Thursday, March 15, 2012

Hepatitis C is alive and well thank you, IV drug use is on the rise and "Spice" ain't nice

It was the best of times, it was the worst of times. I remember fondly those days of my youth, waiting in the rain for concert tickets to Crosby, Stills, Nash & Young, Santana and Jethro Tull.

I hitchhiked everywhere, with my headband in place, and tie dyed shirt hanging over my bell-bottoms hoping to cop a ride.

At the tender age of sixteen I moved out of my parents home, into in a one bedroom apartment with six girlfriends, eating hot pizza for dinner, and scarfing down the leftovers for breakfast.

My parents had no idea the danger I was putting myself in, either did I.

The Drugs

Yes, I am a baby boomer, like most people from this generation I found that in my youth drugs were readily available. I had no idea that a one-time experiment with IV drugs some twenty years earlier would expose me to such a devastating health risk in the future.

For me, a good Catholic girl-most days, I somehow knew judgment day would one day come. I often asked myself how I escaped the consequences of my youth, I didn't  because in 1999 I was diagnosed with hepatitis C. 


According to Dr. John Ward, hepatitis chief at the Centers for Disease Control and Prevention, one out of every 33 baby boomers are infected with hepatitis C.

Baby Boomers At Risk

Born Between 1945 and 1965
Shared needles or other drug-injection equipment.
Received a blood transfusion, blood product or organ before 1992.
Received a blood clotting product before 1987.

Baby boomers are at risk for contracting the virus through blood transfusions during the 1970s and 1980s. Effective bloodscreening for the virus wasn't developed until a first generation ELISA test was introduced in 1990. Between 1990 and 1992, there were some cases of hepatitis C transmitted through the blood supply as this screening test was not sufficiently sensitive to catch all infected blood. By 1992, a second generation HCV antibody test was introduced which significantly reduced the risk of HCV transmission via the blood supply. Patients who have had a blood transfusion prior to 1992 should be tested for HCV.

The Parents
Twenty or thirty years ago my parents, like the the majority of parents, were oblivious to the magnitude of accessibility our generation had to drugs. I was trusted.

Today parents are not that native, the days of Ward and June Cleaver are long gone. With 24 hour cable news and access to the Internet parents know the score. Awareness for HIV, hepatitis B and C has slowly made its way into the family home.  However, this loud and clear warning of chronic blood borne infections often goes unheard by our youth, just as it did generations earlier.

I have paid dearly for my small moment in time. The upside of my experience? Baby boomers make the best parents, we know how to be an effective " nark ".

The kids that are using right now are not aspiring drug addicts. Frankly, neither were we. These kids start out by experimenting, getting caught up with the feeling they get from the first injection which turns into two, then three, and ends with addiction. As parents it's up to us to stop this downward trend, before history repeats itself. Or has it already?

Hepatitis C Infection Continues In Our Children

Fast forward to March 2012, according to an article published a few days ago-
"The incidence of hepatitis C infection is increasing among adolescents and young adults in Pennsylvania, just as it has in other areas in the United States, according to surveillance data for 2003 through 2010."
During that 7-year period, the number of reports of newly recognized confirmed or probable cases of hepatitis C past or present infection among those aged 15-34 years increased from 1,384 to 2,393, representing a near doubling of the rate of cases (from 43 to 72) per 100,000 population, Dr. Sameh W. Boktor reported in a poster at the International Conference on Emerging Infectious Diseases.
 Continue Reading Here
The Transmission Of Hepatitis C In IV Drug Users

Hepatitis C is nearly 10 times more transmissible by a shared needle than HIV. In the United States, every year 15,000 people are newly infected with hepatitis C through sharing syringes and contaminated injection equipment. Sharing this contaminated equipment can transmit the virus - the first time - or - only time - its used.

Hepatitis C is the most common chronic blood borne infection in the United States, with 35,000 to 185,000 new cases diagnosed per year. Recently the CDC reported that hepatitis C–associated deaths are now more common in the United States than HIV-related deaths.

Why heroin use is once again increasing

One drug of choice is/was Oxycontin, the drug has become known as “Oxy” or “Hillbilly Heroin” and "White Collar" heroin. IV-oxycontin users crush up the pill and inject a diluted Oxycontin mix. To
 discourage misuse of the drug in 2010 the FDA demanded a  new formulation of Oxycontin. The drug manufacturer Purdue Pharma L.P., changed the drug by making it difficult to crush and inject. The pill no longer dissolves in water, instead it becomes a thick goopy material.

In California the prescription pain medication is becoming one of the most abused and misused drugs. On the street the drug is expensive, the price ranges from 20 to 40 dollars a pill. In Ottawa, Canada Oxycontin is the third most common used drug among addicts. The top two drugs are cocaine, including crack cocaine and marijuana.

The difficulty of injecting Oxycontin has played a roll in the increase use of heroin.  Oxycontin users can no longer inject the drug, and heroin isn't as potent when snorted, so IV use increases. In this 2011 video  Dr.Todd S. Carran discusses the rise in heroin use in Ohio, reporting that for adolescents, heroin is as easy to buy as a pack of cigarettes. Reuters reported in 2011 that in Massachusetts hepatitis C infections are increasing in the white youth population, fueled by the increase use of heroin and other injection drugs.

New synthetic drugs

Today heroin is still easily accessible, along with a new list of dangerous drugs including bath salts, spice, salvia and a new synthetic drug known as "Jewelry Cleaner" which also is called, " Eight Ballz" and " Cosmic Blast". More on the drug here.

 I am grateful that the biggest part of my job as a parent is complete. These new drugs, although often not injected have a whole new list of dangers. The only way a parent, loved one, or friend can recognize drug use or addiction, is to become knowledgeable about the drugs available on the streets.

So, we begin with an update below on the health dangers of bath salts. The video and article is from Virginia Commonwealth University. In a study from the University researchers found that "Bath salts can produce similar but stronger effects than off-the-street methamphetamine, cocaine or both.

A few months ago we read about a woman who injected the street drug under the skin causing a flesh-eating disease, read more here at Medscape. Also, over at Medscape is a slide-show to aid clinicians in identifying, and managing this "new face of abused drugs". When I watched the slide-show I thought to myself if clinicians need help, what about the parents. I sort of borrowed the photos, and text, adding them to the blog below.

Bath Salts Update: New Research, New Evolution

Eric Peters
VCU Communications and Public Relations

In 2010, following legislation to halt a nationwide surge in the legal sale and use of synthetic marijuana, a new and far more dangerous group of legal designer drugs emerged.
The use of these new designer drugs, which are commonly referred to as bath salts and still available everywhere from the Internet to convenience stores and head shops, quickly rose to epidemic

 The New York Times reported, “Some of the recent incidents include a man in Indiana who climbed a roadside flagpole and jumped into traffic, a man in Pennsylvania who broke into a monastery and stabbed a priest, and a woman in West Virginia who scratched herself ‘to pieces’ over several days because she thought there was something under her skin.”
The active ingredients in bath salts were identified soon after use began to spread, but studies involving the effects of those chemicals on the brain, especially in tandem with one another, were never extensively explored until now.

Researchers at Virginia Commonwealth University this month presented their findings from such a study, which reveals the neurological reasons bath salts can produce similar but stronger effects than off-the-street methamphetamine, cocaine or both.
While these designer drugs are labeled as bath salts, they are anything but, and were never intended to be used as such.

The two main active ingredients in bath salts are Methylenedioxypyrovalerone (MDPV) and mephedrone, and VCU researchers found that it is the combination of these two chemicals that contributes to many of the negative effects of bath salts.

“It’s like a double punch,” says Louis J. De Felice, Ph.D., one of the researchers on the VCU study. “It’s as if a person were to take methamphetamine and cocaine at the same time.”
The mephedrone acts like methamphetamine by releasing dopamine into the brain while the MDPV acts like cocaine by preventing dopamine from being absorbed back into the brain.
“So that means the dopamine is out there, but unlike in a natural situation, it’s not able to be taken back up again,” explains De Felice.

Additionally, De Felice and colleagues discovered that the excess dopamine is likely to remain, along with the stimulating effects, long after the chemicals were removed.
The researchers at VCU only studied these long-lasting stimulating effects up to 30 minutes after removal of the chemicals, but have additional research planned that might help identify this phenomenon as the reason behind bath salts’ lingering psychotic and physical effects that sometimes last for days or weeks.

It was because of these negative effects that many bath salt variations had been outlawed throughout much of the U.S. by early 2011, but they remained easy to acquire through the Internet. According to the American Association of Poison Control Centers, there were more than 6,000 calls to poison control centers pertaining to bath salts in 2011, more than10 times the number in 2010.
Another problem, says Rutherfoord Rose, Pharm.D., director of VCU’s Virginia Poison Center, is that as soon as one ingredient or designer drug is outlawed, another takes its place.
“Substances like 2ce, 2ci and 25i have become the newest thing since bath salts were outlawed in most states,” he says. “They appear to have similar effects to the ingredients in bath salts, but in some cases we’ve seen the effect to be even more severe, producing refractory seizures, convulsions and bleeding in the brain.”

Rose says when it comes to new drugs like these, as the case once was with bath salts, his center relies on verbal reports from friends and users to identify what has been ingested because labs simply can’t test for new and emerging drugs that haven’t yet been identified and studied.
So the fight continues and researchers such as De Felice and his colleagues push forward, studying, identifying and working as quickly as possible to publish research that sheds light on how and why these chemicals are so dangerous.

The New Face of Abused Drugs
Source- Medscape


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