The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.
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Esketamine for Treatment-Resistant Depression — First FDA-Approved Antidepressant in a New Class
Treating major depressive disorder remains an important challenge worldwide. The disorder impairs productivity, social functioning, and overall health, reducing life expectancy and burdening health care systems.1 Although many treatments exist, at least a third of patients do not have a response after two or more trials of antidepressant drugs and are considered to have treatment-resistant depression.2 Such patients have an increased risk of suicide relative to both the general population and patients with nonresistant major depressive disorder; at least a third of them attempt suicide.3
The FDA recently approved the S-enantiomer of ketamine, esketamine, a rapidly acting drug shown to be effective in patients with treatment-resistant depression.
Balancing these potential risks with the benefits of an effective drug for a serious disease for which there is substantial unmet need, the FDA approved esketamine with a Risk Evaluation and Mitigation Strategy (REMS). The intent of the REMS is to mitigate the risk of serious adverse outcomes resulting from sedation, dissociation, and abuse and misuse, while providing access to this effective treatment for treatment-resistant depression. Esketamine will be dispensed and administered to patients only in a medically supervised health care setting where they can be monitored for adverse reactions for at least 2 hours; pharmacies that dispense esketamine must ensure that the drug is dispensed only to clinics and hospitals that are certified in the REMS.
Learn About E-Cigarettes!
Electronic cigarettes, or e-cigarettes, were invented in 2003 by Chinese inventor and pharmacist Hon Lik. Although many companies and advocates continue to bill them as a safer, smokeless alternative to traditional cigarettes, a U.S. Surgeon General report alarmingly found that 16% of high school students regularly use e-cigarettes. What’s worse, many young people who begin using nicotine through e-cigarettes will start to use traditional cigarettes later, according to the National Institute on Drug Abuse.
Smokers need help to quit, and those who can’t quit deserve a safer alternative. However, there’s a growing body of research indicating that e-cigarettes do more harm than good, and the companies selling them shamelessly advertise these products to youth in order to attract lifelong, valuable customers in ways that tobacco companies are prohibited from doing:
- E-cigarette companies use candy and fruit flavors that are known to attract youth.
- They spend millions of dollars on aggressive marketing tactics.
- They spend millions more lobbying to stop life-saving regulations.
- They produce their own research, claiming that e-cigarettes pose only a minimal risk to users despite having no long-term evidence to make that claim.
- And, their products only minimally increase the number of smokers who are able to quit.
We support the Food and Drug Administration’s crackdown on e-cigarettes because with millions of teens using e-cigarettes every year, this is the beginning of an epidemic of nicotine addiction, and we invite you to learn more about these new nicotine delivery systems from the resources below.
Launched by the U.S. Surgeon General's office, Know the Risks: E-Cigarettes & Young People has quick and ready access to information about what e-cigarettes are, the trends in use, why they're bad for youth, and much more.
The National Institute on Drug Abuse provides this fact sheet about e-cigarettes, which includes their effects on teens, how teens are using them, the link between e-cigarette use and traditional cigarette use, and information about nicotine addiction.
The US Opioid Crisis is more than it appears!
The Institute for Behavior and Health is pleased to share with you an interview of IBH President Robert L. DuPont, MD featured in Opioid Watch of The Opioid Research Institute:
Cost Legal Cannabis ILLINOIS - REPORT
Conclusion: USA – Illinois: Even under this conservative scenario, and omitting important cost centers such as long-term health costs, marijuana legalization will cost Illinois approximately $670.5 million in 2020, significantly more than the $566 million in revenues that pro-legalization activists project.
The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime
March 6, 2018 - Abstract
Naloxone access may unintentionally increase opioid abuse through two channels: (1) saving the lives of active drug users, who survive to continue abusing opioids, and (2) reducing the risk of death per use, thereby making riskier opioid use more appealing. By increasing the number of opioid abusers who need to fund their drug purchases, Naloxone access laws may also increase theft. We exploit the staggered timing of Naloxone access laws to estimate the total effects of these laws. We find that broadening Naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality.
Nutrition in Addiction Recovery
This document has been prepared to educate people about how drugs and alcohol can disrupt the normal functioning of the body and how better nutrition can help diminish some of these biochemical and digestive problems. This document only focuses on one specific component of a comprehensive recovery treatment program—better nutrition. It is not intended to be used as a substitute for a doctor’s advice or as a recovery treatment program.
Beyond Supply: How We Must Tackle the Opioid Epidemic
Email the author MD A. Benjamin Srivastava, Mark S. Gold, MD
Department of Psychiatry, Washington University School of Medicine, St Louis, MO
The opioid epidemic is the most important and most serious public health crisis today. The effects are reported in overdose deaths but are also starkly evident in declines in sense of well-being and general health coupled with increasing all-cause mortality, particularly among the middle-aged white population.1 As exceptionally well described by Rummans et al in this issue of Mayo Clinic Proceedings, the cause of the epidemic is multifactorial, including an overinterpretation of a now infamous New England Journal of Medicine letter describing addiction as a rare occurrence in hospitalized patients treated with opioids, initiatives from the Joint Commission directed toward patient satisfaction and the labeling of pain as the “5th vital sign,” the advent of extended-release oxycodone (OxyContin), an aggressive marketing campaign from Purdue Pharma L.P., and the influx of heroin and fentanyl derivatives.
To date, most initiatives directed toward fighting the opioid initiatives, and the focus of the discussion from Rummans et al, have targeted the “supply side” of the equation. These measures include restricting prescriptions, physician drug monitoring programs, and other regulatory actions. Indeed, although opioid prescriptions have decreased from peak levels, the prevalence of opioid misuse and use disorder remains extremely prevalent (nearly 5%). Further, fatal drug overdoses, to which opioids contribute to a considerable degree, continue to increase, with 63,000 in 2016 alone.6 Thus, although prescription supply and access are necessary and important, we need to address the problem as a whole. To this point, for example, the ease of importation and synthesis of very cheap and powerful alternatives (eg, fentanyl and heroin) and the lucrative US marketplace have contributed to the replacement pharmacy sales and diversion with widespread street-level distribution of these illicit opioids; opioid-addicted people readily switch to these illicit opioids.
A complementary and necessary approach is to target the “demand” side of opioid use, namely, implementation of preventive measures, educating physicians, requiring physician continuing education for opioid prescribing licensure, and addressing why patients use opioids in the first place. Indeed, prevention of initiation of use is the only 100% safeguard against addiction; however, millions of patients remain addicted, and they need comprehensive, rather than perfunctory, treatment. Rummans and colleagues are absolutely correct in their delineation of the unwitting consequences of a focus on pain, given that a perceived undertreatment of pain fueled the opioid epidemic in the first place. They are correct to point out how effective pain evaluation and treatment are much more than prescribing and should routinely include psychotherapy, interventional procedures, and nonopioid therapies. In addition, we have described the crossroads between pain and addiction as well as successful strategies to manage patients with both chronic pain syndromes and addiction.
The Key Role of Prevention In Addressing the Current Landscape of Substance Abuse in America: A Perspective
Presented 2018 Annual PREVENTION DAY February 2018
Elinore F. McCance-Katz, MD, PhD – Assistant Secretary for Mental Health and Substance Use
Substance Abuse and Mental Health Services Administration (U.S. Department of Health and Human Services)
Reducing Addiction Must Begin with Youth Prevention
Iceland knows how to stop teen substance abuse but the rest of the world isn’t listening!
Today, Iceland tops the European table for the cleanest-living teens. The percentage of 15- and 16-year-olds who had been drunk in the previous month plummeted from 42 per cent in 1998 to 5 per cent in 2016. The percentage who have ever used cannabis is down from 17 per cent to 7 per cent. Those smoking cigarettes every day fell from 23 per cent to just 3 per cent.
The way the country has achieved this turnaround has been both radical and evidence-based, but it has relied a lot on what might be termed enforced common sense. “This is the most remarkably intense and profound study of stress in the lives of teenagers that I have ever seen,” says Milkman. “I’m just so impressed by how well it is working.”
If it was adopted in other countries, Milkman argues, the Icelandic model could benefit the general psychological and physical wellbeing of millions of kids, not to mention the coffers of healthcare agencies and broader society. It’s a big if.