Narconon PSA  

Cindy McCain's well-publicized addiction to prescription painkillers cost a doctor his medical license and led to the shutdown of the charity where she illegally obtained her drugs, the Washington Post reported Sept. 12.

McCain has publicly acknowledged her addiction and recently has said that she plans to raise awareness about the issue if her husband, John McCain, becomes president. "I think [recovery] made me a better person as well as a better parent, so I think it would be very important to talk about it and be very upfront about it," McCain said, pledging to "to talk about it as much as possible because I don't want anyone to wind up in the shoes that I did at the time."

Less widely discussed, however, is the damage that McCain's addiction in the late 1980s and early 1990s caused to others. McCain convinced a doctor with the charity she founded, the American Volunteer Medical Team, to write phony prescriptions for prescription painkillers in the names of three staff members and give her the drugs. The staff members didn't know their names were being used.

The charity, which sent volunteer doctors and nurses on overseas mercy missions, kept supplies of prescription drugs like Vicodin, Percoset and Tylenol 3 to support its charitable mission.

After a Drug Enforcement Administration (DEA) investigation, the doctor, John Max Johnson, lost his medical license and has never practiced medicine again. The publicity and controversy around the McCain case also led to the charity shutting down.

Cindy McCain's parents confronted her about her addiction in 1992, and her recovery began shortly thereafter. However, in 1993 a former employee told the DEA about the drug diversion, and McCain was soon facing federal charges of falsely obtaining prescription drugs, which could have led to a 20-year prison sentence. A plea deal allowed her to avoid the charges and enter a diversion program, where she attended treatment and performed community service.

Researchers at Imperial College London demonstrated a method for the treatment of acute pain by using cannabis in ways that will not affect the brain, Science Daily reported Sept. 14. 

The study showed that drugs targeting CB2 cannabinoid receptors -- found in the peripheral nervous system but not in the human brain -- can block the transmission of pain signals. Previous studies have focused primarily on the cannabis-activated CB1 receptors, which are involved in pain relief but are located in the brain and thus prone to side-effects and potential abuse.

The mechanism by which CB2 receptors provide pain relief is similar to the way opiate receptors work under the effects of morphine, and may be an alternative acute-pain treatment, the researchers found.  "It suggests we could alleviate pain by targeting the cannabinoid receptor CB2 without causing the kinds of side-effects we associate with people using cannabis itself," said lead study author Uma Anand.

Further clinical trials of drugs that target the CB2 receptors are planned. The research appears in the September 2008 issue of the journal Pain.

Amid growing reports of patient deaths and complications caused by problems with legally prescribed pain medication, the Food and Drug Administration (FDA) is discussing the possibility of requiring doctors to receive specialized training before prescribing narcotics, the New York Times reported Aug. 16.

The imposition of license requirements such as continuing education on physicians is generally the responsibility of state medical boards, but the FDA is looking into this area because state boards have done little to require training in prescribing pain medication. The federal agency is expected by early next year to release some recommendations, which also may include requiring drug makers to engage in more monitoring of how their products are prescribed.

Federal officials have been frustrated that advisories they have sent to physicians about prescribing dangers associated with the drugs methadone and fentanyl do not appear to be lowering the number of adverse incidents resulting from improper prescribing.

"We are putting out communications," said Gerald Dal Pan, M.D., director of the FDA's office of surveillance and epidemiology. "We don't know why they are failing."

Physicians generally are required only to demonstrate proof of their license in order to receive federal authorization to prescribe narcotics. Some pain management experts fear that if these requirements were made significantly more stringent, some physicians would stop prescribing altogether and consumers would have fewer options for pain management treatment. 

A survey of 12-to-17-year-olds conducted by the National Center on Addiction and Substance Abuse (CASA) at Columbia University revealed that teens are finding it increasingly easy to obtain prescription drugs, and "problem parents" may be contributing to their teens' drug use, the Washington Post reported August 14.

When asked "Which is easiest for someone your age to buy: cigarettes, beer, marijuana, or prescription drugs such as OxyContin, Percocet, Vicodin or Ritalin, without a prescription?" 19 percent responded that it was easier to find prescription drugs, compared to 13 percent one year ago. Marijuana remains an easy-access drug for teens, with 43 percent of seventeen-year-olds claiming the drug could be purchased within an hour.

The study also found a correlation between the degree of parental awareness of their teenager's nighttime activity and an increase in illegal and prescription drug use. Of those teens out after 10 pm, one half claim to be with people smoking and taking drugs.

"Half of the teenagers were saying they were out on school nights, but only 14 percent of the parents knew that they were out," said Elizabeth Planet, CASA's director of special projects and the study's coordinator. "There are lots of factors at play here. Parents are not paying attention. There are parents who are out in the evening themselves. There are parents out at work."

Joseph Califano, chairman and president of the center, warns of the danger of parents becoming "passive pushers," as evidenced by the statistic showing that 34 percent of teenage prescription drug abusers obtain them in the home.

"This is a very different generation of children," said Stephen Pasierb, the president of Partnership for a Drug-Free America. "Prescription drugs are entrenched, and they have not moved for five years, and this generation of parents simply [does] not understand the problem."

Parents are less likely to be aware of a younger child’s cigarette and alcohol use than that of an older child, according to analysis of multiyear data from the National Survey on Drug Use and Health (NSDUH).

Less than half of mothers knew that their 12- to 14-year-old child had used cigarettes (42%) or alcohol (33%) in the past year, compared to 57% and 61%, respectively, of mothers of 15- to 17-year-olds.

In contrast, age made no difference for the mother’s awareness of marijuana use -- less than half (41%) of parents of both younger and older children were aware of their child’s marijuana use. Similar results were found for fathers.

These findings illustrate the need for parent-oriented substance abuse prevention programs, with a particular need for alcohol and tobacco education for parents of middle school age youth.