Editorial cartoonists did their duty in Australia’s tobacco war

By Jim Gogek

Australia’s plain packaging: Note brand names in the olive drab bar at bottom. That’s all the pack advertising tobacco companies get

By now, we’ve all seen the new generation of pictorial health warnings gracing tobacco packs in enlightened countries, though not yet in the United States, which is falling behind other nations in tobacco prevention. One of the great victories in the war against the global tobacco epidemic has been Australia’s move to plain packaging with graphic warnings for cigarette packs.

In August 2012, the government prevailed in Australia’s highest court against Big Tobacco, which was trying to block plain packaging and pictorial warnings. Big Tobacco knows such warnings are effective. Many studies have shown it, including a study just published in the American Journal of Preventive Medicine showing that graphic health warnings are effective across all socioeconomic and racial lines. This is really important, because special populations have been hardest hit in the global tobacco epidemic, in part because the tobacco industry has been targeting poor people and ethnic groups.

But the gruesome, accurate warnings aren’t the only graphic images used in Australia’s battle against Big Tobacco. Australia’s editorial cartoonists created graphic images of their own:

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Posted in Addiction, Big Tobacco, Cigarette warning labels, Second-hand smoke, Smoke-free, Smoking, Tobacco, Tobacco cessation, Tobacco marketing, Treatment | Tagged , , , , , , , , , , , , , , | Leave a comment

Marijuana legalization: Damn the science, full speed ahead

By Jim Gogek

If tobacco was not legal, and we knew the full scientific extent of its health impacts, would we legalize it today?

Not a chance. A substance that’s dangerously addictive and kills half the people who use it as directed? The FDA would never allow it. But we didn’t know the science hundreds of years ago, and tobacco became a common part of society. It’s too late to illegalize it.

Several states are considering legalization of marijuana. While the federal government has said it will not allow marijuana to be legal, state ballot initiatives notwithstanding, many Americans who would vote to legalize marijuana are doing so without knowing – or without believing – the science about the drug.

While we don’t know the full extent of marijuana’s impacts, we know enough to declare it harmful. Research over the last two decades has dramatically enhanced our knowledge about marijuana.

Here’s a sample of what we know, and the research that shows it. Don’t believe me, though. Read the research for yourself.

Marijuana is linked to a lot of health problems:

  • Hall W, Degenhardt L. Adverse health effects of non-medical cannabis use. Lancet, 2009. “The most probable adverse effects include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health.”

It harms the brain, particularly the adolescent brain:

Marijuana smoke harms the lungs:

And it contains carcinogens:

  • Evidence on the carcinogenicity of marijuana smoke. Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 2009. “…There is some evidence from studies in humans that marijuana smoke is associated with increased cancer risk… the similarities in chemical composition and in toxicological activity between marijuana smoke and tobacco smoke, and the presence of numerous carcinogens in marijuana (and tobacco) smoke, provide additional evidence of carcinogenicity…”

It’s linked to mental illness, especially schizophrenia:

Marijuana use by drivers doubles the risk of car crashes:

No matter what anybody says, marijuana is addictive:

And finally, a big problem for our high-tech, innovation-based economy is that marijuana, frankly speaking, makes you stupid:

The point is this: We’re learning more and more about the impacts of marijuana on disease, mental health, car crashes and education, and it doesn’t look good. We’ll learn more as research continues.

Marijuana may not be as dangerous as tobacco or alcohol, but that’s no reason to legalize it. We already have two harmful, legal drugs in tobacco and alcohol. Why increase the death, disease, disability and economic damage they cause by adding a third one?

Posted in Addiction, Drug abuse, Marijuana, Marijuana legalization, Medical marijuana, MJ lobby, Pot doc, Recovery, Substance abuse, Substance use disorder treatment, Treatment, Weed | Tagged , , , , , , , , , , | Leave a comment

Substance abuse a “crisis” in military; Defense Department response is inadequate and outdated: Report

By Jim Gogek

Two weeks before a high-powered presidential election is probably not the best time to release a major report – if you want anybody to notice it. But the Institute of Medicine, part of the National Academies, just came out with a critically important report on substance abuse in the military, calling the situation a “crisis” that reduces military readiness. And the report shows that the Defense Department’s response is inadequate and outdated.

Could federal lawmakers on the various Armed Forces committees take time out from campaigning to read it?

Entitled “Substance Use Disorders in the U.S. Armed Forces,” the report says that in the Iraq-Afghanistan war era, with longer deployments and greater exposure to combat, military personnel are drinking more and drinking more heavily. At the same time, prescription drug abuse, especially painkillers, is escalating, partly because of increasing prescriptions for chronic pain to cope with the rising number of injuries during a decade of continuous war.

Military physicians wrote nearly 3.8 million prescriptions for pain medication in 2009, more than quadruple the number of such prescriptions written in 2001IOM report

The report, which says the DoD needs to change the entire way it delivers substance use disorder treatment, was funded by the DoD itself. Today, the military relies almost entirely on inpatient treatment; the report recommends employing outpatient treatment because it costs less, is often equally effective and allows people to continue working and living their lives while undergoing treatment. Outpatient treatment has become the mainstay for most civilian health systems.

The report also recommends confidentiality so that more service members will seek help.

Source: IOM report

That would represent a big change in the military environment, but it’s necessary. Other recommendations include:

  • Enforce regulations on underage drinking, reduce the number of alcohol outlets on military bases and limit hours of alcohol sales
  • Improve tracking and reduce access to controlled medications like painkillers
  • Institute effective evidence-based treatment and increase use of technology for prevention, screening, diagnosis and treatment
  • Introduce screening for alcohol abuse in all military healthcare
  • Increase standards of professional training for treatment personnel
  • Use medication-assisted treatment for substance use disorders
  • Integrate substance use disorder treatment with other health care
  • Launch joint effort with VA to raise public profile of treatment and fight stigma
  • Improve data collection on substance abuse in the military

In other words, the military needs to join the 21st century when it comes to substance use disorder treatment. But so do most healthcare systems in America.

Posted in Addiction, Alcohol, Alcohol abuse, Binge drinking, Drug abuse, Drunk driving, Integrated treatment, Military substance abuse, Painkiller abuse, Recovery, Substance abuse, Substance use disorder treatment, Treatment, Uncategorized, Underage drinking | Tagged , , , , , , , , , , , , , , , , | Leave a comment

Alcohol myth busted: Letting youngsters sip alcohol does not teach them to be responsible drinkers

By Jim Gogek

I’ve never been clear where the idea comes from that if you let your young child sip alcohol that he or she will learn how to be more responsible about booze later in life. This falls under the same category that if you go outside with wet hair you’ll catch a cold or if you go swimming less than an hour after eating you’ll get cramps. Yet, a lot of people think that letting kids sip alcohol will avoid a forbidden-fruit response, so they’ll learn how to drink properly — like European youth.

A study by Christine Jackson, Ph.D., of RTI International, published in the Archives of Pediatric and Adolescent Medicine, polled a thousand moms and their 3rd-grade children and found that one in five moms believe that allowing their kids to sip alcohol makes them less likely to experiment with alcohol as teens, and 40 percent think that if they prohibit their children from drinking, it will trigger a forbidden-fruit desire to drink even more. Not surprisingly, the study shows that children whose parents let them sip alcohol are more likely to initiate alcohol use at a younger age, which in turn is linked to greater alcohol problems.

One false belief at play here is that if kids learn to drink responsibly at home, they will also drink responsibly with their friends. It’s amazing to me how many parents entirely forget what it’s like to be a teen-ager. Teens’ behavior among their friends is very different from teens’ behavior at home around their parents. That’s part of being a teen.

European kids may have lower rates of drunk driving problems than US kids. But that’s because they drive less, not because they drink less.

Now what about European youth? Do they really drink more responsibly than US youth because their parents allow them to drink from a young age in a family setting? The fact is that underage drinking problems are worse in Europe than in the United States — and in some Euro countries much worse.

Data comparing drinking among Euro vs. US kids has been followed for years using the European School Survey Project on Alcohol and Other Drugs and the United States Monitoring the Future Survey. The latest examination of this data by Bettina Friese and Joel Grube of the Prevention Research Center looked at 2007 figures and found that most European countries have higher intoxication rates among young people and a greater percentage of young people being intoxicated before age 13 compared to the United States. Three times more kids in the UK and Denmark — and nearly two times as many in Austria, Finland, Ireland and Germany — report getting drunk before age 13, compared to US kids.

So, contrary to the belief of many people, parents letting kids sip alcohol may lead to worse underage drinking problems. And Europe – where kids are allegedly exposed to alcohol at younger ages – has worse underage drinking problems than the United States. Two more ATOD myths exploded by real evidence.

Posted in Addiction, Alcohol, Alcohol abuse, Binge drinking, Recovery, Substance abuse, Underage drinking | Tagged , , , , , , | 3 Comments

Big Tobacco: The biggest and most willing liar

By Jim Gogek

Frank Niles (right) had NOTHING on Big Tobacco when it comes to lying

In the film noir The Naked City, Detective Muldoon tells the smarmy Frank Niles, “…you are probably the biggest and most willing liar I have ever met.”

Muldoon never met the modern day tobacco industry. In its battle against California’s Proposition 29, the $1 sales tax increase on cigarette packs, commercials brought to you by your friends at RJ Reynolds and Philip Morris tell the biggest and most willing lies I’ve ever heard.

LIE: No money will go to cancer

TRUTH: About $440 million will go to research into cures for cancer and other tobacco-related disease. In fact, Prop. 29 will make California the second biggest cancer research funder in the world.

LIE:  It will divert money from our schools

TRUTH: This doesn’t even make any sense. Prop. 29 won’t affect schools except that fewer kids will begin smoking because tobacco will be more expensive

LIE: Wasteful spending creating massive bureaucracy

Truth: Administrative costs are capped at 2%

And on and on. Below is a great interactive graphic on CaliforniasforaCure.org that answers each of Big Tobacco’s lies, and even tells you who those doctors are that shill for the tobacco industry. I’m pretty sure a majority of California voters are smart enough to dismiss Big Tobacco’s lies. In a way, it’s instructive to hear the bold-faced whoppers by Big Tobacco, because now you know how an industry gets fabulously rich selling a product that kills half the people who use it as intended – by lying.

Click for Big Tobacco: Lord of the Lies

Posted in Addiction, Big Tobacco, Second-hand smoke, Smoke-free, Substance abuse, Tobacco, Tobacco and kids, Tobacco lies, Tobacco marketing | Tagged , , , , , , , | Leave a comment

Mentally ill, addicted and tobacco: Public views change slowly as clinicians start taking responsibility for smoking cessation

By Jim Gogek

Outdated views on smoking among the mentally ill and addicted need to be changed.

The new frontier in the war against tobacco is special populations, particularly people with mental disorders, including addiction. Unfortunately, an uninformed, paternalistic public view prevails about smokers with schizophrenia or alcoholism, and it goes like this: “Oh, those poor people. Why don’t you just leave them alone and let them smoke? God knows they’ve got enough problems.”

That presumes, at best, that people with behavioral conditions don’t want to quit smoking or, at worst, that their lives aren’t worth saving. Fortunately, this blindness to the problem of smoking among people with mental illnesses is beginning to clear as reality dawns:

Smoking rate in the general US population is about 20%, although it’s as low as 12% in California

• People with psychiatric diagnoses have much higher rates of smoking and smoke more cigarettes than the general populations. In the United States, 44% of cigarettes are consumed by people with mental illnesses, including substance use disorders. People with serious mental illnesses die on average 25 years earlier than the general population, usually from tobacco-related disorders such as heart and lung disease.

• Alcoholics are three times more likely to smoke than the general population.  Alcoholics are more likely to die from tobacco than from alcohol.

In the past, psychiatrists, drug treatment counselors and other clinicians believed that patient smoking wasn’t their problem. Many still believe that. But a growing number are changing their minds. Drug counselors – many of whom are themselves recovering addicts who smoke – are facing up to the findings that quitting smoking during treatment doesn’t harm recovery and, in fact, may help it. A belief-change is growing among psychiatrists and other clinicians in behavioral health that confronting smoking among patients is part of their job. An editorial in the September 2011 edition of the American Journal of Psychiatry concluded that when a psychiatrist is faced with a patient who smokes, “doing nothing is now unacceptable.”

The editorial categorically rejects those unthinking assumptions that have cost the lives of countless people with mental illnesses:

“These patients do not want to quit.” In fact, they do, and at rates (70%–80%) comparable to those in the general population.

“They are not able to quit.” But many do, and with only slightly less success than the general population.

“If they quit, their mental health or substance abuse conditions will worsen.” Mental health conditions can be stable or even improve, alcoholics who stop smoking are more likely to stay sober, and hospital wards that go smoke-free have fewer aggressive incidents and more staff time freed up for therapeutic encounters.

Excellent support exists for clinicians who want to help patients quit smoking: http://smokingcessationleadership.ucsf.edu/BehavioralHealth.htm

The Smoking Cessation Leadership Center at University of California San Francisco launched a comprehensive effort to train and support behavioral health clinicians in how to help patients quit smoking, including through a good series of newsletters that anybody can subscribe to. Clinicians who are tired of watching their behavioral health patients kill themselves with cigarettes should check it out.

Posted in Big Tobacco, Smoking, Tobacco, Tobacco cessation | Tagged , , , , , , , , , , , , , , , , , , , , , | 1 Comment

After legalization, the powerful marijuana lobby would kill marijuana taxes. Just ask the San Diego City Council…

Would NORML fight for high taxes against the rest of the MJ lobby? Not very likely…

By Jim Gogek

Advocates for legal marijuana promise that we could tax the heck out of it to pay for any costs it might create, such as the costs of treating the increased number of people addicted to marijuana.

But something happened in San Diego that should make you wonder about such claims. The City of San Diego recently voted for minor regulations on medical marijuana dispensaries to limit them to commercial and industrial zones and keep them at least 600 feet from schools, playgrounds, libraries, child care facilities, parks and churches. Sounds reasonable, right?

Not to the pro-marijuana folks. They quickly got up 46,000 signatures to reverse the regulations and put them on the ballot instead. Citizens for Patient Rights, the Patient Care Association of California and the California Cannabis Coalition raised nearly $150,000 to hire a professional signature-gathering firm. But the City Council says it probably won’t spend the necessary $3 million for an election over these restrictions, not when the city is practically bankrupt. So instead, restrictions on medical marijuana dispensaries will likely be rescinded.

Moneyed special interests always have their own way in California, and marijuana already is a moneyed special interest. It will become an extremely wealthy and powerful industry if marijuana is legalized. Marijuana taxes would be killed by the marijuana industry, just like alcohol and tobacco taxes have always been killed by the powerful alcohol and tobacco industries. Marijuana legalization advocates promise they will support high taxes on marijuana. But San Diego couldn’t even restrict pot dispensaries from opening up near schools without a deadly backlash from the marijuana lobby. What chance would marijuana taxes have?

Posted in Addiction, Marijuana, Marijuana legalization, Medical marijuana, MJ lobby, Recovery, Substance abuse | Tagged , , , , , , , , , , , , , , | 5 Comments