts of reasons. For alcohol, these reasons can be broadly divided into: social, coping, enhancement conformity and motives. Coping with problems and solution-seeking is just one of the reasons.
4) MYTH: A small amount acts as a stimulant (speeds you up). [] This is true of any drug.
                This is UNTRUE for depressants (downers) and some other drugs. Although, the brochure lists sedative effects of depressants later, I don’t understand why it misleads the readers.
5) MYTH: Drugs make a person feel slow and stupid…
                FACT: Same as above. Cocaine hardly makes people feel slow. It is hard to discern why false statements, such as this one, made it into the brochure. There’s almost no wheat among the weeds.
6) MYTH: Marijuana [] can also be brewed as a tea.
                FALSE: The active compounds are not water soluble. THC is fat soluble though.
7) MYTH: people take drugs to get rid of unwanted situations or feelings (p.13)
                FACT: People take drugs for all sorts of reasons. See point 3 above.
8) UNDERSTATEMENT: the long-term effects of alcohol are understated on p.15 – Alcohol is a hard drug.
9) MISTAKE: Cocaine and crack cocaine can be taken orally…
                Yes, BUT it takes ages to start acting and it’s harder to estimate the right dose – the risk of overdose is higher. That’s why people don’t eat cocaine. Coca leaves are chewed not ingested.
10) DEPRESSION can drive anybody to suicide, not just people who use cocaine. Suicidal thoughts (p.19) are one of depression’s symptoms.
11) TOBACCO: no information in the booklet, although my local store sells cigarettes. They are stored very close to the booklets. Most people tried smoking.

Violence

The brochure’s information about the effects of drugs on violence is inconsistent. Moreover, most people use multiple drugs whose effects on relationships synergize. It’s difficult to separate effects of individual drugs. The brochure states:
  • Heroin – violence and crime are linked to its use
  • Inhalants – users may also suddenly react with extreme violence
  • Crystal meth – causes aggression and violent or psychotic behavior
  • Alcohol – can lead to violence and conflicts in personal relationships
  • Alcohol is ‘more harmful than heroin’ say Prof Nutt, King and Williams in the Lancet journal. Watch BBC News interview.

Target group and choice

The brochure’s target group is unclear. Technical terms are used widely alongside academic references. In two places, it mentions development of “Teenage bodies”, and “teens” surveyed about drugs. It misleads the reader to believe that they can make a decision about drugs. The truth is that the only option provided in this booklet is to live drug-free.
The wide availability of this pamphlet worries me most. Despite wrong information, it’s available at the most exposed spot in 24/7 stores – at the cash register. How come those government health promotion brochures are not there (http://healthpromotion.ie/)? Or the excellent Safety First brochure: reality-based approach to teens, drugs and drug education (www.drugpolicy.org/docUploads/safetyfirst.pdf‎)?

The safest life-choice is to not to use any drugs. Drug-free is a world for some, but not for all. Most of us will use some drugs, legal or illegal, at some point in our lives.

Submitting ethics for new research: killing so many trees

Ethical principles, ethics committees and research

This has been a busy week from an ethics perspective. All research should be ethical and adhere to the ethical guidelines. The gatekeepers for the ethical principles are usually ethical committees, institutional review boards or panels. Researchers submit their proposals for approval to the committees and they decide whether the proposed research is in line with the universally accepted principles of ethical research. For example: Research carried out on humans should be in compliance with the Helsinki Declaration (http://www.wma.net/en/30publications/10policies/b3/index.html).

In Ireland, we have 25 committees/ boards who can provide ethical approval and we submitted two applications for ethical approval to two different committees this week:
1. Are psychosocial interventions for problem alcohol use effective among problem drug users in primary care (PINTA): A Controlled before-and-after feasibility study
2. Prospective audit of characteristics of opioid overdoses in an emergency ambulance service
…so many trees going to the ethics.

As usual, we submitted the ethics application on the last day of the deadline.
I wasn’t even sure if the cyclist courier would take it on a bike to the addressee, because the package had surely over 2 kilos. Fingers crossed.