Taking a Look at Drug Trends
Dr. Jane Maxwell
Senior Research Scientist Gulf Coast Addiction Technology Transfer Center in the Addiction Research Institute
University of Texas at Austin
New drugs, new ways of using old drugs, and new populations of users are constantly emerging. Ecstasy is back as a street drug and it is being used by a very different group than the "ravers" we saw a decade ago. Is there credible information on the effects of Ecstasy use and what protocol should be used to treat users who are experiencing problems? With the limits on the sale of over-the counter cold medications, the methamphetamine situation is changing, and probably not for the better, as smoked Ice has replaced powder methamphetamine. What will happen in the future with methamphetamine and what evidence-based protocol should be used to treat this group? Crack cocaine users now look very different than they did a decade ago. Are our programs able to respond to this new group of users?
"Of particular concern is a growing population of teenagers and young adults in their 20s who are inhaling heroin." About three-quarters of the cannabis users coming into treatment are referred by the criminal justice system. How do we work with the justice system to increase optimal treatment outcomes? There is increasing evidence of co-occurring mental health problems among heavy cannabis users, and we clearly need to expand the concurrent delivery of treatment for both disorders. Abuse of prescription opiates is rapidly escalating, and while attention has been focused on the young, it is also a problem with older adults. What are the addiction concerns for chronic pain patients? Downers, especially the benzodiazepines, are being combined with all sorts of other drugs to achieve euphoria, and club drugs such as GHB and PCP are still on the scene.
Heroin not only remains a problem, but inhalation by teenagers and young adults in their 20s is a deadly problem. Each of these drugs can require very different prevention and treatment techniques and we need to take advantage of the latest research as we work with these users.
Of particular concern is a growing population of teenagers and young adults in their 20s who are inhaling heroin. The proportion of these young people who are Hispanic is increasing, and our intervention efforts need to be culturally appropriate to work with them and their families. In Texas, under the leadership of the Greater Dallas Council on Alcohol and Drug Abuse, a coalition of more than 70 different groups and individuals has come together to organize a community-wide response to the "cheese" heroin overdoses and deaths. This response includes education, prevention, treatment, law enforcement, data collection, recovery programs, media resource development. This is a model for any community coalition.
I feel strongly about getting the word out about the response of this treatment community to aid young persons who are heroin dependent. There has been no research in the last 25 years on treating young users of heroin. Dallas has used a Robert Wood Johnson Advancing Recovery grant to form a coordinated treatment system with inpatient detoxification, residential, and intensive and supportive outpatient services. To retain these youths in treatment, Motivational Interviewing is being used. To help these young people achieve and maintain abstinence from heroin, Suboxone (buprenorphine + naloxone) is being trialed both in detoxification and as an adjunct to residential and outpatient therapies. And special outreach and education about treatment is being targeted to the families of these youths.
For over half a century, the Texas Behavioral Health Institute and its predecessors, the Summer Institute on Alcohol Studies and the Texas Alcohol and Drug Institute have offered unique opportunities to share the latest research with prevention and treatment professionals. It will be held at the Hilton Anatole in Dallas from August 25-29, 2008. There will be three sessions where we will share the current trends and patterns in substance use, the relationship with co-occuring mental health problems, and the need for targeted prevention and treatment.
Drug trends are just a few of the numerous substance abuse and mental health issues to be explored at the Institute, and I look forward to seeing you there. For information on the conference, go to www.texinstitute.com or call 877.451.8700.
Senior Research Scientist Jane C. Maxwell, Ph.D., is with the Gulf Coast Addiction Technology Transfer Center in the Addiction Research Institute at the University of Texas at Austin. Formerly, she was head of research at the Texas Commission on Alcohol and Drug Abuse. She has been a member of the Substance Abuse and Mental Health Services (SAMHSA) National Advisory Council and is a member of the Drug Abuse Advisory Committee to the Food and Drug Administration (FDA) Center for Drug Evaluation and Research, as well as a member of the Reference Group to the United Nations on HIV and Injecting Drug Use. She is also a member of the National Institute on Drug Abuse (NIDA) Community Epidemiology and Border Epidemiology Work Groups, the College on Problems of Drug Dependence, the Research Society on Alcoholism, and the International Council on Alcohol, Drugs, and Traffic Safety. She has been a Fulbright Senior Specialist and is an adjunct professor at the Centre for Accident Research, Queensland University of Technology in Brisbane, Australia. Her research specialties include trends and patterns of substance abuse in Texas, nationally, and internationally, with special interest on the US-Mexico border; research in patterns of use and abuse of methamphetamine, party drugs, methadone, and prescription drugs; impaired driving programs; and the relationship of substance abuse and HIV/AIDS.