Assessing Drinking Risks
The National Institute of Alcohol Abuse and Alcoholism (NIAAA) has created a new website called "Rethinking Drinking," designed to help users define their drinking patterns and develop strategies and options for dealing with alcohol-related problems. Please follow the link below for more information.
Drug Screening
This website is a service provided by
Join Together, a national project of the Boston University School of Public Health.
This website does not provide a diagnosis of alcohol/drug abuse or dependence. It cannot tell people for certain whether or not they have a problem. Rather, DrugScreening.org is a self-screening tool to help adults assess their own drug and alcohol use, and find out their likely risk level for experiencing harms to their health or other negative consequences. Through education and referral, it urges those whose drug and alcohol use is likely to be harmful or hazardous to seek further evaluation from a qualified professional.
Drug and alcohol misuse and dependence are major public health problems, resulting in more than 100,000 deaths per year in the United States and costing the healthcare system billions of dollars annually. Drug and alcohol problems are a major cause of injuries, violent crime, lost productivity at work and school, family and social problems, injuries, and disease.
CESAR
FAX
U n i v e r s i t y o f M a r y l a n d , C o l l e g e P a r k
A Weekly FAX from the Center for Substance Abuse Research
June 2, 2008
Vol. 17, Issue 22
What is a waterpipe?
A waterpipe, also known as a hookah, is a long-necked device used to smoke tobacco. The tobacco is indirectly heated in a bowl, often using a quick-lighting charcoal, and the smoke is filtered though water. What are other names for a waterpipe?
Hookah, hubblebubble, nargile, argileh, shisha, boory, and goza(and various spellings of these terms) are all names for a waterpipe. What type of tobacco is smoked in a waterpipe?
The most common waterpipetobacco in the United States is maassel(also spelled mu'essel, mu'assel; sometimes referred to as shisha), a tobacco sweetened with honey or molasses that is available in a variety of flavors, including apple, banana, strawberry, chocolate, mint, coffee, rose, and vanilla. Tobacco-free herbal maasselis also available. One bowl of maasselwill typically last 30-45 minutes when smoked in a waterpipe. Where can you buy a waterpipeor maassel?
Waterpipesand maasselare widely available for purchase on the internet and in certain retail establishments, such as hookah lounges and Middle Eastern markets. The same age restrictions that apply to purchasing other tobacco products (18 or older in most states)also apply to purchasing waterpipesand maassel. Online prices for packaged maasselrange from $7 to $20 for 250g, which will fill approximately 20-30 bowls. Maasselis also sold in single-serve packages ("shots") for less than $1 each. Who uses waterpipes?
Waterpipeusers are primarily young adults between the ages of 18 and 25, particularly college students. Surveys estimate that between 15% and 20% of college freshmen have used waterpipesin the past month. Where are waterpipesused?
Waterpipesare generally used in a group setting, either in a private residence or a public hookah lounge (also called hookah bars or cafes). Hookah lounges are an increasingly popular alternative to bars and clubs, as they may be open later hours (e.g., until 4:00 a.m.) and are open to those who are under 21. Most hookah lounges require customers be of legal adult age, but some establishments that sell herbal maasselmay have a lower minimum age. Several online hookah bar directories are available (e.g., www.hookah-bars.com, www.hookahculture.com), and an informal review found that the cost for the use of a hookah and a bowl of maasselat hookah bars range from $5 to $20. What are the perceptions of the harm of waterpipeuse?
The majority of waterpipesmokers believe that waterpipesmoking is less harmful than cigarette smoking. For example, most beginning waterpipesmokers (90%) believe cigarette smoking is more addictive than waterpipesmoking. Another survey found that 83% of waterpipeusers believed a cigarette smoker who switched to waterpipeuse would experience a small to moderate reduction in health risks. These findings are of concern, since perceptions of low risk are often related to higher prevalence of use. What are the health effects?
The next issue of the CESAR FAXwill review current research on the health effects of waterpipeuse, including misconceptions that may contribute to the growing popularity of hookah smoking.
Nationwide Public Health Alert Issued Concerning Life-Threatening Risk Posed by Cocaine Laced with Veterinary Anti-Parasite Drug
The Substance Abuse and Mental Health Services Administration (SAMHSA) is alerting medical professionals, substance abuse treatment centers and other public health authorities about the risk that substantial levels of cocaine may be adulterated with levamisole- a veterinary anti-parasitic drug. There have been approximately 20 confirmed or probable cases of agranulocytosis (a serious, sometimes fatal blood disorder), including two deaths, associated with cocaine adulterated with levamisole. The number of reported cases is expected to increase as information about cocaine adulterated with levamisole is disseminated.
“SAMHSA and other public health authorities are working together to inform everyone of this serious potential public health risk and what measures are being taken to address it,†said SAMHSA Acting Administrator Eric Broderick, D.D.S., MPH.
Levamisole is used in veterinary medicine and is currently approved for use in cattle, sheep and swine as an anti-parasitic agent. Although it was once used in human medicine in the past for treating autoimmune diseases and cancer, it is no longer an approved drug for human use.
Ingesting cocaine mixed with levamisole can seriously reduce a person's white blood cells, suppressing immune function and the body's ability to fight off even minor infections. People who snort, smoke, or inject crack or powder cocaine contaminated by levamisole can experience overwhelming, rapidly-developing, life threatening infections. Other serious side effects can also occur.
According to the Drug Enforcement Administration and State testing laboratories, the percentage of cocaine specimens containing levamisole has increased steadily since 2002, with levamisole now found in over 70 percent of the illicit cocaine analyzed in July. In addition, a recent analysis in Seattle, Washington found that almost 80 percent of the individuals who test positive for cocaine also test positive for levamisole.
According to the SAMHSA alert substance abuse treatment providers, clinicians, outreach workers, and individuals who abuse cocaine need to be aware of the following:
A dangerous substance, levamisole, is showing up with increasing frequency in illicit cocaine powder and crack cocaine. Levamisole can severely reduce the number of white blood cells, a problem called agranulocytosis. THIS IS A VERY SERIOUS ILLNESS THAT NEEDS TO BE TREATED AT A HOSPITAL. If you use cocaine, watch out for:
* high fever, chills, or weakness
* swollen glands
* painful sores (mouth, anal)
* any infection that won’t go away or gets worse very fast, including sore throat or mouth sores -skin infections, abscesses -thrush (white coating of the mouth, tongue, or throat) -pneumonia (fever, cough, shortness of breath).â€
SAMHSA is working with the U.S. Centers for Disease Control and Prevention (CDC), the Drug Enforcement Administration, the Food and Drug Administration, the Office of National Drug Control Policy, and other federal and international organizations, as well as state agencies to monitor the levamisole issue. CDC will be publishing a case report analysis in the Morbidity and Mortality Weekly Report (MMWR) and will be working with state health departments to systematically collect information on cocaine-associated agranulocytosis cases. Information from this effort will be used to guide treatment and prevention initiatives to address this public health concern.
Individuals are encouraged to report suspected and confirmed cases of agranulocytosis that are associated with cocaine abuse to their respective state health departments. Cases can also be reported to local Poison Control Centers (1-800-222-1222), these centers may also provide assistance in clinical management and additional reporting.
For further medical/technical information, contact Nicholas Reuter, SAMHSA (Nicholas.reuter@samhsa.hhs.gov).
