Breaking News
January 17, 2018 - Lactation May Lower T2D Risk in Younger Women
January 17, 2018 - New Atopic Dermatitis Yardstick provides practical guidance and management insights
January 17, 2018 - New biodegradable pressure sensor could help monitor serious health conditions
January 17, 2018 - HSS orders Sectra’s 3D pre-operative planning solution for improving patient outcomes
January 17, 2018 - Study identifies six new genes regions associated with diabetes
January 17, 2018 - Women do not receive timely diagnosis for heart disease
January 17, 2018 - AbbVie’s Upadacitinib Shows Positive Results as Monotherapy in Phase 3 Rheumatoid Arthritis Study, Meeting All Primary and Key Secondary Endpoints
January 17, 2018 - Should President Trump’s Physical Include a Cognitive Screen?
January 17, 2018 - Could gene therapy someday eliminate HIV?
January 17, 2018 - Researchers identify new anti-inflammatory drug target
January 17, 2018 - Loxo Oncology Initiates Rolling Submission of New Drug Application to U.S. Food and Drug Administration for Larotrectinib for the Treatment of TRK Fusion Cancers
January 17, 2018 - Trunk Imaging Tied to Higher Nephrectomy Risk
January 17, 2018 - Campaigners incensed at failings in Africa AIDS war
January 17, 2018 - Research opens door to development of new treatment for type 2 diabetes
January 17, 2018 - Bariatric surgery extends lifespan in obese patients, shows study
January 17, 2018 - Bristol-Myers Squibb Receives FDA Approval for Opdivo (nivolumab) as Adjuvant Therapy in Patients with Completely Resected Melanoma with Lymph Node Involvement or Metastatic Disease
January 17, 2018 - Ewww Moments in the ER: That’s Improbable!
January 17, 2018 - Methods from optogenetics, machine learning should help improve treatment options for stroke patients
January 17, 2018 - Booze may help or harm the heart, but income matters
January 17, 2018 - Three-dimensional organization of genome plays key role in gene expression, cell fate
January 17, 2018 - Scientists identify six new gene regions that may help treat type 1 diabetes
January 17, 2018 - Top nutrients needed to boost mood and energy levels on Blue Monday
January 17, 2018 - Scientists develop unique technique to map elasticity of cell components
January 17, 2018 - Obesity surgery reduces the risk of death by half finds new study
January 17, 2018 - Raw Meat Not the Safest Choice for Your Dog or for You
January 17, 2018 - Men who lack HSD17B4 gene may be more susceptible to treatment-resistant prostate cancer
January 17, 2018 - High-Dose Aspirin Preferred for Kawasaki’s
January 17, 2018 - Study suggests risk management approach to combat EMS fatigue
January 17, 2018 - A new therapy against obesity
January 17, 2018 - Doctors warn against holding your nose and closing your mouth to contain a sneeze
January 17, 2018 - Measles outbreak alarms public health officials
January 17, 2018 - FDA Slaps Class Warning on Gadolinium Contrast Agents
January 17, 2018 - Distinct human mutations can alter the effect of medicine
January 17, 2018 - ASIT biotech’s new article presents clinical results of gp
January 17, 2018 - Alternative tobacco use by adolescents associated with greater odds of future cigarette smoking
January 17, 2018 - A High-Salt Diet Produces Dementia In Mice
January 17, 2018 - Scientists provide insights into crucial interaction for DNA repair
January 17, 2018 - Sanofi and Regeneron Announce Positive Topline Pivotal Results for PD-1 Antibody Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma
January 17, 2018 - Morning Break: Pfizer Kills AD/PD Pipeline; Trump Affirms His Mental Health; Humira Pricing Strategy
January 17, 2018 - Researchers see gene influencing performance of sleep-deprived people
January 17, 2018 - Fast food triggers the immune system making it hyperactive
January 17, 2018 - Scientists find increased risk of HIV outbreaks in Ukraine due to war-related migration
January 17, 2018 - New universal flu vaccine moves to clinical trial phase and could be a reality soon
January 17, 2018 - Cocaine de-addiction breakthrough shows promise
January 17, 2018 - FDA Accepts New Drug Application for Seysara (sarecycline) for the Treatment of Moderate to Severe Acne
January 17, 2018 - Robotic Telestenting; BP Cuff Smartwatch; Medicare Bundled Care
January 17, 2018 - New cellular approach found to control progression of chronic kidney disease
January 17, 2018 - Lamprey genes provide clues to repair spinal cord damage, finds study
January 17, 2018 - Tissue-based soft robot could lead to advances in bio-inspired robotics
January 17, 2018 - Mostly the healthy and wealthy Americans use mobile phone apps to track sleep habits
January 17, 2018 - FDA Alert: Varubi (rolapitant) Injectable Emulsion: Health Care Provider Letter
January 16, 2018 - NeuroBreak: Rough Days for Neuroscience Research; Another Migraine Drug Advances
January 16, 2018 - The ‘greatest pandemic in history’ was 100 years ago – but many of us still get the basic facts wrong
January 16, 2018 - Serena Williams Shares Childbirth Ordeal
January 16, 2018 - The Artificial Brain as Doctor
January 16, 2018 - Type 2 diabetes has hepatic origins
January 16, 2018 - Expert discusses how to identify, support individuals with drug or alcohol addiction in workplace
January 16, 2018 - Starting menstruation early increases risk of cardiovascular disease and stroke in later life
January 16, 2018 - CapsoVision receives CE Mark approval for use of CapsoCam Plus System in pediatric patients
January 16, 2018 - Researchers develop new dynamic statistical model to follow gene expressions over time
January 16, 2018 - Alzheimer’s ‘looks like me, it looks like you’
January 16, 2018 - By the Numbers: Physicians’ Economic Impact
January 16, 2018 - Sound Health | NIH News in Health
January 16, 2018 - Modifying baby formula doesn’t prevent type 1 diabetes in children
January 16, 2018 - Energy drinks dangerous for kids
January 16, 2018 - When you need a breast screening, should you get a 3-D mammogram?
January 16, 2018 - Johns Hopkins gets approval to perform HIV positive to HIV positive living donor kidney transplants
January 16, 2018 - The Salk Institute and Indivumed collaborate for cutting-edge cancer research
January 16, 2018 - Study reveals negative long-term effects of heavy cannabis use on brain function and behavior
January 16, 2018 - Many gym-goers injure themselves by pushing harder to be better than friends
January 16, 2018 - Risankizumab Meets All Primary Endpoints Reporting Positive Results in Fourth Pivotal Phase 3 Psoriasis Study
January 16, 2018 - Federal Junk Food Tax Feasible, Study Says
January 16, 2018 - Do girls have stronger teeth than boys?
January 16, 2018 - New high-sensitivity blood tests could aid faster diagnosis and treatment for heart attack
January 16, 2018 - How fatal mitochondrial diseases may strike offspring of families with no history of the conditions
January 16, 2018 - TherapeuticsMD Announces FDA Acceptance of New Drug Application and Prescription Drug User Fee Act (PDUFA) Date for TX-004HR
January 16, 2018 - Morning Break: Food Pharmacies; Obamacare Sign-ups Dip; Top Pot Studies
January 16, 2018 - Blood pressure declines 14 to 18 years before death
January 16, 2018 - ViLim Ball technology helps reduce uncontrollable shaking hands
January 16, 2018 - Researchers use immune-mimicking biomaterial scaffolds to fast track T cell therapies
Experts Examine Trump’s ‘Just Say No 2.0’ Message on Drugs

Experts Examine Trump’s ‘Just Say No 2.0’ Message on Drugs

image_pdfDownload PDFimage_print

President Donald Trump, in announcing Thursday that the opioid epidemic is a public health emergency, seemed to revise the Reagan-era “Just Say No” approach to drug abuse. In previous talks on drugs, Trump directly showed his support for this concept.

MedPage Today invited addiction experts to comment on the “Just Say No” approach and to discuss the data on its effectiveness historically.

Sharon, Levy, MD, MPH, Children’s Hospital, Boston: “Just Say No” sounds oversimplified and corny, but it’s on the right track. I’d like a slightly more sophisticated message that our kids hear from the adults in their lives that goes something like this “choosing not to use alcohol or drugs is best for your health.” I was a bit frustrated when President Trump stopped a little bit short of that message. He talked about how his brother struggled with alcoholism and so he never tried alcohol, but then he talked about some other drugs that he might have tried or at least he implied that. I think it was supposed to be a joke but I worry that it detracted from the main message. To be effective we have to be very clear with adolescents: “Non-use is best for health.” If we failed to frame messages that are inclusive of all substances we just ping-pong from one problem to the next and we are at risk of watching rates of marijuana use go up while alcohol and cigarettes decrease.

Marvin D. Seppala, MD, Chief Medical Officer, Hazelden Betty Ford Foundation: The genesis of the current crisis lies in the overprescribing of prescription opioids by healthcare professionals. Why would patients “Just Say No” to relief from suffering when nothing else is offered? Those at highest risk of addiction are genetically predisposed, and addiction is not screened for nor attended to in most medical settings. When we begin to recognize the realities of addiction as a brain disease we will alter policy and practice, train our healthcare professionals appropriately, stop fighting a war and treat these people with the same dignity and respect offered anyone with a life threatening illness.

David Craig, PharmD, Moffitt Cancer Center: I’m not aware of evidence that supports this type of “Just Say No” messaging and its relationship to downward trends in drug use. I am not opposed to increased messaging that highlights the harms of drug use, however, I’m not positive this alone will save lives. In my opinion, ways to reduce drug use should focus on destigmatizing those with a drug use disorder using better identification tools and more available treatment options.

Sarah L. Desmarais, PhD, North Carolina State University: There is scientific consensus that “Just Say No” is not an effective strategy to address substance use, including opioids. There have been several meta-analytic reviews of the research that show “Just Say No” programs typically have little to no effect on substance use for several reasons. “Just Say No” programs often don’t include the key elements that contribute to successful substance abuse prevention, such as multiple sessions over long period of times that include opportunities for building and rehearsing skills. They also can have the unintended effect of contributing to increases in the use of milder substances, such as alcohol. Harm reduction approaches have been shown to be much more effective.

Dessa Bergen-Cico, PhD, Syracuse University: Trump’s message for prevention boils down to “Just Say No 2.0,” the same ineffective ill-informed approach from the 1980s under Nancy Reagan.

There is an international evidence based approach to drug policy which encompasses four pillars: 1) prevention, 2) harm reduction, 3) treatment, and 4) enforcement.

Politicians often use drugs and addiction issues as proxies for other agendas like “building walls” and blaming the crisis on other countries and cultures. The more difficult and long-range solutions require ongoing comprehensive prevention at the pre-K-12 level.

Prevention is an upstream process meaning that it needs to begin early and it is more about developing emotional regulation skills than “drug education.”

The more difficult and long-range solutions require ongoing comprehensive prevention at the pre-K-12 level. The most promising and lasting prevention strategies may be social emotional learning and mindfulness-based training which fosters self-regulation, distress tolerance, and resiliency. People turn to alcohol and other drugs in unhealthy ways when they lack the skills and capacity to effectively manage difficult emotions and mental health problems (e.g., depression, anxiety etc.)

Although knowing the risks involved in using various substance is important – it alone does not change behavior or prevent experimentation. To understand this all we need to do is look at American eating behavior. There are many complex psychological and social factors that influence why we may know what is healthy to eat and why we don’t choose healthy foods most of the time.

Stefan Kertesz, MD, MSc, University of Alabama at Birmingham School of Medicine: In terms of scientific data, it has always been the case that young adults tend to think drugs are harmful, and for every drug but marijuana that simply is not changing much. Among 12th graders, the percentage who disapprove of trying heroin once or twice was 95% in 1990 and 94% in 2016. (p. 423)

The percentage who disapprove of using marijuana occasionally has really dropped (50.5% in 2016 compared to 69% in 2006). In that regard, our 12th graders reflect social perceptions more broadly. There may be risk there, since use of marijuana in adolescence may have some association with illicit drug use, so we should attend to that.

But on whole, illicit drug use by adolescents has been on a decade-long downward slide (see p. 219, Table 5). So with most young adults disapproving, and most not using drugs, it’s hard to see why we need to tell them to disapprove of what they’re continuing to not use for the most part. The 10-year trend in report of any drug use is down for narcotics other than heroin, down for alcohol, down for cocaine, and it’s very slightly up for marijuana.

J.C. Garbutt, MD, University of North Carolina at Chapel Hill: Start investing in primary prevention efforts to reduce the number of individuals who become addicted to opioids. This will require input from experts who know how to intervene successfully with youth, simply “Just Say No” is not going to work. But, if we come up with smart plans based on solid evidence we can have an impact. I think two examples provide evidence that major changes in behavior related to drugs can happen.

First, the change in rates of cigarette smoking over the past 20 years in the United States has been a tremendous public health success and has saved many lives. This occurred through many efforts including a change in public attitude towards smoking. Second, the drop in deaths from drinking and driving has been another huge success with about 10,000 fewer deaths a year. Again, this occurred through education, advertising, tax policy, legal changes and overall change in public attitudes. Can we do the same thing with opioids? I think so if we are smart and devote the needed resources to the task.

William Moyers, Vice President of Public Affairs and Community Relations, Hazelden Betty Ford Foundation: The phrase “Just Say No” is an important parenting tool, not a public policy strategy to deal with America’s addiction crisis.”


Tagged with:

About author

Related Articles