By DAMIEN CAVE
NY TIMES
Saturday, June 14, 2008

MIAMI — From “Scarface” to “Miami Vice,” Florida’s drug problem has been portrayed as the story of a single narcotic: cocaine. But for Floridians, prescription drugs are increasingly a far more lethal habit.

An analysis of autopsies in 2007 released this week by the Florida Medical Examiners Commission found that the rate of deaths caused by prescription drugs was three times the rate of deaths caused by all illicit drugs combined.

Law enforcement officials said that the shift toward prescription-drug abuse, which began here about eight years ago, showed no sign of letting up and that the state must do more to control it.

“You have health care providers involved, you have doctor shoppers, and then there are crimes like robbing drug shipments,” said Jeff Beasley, a drug intelligence inspector for the Florida Department of Law Enforcement, which co-sponsored the study. “There is a multitude of ways to get these drugs, and that’s what makes things complicated.”

The report’s findings track with similar studies by the federal Drug Enforcement Administration, which has found that roughly seven million Americans are abusing prescription drugs. If accurate, that would be an increase of 80 percent in six years and more than the total abusing cocaine, heroin, hallucinogens, Ecstasy and inhalants.

The Florida report analyzed 168,900 deaths statewide. Cocaine, heroin and all methamphetamines caused 989 deaths, it found, while legal opioids — strong painkillers in brand-name drugs like Vicodin and OxyContin — caused 2,328.

Drugs with benzodiazepine, mainly depressants like Valium and Xanax, led to 743 deaths. Alcohol was the most commonly occurring drug, appearing in the bodies of 4,179 of the dead and judged the cause of death of 466 — fewer than cocaine (843) but more than methamphetamine (25) and marijuana (0).

The study also found that while the number of people who died with heroin in their bodies increased 14 percent in 2007, to 110, deaths related to the opioid oxycodone increased 36 percent, to 1,253.

Florida scrutinizes drug-related deaths more closely than do other states, and so there is little basis for comparison with them.

It has also witnessed several highly publicized cases in recent years that have highlighted the problem. Only last year, an accidental prescription drug overdose killed Anna Nicole Smith in Broward County.

Still, the state has lagged in enforcement. Thirty-eight other states have approved prescription drug monitoring programs that track sales. Florida lawmakers have repeatedly considered similar legislation, but privacy concerns have kept it from passing.

As a result, federal, state and local law enforcement officials say, Florida has become a source of prescription drugs that are illegally sold across the country.

“The monitoring plan is our priority effort, but that is not enough,” William H. Janes, the Florida director of drug control, said in a statement accompanying the study. He said Florida was also looking at ways to curb illegal Internet sales and to encourage doctors and pharmacists to identify potential abusers.

Some local police departments have taken a more novel approach.

In Broward County on May 31, deputies completed a “drug takeback” in which $5 Wal-Mart, CVS or Walgreens gift cards were distributed to 150 people who cleaned out their medicine cabinets and turned in unused drugs in an effort to keep them out of young people’s hands.

“The abuse has reached epidemic proportions,” said Lisa McElhaney, a sergeant in the pharmaceutical drug diversion unit of the Broward County Sheriff’s Office. “It’s just explosive.”

BBC News | Friday, June 29, 2007

A legal challenge to the government’s smoking ban in England has been launched at the High Court.

Freedom To Choose says the change in the law from 1 July contravene the European Convention on Human Rights.

A judge will now decide whether they have a case raising genuine issues of law that should go to a full trial.

The government said it would vigorously fight any challenge to the ban, which applies to almost all enclosed public places and workplaces.

‘Test case’

Freedom To Choose lodged a petition for a judicial review of the legislation at the Royal Courts of Justice in London.

The group cites Article One of the First Protocol of the European Convention on Human Rights which assures the right to the peaceful enjoyment of possessions. It also points to Article Eight which covers the right to respect for privacy.

“This will be a legal test case with significant wider public interest,” says the group, which is spearheaded by pub landlord Robert Feal-Martinez.

“We want the government to realise a total ban is not necessary,” said Mr Feal-Martinez, who argues that ventilation systems can reduce the harmful impact of second-hand smoke.

The group’s legal case has been funded entirely by public donations, gathered through its website and public events.

Somewhat confusingly, there is another anti-smoking campaign called Freedom2Choose, started by the managing director of Blackpool-based tobacco vending machine supplier Duckworth.

They are not involved with the current legal action.

The smoking ban in England follows similar moves in Scotland, Northern Ireland and Wales.

Associated Press | Thursday, June 28, 2007
By LINDSEY TANNER
AP Medical Writer

CHICAGO (AP) — The American Medical Association on Wednesday backed off calling excessive video-game playing a formal psychiatric addiction, saying instead that more research is needed.

A report prepared for the AMA’s annual policy meeting had sought to strongly encourage that video-game addiction be included in a widely used diagnostic manual of psychiatric illnesses.

AMA delegates instead adopted a watered-down measure declaring that while overuse of video games and online games can be a problem for children and adults, calling it a formal addiction would be premature.

“While more study is needed on the addictive potential of video games, the AMA remains concerned about the behavioral, health and societal effects of video game and Internet overuse,” said Dr. Ronald Davis, AMA’s president. “We urge parents to closely monitor children’s use of video games and the Internet.”

Despite a lack of scientific proof, Jacob Schulist, 14, of Hales Corners, Wis., says he’s certain he was addicted to video games - and that the AMA’s vote was misguided.

Until about two months ago, when he discovered a support group called On-Line Gamers Anonymous, Jacob said he played online fantasy video games for 10 hours straight some days.

He said his habit got so severe that he quit spending time with family and friends.

“My grades were horrible, I failed the entire first semester” this past school year because of excessive video-game playing, he said. “It’s like they’re your life.”

Delegates voted to have the AMA encourage more research on the issue, including seeking studies on what amount of video-game playing and other “screen time” is appropriate for children.

Under the new policy, the AMA also will send the revised video-game measure to the American Psychiatric Association, asking it to consider the full report in its diagnostic manual; the next edition is to be completed in 2012.

Dr. Louis Kraus, a psychiatric association spokesman, said the report will be a helpful resource.

The AMA’s report says up to 90 percent of American youngsters play video games and that up to 15 percent of them - more than 5 million kids - might be addicted.

The report, prepared by the AMA’s Council on Science and Public Health, also says “dependence-like behaviors are more likely in children who start playing video games at younger ages.”

Internet role-playing games involving multiple players, which can suck kids into an online fantasy world, are the most problematic, the report says. That’s the kind of game Schulist says hooked him.

Kraus, chief of child and adolescent psychiatry at Chicago’s Rush Medical Center, said behavior that looks like addiction in video-game players may be a symptom of social anxiety, depression or another psychiatric problem.

He praised the AMA report for recommending more research.

“They’re trying very hard not to make a premature diagnosis,” Kraus said.

In other action on the final day of the AMA’s annual policy meeting, delegates:

- Voted to have the AMA support government policies requiring fast-food restaurant chains to provide menus detailing nutritional information including calories, fat and sodium content. A key way to fighting the obesity epidemic “is that people know what they’re eating,” Davis said.

- Recommended more research on a potential link between high fructose corn syrup and obesity. A measure had sought to have the AMA seek government restrictions on the popular sweetener and food labels declaring that excessive consumption of it may lead to obesity.

- Rejected a move to lobby for limits on the noise levels of in-ear headphones used with iPods and other music-playing devices. A resolution supporting limits said devices with in-ear headphones can generate sound well above 100 decibels - more noise than a chain saw makes and levels that have been linked with permanent hearing loss. AMA delegates voted instead to seek more research on the issue.

Children are developing diseases because adults light up in front of them

Denis Campbell, health correspondent
The Observer
Sunday, June 24, 2007

Children are contracting serious illnesses because of their parents smoking at home, says the government’s chief medical officer, who has warned adults not to light up in front of their sons and daughters.

In an interview with The Observer, Sir Liam Donaldson, Britain’s most senior doctor, pledged that there would be a further sustained crackdown on smoking after the ban comes into force in England next Sunday.

He promised renewed public health advertising campaigns to try to educate parents who smoke. ‘We will strengthen and make regular the message to parents about the risks to their children of smoking. This is something we will need to constantly remind them about.

‘The dangers of parents smoking in front of their children are increased risk of respiratory diseases, bronchitis, middle ear infections, asthma attacks in children that are prone to asthma and increased risk to babies if there is a pregnant person in the household.

‘While the number of parents who smoke is falling, children’s exposure to parental smoke remains “a problem area”, he said.

Future plans to restrict smoking include

· Removing cigarettes from public display;

· Putting graphic picture warnings on cigarette packets showing the health effects of smoking, including blocked arteries, rotten teeth and gangrene;

· Outlawing the sale of packets of 10 cigarettes to deter consumption, especially among children;

· Reducing the number of cigarettes that Britons can bring into the country from inside the EU from 3,200 to 200.

The number of Britons who smoke has fallen to 24 per cent and ministers hope going smoke-free will over time bring about another 4 or 5 per cent drop. ‘But if we want to go further we have got to reinforce all these other tobacco measures and denormalise smoking completely,’ said Donaldson.

‘The first of July is not when action stops; it’s a launchpad from which we can make further massive strides. I hope people will be behind some of the slightly controversial measures.’

He wants cigarettes to be hidden away in shops. ‘If you walk into the average supermarket one of the things that confronts you straight away is a wall of cigarettes. That’s unhelpful. I’d like to see them remove the wall of cigarettes and keep them under the counter,’ said Donaldson.

‘Some people would resent the idea of cigarettes being kept under the counter like magazines that you wouldn’t want displayed. But I think that these are all part of the denormalisation process. Supermarkets are big, responsible organisations which already try to help on things like obesity. Wouldn’t they like to strike another blow for health and play their part on a disease that still kills over 100,000 a year?’

Health campaigners last night welcomed Donaldson’s pledges. Professor John Britton, a consultant in respiratory medicine and chair of the Royal College of Physicians’ tobacco advisory group, said: ‘If you take care of your child and do the things responsible parents do, such as making sure your child is safe in the car, to then smoke in the same building as them is irrational and irresponsible. To do that is a serious assault on the children’s health and wellbeing.’

Dr Vivienne Nathanson, head of science and ethics at the British Medical Association, said ensuring cigarettes became an under-the-counter product would help reduce smoking among children. ‘We know that there’s a potent link between children recognising cigarette packets, for example through their colours, and starting to smoke,’ she said. ‘So the less they see, the less they will recognise and the less likely they will be to see tobacco as an aspirational product.’

Simon Clark, director of smokers’ rights group Forest, criticised the proposals. ‘It’s wrong to draw an automatic correlation between children seeing parents smoke and then assuming that they will take up smoking. There’s a generation of people today who grew up in an era when a lot of adults smoked yet many of them are non-smokers. It’s incredibly hypocritical of government to try to denormalise smoking and vilify smoking and imply that it’s an anti-social activity given the enormous amount of tax the government makes from tobacco.’

BBC | Wednesday, June 6, 2007

People on anti-HIV drug Viracept are being warned batches of the therapy may have been contaminated with potentially cancer-causing chemicals.

The Medicines and Healthcare products Regulatory Agency put out the alert after makers Roche moved to recall all batches of the drug in circulation.

The watchdog said patients prescribed the drug should “contact their doctor immediately” to change medication.

It is thought there are about 550 people using the drug in the UK.

Roche said contamination had been caused by “human error”.

Viracept, also known by the generic name nelfinavir, works by reducing the amount of virus in the body.

The drug is a protease inhibitor, a class of drugs that helped revolutionise HIV treatment in 1990s.

Such drugs slow down or prevent damage to the immune system, and reduce the risk of developing Aids-related illnesses.

Viracept received marketing approval in the US in March 1997 and in the European Union in January 1998.

It is licensed for use in combination with other anti-retroviral drugs.

The MHRA said there were fears the drug had been contaminated with a genotoxic substance, which is one that can affect the genes and potentially cause cancer.

Reports

A spokeswoman for Roche said there was no indication that the contamination was deliberate.

“Roche has received several reports that some batches of Viracept 250 mg tablets have a strange odour.

“A detailed chemical analysis of the affected tablets showed they contain higher than normal levels of methane sulfonic acid ethylester.

“In the interest of patients safety Roche has decided to recall all batches of Viracept tablets and powder.”

Roger Pebody, treatment adviser for the Terrence Higgins Trust, said the drug was in one of the older classes and was not widely used in the UK now.

He said missing just one dose could lower the effectiveness of the overall course of treatment.

“These people have probably been on the drug for several years and it has worked well for them so they have had no reason to change it.

“It is essential that people who are taking it go to their doctor immediately in the next day and work out with their doctor the best way to proceed.”