Archive for June, 2017

From Punishing Users to Treating a Disease

Posted on: June 30th, 2017 by sobrietyresources

Addressing addiction has changed from force to care as the opioid epidemic has exponentially grown

Opioid addiction takes a personal toll, but it also has countrywide consequences.

On an average day in the U.S., someone begins nonmedical use of opioids every 22 seconds; someone starts using heroin every two and a half minutes; and someone dies from opioid-related overdose every 16 minutes, according to the Centers for Disease Control and Prevention.

Fatal accidents involving both legal and illegal prescription drugs surpassed those involving alcohol in 2015, a new Governors Highway Safety Association study finds. And, according to the Federal Bureau of Prisons, 46.3 percent of federal inmates across the United States are serving time for drug-related offenses.

Opioid abuse has skyrocketed in the last 15 years, and the U.S. government has started to change its approach to the problem, transitioning from a “war on drugs” mentality that pegged users as criminals to efforts to treat people as victims suffering from a disease – a move that many think comes down to black vs. white.

“We are very glad that this issue has national attention, and that we’re now changing the paradigm and talking about the disease of addiction, [but] we do need to point out that there is a racial component involved, too,” says Dr. Leana Wen, Baltimore City’s health commissioner. “When addiction primarily affected those in inner cities who are poor and minorities, … we were talking about addiction as a crime. And now that it is affecting white communities and potentially wealthier communities, it is seen as a disease.”
Karen Holliday, a recovering addict of 30 years who has been in and out of jail, agrees.

“That went on for a long period of time because they didn’t address my addiction or my mental issues,” Holliday, who is African-American, recalls. “It wasn’t a problem at first, it was acceptable to some people on a higher level; they didn’t care about those on the bottom level. Now that it’s climbed up the ladder, it’s becoming a priority for them.”

Drug abuse is not a new problem

Drug abuse is a complex, chronic issue that affects all 50 states and thousands of families each day. The solution isn’t simple, and there is no one size fits all approach.

One in seven Americans face substance addiction, according to the Surgeon General’s 2016 report.

“The biggest misconception that people have about opioid addiction, and any addiction, is that it is a choice that individuals make. Therefore the implication is that if someone is addicted, it’s a moral failing – if they end up dead, it’s their fault,” Wen says. “Addiction is a chronic brain disease, and needs to be treated like any other chronic illness.”

American opioid use, whether legal or illegal, is nothing new. People in the U.S. have been taking, smoking or injecting opioids in various forms since at least the 19th century. In fact, Bayer – the chemical, pharmaceutical and life sciences company many consumers associate with aspirin – used to sell heroin as a cough suppressant and pain reliever for children in the late 1800s and early 1900s.

But in 1909, Congress passed the Smoking Opium Exclusion Act – often seen as the first federal law against the use of nonmedical substances, it banned the importation of opium except for medicinal purposes. This act primarily affected Chinese immigrants and the working class, who smoked opium to relax much in the same way people enjoy an after-work drink today. The Harrison Act of 1914 further restricted all nonmedical use of opium, morphine and cocaine, imposing taxes on importers, manufacturers and distributors, but not on physicians.
The problem left unaddressed was, and continues to be, that people sought the addictive drugs whether they were legal or not. And while the list of prohibited drugs grew and the penalties became more severe, people still found sources to feed their addiction. Drug use exploded in the 1960s and ’70s, especially among the lower class and African-American communities. The number of people incarcerated on drug-related charges grew in the 1980s and skyrocketed in the ’90s.

Holliday was exposed to substance abuse at an early age. Growing up in the 1960s and ’70s in east Baltimore, she first tried marijuana at the age of 7 and was addicted by 11 to various other drugs. She started taking heroin when she was 13. Drugs were a way to numb the realities of a horrific home life: Her stepfather killed her mother while she and her sister watched, she says, but the abuse was rampant long before that.

“My stepfather was abusing me, from the time I was 3 ’til I was 15,” Holliday says. “I thought that drugs were my escape. It lead me to be somebody that didn’t have to feel that type of issue or pain.”
She was hooked on drugs for 35 years. Despite graduating from high school, she felt she had nothing to live for. She became pregnant. She had two children that she couldn’t take care of because of her addiction, and says she wandered the streets of Baltimore for 30 or so years “like a zombie.”

Physicians have turned to opioids to help with acute and chronic pain for years, though early on the risk of opioid addiction was not fully understood. A letter to the editor, written by a doctor and published in the New England Journal of Medicine in January 1980, was used by pharmaceutical companies to promote opioids for the next few decades, and doctors began to prescribe higher doses and larger quantities of opioid pills.

“They didn’t realize that these were addictive, or as addictive as they are,” says Dr. Mark Edlund, a research scientist for RTI International, an independent, nonprofit research institute.

But patients who received prescriptions for pain found out first-hand how addictive opioids can be.

Morgan, a recovering addict who asked that her full name not be used, was given opioids by her doctor when she was a senior in high school, after she was in a car accident. She became addicted and eventually moved on to heroin.

“I was in search of [opioid] pills and I had a friend and they were like, ‘Well you should try this because it’s cheaper and, you know, it’s better,’” recalls Morgan, describing the first time she tried heroin. “I tried heroin one time, and I never looked back.”
As the opioid crisis escalated dramatically between 1999 and 2015, physicians, pharmacists and researchers began to dive deeper into the long-term effects of opioids, and since 2005 have worked on offering lower doses and prescribing opioids to people at lower risk for addiction. But that level of change takes time, says Edlund.

“Now I think that the challenge is that we have a large number of individuals in the country who are addicted to opioids, and what do you do then?” Edlund continues. “You have a lot of people who are either addicted or they’re on high-dose opioids and maybe they’re not addicted, but it’s unclear whether or not they need those high of doses.”

In 2014, almost 2 million Americans abused or were dependent on prescription opioids, and more than 1,000 people are treated in hospital emergency departments for misusing prescription opioids every day, according to the Centers for Disease Control and Prevention.

Relapsing compounds the problem.
“It is estimated that at least 70 percent of patients administered to treatment programs will relapse in the first year,” says Dr. Nora Volkow, Director of the National Institute on Drug Abuse. “Certain environments, emotions can trigger these memories and lead to relapse. You can’t completely control those aspects of your life from pushing you into relapse.”

Opioids work by stimulating opioid receptors in the nervous system, reducing feelings of pain and flooding the user’s brain with dopamine, a feel-good hormone. The result: a calm and happy high. Once the opioid wears off, however, the person’s brain dopamine levels drop and the euphoria disappears, leaving the user craving more. The body rapidly builds up a tolerance to opioids, so it takes more and more of the drug to create the same pain-relieving and euphoric effects.

People who have been treated for opioid addiction or who tried to stop using are often unaware that they no longer have the tolerance levels they once had. When they try the drug again, often at the high doses they used to abuse, they end up overdosing.
That’s what happened to Scott Klima.

Klima first began taking nonmedical opioid prescription pills when he was in high school, his sister, Kristy Flower, recalls. He wanted marijuana, but his dealer was out, so he opted for something else.

“It was something that he tried. He said it was a one-time thing, that he was just experimenting,” Flower says. “He liked to smoke marijuana, basically. Once he tried heroin, that was it.”

While Klima struggled with his addiction for the next several years, their parents tried whatever they could to help him, Flower says. They tried group counseling sessions, a move from Maryland to Florida and multiple treatment centers, but nothing stuck.
In May 2006, the police came knocking on Flower’s door, saying that Klima had to answer charges against him in Florida for possession of marijuana. Shipped south, he spent months waiting to hear from his public defender and family, Flower says, and he was offered no treatment options while incarcerated.

When he was finally released in late December 2006, Flower says, Scott was far from home. He had no money or shoes, and he had nowhere to go and no way to contact his family. He managed to make it back up to Maryland by mid-April, but Flower recalls that something in him had changed. The whole ordeal, she says, “truly broke his soul and left him with little or no self-esteem.”

In the last year of his life, he tried to stay clean, Flower says.

Klima resumed working with their dad for a pool company, and received his first paycheck on Friday, May 18, 2007. The next morning, a cop was at Flower’s door to inform her that her brother was dead.

“It was just one more time – he had a paycheck, and tried it one last time, and he didn’t wake up the next day,” Flower says. “I honestly do believe in my heart that if he could have been given proper treatment versus incarceration, he’d still be here today.”

The way authorities and experts view addiction is changing, with treatment, and not incarceration or punishment, being heralded as a better way to combat addiction.

Holliday has been in recovery for three years, though she would tell you herself that it was not by choice. After three decades between jail cells and living on the streets, she woke up in a psychiatric ward and was informed that she had undiagnosed schizophrenia.
“Once I got the treatment for my issues and schizophrenia, I realized I didn’t want to use anymore. I didn’t want to be homeless, I didn’t want to go to jail again,” Holliday says.

Experts say they know treatment works, but people aren’t able to access the help they need when they need it. Only one in 10 people with substance abuse disorders receive the treatment and support to address their addiction, according to the Surgeon General’s 2016 report.

“We actually know what works, and the frustrating thing for us as public health officials is that we know what works, we just need the resources to be able to get there,” Wen says. “If we said that now there’s an Ebola outbreak, or now we need to cure cancer, the next question would be what are the resources we are going to commit? We should treat addiction with the same urgency and attention as we do any other illness.”–FzD6jDz8-tnA-QaLSnxIGsuZnVAl_LmBR4v2m78EqOQuDGi08VUc5603UYdg4WC2YEQXYEyRQytIfzyasi-8U6UnnUmYPQyekorl6JUmKT07-EPo&_hsmi=53776459

Heroin Addiction Costs Us More Than $50 Billion Per Year

Posted on: June 22nd, 2017 by sobrietyresources

The heroin problem in the United States continues to worsen, with the number of reported users doubling from 2000 to 2013, and climbing since. Heroin overdose deaths have more than tripled in the last 15 years.

But how much does the heroin epidemic cost the United States? A lot. Researchers seeking to put a number on it have come up with a new figure: more than $51 billion. That’s a vast sum, equivalent to the gross domestic product of countries like Lebanon and Croatia.

Researchers from the University of Illinois at Chicago calculated the cost of heroin use to society in a study published in the journal PLOS ONE . To come up with a figure, they looked at all the ways that the drug impacts the estimated 1 million active users nationwide and those with whom they interact and effect.

These include costs to treat diseases that are made more likely and spread through the use of needles, such as hepatitis C, hepatitis B, HIV-AIDS and tuberculosis. Treatments for neonatal abstinence syndrome, a group of problems that occurs in infants exposed to heroin in the womb, are also included. Heroin users are also more likely to be incarcerated and to commit crimes, which have heavy costs, and they are significantly less productive than other members of society (resulting in lost potential income and services). The researchers also accounted for treatments for addiction and overdose.

Heroin users who are locked up are particularly expensive to society. The scientists estimate each bears a cost of to the United States of nearly $75,000 per year. This figure is mostly driven by productivity loss ($29,000), incarceration costs ($31,000) and, perhaps surprisingly, treatment for hepatitis C (a chronic condition with a treatment tab of $9,000). HIV, spread via heroin use, also takes a large toll; the condition is estimated to cost $300,000 to treat over a lifetime.

Overall, the average heroin user bears a $50,800 cost to U.S. society annually. That’s just a hair below the latest U.S. median annual salary of $51,272.

The authors note that addressing heroin use disorder as a medical rather than a legal problem, one which can be treated, and reducing the number of incarcerated heroin users would save society a lot of money.

If more is not done, the problem is likely to get worse, the costs will grow. “Without meaningful public health efforts, the number of heroin users is likely to continue to grow; the downstream effects of heroin use, such as the spread of infectious diseases and increased incarceration due to actions associated with heroin use, compounded by their associated costs, would continue to increase the societal burden of heroin,” the authors write in the study.

‘I was addicted to heroin- and it could happen to anyone’

Posted on: June 20th, 2017 by sobrietyresources

By Charlotte Hilton Andersen Published June 20, 2017

Liz Cohen remembers the exact moment she gave in to heroin. Sitting in a rundown motel room with her boyfriend and starting to feel the intense pains of withdrawal, she says she begged him to get her more drugs. But when he told her that all he could give her was heroin, she balked. Up until that point she’d stuck to prescription painkillers like Vicodin and Oxycontin, uppers like cocaine and speed, and drinking—heroin, she says, was the line she wouldn’t cross.

“In my mind, I wasn’t really a drug addict, I was just a girl who liked to party. But heroin was serious, heroin was for junkies on the street,” she says. “So I told my boyfriend, ‘No, anything but that. We promised we’d never do that.’”

His reply shocked her. “You’ve already been doing heroin for months,” he said bluntly, explaining that while she’d thought the powder she was snorting was crushed-up painkillers it turns out he’d been giving her the cheaper narcotic heroin, instead. And, he added, he knew a faster, easier way to get the high she so desperately craved. He handed her a needle.

“I was devastated, I’d become what I’d always said I wouldn’t be,” she says. But that feeling disappeared quickly. “The second I stuck the needle in my arm, the whole game changed. I was in love. Heroin became my life, my love, my everything.”

A popular, pretty, former high school basketball star, Liz was the last person you’d expect to end up a homeless drug addict. Yet it was her beloved sport that first introduced her to the opiates that would consume her life.

Her freshman year, she was goofing around and turned her ankle, tearing all of the ligaments. At the ER, the doctor prescribed her Percocet, an opioid painkiller. At first she says it made her nauseous, but it didn’t take long before she realized the powerful pills killed not just the physical pain but also the emotional pain. And facing a year of surgery and recovery instead of playing ball with her team, the teen had a lot of emotional pain.

“They made me feel so euphoric and invincible that I used up my one-month prescription in one week,” she says. After that, she lied to her doctor about her pain levels to keep the prescriptions coming.

Liz is not alone. According to the Centers for Disease Control and Prevention, “past misuse of prescription opioids is the strongest risk factor for starting heroin use,” and three out of four new heroin users report having abused opioids before using heroin.

Eventually, Liz moved on from her opioids to harder drugs, and she forgot all about the basketball team, academics, and her dream of getting a sports scholarship. By her senior year of high school, she flunked out and ran away from home to move in with her dealer boyfriend—the one who would get the teen hooked on heroin.

Not long after she embraced shooting up, Liz, who’d always known she was adopted, found her birth parents and made plans to meet them.

On the day of their visit, her biological mom answered the door, handed Liz a handful of painkillers and said, “Nervous? These will make the conversation easier.”

Liz felt like she’d finally found her people. She soon moved in with her biological parents, getting high with her birth mom every day. And then Liz’s world was shattered. A lifetime of drug abuse and hard living caught up to her mom and she died of liver failure.

“She was only 43 years old—way too young to die—but she looked 90,” Liz remembers. “One of the last things she said to me was to ask me to sneak her drugs into the hospital, she didn’t even realize how messed up that was. And it finally hit me, is this really what I want for myself?”

Liz, now in her early twenties, made a commitment to get clean. At first she thought she could break the habit on her own, but eventually she checked into treatment at Caron Treatment Center. It took her two years and two separate times through the program to finally free herself from heroin, a grueling process she describes as the hardest thing she’s ever done.

Now, at 28, she’s six years sober, is in a healthy relationship, has reconciled with the parents who raised her, and is in school studying to be a social worker. And, as a happy bonus, she says she’s rediscovered the “natural high” of exercise, doing weekly Zumba classes.

But when it comes to medication, she still worries. After a recent eye surgery, she took nothing but ibuprofen rather than risk taking an opiate, and she says she wishes that more people understood how powerful those medications are.

“It’s so scary, doctors need to be more careful prescribing painkillers. I wish they would have warned me or my parents of the risk of addiction. What happened to me could happen to anyone,” she says. “Because you think, hey, if a doctor prescribes it, it should be safe, right?”

But she says she finally found peace, both with her past and her future. “I had such self-hatred for so long, I was suicidal,” she says. “I didn’t think I’d survive—but not only did I survive, I came out even stronger.”

Few opioid-addicted youth get standard treatment medication

Posted on: June 19th, 2017 by sobrietyresources


CHICAGO — Jun 19, 2017, 1:48 PM ET

Only 1 in 4 teens and young adults with opioid addiction receive recommended treatment medication despite having good health insurance, according to a study that suggests doctors are not keeping up with the needs of youth caught up in the worst addiction crisis in U.S. history.

“Young people may be dying because they are not getting the treatment they need,” said Brendan Saloner, an addiction researcher at Johns Hopkins Bloomberg School of Public Health who wrote an editorial published with the study Monday in JAMA Pediatrics.

Researchers looked at records for nearly 21,000 patients ages 13 to 25 from one large insurance carrier, UnitedHealthcare.

All were diagnosed with opioid addiction, but only 27 percent were given buprenorphine or naltrexone during 2001-2014, years when addiction was soaring.

“The take-home message for parents is: If you have a child struggling with opioid addiction, understand that there are medications that support and sustain recovery,” said study author Dr. Scott Hadland of Boston Medical Center.

Hadland was following a hunch when he began the study last year. In his practice, he was seeing more young people addicted to opioids. Many already had been through multiple treatment programs and they told him they’d never before been offered treatment medication.
Doctors must become more comfortable treating addiction with medications, Hadland said, noting that buprenorphine and naltrexone are recommended by the American Academy of Pediatrics.

Buprenorphine is given daily as a pill or film that dissolves under the tongue. It costs about $100 a month. Doctors need special training and a government waiver to prescribe it. A common version of buprenorphine is Suboxone.
Vivitrol is a brand-name version of naltrexone. It’s a shot given once a month and can be used only with patients who have completely detoxed from opioids. It costs about $1,000 per month.

The drugs work slightly differently, but both can ease cravings while patients work on addiction issues in counseling.
In the study, females, blacks and Hispanics were even less likely to receive the medications than males and whites. It’s unclear why, but unequal access to care or doctor bias could be to blame.

“The treatment gap is bad for everybody and even worse for certain subgroups,” Hadland said. “Even though all the youth in our sample had access to high-quality health insurance, they may not have had equal access to high-quality addiction care.”
Hadland and his colleagues plan to study access to treatment medications for youth from low-income families covered by government health insurance programs such as Medicaid.

Heroin vaccine comes a step closer to human use

Posted on: June 14th, 2017 by sobrietyresources

Ben Coxworth June 6, 2017

While it may not be possible to cure actual heroin addiction via a simple injection, scientists at The Scripps Research Institute are developing what is perhaps the next-best thing – a vaccine that keeps addicts from experiencing the heroin high. Without that reward available, kicking the habit could be considerably easier. The vaccine was recently proven effective on non-human primates, making it the first vaccine against an opioid to ever do so.

 Developed by a team led by Prof. Kim Janda and postdoctoral researcher Paul Bremer, the vaccine exposes the immune system to part of the heroin molecule’s unique structure. The immune system responds by producing antibodies that neutralize heroin molecules, keeping them from reaching the brain.

The vaccine has been in the works for the past eight years, and has already seen success when used on lab rats. More recently, however, it was trialled on four rhesus monkeys, and in a form that more closely resembles heroin.

The monkeys each received three doses, and all subsequently showed “an effective immune response” at neutralizing various amounts of heroin. Although the effect was most pronounced during the first month following the vaccinations, it lasted for more than eight months overall.
Two of the animals had also received the vaccine seven months earlier, for a separate study. They did particularly well in the more recent study, suggesting that their antibody-producing cells had developed a memory of the vaccine. Should that effect apply to humans, it would mean that people receiving the vaccine may develop a long-term immunity to heroin.

As a side note, the vaccine works only against heroin, and not other opioids. This means that patients could still take opioid-based painkillers or other medications as needed.

Scripps is now looking at licensing the technology to a commercial partner, for use in clinical trials on humans.
A paper on the research was recently published in the Journal of the American Chemical Society.

Breaking our addiction to rehab

Posted on: June 12th, 2017 by sobrietyresources


June 10, 2017 at 12:04 am

Earlier this month, the Orange County Register published a report examining addiction treatment facilities in Southern California and the enormous challenge of substance abuse our community faces. The Register’s story highlights a disease that has ravaged our communities, ruined many families and ended many young lives, and identified the significant gaps that still exist in treatment. It also puts in stark focus the urgent need to rethink how we care for addicted patients. The days of treating chemical dependency as a standalone sickness — with rehab clinics operating without regard for the underlying health and social challenges that lead to addiction — simply have to end.

The number of Americans who have a substance use disorder has skyrocketed to epidemic levels. Orange County has not been spared: Drug and alcohol deaths in the county increased by 82 percent since the millennium, and hospitalizations cost us more than $100 million a year. We have a disproportionately large number of rehab clinics for those seeking to break the cycle of addiction. And as the Register reported, these facilities are often focused on profits and not adequately regulated or held accountable for providing subpar treatment. We will never beat addiction in Orange County if we continue treating it with quick fixes meant to turn a buck.

No one advocacy group, provider, rehab clinic or government agency can solve this challenge alone. If we’re going reverse this affliction, we need to do it together, and we need to do it in a holistic way that looks at other mental health issues, the social needs of patients, the awareness and education in our community, and the standard of care at our clinics and facilities.

First, we must acknowledge the link between substance use disorders and other health issues. Substance abusers are two times more likely to have psychiatric disorders and mental illnesses like depression, anxiety or bipolar disorder. Mental illnesses can lead to drug abuse as a form of self-medication. Both substance use disorders and other mental illnesses are caused by overlapping factors such as underlying, genetic vulnerabilities and/or early exposure to stress or trauma. We must treat addiction with the highest clinical standards that look at the whole picture, not the common (but often superficial) symptoms. We need strong policies that promote evidence-based treatments with high-quality treatment options, and limit clinics that only provide temporary or superficial care.

And we need strong local partnerships that can provide the kind of wraparound support services that addicts need before and after rehab to truly heal — services that help them find a safe place to sleep or a good meal, or, often, just someone to talk to. Stable and structured supportive housing is key to promote and stabilize recovery, particularly for the vulnerable populations like the homeless, addicted teens and formerly incarcerated individuals.

Above all, we must view addiction as a part of the broader problem of mental illness and social crisis in our community.

Orange County has started doing many of these things. Our health system recently helped convene a group of mental health advocates, other health system representatives, academia, foundations, housing providers, faith-based leaders and city and county government agency officials. Finally, we have all the critical stakeholders at the same table to develop a behavioral health system of care supported by public/private/academic collaboration to achieve the healthiest community. And we’ve just established the county’s first comprehensive hospital-based continuum of care with intensive inpatient and outpatient services for patients facing addiction. But, as the Register report makes clear we have a very long way to go.

Breaking the cycle of addiction won’t be easy and it won’t happen fast. But if we stop viewing addiction in isolation and see it for the broad health and social health crisis that it is, we just may be able to finally end the cycle with meaningful solutions.

Clayton Chau, M.D., Ph.D., is the regional executive medical director of St. Joseph Hoag Health’s Institute for Mental Health & Wellness.

Man and his mother found dead after apparent heroin overdoses in St. Louis home

Posted on: June 7th, 2017 by sobrietyresources

By Christine Byers St. Louis Post-Dispatch Jun 5, 2017

ST. LOUIS • A woman called police Sunday after she could not wake her daughter and grandson, and police believe both fatally overdosed on heroin.

The victims — a woman in her 50s and her son, about 30 — were pronounced dead by EMS workers at a home in the 3100 block of Pennsylvania Avenue just after noon on Sunday, police said.

Officers found the mother and son slumped over on a bed with a syringe and baggie of suspected heroin on a nightstand in the Benton Park West home, police said.

Privileged teenagers at high-achieving schools are up to three times MORE likely to battle a drug addiction in their mid-20s

Posted on: June 7th, 2017 by sobrietyresources

  • Some 40 percent of men from affluent areas face addiction by the age of 26
  • High-pressure schools with impressive grades are thought to be to blame
  • Universities continue to offer limited places and require demanding applications
  • Well-off families increases a student’s disposable income, prompting fake IDs
  • Peer pressure and parental ignorance to the problem may also play a role

By Alexandra Thompson Health Reporter For Mailonline

PUBLISHED: 11:01 EDT, 31 May 2017 | UPDATED: 11:50 EDT, 31 May 2017

High-school students living in affluent communities are up to three times more likely to have a drug or alcohol addiction in their mid-20s, new research reveals.

Up to 40 percent of men who attended schools in privileged areas are battling addiction by the age of 26, the study found. Some 24 percent of women are affected.

Researchers believe the high-pressure environments of schools with impressive average grades and lots of extracurricular activities in privileged areas are to blame.

Coming from a well-off family may also increase a student’s disposable income and therefore their access to fake IDs, the researchers add.

They warn this trend is unlikely to wane while universities continue to offer limited places and demand extensive applications.

How the study was carried out

Researchers from Columbia University analysed students from affluent communities in the north-east of the US.

The students were assessed while still at school and were then analysed again annually for four years or from the ages of 23 to 27.

Key findings

Results, published in the journal Development and Psychopathology, revealed up to 40 percent of men and 24 percent of women in the study had a drug or alcohol addiction by the age of 26.

This is up to three times higher than the national average, the research adds.

The researchers believe these findings may be due to students been under high amounts of pressure as they attended schools with impressive average grades and a lot of extracurricular activities.

Pressure may have also come from the students’ parents.

Lead author Suniya Luthar said: ‘Without question, most of the parents wanted their kids to head off to the best universities.’

Family affluence may have also made it easier for the students to access drugs and alcohol.

Ms Luthar said: ‘Many kids in these communities have plenty of disposable income with which they can get high-quality fake ID’s, as well as alcohol and both prescription and recreational drugs.’

The researchers also blame peer pressure and parental ignorance towards substance abuse.

What the research means for the future
Ms Luthar said: ‘Messing with drugs and alcohol really should not be trivialized as just something all kids do.

‘For high-achieving and ambitious youngsters, it could actually be persuasive to share scientific data showing that in their own communities the statistical odds of developing serious problems of addiction are two to three times higher than norms.

‘And that it truly just takes one event of being arrested with cocaine, or hurting someone in a drunken car accident, to derail the high profile positions of leadership and influence toward which they are working so hard for the future.’

The researchers added, however, pressures placed upon students are unlikely to wane any time soon.

Ms. Luthar said: ‘As long as university admissions processes continue to be as they are – increasingly smaller number of admits per applications and requiring impossible resumes – these young people will continue to be frenetic in pursuing those coveted spots – and many will continue to self-medicate as a result.’

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