Outpatient treatment now available with private insurance and other forms of payment

Youth Bridge, Inc. announces that the agency is now taking Medicaid, ARKids 1st, forms of private insurance and alternative payment options for outpatient treatment. The Medicaid approval will ensure all teens and their families can access all mental health programs offered at the agency. Youth Bridge provides individual and family counseling in the following areas: grief counseling, anger management, depression, anxiety, adjustment issues, stress management, physical and emotional abuse, drug and alcohol abuse, behavioral issues and personality disorders. Through Youth Bridge’s continuum of care the agency is also able to provide psychiatric evaluations, treatment for severe and persistent mental illness and medication management.

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Recently published research shed light on the impacts that drug use by friends, parents and siblings have on drug use later in a person’s life. The study focused on the specific effects that marijuana use by significant others has on adult marijuana use in the 4th decade of life (31-37 years of age), the impacts were compelling and they were profound. Reviewed in the Journal of the Addictions [1], the study evaluated the impacts that marijuana use by parents, spouses, brothers, sisters and peers had on an individual’s propensity to use marijuana a later in life. Addiction professionals have known anecdotally that relapse and a person’s later life use of a particular drug of abuse is influenced by whether or not important people in their life also used. Studies reviewed in past issues of the MEDTOX DAR quarterly newsletter have illuminated the role that peers have in the drug use habits of adolescents and young adults, it’s axiomatic that peer pressure is uniquely powerful in its ability to prompt teenagers to experiment and later regularly use drugs like alcohol, marijuana, methamphetamine and cocaine.

This study isolated four separate variable forces of influence and ranked each for its predictive power in the establishment of mid-adulthood marijuana use. Further work will need to be done to establish whether there is a clear causal relationship between one and the other however. The independent variables were established as: (1) History of parental marijuana use, (2) Sibling marijuana use, (3) Peer marijuana use and (4) Significant other (spouse etc.) marijuana use. The least predictive factor in this study was history of parental marijuana use. The strongest factor was that of peer marijuana use, something that most parents and teachers would vouch for. Not too far behind peer marijuana use was that of sibling marijuana use. The lessons from this extensive survey are obvious. Guiding youngsters in the selection of their friends, clearly communicating values and expectations to kids are vital towards good judgment used in the selection of their friends. Who kids hang out with is an area of worthy study and concern for parents. As it is, it’s important for parents to not use drugs around their kids as well. These concepts would seem to be self-evident, but not until data hits paper and then gets published do adults really pay attention. But as life rolls on, it’s important to keep an eye on our kids’ friends and acquaintances. Companions who are known marijuana users continue to influence an adult’s decision to use marijuana later in life. Considering the compelling scientific evidence that marijuana has long-term deleterious effects on the brain, we should do all we can to dissuade a friend or family member from using the drug.

[1] Brook JS, Zhang C, et. al. Pathways from earlier marijuana use in the familial and non-familial environments to self-marijuana use in the fourth decade of life. Am J Addict 2008; 17: 497-503

Reproduced with permission from The MEDTOX® Journal

When a lab report informs you that a particular sample that you’ve submitted was “diluted,” of what relevance is this fact and what should you do about it? These questions are frequently posed to us and unfortunately, “dilution” is a gray area of inference and suspicion. Although there is not a clear-cut explanation as to how dilution occurs, the federal government has established guidelines for the determination as to what dilute is. It is incumbent upon any institution that undertakes drug testing to establish its own particular policy and procedures for dealing with samples that have been identified by the laboratory as dilute. This responsibility extends to instances where a person being tested somehow managed a substitution of his or her urine; substitution is an additional phenomenon that collectors must actively guard against.

What is a dilute urine sample? What is a substituted sample? The laboratory follows the rules set forth by the Substance Abuse and Mental Health Services Administration (SAMHSA). Here are the rules:

A sample is “Dilute” if it meets one of the following conditions:

1. Dilute: Creatinine is greater than or equal to 5.0mg/dL AND less than 20 mg/dL AND the Specific Gravity equals 1.002
2. Dilute: Creatinine is less than or equal to 5.0 mg/dL AND the Specific Gravity is greater than 1.0010 AND less than 1.0030.

A sample is “Substitued” if it meets one of the following conditions:

1. Substituted: Creatinine is less than 2.0 mg/dL AND the Specific Gravity is less than 1.0010
2. Substituted: Creatinine is less than 2.0 mg/dL AND Specific Gravity is greater than or equal to 1.0200.

Dilution is not the same as sample adulteration. Adulteration has occurred when foreign substances are intentionally and directly added to a urine specimen that is to be submitted for testing. There are various products available and sold over the Internet for oral consumption claiming to help “rid the body of toxins”. Although these “body cleansing” products claim efficacy in beating drug tests, they’re typically no more effective or useful than old-fashioned techniques of water or green tea system flushing.

But a dilute specimen isn’t always the result of a nefarious act on the part of the person being tested. There are medical conditions that can produce dilute urine specimens from otherwise compliant people. Dilute urine can also be caused by the direct pouring of water or some other liquid it into a urine specimen at the time of collection; over-hydration, or over consumption of liquids prior to collection, especially those that contain diuretic agents. These sorts of things may be entirely innocent, or the may be done intentionally on the part of an individual who wishes to influence the result of a drug test. Testing agencies might consider the development of a set of rules and admonitions that can be communicated to people being tested that establishes an agency’s processes for interpretation of samples that have been tampered by dilution or substitution. Consequences for such behaviors are important towards insuring that your process of drug testing is secure and reliable.

Federal guidelines can be found by visiting:

• http://edocket.access.gpo.gov/2008/E8-26726.htm
• http://www.samhsa.gov/index.aspx

Reproduced with permission from The MEDTOX® Journal

Suboxone and Subutex are brand names for a synthetic narcotic called buprenorphine. The pharmacology of buprenorphine is novel, it blocks opiate receptors in the brain, the receptors most associated with opiate euphoria that narcotic abusers seek. Buprenorphine is however active at subset of opiate receptors, receptors that aren’t chemically connected to an opiate euphoria. In fact, people who’ve abused buprenorphine with an expectation that they’ll get high like they do on heroin, report that the experience a feeling of unease, nausea and a sense that they’re about to jump out of their skin. Nevertheless, geographical clusters of buprenorphine abuse have emerged in cities and communities where the drug has been extensively used to detoxify opiate addicted patients.

Like other pharmaceuticals, Buprenorphine has been diverted to the street and has been experimented with by ever-curious drug users. Addiction, dependence and withdrawal can occur with chronic use of the drug. When used as directed, buprenorphine clamps down on opiate receptors in the brain and elsewhere in the body, it blocks the activity of powerful opiate euphoriants like heroin, oxycodone and morphine. As physicians become more and more familiar and comfortable with the use of this drug, newsletter readers should expect to see and hear of more cases of buprenorphine abuse on the street.

Reproduced with permission from The MEDTOX® Journal

Recently, stories have reached the Drug Abuse Recognition (DAR) program about the consumption of Sure Gel pectin solution as a means of masking THC in otherwise positive urine tests.

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