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NEW YORK (Reuters Health) - Infants born to women with substance abuse problems will fare better if their mothers undergo treatment for these problems early in pregnancy, according to the largest study to date to investigate this issue.

In fact, they did just as well as babies born to mothers who didn’t have issues with drug or alcohol use on nearly all of the measures the researchers looked at, Dr. Nancy C. Goler of The Permanente Medical Group in Vallejo, California, and her colleagues found.

"It is time for our nation to look at the issue of substance abuse in pregnancy with a non-judgmental, coordinated, effective intervention that all pregnant women can easily access," they write in the Journal of Perinatology. Such treatment should become the "national standard," Goler and her team urge.

Kaiser Permanente Northern California (KPNC) screens pregnant members for substance abuse with questionnaires and urine tests and offers "state of the art" treatment through its Early Start program, the researchers explain in their report. Women identified as having problems receive care from a specialist in both prenatal care and substance abuse treatment who is based at her local Woman’s Health Clinic.

To evaluate the program’s effectiveness, the researchers looked at outcomes for 49,985 women who underwent screening at KPNC clinics from January 1, 1999 to June 1, 2003. They compared four groups: the 46,553 women who screened negative for substance abuse problems (control group); 2,073 who screened positive and underwent treatment; 1,203 with substance abuse problems who were assessed as part of the Early Start program but weren’t treated; and 156 who tested positive for substance abuse but weren’t assessed or treated.

Most women in each of the four groups received the same amount of prenatal care, but the control and treatment groups were more likely to begin prenatal care before 13 weeks of pregnancy than women in the other two groups.

The rates of 8 of the 10 maternal or fetal complications the researchers evaluated were similar for the control group and the group of women who received treatment. However, infants born to treated women were slightly more likely to be low birth weight or to require admission to the newborn intensive care unit.

Infants born to women treated for substance abuse were less likely to require assistance in breathing shortly after birth than babies born to women with substance abuse issues who weren’t assessed or treated, Goler and her colleagues found. And fewer of these infants were preterm or low birth weight.

Rates of these and other complications for babies born to mothers who were assessed but not treated for substance abuse were generally between those of the treated women and those who weren’t assessed or treated.

Substance-abusing women who weren’t assessed or treated were significantly more likely than any other women in the study to develop a serious pregnancy complication called placental abruption. Their risk was nearly seven times as great as that for women in the control group. The fetuses of these women also were 16 times more likely to die in utero compared to the control group, while rates of fetal death for women who were assessed or assessed and treated weren’t significantly different from the control group.

Before KPNC initiated its Early Start program, Goler and her team point out, women diagnosed with substance abuse issues were referred to outside treatment programs, but typically didn’t show up for these appointments.

The Early Start model of care "affords women easy access to the program by removing both the physical and emotional barriers that can be overwhelming in pregnancy," the researchers conclude.

The skyrocketing use and abuse of prescription narcotics in Las Vegas is accompanied by a similarly startling increase in the number of fatal overdoses, a Sun analysis has found.

Fatal overdoses involving prescription painkillers more than quadrupled in a decade and now exceed those involving illicit drugs, according to data compiled by the Clark County coroner’s office.

The trend reflects the extraordinarily high use of narcotic painkillers by Nevadans. The Sun reported Sunday that its analysis of Drug Enforcement Administration data shows that Nevadans per person use more hydrocodone — the potent ingredient in the drugs Vicodin, Lortab and Norco — than residents of any other state. Nevadans rank fourth nationally in per person consumption of methadone, morphine and oxycodone, the main ingredient in OxyContin.

The increased use and availability of the drugs are primary factors in the rise of addiction, illegal distribution and fatal overdoses, experts say.

In 1997, there were 57 fatal overdoses in Clark County in which prescription narcotics were a contributing factor, a rate of about five per 100,000 people. In 2007, 258 people died in Clark County from overdoses of prescription narcotics, a rate of 13 per 100,000 people.

In contrast, the number of deaths caused by illicit drugs has plateaued. Street drugs such as cocaine, methamphetamine and heroin were involved in a combined 197 fatal overdoses in 2007.

Deaths involving prescription narcotics exceeded or rivaled those caused by firearms (321) and motor vehicle accidents (234) in Clark County in 2007.

Clark County Coroner Mike Murphy called the prescription drug deaths a “dire situation.”

Doctors who specialize in pain management, and pharmaceutical companies that make the drugs, emphasize that many people are helped by prescription narcotics while acknowledging that a small percentage may become addicted.

Prescription drug overdoses draw national attention when the victims include such celebrities as Heath Ledger and Anna Nicole Smith, but aside from the sensational anecdotes, little is reported about the overall toll of overdoses.

Poisoning, usually caused by unintentional drug overdose, is the second leading cause of injury death in the United States, surpassing firearms in 2004, according to the National Center for Health Statistics.

Prescription narcotics deaths accounted for 56 percent of poisoning deaths nationally in 2005, according to the Centers for Disease Control and Prevention, and their absolute number increased by 84 percent from 1999 to 2005.

Some regional data compiled by medical examiners further illustrate the problem:

• In King County, Washington (Seattle), prescription opiates killed 148 people in 2006, a 572 percent increase since 1997.

• In Virginia, prescription narcotics took 399 lives in 2006, compared with 146 deaths from cocaine and amphetamines.

• In Oklahoma, of 603 drug-related deaths in 2006, more than half, 327, were attributed to hydrocodone, methadone or oxycodone.

• In Florida, people who died of drug overdoses in 2007 had prescription drugs in their systems more often than illicit drugs.

No prescribed narcotic is involved in more deaths among Nevadans than methadone. The long-acting painkiller was named in a third of the 1,771 prescription drug overdoses in Clark County from 1991 to 2007, according to the Clark County coroner’s office. The number of deaths involving methadone climbed from three in 1993 to 20 in 1998 and 105 in 2007. (Cocaine was a factor in 116 Clark County deaths in 2007.)

Methadone, widely used to wean addicts off other drugs, has grown in popularity as a painkiller in recent years. Several doctors said it’s preferred by insurance companies because it’s inexpensive — though insurers dispute this, saying there are many low-cost generic narcotics so there would be no reason to favor methadone.

But methadone is a challenging drug to prescribe because it stays in a person’s system for five to 11 days, even after its effects have worn off, said Las Vegas pain specialist Dr. Jim Marx. That means a patient could take multiple doses of methadone over time to keep pain in check, allowing potentially lethal amounts of the drug to build up in the body. In comparison, hydrocodone leaves the body within hours.

“It’s trickier to prescribe because of its persistence,” Marx said.

Methadone deaths have increased more than those involving any other narcotic, the Centers for Disease Control and Prevention reports.

Its data show Nevada had almost four methadone deaths per 100,000 people from 1999 to 2005, the fourth-highest rate in the United States, behind Maine, Utah and Washington.

The CDC said it’s hard to determine whether the increase in opioid-related deaths is due to prescribing practices, a failure by patients to take drugs properly, or illegal abuse.

CDC medical epidemiologist Leonard Paulozzi told Congress in March the drug overdose deaths correspond to the rapidly rising rates of prescription narcotic use reported by the Drug Enforcement Administration, and the overdose deaths are expected to continue.

Statistics through 2005 “probably underestimate the present magnitude of the problem,” Paulozzi said.

•••

There are many ways to get prescription narcotics illegally, said Matt Alberto, deputy chief of investigations for the Nevada Public Safety Department, the state’s lead prescription drug policing agency.

Unscrupulous doctors sell prescriptions for cash. Abusers shop for doctors who prescribe narcotic painkillers without asking many questions. Children fish around in their parents’ medicine cabinets. Patients forge prescriptions. Pharmacy workers, clinic workers and hospital employees steal the drugs.

The most notorious criminal case of a doctor in Las Vegas illegally providing narcotic drugs involves Dr. Harriston Bass Jr., who, according to evidence at his trial, made house calls to prescribe and distribute prescription narcotics.

Bass drove to patients’ homes, conducted 10-minute exams and then sold the patients two or three bottles of 100 pills each — even though he had no license to distribute controlled substances, according to testimony at his trial. He also wrote prescriptions for patients to fill at pharmacies.

Among his patients was Gina Micali, who received about 300 hydrocodone tablets from Bass every other month, plus a prescription for another 180 and one refill. On each visit she also received the muscle relaxant Soma and the anxiety medication Xanax, plus prescriptions for each. In pills and prescriptions, Bass sold Micali a total of about 1,400 pills per visit, said Conrad Hafen, the chief deputy attorney general, who prosecuted the case.

On Oct. 5, 2005, Micali, 38, died after ingesting too many painkillers she got from Bass.

Hafen told the jury that when police searched Bass’ home, they found $150,000 in cash and large quantities of hydrocodone in bottles labeled with the name of his company — DOCS-24-7 — and a wholesale prescription drug company in Illinois.

Alberto said the Illinois company offered no good explanation for why it was selling drugs to a doctor who didn’t have clearance from the Drug Enforcement Administration.

In March, Bass was convicted of second-degree murder in Micali’s death and was found guilty on more than 50 drug-related charges. He was sentenced to 25 years to life in prison.

A more typical case of illegally diverting prescription painkillers involves Stephanie Ortiz, a former pharmacy technician at four Smith’s grocery stores in Las Vegas. She admitted to the pharmacy board that she gave unauthorized refills of Lortab — a painkiller made with hydrocodone — and free drugs to friends posing as patients. Ortiz filled out refill requests but never faxed or phoned them to physicians for approval, the complaint against her says. She admitted illegally diverting 10,680 doses of the painkiller.

In a letter she wrote admitting her guilt, Ortiz says she started giving the purloined drugs to people she knew, and then got text messages and phone calls saying a random person would come by for another pickup. In exchange for the drugs, Ortiz said, she received VIP tables at nightclubs and access to hotel rooms on busy weekends.

Authorities say young people are cavalier with prescription drugs, sharing them among themselves or sneaking them from their parents and passing them around to their friends. Such a transaction ended in death two years ago this week in Mesquite.

According to an affidavit filed by the Nevada Public Safety Department, Brett Sawyer, 19, was found dead in his bedroom on July 8, 2006. Hidden in a gym bag by his bed was an empty bottle of hydrocodone pills prescribed by a dentist in St. George, Utah, to one of his friends.

Sawyer’s family told investigators he was a drug user. “Brett was the type — if one aspirin worked, three would work better,” his mother said.

Police learned that Sawyer was addicted to OxyContin and often obtained drugs from Cody Morris, who was also an addict and dealt the drugs to his friends.

On July 7, 2006, Morris sold Sawyer three 80 mg OxyContin pills — what some call the Cadillac of prescription narcotics — for $45 each. Morris said he warned Sawyer not to take more than one at a time and to avoid mixing them with alcohol.

Sawyer was dead the next day.

Morris pleaded guilty to manslaughter and was sentenced to three years’ probation.

Alberto, the investigator, said it’s as common for drug dealers to sell prescription narcotics as it is methamphetamine or cocaine — and more profitable. An ounce of methamphetamine might sell wholesale in Las Vegas for $700, he said, but the same weight in OxyContin pills would be $3,000. He guessed the illegal abuse of prescription painkillers could account for 10 percent of the state’s total use.

Alberto laments that policymakers and the public are focused on street drugs, and virtually ignore the dangers in people’s medicine cabinets. Narcotics investigators for Metro Police do not investigate prescription drug dealing and deal with the drugs only on a reactive basis, a spokesman said.

Yet prescription narcotics are becoming more popular than marijuana for new abusers. The 2006 National Survey on Drug Use and Health found that among new drug abusers, 2.2 million people chose prescription painkillers and 2.1 million preferred marijuana.

Nothing stimulates the brain with pleasure more than drugs. But doctors disagree about the threat of drug addiction. People at risk of becoming addicted to them range from 3 percent to 18 percent of the population, depending on the study or the expert.

Prescription narcotics can change the brain’s chemistry, creating a physical and psychological dependence that compels addicts to forgo career, children, money, sleep, sex and all-around well-being in pursuit of the drug of choice.

Officials with the Nevada Substance Abuse Prevention and Treatment Agency say the rise in prescription narcotic addiction in the state cannot be quantified because of the way records are kept. Nationally, a 2006 Substance Abuse and Mental Health Services Administration survey showed that an estimated 5.2 million people 12 and older took narcotic painkillers for nonmedical purposes 30 days before the survey, up from about 4.4 million in 2002.

People seem to think that because the drugs are commercially manufactured and approved by the Food and Drug Administration, their abuse is less risky than that of illicit drugs, said Steve Pasierb, president of the Partnership for a Drug-Free America.

“This is a deadly behavior,” Pasierb said of the drug abuse. “When prescription drugs are abused in the same way as illegal street drugs, they’re every bit as addictive and they’re every bit as deadly.”

(CNN) — The transitional year between child and teenager is crucial in fighting teen drug use, according to a new survey.

The research by the Columbia University’s National Center on Addiction and Substance Abuse found age 12 to 13 to be a time when children are increasingly exposed to drugs and often moving away from the control and influence of their parents.

"In no other year do teens’ perceptions and attitudes shift so markedly," the center said.

The survey found a 13-year-old is three times more likely than a 12-year-old to know how to buy drugs. It also found about twice as many 13-year-olds do not have adult supervision at home after school.

"America’s children have been crying out for help and not enough people are listening," said the center’s president, Joseph A. Califano Jr.

The annual survey of 1,000 teen-agers, 824 teachers and 822 principals found for the fourth year, teens believed drugs were their most pressing problem. In all, 39 percent of 17-year-olds said they drank alcohol, 23 percent said they smoked in the last 30 days, and 41 percent said they have smoked marijuana.

Teenagers who used one substance such as alcohol were more likely to use another such as marijuana, and marijuana uses were more likely to drink.

The survey documented a wide gap between the students and principals in perceived drug use in their schools. More than half of teen-agers and 41 percent of teachers said the drug problem at their schools is getting worse, but just 15 percent of principals saw an increasing problem.

Eighteen percent of principals, compared with 78 percent of teen students, said their schools were not drug-free.

"Principals make monkeys of themselves as they reveal their see no evil, hear no evil, speak no evil posture," said Califano, a former secretary of Health, Education and Welfare in the Carter administration.

The survey did find some hopeful statistics. It reported teen-agers who attend religious services are less likely to smoke cigarettes or marijuana or spend time with those who do.

It also found teen-agers who have never smoked marijuana are more likely to heed their parent’s opinions.

NEW YORK (AP) — Steven Tyler sought the "safe environment" of rehab last month to recover from more than just surgery — the Aerosmith frontman now says was fighting a dependency on pain and sleep medication.

"To have your feet done, to have your leg done, you have to be on narcotics," Tyler told The Associated Press on Friday. "You have to be on sleep aids at night. I don’t know about Joe (Perry) but I was off and running and I didn’t like the me that was me."

Tyler released a statement in late May saying he checked into a rehab facility in search of a "safe environment" to recover from several foot surgeries and physical therapy. Tyler said the procedures were to correct longtime foot injuries resulting from his physical performances as the singer for the blues-rock band.

"This was a month ago, so I just put the brakes on and checked into detox and just pulled the plug on all of it," he told the AP on Friday night at the Hard Rock Cafe in Times Square, where he and bandmates were promoting "Guitar Hero 3: Aerosmith."

The 60-year-old was known for heavy drug and alcohol abuse in the 1970s and early 1980s, but completed rehabilitation in 1986, after which Aerosmith enjoyed a successful revival.

WASHINGTON (AP) — Many of the nation’s estimated 10.8 million underage drinkers are turning to their parents or other adults for free alcohol.

A government survey of teens from 2002 to 2006 said slightly more than half had engaged in underage drinking.

Asked about the source of alcohol, 40 percent they got it from an adult for free over the past month, the survey said. Of those, about one in four said they got it from an unrelated adult, one in 16 got it from a parent or guardian and one in 12 got it from another adult family member.

Roughly 4 percent reported taking the alcohol from their own home.

"In far too many instances parents directly enable their children’s underage drinking — in essence encouraging them to risk their health and well-being," said acting Surgeon General Steven K. Galson. "Proper parental guidance alone may not be the complete solution to this devastating public health problem — but it is a critical part."

The nationwide study by the Substance Abuse and Mental Health Services Administration, being released Thursday, tracks the social contexts involved in underage drinking, a problem leading to thousands of alcohol-related traffic deaths and injuries each year.

About one out of five of those aged 12 to 20 — or roughly 7.2 million people — said they had taken part in binge drinking, defined as consuming five or more drinks on at least one occasion in the past month, the survey said. Rates were significantly higher if they lived with a parent who engaged in binge drinking.

The study, which uses data from the National Surveys on Drug Use and Health, is based on a scientific random sample of 158,000 people aged 12 to 20 in the United States. Among the other findings:

• Over half of current underage alcohol users were at someone else’s home when they had their last drink, while 30.3 percent were in their own home. About 9.4 percent were at a restaurant, bar or club.

• About 3.5 million teens aged 12 to 20 each year meet the diagnostic criteria for having an alcohol use disorder, such as dependence or abuse.

• Among younger teens, slightly more girls reported drinking than boys did. In the middle teens, they drank at roughly the same rate. Among 18 to 20-year-olds, boys outpaced the girls.

• Rates of underage drinking and binge drinking were slightly higher at the opposite ends of the economic spectrum.

• Rates of current and binge alcohol use among 12 to 20 year olds were higher in the Northeast and Midwest than in the South or West.

• Rates of alcohol use disorder among those aged 12 to 20 was higher for American Indians or Alaska Natives (14.9 percent) than for whites (10.9 percent), blacks (4.6 percent), Hispanics (8.7 percent) and Asians (4.9 percent).

"This report provides unprecedented insight into the social context of this public health problem and shows that it cuts across many different parts of our community," said Terry Cline, administrator of SAMHSA. "Its findings strongly indicate that parents and other adults can play an important role in helping influence — for better or for worse — young people’s behavior with regard to underage drinking."

The prescription drugs allegedly found in Al Gore III’s possession this week are favorites among young people, according to drug abuse experts, who say prescription drugs may soon overtake street drugs in popularity.
 

Some young people perceive that prescription drugs are safer than street drugs, experts say.
 

"I wouldn’t be surprised if right now at this point in time, there are more kids abusing prescription drugs than abusing marijuana," said Joseph A. Califano Jr., chairman and president of CASA, the National Center on Alcohol and Substance Abuse at Columbia University.
 

Gore was arrested on charges of possessing — in addition to marijuana — Vicodin, Xanax, Valium and Adderall.
 

According to a CASA report, between 1993 and 2005 the proportion of college students abusing Vicodin and other opiods went up 343 percent, about 240,000 individuals. The numbers increased 450 percent, or by 170,000 students, for tranquilizers such as Xanax and Valium, and 93 percent, or 225,000 students, for stimulants, including Adderall.
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Prescription drug abuse is particularly common among upper middle class students, according to Lisa Jack, a clinical psychologist at Augsburg College in Minneapolis, Minnesota.
 

"It just goes to show that where you’re from doesn’t matter," Jack said.
 

And young people don’t have to go far to get these drugs. "Prescription drugs are very easy for kids to get," Califano said. "They can get them from the Internet. They can get them from their parents’ medicine cabinets. They can get them from their friends."
 

He said often students get them from friends who were prescribed these drugs legitimately.

"Kids sell them to each other," Jack said. "Drug trading happens all the time."
 

Experts say it’s particularly a problem with Adderall, a drug prescribed legitimately to millions of young people with attention-deficit hyperactivity disorder.
 

According to CASA, more than a third of children ages 11-18 in Wisconsin and Minnesota who’d been prescribed Adderall and other ADHD medications reported being approached to sell or trade their drugs.
 

And often they say yes, according to one Canadian study that found one out of four teens who’d been legitimately prescribed Ritalin gave or sold some of their drugs.
 

Another appeal to prescription drugs, besides the easy access, is that young people often perceive them as safer.

"They don’t have to go to the streets and deal with some guy they don’t know and get marijuana where they don’t know what’s in it," Califano said. "Also, they see their parents using these drugs, so they seem safe."

Jack said prescription drugs can be more challenging to treat than addiction to street drugs. "In traditional drug abuse, addicts can say, ‘I’ve been using meth or coke or pot,’ and an addiction specialist knows what to do," she said. But with prescription drugs, "sometimes the kids don’t even know what they’ve been taking. They just pass the pills around."
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Part of the solution would be for drug makers to formulate their products so they’re harder to abuse, said Califano, adding that anti-drug campaigns also should focus more on prescription drug abuse.

Parents need to do their part as well, he said. "When I was a kid in Brooklyn, when parents had liquor, they locked up the liquor cabinet," he said. "Maybe parents need to lock up the medicine cabinet."