Day: December 4, 2017

Doctors across the U..S could soon be prescribing formerly illegal drugs as therapy for two hard-to-treat diseases – childhood epilepsy and Post-Traumatic Stress Disorder. A growing body of scientific evidence is leading the U.S. Food and Drug Administration to take a closer look at cannabidiol, an extract of marijuana, and MDMA, an ingredient in the party drug ecstasy.

The makers of a cannabidiol product named Epidiolex have now completed all three phases of FDA-approved clinical studies. The submission for FDA approval includes clinical data on 1,500 patients, 400 of whom had used it for more than a year. If it is approved, Epidiolex could be part of the legal arsenal for treating epilepsy within a year.

MDMA

The Multidisciplinary Association for Psychedelic Studies (MAPS) is a non-profit organization focused on beneficial medical uses of psychedelics and marijuana. It funded six Phase 2 FDA-approved clinical studies of MDMA combined with therapy for treating Post-Traumatic Stress Disorder. The only PTSD medicines currently approved by the FDA usually don’t work well, says Boulder, Colorado, psychiatrist Will Vanderveer, “and leave millions of people still symptomatic and suffering. And dying from suicide.”

Vanderveer worked with psychotherapist Marcela Ot’Alora, the study’s principal investigator, on the three-month long protocol, which included a monthly dose of MDMA and weekly therapy sessions. There were 28 participants. When they were given MDMA, therapists stayed with them during the eight hours the drug was active, helping them recall past traumas in a more effective way.  

Ot’Alora says the MDMA promoted trust with the therapists, and the insights gained were profound.

“It could be crying, it could be even screaming. They realize, ‘wow, I was completely going away and dissociated from the experience, and now I see what was really happening.’ Anger can come up, really getting in touch with the anger at what was done to them.”

Karen, one of the participants, was plagued by nightmares and dread after being sexually abused as a child. She says that decades of therapy and anti-depressant drugs did not help, but this protocol did.

“I don’t walk around just thinking I’m garbage anymore. You know, I feel like, wow, you know, I’m kind of a good person here.” James was a combat medic, and returned from a tour of duty in Afghanistan with PTSD. He tried a number of different therapies, but still felt like he was in a dark cave, with no way out. Then he found the MDMA study. In an on-line documentary about the study, he describes the drug as “a kind of light,” and the therapists as “guides. And I could see around the cave and figure out how to get out of there. It was really helpful.”  

The MDMA plus therapy protocol eliminated symptoms in nearly 70 percent of the participants previously diagnosed with treatment resistant PTSD.  The final step before requesting FDA approval as a prescription medicine is Phase Three trials, which are scheduled to begin next year.
…

NASA has nailed an engine test on a spacecraft 13 billion miles away.

Last week, ground controllers sent commands to fire backup thrusters on Voyager 1, our most distant spacecraft. The thrusters had been idle for 37 years, since Voyager 1 flew past Saturn.

To NASA’s delight, the four dormant thrusters came alive. It took more than 19 hours — the one-way travel time for signals — for controllers at the Jet Propulsion Laboratory in Pasadena, California, to get the good news.

Engineers wanted to see if these alternate thrusters could point Voyager 1’s antenna toward Earth, a job normally handled by a different set that’s now degrading. The thrusters will take over pointing operations next month. The switch could extend Voyager 1’s life by two to three years.

Launched in 1977, Voyager 1 is the only spacecraft traveling through interstellar space, the region beyond our solar system. Voyager 2 is close on its heels — nearly 11 billion miles from Earth. The thruster test worked so well that NASA expects to try it on Voyager 2. That won’t happen anytime soon, though, because Voyager 2’s original thrusters are still working fine.

The Voyager flight team dug up old records and studied the original software before tackling the test. As each milestone in the test was achieved, the excitement level grew, said propulsion engineer Todd Barber.

“The mood was one of relief, joy and incredulity after witnessing these well-rested thrusters pick up the baton as if no time had passed at all,” he said in a statement.

The twin Voyagers provided stunning close-up views of Jupiter and Saturn. Voyager 2 also offered shots of Uranus and Neptune.
…

Governments must do far more to include the needs of young people in the global fight against HIV and AIDS, according to a new report. Despite progress in tackling the disease, it is estimated that 1,700 new HIV infections occur every day among young people around the world, and the problem is particularly acute in Africa.

It is time policymakers recognized that HIV-positive adolescents face unique challenges, says the report from the London School of Hygiene and Tropical Medicine, alongside the charity Sentebale.

Among the recommendations are that young people receive adequate psychosocial support; a human rights-based approach to testing and care, and finding ways to sensitively discuss sex and relationships for adolescents living with HIV, the virus that causes AIDS.

​Professor Rashida Ferrand, who co-authored the research, says too many barriers are in place.

“We really need to be thinking about all the barriers at every step in that broad environment, both at facility level in clinics et cetera, but also recognizing the fact that most of the time young people do not spend in facilities. So, we have to think of modifying the environments and the barriers that those environments place,” Ferrand said.

Campaigners say many adolescents in Africa are unaware of their HIV status and are afraid to get tested.

‘Every single day I face stigma’

Twenty-three-year-old Masedi Kewamodimo was born with HIV. Both her parents died from AIDS. Growing up in her native Botswana, Masedi grew frustrated with the barriers she faced and decided to reveal her HIV status in order to campaign for better treatment.

“It is one of the most difficult things I have faced in my whole life. Every single day I face stigma.  People talk about it because one they fear it; two, they assume certain people within our society have it; and three, they feel like they cannot welcome people who are living with HIV and AIDS,” Kewamodimo told VOA.

The charity Sentebale, which helped put together the policy recommendations, was co-founded by Prince Harry, who is newly engaged to American actress Meghan Markle. She has also campaigned on health issues in Africa.

Earlier this year, the prince chaired a meeting in London on adolescents with HIV, titled “Let Youth Lead,” and called for a change in global education on the disease.

“Young people, the first time they know of the first time they hear anything about HIV and AIDS is probably by the time it is too late.  Whether it is in the education system here in the UK, whether it is across Africa, whether it is across the world, HIV needs to be treated exactly the same as any other disease,” Prince Harry said.

Campaigners hope the royal couple’s star power will help them spread the vital message that young people’s needs and fears must be addressed in the global drive to tackle HIV and AIDS.
…

A growing body of scientific evidence is leading the U-S Food and Drug Administration to take a closer look at two illegal drugs that the federal government deems to have “no currently accepted medical use.” Now both are nearing the finish line for potential approval, as legal prescriptions for the treatment of childhood epilepsy and post-traumatic stress disorder. From Boulder, Colorado, Shelley Schlender reports.
…

Anthony walks the streets of Philadelphia’s Kensington neighborhood looking for two competing things: His next heroin fix – and help in what he says is his struggle to end addiction.

He traces the habit to one fateful day.

“I shattered my leg and I was on oxycodone pain medication prescribed through my doctor,” recalls the 28 year-old, who asked for anonymity to share his story. “I withdrew so bad, a friend put me on heroin and it’s been a slippery slide for five years.”

He ended up in Kensington, a predominantly Hispanic neighborhood where drug users can find some of the cheapest and purest heroin in the country. The area is also home to unscrupulous healthcare providers who continue to over-prescribe opioid medications. 

Open drug use occurs within easy view of storefronts. Teenagers riding their bikes pass addicts in zombie-like states on the sidewalks and porches. Kensington is a destination for heroin users from afar. Many end up staying to feed their addiction.

“We have not only people from other parts of the state, we have people from other parts of the country who come here,” said Drug Enforcement Administration (DEA), Special Agent Patrick Trainor. “Unfortunately, it’s sparked a heroin tourism industry,”

The drug epidemic is not a new phenomenon for Kensington. For decades, it’s contended with addicts. More than half the population lives below the poverty line, 2.5 times the rate of the rest of Philadelphia. The wide availability of prescription opioids from healthcare providers, along with the influx of individuals from outside the community, has made matters dramatically worse.

In 2017, a deal was reached by city officials to clear out an open air heroin market known as El Campamento, or “The Tracks.”

It existed beneath sunken train tracks, hidden from street level. The property was riddled with syringes and all kinds of drug paraphernalia.

People in the area regularly died from drug overdoses. At times, 75 to 125 opioid addicts lived there in makeshift homes.

“It was contained,” said Councilwoman Maria Quinones Sanchez, who represents the Philadelphia district that includes Kensington. “But now it’s out in the open and people are kind of struggling about dealing with the problem. What are we going to do with it? Because this problem is not going to go away in the next six months or in the next year,” said Sanchez.

Pure Heroin Fills the Streets of Kensington

The attraction of Kensington is simple: cheap and powerful heroin primarily piped in by Mexico’s Sinaloa cartel. And in the streets of Kensington, drug dealers compete with one another to sell heroin, some laced with fentanyl, a synthetic opioid.

“In order to compete, you have to have the purest stuff on the street, we’ve seen purity levels in Philadelphia around 93% at times, and that’s street purity level,” said (Drug Enforcement Administration) DEA Special Agent in Charge Gary Tuggle. “So in order to compete with that, many groups have started to adulterate that 50% [of heroin] or so with fentanyl. Often not recognizing the fact that fentanyl is 80 to 100 times more powerful than morphine, 50 to 80 times more powerful than heroin.”

Davey, a 31-year-old heroin addict knows firsthand how strong, and dangerous, the fentanyl laced drug can be. “I had a good friend, the bag was empty, I scraped an empty bag for him, some grains, and just a tiny amount and he overdosed,” Davey said. “That’s just how powerful it is.”

Philadelphia recorded 900 overdose deaths in 2016. Officials say the city is on track for at least 1,200 deaths in 2017. Overdoses are the number one cause of death in Philadelphia for every age group from 25 to 44, the number two cause from age 45 to 54, and the number three cause from age 55 to 64.

“It’s extraordinary to have an epidemic like this appear on leading causes of death,” said Dr. Thomas Farley, Philadelphia’s Health Commissioner. “The problem is not only not slowing down, but it’s accelerating. There are not enough beds for addicts he said.

“I lived through the worst drug epidemics in the country’s history. The post-Vietnam heroin epidemic, the crack cocaine epidemic of the ‘80s and early ‘90s and then there’s this particular opioid epidemic that dwarfs the other two,” Tuggle said.

“It has a feeder system to it that the others didn’t have. And that’s the misuse and abuse of prescription opioids,” Tuggle said.

“We still have a major focus on the enforcement piece, but we also engage with the community in prevention and education to try to drive down that insatiable demand for opioids that exists in this country,” said Tuggle. The engagement includes non-traditional partnerships within the public health sector such as treatment providers and medical examiners where they analyze data to assist in explaining the drug epidemic trends.

Councilwoman Sanchez wants all sectors working together to ensure those who understand what is happening are the ones leading the fight. “We now have to have the political will to sit all of those actors at the table and say, ‘OK, how do we work our way backwards,” she said.

The biggest obstacles are lack of treatment facilities and housing for addicts and others. Estimates suggest that 30,000 heroin addicts are in Philadelphia, currently, only half would have access to proper treatment.

“Not all people who are drug users have housing, and housing is often a part of treatment. It’s hard for people to get treatment if they are living on the street,” said Dr. Farley. 

A Community Connected beyond the Drug Epidemic

On a recent walk down Kensington Avenue, Sanchez recalls growing up in the neighborhood and her commitment to the people.

“All I see is people who survive despite circumstances that are sometimes created outside of their control, and those are the folks that I represent,” she said. “And so my job is to be the cheerleader for those folks who work really hard and despite all the situation, whether it’s the teacher, principal, the librarians, you know, the folks that are here.”

Convenience store owner Sam Kuttab said things have improved some. He plans to stay in Kensington.

“About 10 years ago we had a big fire here and the insurance company paid us good money,” Kuttab said. “We could have just taken the money and moved on. But we felt there is a community here, there’s a community here that really appreciated our services, and we appreciated them. So we put our money back into this neighborhood, and it’s paid off,” he said.

Officials recognize there are obstacles, but unless they do something impactful more people will die in Kensington and Philadelphia.
…

President Trump’s opioid commission is calling for more federal funding to battle addiction and deadly opioid drug-related overdoses in the United States. More than 175 Americans are dying every day and the Trump administration has declared the opioid crisis a “public health emergency”. VOA’s Chris Simkins takes us to a hard hit Philadelphia neighborhood where the opioid epidemic is on open display.
…