Substance Abuse

Survey Reveals Lower Public Trust Over Safety of E-Cigarettes

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Recent research has proven that people’s perception of e-cigarettes as the safer one to use compared to traditional cigarettes has declined over the years.

Johns Hopkins Bloomberg School of Public Health Professor Eric Ford, the team leader of the study, said that it is a good thing that people are now more informed of the adverse health impacts of electronic cigarettes despite the lack of action from the government or public health organizations. He also said that public  awareness goes a long way in keeping an eye on the things that could result to irreversible trends on public health, like the use of e-cigarettes.

Sponsored by the  U.S. National Cancer Institute, the study made use of surveys among 3,000 respondents who were smokers, former smokers, and non-smokers in the years 2012, 2013, and 2014. While the awareness on e-cigarettes rose from 77 to 94 percent (a difference of 17 percent) between the year 2012 and 2014, people’s perception that it is safer than traditional cigarettes fell from 50 percent to 43 percent between the same time periods, as reported in a news item.

In order to regulate and discourage the use of e-cigarettes, the U.S. Food and Drug Administration has started to lay out their plans on regulating and prohibiting the purchase and selling of e-cigarettes especially among the youth.


Options For Drug Addiction Treatment

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Drug addiction is a condition that has plagued so many families and has reached a point where there is a need to put our best efforts in order to fight it. The war against drugs is a huge call to everyone to participate in preventing the spread of the “disease”, and may have somewhat affected the drug trade in several countries.  Coming up with stricter laws to prevent illicit substances from further harming individuals and families should be a continuous move.

The Real Score on Substance Abuse

In recent years, the U.S. has been confronted with so many drug-related incidents involving the youth. According to the latest Monitoring the Future Survey of drug use and attitude, there has been a decline in substance abuse among 8th, 10th and 12th graders. However, it is not enough reason to rejoice over the decline as there are other incidents that have affected several lives because of drug use.

The Citizens Commission on Human Rights (CCHR) documented at least 35 incidents of school violence committed under the influence of psychiatric drugs.

It is more painful to see the deaths of so many innocent lives where users would randomly shoot at people or run them over because of being intoxicated with alcohol or illicit drugs. Apart from having law enforcement authorities on full alert with regards to drug trading and keeping a watchful eye on users, several government agencies and non-government institutions have put their best efforts in extending help in terms of dissemination of information about the effects of drug misuse on individuals and the society as a whole. Programs are also being conducted to help those who need to recover from drug addiction.

The Drug Rehabilitation Process

It is the goal of any rehabilitation institute to provide the utmost medical care needed by a recovering drug user. We know that there are specific medications given to individuals who have involved themselves with different kinds of drugs. While these can be helpful, it is still best that a rehabilitation program should be individualized to best suit the needs of the patient.

The whole process of recovery may be a daunting time for the patient, knowing that the initial stage of the process will also involve a series of painful withdrawal symptoms.

However, apart from completely helping to get rid of the illicit substances in the body, another part of the recovery program is aimed towards the psychological health of the patient. In this case, the mind is slowly programmed to get back to the old self and regain confidence and self-worth, with the help and support of family and friends.

The road to recovery means lifelong commitment and dedication. It may not be an easy path but it will be definitely rewarding to be able to achieve the goal of gaining back the life that was lost.

Key Elements Towards Drug Addiction Recovery

An effective treatment plan for drug users may vary depending on the kind of substance abused, as well as the degree and duration of misuse. However, the process towards any recovery plan contains the following basic components:

1. Finding the Right Rehabilitation Center

There are a lot of rehabilitation centers all over the country. Recovering addicts or their loved ones should be able to find the right treatment facility that can provide the support needed, based on the specific needs of the patient.

Initially, the rehabilitation center will provide some diagnostic screening to be able to determine the most optimal treatment plan for the patient. Every detail should be presented: the type of substance used, the amount of substance used, and the length of time that the patient has been using the substance.

The center should be informed about the family history to be able to establish the root cause of addiction. From this information, the treatment facility and the patient’s family should be able to discuss financial arrangements.

It is important that the patient, with the help of the family, will be able to find the right program that can best help him/her. Once he/she feels comfortable to whatever has been presented, then it is more likely that the patient can live a life good health and sobriety.

2. Detoxification

Detoxification is the process where the abused substance is taken away from the patient’s system. It is not an abrupt process since during this stage the patient may experience withdrawal symptoms ranging from mild to unfavorable.

Medication is usually given to ease the withdrawal symptoms, and this may include opiate prescription drugs and heroin. These same drugs are commonly misused, but if given under direct supervision by a doctor, it should be able to help and not aggravate the patient’s condition.

Withdrawal is the stage wherein the patient may experience unfavorable symptoms due to insufficient amount of drugs that he used to take, in which case the body may no longer be accustomed to the decrease in substance intake.

Withdrawal symptoms appear within the first 24 hours after the last drug misuse. Symptoms may include:

  • Agitation
  • Cramping
  • Decreased appetite
  • Extreme depression
  • Loss of concentration
  • Muscle tension and pain
  • Headache
  • Nausea and Vomiting
  • Hallucinations
  • Seizures
  • Trembling
  • Stroke
  • Heart attack

Detox Medications

Medications are often given to drug users to help them overcome painful withdrawal symptoms. The drugs to be prescribed will depend on the type of substance used by the patient. The need for these drugs to complete the process is highly important because it is through these medications that the patient will be able to slowly keep up with the normal way on how the bodily systems should work.

  • Barbiturates: These are mild sedatives that help in relieving irritability, anxiety and discomfort. It may also prevent seizures during the detoxification process.
  • Benzodiazepines: These are anxiolytics that are commonly used during alcohol detoxification to help reduce seizures, relieve anxiety or depression, and decrease the severity of withdrawal symptoms.
  • Buprenorphine: This drug is used to treat heroin and opiate prescription medication. However, this was later on replaced by methadone due to the latter’s inability to produce a euphoric feeling.
  • Methadone: This type of drug is given to ease patients who have severe drug addiction problems. The dose is slowly lessened as the process progresses to prevent from being addicted to this drug.

3. Psychological Therapy

After undergoing the detoxification process, the patient is moved to therapy wherein the focus is towards behavior. It is a known fact that drug addiction does not only affect the patient’s body, but also largely alters brain functioning to cause impairment in decision-making and other brain activities.

To help patients slowly get back to their normal selves, therapy (which can be individual or with a group) is suggested to the patient.

Psychological therapy focuses on letting the patient realize and confront any existing problems that may have led him/her towards drug addiction. From there, the individual should be able to overcome addiction and have a better perspective about life.

The therapy is not for the patient alone; some programs may include the family as part of the process. It is also important that the family participates in the “healing process” as they have also suffered with their family member’s drug addiction. This can be a great way to speed up the recovery of the patient.

4. Recovery and After Care Program

Therapy may sound like the end of the rehabilitation program, but some people may have to deal with a lifelong journey of trying to keep sober. There is always a possibility for a relapse most especially if the patient does not stay away from people who may have influenced him to take drugs.

For those who are willing to go on a straight path towards recovery, after care programs may help. These programs involve having weekly visits at the rehabilitation centers, conducting regular drug testing, or even allowing recovering individuals to stay at a sobriety clinic for them to participate in group sessions. These programs may also include doing chores until they feel that they can start living normally outside the facility.

Drug Addiction Treatment Options

There are various treatment options available for drug users who opt to recovery from their addiction.

Inpatient Recovery Programs

This may be the most effective kind of treatment program as patients with co-occurring disorders may be treated. Treatment facilities offer a 24-hour intensive medical care under strict medical supervision where health professionals provide simultaneous care for any co-occurring medical and or mental health conditions.

The inpatient treatment includes:

  • A structured program where patients remain in the facility from 6 to 12 months with the entire community and highly-skilled professionals who will positively influence patients towards having a drug-free kind of life.
  • Short-term residential treatment is the detoxification and initial counseling provided to a drug user, and is offered in preparation for community-based treatment.
  • Recovery housing or sober living homes are offered to patients who have completed the program and are being prepared to face the outside world. This is made possible by providing short-term housing for patients to aid them in making the transition.

Inpatient facilities may be in the form of a hospital or a residential facility. Some residential facilities may offer more than what one can expect like living in a luxurious home (resort-like facility) or an executive set-up (where businessmen are allowed to continue with their involvement with their work while being treated inside the facility).

Outpatient Behavioral Treatment

Some individuals may not require full-time recovery process to be placed in an inpatient treatment setup. They are given schedules on when to check in with their facilitators to check on their progress.

Initial treatment may require frequent visits weekly. After completing the initial stages, the treatment may require fewer meetings per week with shorter hours per session.

This type of program is also given to patients after the detoxification process wherein psychological assessment and rehabilitation is given. This may involve individual or group counseling which may include:

  • Cognitive-behavioral therapy: According to the Psychiatric Clinics of North America, this is a very effective means of helping individuals with substance abuse.
  • Motivational interviewing: This encourages the patient to fully surrender the addiction and to start rebuilding his life.
  • Motivational incentives: These encourage the patient to focus on what motivates him to become better and to completely stay away from drugs.
  • Multidimensional family therapy: This is a great way of involving the whole family for the recovery process.

A 12-step program may be suggested to help patients to fully recover by being with the same individuals who have gone through the same predicament and be able to help one another overcome their addiction completely.

Some of the well-known support groups include the following:

  • Alcoholics Anonymous (AA): A support group for people who are recovering from alcohol addiction.
  • Narcotics Anonymous (NA): This is similar to the Alcoholics Anonymous support group, but focuses on people who are recovering from drug addiction.

Meanwhile, specialized drug recovery support groups that have adapted the 12-step program include Cocaine Anonymous and Heroin Anonymous.

Treatment for Drug Abusers and Addicted Individuals Involved in Crimes

Individuals who have been out behind bars and are simultaneously given help to recover from addiction have less likelihood for a relapse because the individual is able to consistently go on with the program and become more focused on aiming for a renewed life than those who are not under any legal conditions.

It has been reported that those individuals who took the program while completing the required jail term are more likely to continue the program and have better chances of complete recovery.


It should be emphasized that drug addiction is a treatable and recoverable condition. Individuals should just be willing to give up on the addiction and start facing life again.

In order to have a successful treatment program, a person should look for the best drug treatment facility that can best suit his needs, and follow the program that has been tailor-made to fit with his drug addiction problem. Recovering addicts must also undergo a continuous aftercare program that will help them in seeking solutions to problems that have lead to addiction, in realizing what they can do to make life worthwhile, in rebuilding their lives and broken relationships, and in avoiding a relapse.

It is never an easy journey for these drug users to completely get back to their usual lives. However, with the support, love and care of family members and friends, the bumpy road may just be worth the trip.

Real Drug Stories

Drug Policy Alliance Campaigns Against Jeff Sessions For Attorney General

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The Drug Policy Alliance is spearheading a drive to stop the nomination of Alabama Republican Senator Jeff Sessions as Attorney General. The campaign, which comes with a new video, was launched January 4, 2017.

The initiative exposes Jeff Sessions’ appalling record on drug policy, civil and human rights, and criminal justice reform. The accompanying video was created by award-winning filmmaker Dream Hampton, and features a call to action requesting people to ask their Senators to reject the nomination of Session for Attorney General.

The Drug Policy Alliance is collaborating with a wide coalition of organizations across the political spectrum who are against Sessions. Last December, it organized a teleconference for reporters focusing on the senator’s civil and human rights record, criminal justice reform, and drug policy. Aside from Drug Policy Alliance, expressing their concerns about Sessions are representatives from Latino Justice, NAACP Legal Defense Fund, the Council on American Islamic Relations, the Cato Institute, and the Samuel DeWitt Proctor Conference, as reported in a news article.

This is not the first time that Sessions’ atrocious civil rights record has been a major concern. In 1986, his confirmation was rejected by the Republican-controlled Senate Judiciary Committee due to his extensive record of racist comments and actions. One of his black colleagues made a testimony that Sessions called him a “boy.” He was also accused of using his authority as an attorney to file cases against civil rights activists who were helping African-Americans to register so they could vote.

According to Bill Piper, Senior Director of National Affairs of the Drug Policy Alliance, they will do everything to stop Sessions from being confirmed.

Health & Wellness

Obese Parents May Cause Poor Development in Kids

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A new study by the National Institutes of Health revealed a link between obesity in children of obese parents and developmental delays.

Findings of the research revealed that children of obese mothers were likely to fail tests of fine motor skill such as controlling small muscle movement particularly in the fingers and hands. In the case of children of obese fathers, they are more likely to fail tests involving social competence. Meanwhile, those who were born to extremely obese parents are likely to fail in problem solving ability tests.

Compared to children of normal weight mothers, children of obese mothers are 70 percent at risk of failing the test indicators of fine motor skill by age 3. Children of obese fathers, on the other hand, are 75 percent more likely of failing personal and social domain indicators upon reaching the age of 3. Children of both obese parents are three times at risk of failing problem solving indicators by the age of 3.

The study, which appeared in Pediatrics, was conducted by a team of scientists from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health. According to Dr. Edwina Yeung, Ph.D, previous studies centered on the pre- and post-pregnancy weight of the mother.

“Our study is one of the few that includes information about fathers, and our results suggest that the weight of the father also has a significant influence on the development of the child” said Dr. Yeung via a news item. She was also an investigator in the NICHD’s Division of Intramural Population Health Research.

Dr. Yeung and her coauthors cited research which showed that 1 in 5 pregnant American women suffer from overweight or obesity.

Substance Abuse

Kinds of Designer Drugs

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The increasing number of designer drugs has put Americans at risk. The 2013 World Drug Report of the United Nations Office on Drugs and Crime (UNDOC) revealed that the abuse of illicit substances continues to grow and more synthetic drugs find their way in the market. In this article, we will discuss the different kinds of designer drugs.

What Are Designer Drugs?

Designer drugs are substances that are manufactured in a laboratory. The manufacturers change the properties of a drug using the tools of chemistry. These substances may not be subjected to quality control standards or governmental oversight.

Designer drugs are manufactured in a different way other drugs are normally created. Should the government regulate an ingredient or element, the manufacturers would change things again so as not to be arrested. But just like other drugs, designer drugs are capable of altering the functions of the human brain.

Where Did Designer Drugs Originate?

Designer drugs are actually not new. Back in the 19th century, a lot of these kinds of drugs were being designed. In 1803, German pharmacist F.W. Serturner separated morphine from opium. In 1855, a chemist named Edeleano isolated cocaine from the coca bush. The isolation and combination of drugs have resulted to the production of new uppers, downers, tranquilizers, and painkillers.

Today, these substances are very common and popular. However, they were once unknown substances that no one dared to study about.

The most popular example of designer drugs is ecstasy. This substance was the result of the synthesis of MDA and MMDA, both illegal drugs. Derived from the oil of nutmeg, these two substances can have various adverse effects such as headache, dizziness, and abnormally fast heart rate, to name just a few.

After ecstasy was outlawed, a new alteration of MMDA called “eve” was born.

How Lethal Are Designer Drugs?

As new drugs are discovered, drug manufacturers will continue to change the form of the drug and the health of the public will continue to be at risk.

Take the case of fentanyl, which is also known as “China White.” This substance has around 1,400 possible chemical alterations. While some of them are used for medicinal purposes in the operating room, fentanyl used in the streets as a synthetic heroin has been linked to more than a hundred deaths on a yearly basis due to its strength. This substance is so lethal that it can be placed on the head of a pin to kill 50 people.

Another highly lethal designer drug is MPTP. This heroin-like drug has resulted to more than 400 cases of Parkinson’s disease, which can permanently disable those that are affected.

These efforts to alter the composition of a drug can produce the same effects and dangers of illegal drugs. Drug manufacturers are doing this to prevent prosecution.

The Growing Designer Drugs Menace

In July 2012, U.S. President Barack Obama signed a law banning designer drugs to cover 26 chemicals commonly used in manufacturing synthetic drugs. Even then, designer drugs continued to become popular. In the last four years, more than 300 different designer drugs have entered the market and wreaked havoc in communities.

Most suppliers have the ability to change the chemical formula of a drug so that it will not contain illegal chemicals, thereby allowing them to sell drugs legally. Most drugs of this kind are constantly changing form and remain unregulated in the online market. It would take government initiatives in countries that manufacture drugs to stop the manufacture and distribution of these synthetic drugs.

If not regulated online, the public can easily access these synthetic drugs. Local government leaders must take the necessary steps to counter the spread of synthetic drugs. One effective measure is by educating their constituents about the dangers of synthetic drugs. They can also provide proper addiction and rehabilitation treatment, and making individuals and establishments that sell illegal substances liable.

According to recent statistics, a total of 200 search and arrest warrants related to synthetic drugs have been issued by the Drug Enforcement Agency (DEA) and from that number, 150 were arrested. Aside from that, roughly $200 million in cash and assets were seized. These figures were derived from the 2012 Monitoring the Future Survey of the Drug Abuse Network.

Who Are Prone To Abusing Synthetic Drugs?

The following people are likely to abuse synthetic drugs:

Young Teens

Teenagers aged 12 to 17 years old are susceptible to synthetic drug abuse. They are likely to try out these drugs due to their gullibility and curiosity.

Recovering Addicts

People who are recovering from drug abuse will look at synthetic versions as an alternative to illegal drugs. Given the volatile potency of designer drugs, they could be trying something more potent than what they are recovering from.

Convicted Felons

Synthetic drugs are very accessible in prison and the temptation to try them out can be very strong among convicted individuals.

Kinds of Designer Drugs

Here are some of the most common kinds of designer drugs, and how each substance can affect human health:

Synthetic Cannabinoids

Synthetic cannabinoids are falsely marketed as a safe and legal alternative to marijuana. Popularly known as Spice or K2, these substances are sold together with other tobacco products. These designer drugs also goes by popular names such as Yucatan Fire, Skunk, and Moon Rocks.

Synthetic cannabinoids are sold in huge amounts online to dealers in the United States who in turn repackage them for individual selling. This is considered the second most abused drug among high school students next to marijuana. They contain harmful chemical additives that may lead to rapid heart rate, paranoia, vomiting, hallucinations, and heart attack due to limited supply of blood to the heart.

Since they have a “not for human consumption” label, they are not covered by any legal regulations that govern drugs, even though they are more potent than illegal drugs.

All cannabinoids, which include the synthetic compounds in Spice, are classified together with marijuana as a Schedule 1 drug. However, manufacturers of the drug have managed to stay legal by slightly altering the chemical structure in order to create a new compound, which has not yet been classified as illegal.

Because the chemical composition of synthetic marijuana is constantly changing, there is very little data on its effects on the human body. However, those who have abused the synthetic drug have reported various symptoms such as rapid heart rate, vomiting, agitation, confusion, and hallucinations.

Aside from that, synthetic cannabinoids have also been known to increase blood pressure. In a few instances, it has also been linked to heart attacks.


Chemical structure of AMT

Alpha-Methytryptamine (AMT) was first developed in the 1960s as an anti-depressant. As a psychedelic and stimulant drug, the drug is known for creating a feeling of euphoria and hallucinations just like MDMA or LSD even though the chemicals are structurally unrelated. Although still legal in Canada and the UK, aMT was permanently classified as a Schedule 1 drug. It is easily accessible online where it is being sold as a “health supplement.”

Another good example of a psychedelic drug is N-bomb, found in the drug LSD. These are lethal hallucinogens that come in either liquid or powdered form.

Synthetic psychedelics can also be inhaled, injected, or used as a suppository. Small quantities of the drug can last for more than 12 hours.

Synthetic Cocaine

Synthetic cocaine is readily available and legal in most countries. It is being sold on the Internet as a “research chemical” or as a “plant food.” It is known by several names such as Mind Melt, Amplified, or Mint Mania.

Synthetic Cathinones

Commonly known as bath salts, synthetic cathinones go by different names such as Arctic Blast, Blue Silk, and Monkey Dust. Bath salts have emerged as a serious and growing public health and safety concern.

When in crystalline form, it is similar to amphetamines and may lead to elevated blood pressure, agitation, hallucinations, and excited delirium.

Synthetic Opioids

Synthetic opioids such as fentanyl and ketamine are easily accessible. They are usually injected but ketamine comes in smoke or sniff varieties. They are associated with unpredictable and more severe side effects than the opioids where they came from.

Ketamine is popularly called Vitamin K on the street.

Synthetic Sedatives

Synthetic sedatives are known by different street names such as barbies, blue devils, pink ladies, sleepers, and barbiturates. They are classified as a depressant-type drugs. They are used to alleviate symptoms of tensions and anxiety by bringing the user into a calm and relaxed state.

Synthetic sedatives are classified as Class B narcotics.

Synthetic Piperazines

Originally developed for the treatment of parasitic infections, synthetic piperazines have allegedly caused the euphoric feeling to the users just like amphetamine and MDMA. They are usually marketed as herbal ecstasy.

Synthetic Dissociatives

Dissociatives goes by many street names: acid, blotter, doses, hits, microdots, among others. LSD is a good example of this drug. It is a clear, white, odorless, and water soluble material derived from lysergic acid.

Dissociative drugs may be used as a medical anesthetic. It has euphoric properties that can make the user addicted to it. This type of drugs can be gaseous, liquid, or as a powder, and is designed for medicinal and culinary purposes.

Synthetic Androgens

Anabolic steroids may be administered through injection.

Synthetic androgens have become infamous as performance-enhancing drugs. The most common example is anabolic androgenic steroids. To veer away from prosecution, these substances are marketed as nutritional supplements.

In the absence of clinical studies, there is little information about the pharmacological effects and metabolism of unapproved steroids. Strict regulations and improved education is needed.

Synthetic Empathogens

From the name itself, synthetic empathogens produce experiences of empathy or sympathy such as oneness, relatedness, or emotional openness. They are psychoactive drugs that are different from hallucinogens, amphetamine, or stimulants.

Synthetic Nootropics

Also called smart drugs, nootropics are designed for enhancing cognitive functions, particularly executive, memory, creativity, or motivation of healthy individuals. Coined in 1972 by Corneliu Giurgea, a psychologist and chemist, nootropics came from the Greek words νους nous meaning “mind” and τρέπειν trepein which means “to bend or turn”.

In 2015, sales of cognition-enhancing supplements breached the US$1 billion mark.


With synthetic drug use continuing to grow, there is a need for world governments and individuals to be more vigilant. Proper education needs to be strictly enforced, and regulations needs to be put in place.

Helpful Links and Resources

Medical Marijuana Substance Abuse

Teens Perceive Less Danger in Cannabis After Recreational Marijuana Legalization

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While the rate of marijuana use continues to increase, its perceived danger has decreased among 8th and 10th graders in the state of Washington. This was according to a study conducted by UC Davis and Columbia University Mailman School of Public Health and published online in JAMA Pediatrics. The findings of the study come in the heels of the legalization of recreational marijuana.

In the state of Colorado, there was also no change in use or perceived harm among teens in similar grades. Washington and Colorado were the first two states to legalized recreational marijuana in 2012. Two years later, Alaska, Oregon, and Washington DC also legalized recreational cannabis use. Just this November, California, Massachusetts, and Nevada voted for its legalization.

The study was the first to make an assessment of the perception of teens regarding marijuana use before and after the legalization of recreational use. The findings were compared to the attitudes of teens were marijuana use is still considered illegal, according to a news article.

According to Deborah Hasin, an epidemiology professor at the Mailman School of Public Health of Columbia University and psychiatry at the Columbia University, the perceived danger of marijuana has seen a sharp drop in the last few years in the United States, even though there were adverse effects associated with marijuana use in some adults and adolescents. Hasin served as the principal investigator of the study.

In states where marijuana use is still not legal, the perceived harm saw a 5 to 7 percent decrease among students in the same grade levels. However, marijuana use dropped by 1.3 percent and 0.9 percent. Among older adolescents in Washington and Colorado, there were no changes in perceived harmfulness after the legalization.

Drug Testing Real Drug Stories

Five Biggest Stories in TestCountry Blog for 2016

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Hello 2017! As we welcome the New Year, let us review the biggest and most viewed articles of 2016 in the TestCountry blog.

5. What is Clonazolam and Why Is It Dangerous?

Designer drugs have become popular in recent years, and that’s why a lot of people are looking for information about some of these drugs. One of the trending articles this year was our feature on clonazolam, a fast-acting benzodiazepine with a high potential for addiction and tolerance.

4. Kratom Ban Expanding In More U.S. States

As kratom emerges as one of the most popular topics of 2016, our article on the kratom sent online readers scrambling for more information about the kratom ban, which is increasingly expanding in more states. Although the Drug Enforcement Agency (DEA) has not placed kratom under Schedule I, many U.S. states have pursued a ban on the use of this controversial substance.

3. All You Need To Know About U-47700

This drug has probably risen in popularity after the death of legendary music icon Prince was linked to his use of a cocktail of drugs that included U-47700. Our article about U-47700 discussed everything that you need to know about the substance.

2. Kratom Ban Lifted By DEA

Whether you are a supporter or part of the opposition, you cannot deny the fact that news on kratom ban have become very popular this year. This feature on DEA’s decision to dismiss an earlier move to categorize kratom as a Schedule I drug became one of our most read articles this year.

1. All You Need to Know About Urine Drug Testing Cheating

Whatever the motive behind the boost in readership for this particular blog post — whether to become more informed or to learn how to cheat drug tests — this article on drug test cheating became our biggest story of the year.


We hope you learned so much from our articles in 2016. Rest assured, the TC blog will provide a lot more information about drug testing and trending topics on drugs.

Drug Testing

FAQ on CPT Drug Testing Codes G0477-G0483

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There has been confusion among Medicare payers and laboratories with regards to the proper billing of drug tests. With the release of the new HSCPC “G” codes, some other tests that healthcare payers have taken were told to be not covered under these codes.

In this article, we will share answers to some of the frequently asked questions about the CPT drug testing codes:

What is the difference between the CPT codes and HCPCS codes?

CPT stands for Current Procedural Terminology and is administered by the AMA (American Medical Association). Meanwhile, HCPCS stands for Healthcare Common Procedural Coding System and is a standardized coding system for the description of specific services and items.

HCPCS codes having three levels, Level I, Level II and Level III. All CPT codes are HCPCS codes but are only found on Level I HCPCS.

When and how was HCPCS established?

HCPCS was established in 1978 which was based on AMA’s CPT processes. With the implementation of HIPAA in 1996, facilities started using HCPCS for transaction codes.

What are the HCPCS Levels?

Although HCPCS has its own guidelines, it works hand in hand with CPT codes. The different levels are as follows:

  • Level I codes consist of the AMA’s CPT codes and is numeric.
  • Level II codes indicate the HCPCS alphanumeric code set, and primarily include non-physician products, procedures, and supplies outside the scope of CPT.
  • Level III codes, also called HCPCS local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurance companies for the purpose of specific programs and scope. These items may be found in the HCPCS reference coding book. Some coders are required to indicate Level III codes ont opt of code sets for Levels I and II, but these codes are not accepted in all states.

What are the non-physician services covered under HCSPC codes?

HCSPC Level II codes are used for billing and identifying items and services such as:

  • Ambulance services
  • Prosthetic devices
  • Drugs, infusion additives, and ancillary surgical supplies
  • Non-physician services not covered by CPT codes (Level I codes)

How would you determine which code to use along with your health plans?

Different health insurance companies may use different kinds of codes. It is best to know which codes your health insurance company uses by knowing the following:

  • When the CPT and a HCPCS Level II code for a specific service or procedure have pretty much the same narratives, using the CPT code is recommended. Otherwise, the HCPCS Level II code should be used instead.
  • Check for a HCPCS national code when a CPT code description contains an instruction to include additional information, such as describing a specific medication.

What are the newly released “G” Codes?

The following codes are the newly released “G” codes that the Centers for Medicare and Medicaid Services (CMS) currently recognize:

HCSPS code G0477

A presumptive drug test used in any number of drug classes, any number of devices or procedures capable of being read by direct optical observation only (such as dipsticks, cups, cards, and cartridges) that includes sample validation when performed per date of service.

HCPCS code G0478

A presumptive drug test used in any number of drug classes, any number of devices or procedures read by instrument-assisted direct optical observation such as dipsticks, cups, card and cartridges that includes sample validation when performed per date of service.

HCPCS code G0479

A presumptive drug test used in any number of drug classes, any number of devices or procedures by instrumented chemistry analyzers (utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, DHPC, and GC mass spectrometry) that include sample validation when performed per date of service.

HCPCS code G0480

A drug test definitive that uses any of the following:

  • Drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily sterioisomers), including, but not limited to:
    • GC/MS: any type, single or tandem)
    • LC/MS: any type, single or tandem and excluding immunoassays (IA, EIA, ELISA, EMIT, FPIA)
    • Enzymatic methods: such as alcohol dehydrogenase
  • Stable isotope or other universally recognized internal standards in all samples, such as to control for matrix effects, interferences and variations in signal strength
  • Method or drug-specific calibration and matrix-matched quality control material, such as to control for instrument variations and mass spectral drift; qualitative or quantitative, all sources, includes specimen validity testing, per day, 1-7 drug class(es), including metabolite(s) if performed. [source]

HCPCS code G0481

A drug test definitive that uses any of the following:

  • Drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily sterioisomers), including, but not limited to:
    • GC/MS: any type, single or tandem)
    • LC/MS: any type, single or tandem and excluding immunoassays (IA, EIA, ELISA, EMIT, FPIA)
    • Enzymatic methods: such as alcohol dehydrogenase
  • Stable isotope or other universally recognized internal standards in all samples, such as to control for matrix effects, interferences and variations in signal strength
  • Method or drug-specific calibration and matrix-matched quality control material, such as to control for instrument variations and mass spectral drift, qualitative or quantitative, all sources, includes specimen validity testing, per day, 8-14 drug class(es), including metabolite(s) if performed.

HCPCS code G0482

A drug test definitive that uses any of the following:

  • Drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily sterioisomers), including, but not limited to:
    • GC/MS: any type, single or tandem)
    • LC/MS: any type, single or tandem and excluding immunoassays (IA, EIA, ELISA, EMIT, FPIA)
    • Enzymatic methods: such as alcohol dehydrogenase
  • Stable isotope or other universally recognized internal standards in all samples, such as to control for matrix effects, interferences and variations in signal strength
  • Method or drug-specific calibration and matrix-matched quality control material, such as to control for instrument variations and mass spectral drift, qualitative or quantitative, all sources, includes specimen validity testing, per day, 15-21 drug class(es), including metabolite(s) if performed.

HCPCS code G0483

  • Drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily sterioisomers), including, but not limited to:
    • GC/MS: any type, single or tandem)
    • LC/MS: any type, single or tandem and excluding immunoassays (IA, EIA, ELISA, EMIT, FPIA)
    • Enzymatic methods: such as alcohol dehydrogenase
  • Stable isotope or other universally recognized internal standards in all samples, such as to control for matrix effects, interferences and variations in signal strength
  • Method or drug-specific calibration and matrix-matched quality control material, such as to control for instrument variations and mass spectral drift, qualitative or quantitative, all sources, includes specimen validity testing, per day, 22 or more drug class(es), including metabolite(s) if performed.

What are the limitations of these drug tests?

Only one presumptive/definitive test may be billed to a patient per DOS. This means that subsequent tests will be denied.

What problems did Medicare payers and laboratories experienced after the release of the new “G” codes?

The release of the “G” codes created confusion in properly coding for the right test as well as proper billing of the tests provided.

What could be the effect of not being aware of using the right codes for billing?

It will have a negative impact on the revenues of the laboratories as well as the insurance payers paying incorrectly or insurance companies denying them for incorrect reasons.

Helpful Links and Resources


Health & Wellness Substance Abuse

Kratom Strains and How To Identify Them

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Kratom is a tree-like plant that is commonly found in Southeast Asia that belongs to the family of plants as coffee. It has also been used in Thailand and its neighboring Asian countries as an herbal remedy because of its opiate-like effect. It is also known to help as treatment for withdrawal symptoms associated with opiate addiction.

Kratom does not belong to the list of controlled substances and can be bought through the Internet and head shops. This substance comes in different forms such as loosed chopped, capsules and compressed tablets.

Researchers have found more than 20 biological active chemicals in the drug which can pose potential risk on drug dependency. It is now banned in some Asian countries despite its long history of use as herbal medicine due to its addictive potential.

Effects of Kratom

When taken in low doses, kratom effects may take place within 10 minutes and may last from 60-90 minutes. Most kratom users say that they feel a euphoric effect while others have reported to have experienced an uncomfortable feeling of anxiety. Its total effect is similar to amphetamine but with much less intensity. Symptoms include:

  • Decreased appetite
  • Increased libido
  • Increased alertness
  • Increased sociability
  • Decreased inhibitions

At doses of between 5-15 mg, users may experience the following:

  • Analgesia
  • Dream-like state
  • Drowsiness
  • Cough suppression
  • Decreased in symptoms of opioid withdrawal

For those who take more than 15 mg, the user may experience extreme sedation and loss of consciousness.

kratom pills dietary supplements

Kratom Strains Based on Veins and Stems

Kratom can be categorized according to different strains, as well as the varieties of color of veins and stems. The differences of these strains provide varying effects. The strength of kratom may be identified based either on the location or its color strain.

Here are the kratom strains based on stem and vein color:

White and green strains

These strains induce energy and productivity. Leaves from white stem kratom produce more stimulating effects than the red vein variety. The green leaves varieties are believed to provide clearer thinking and endurance. This is the type of strain that most athletes prefer to use.

A number of studies showed that the green vein variety aids in treating anxiety and depression.

Red strains

This kind induces calmness, sedation and relaxation, which is the opposite of the two other strains. After the initial rush of energy, the calming effect takes place. This variety is often used to provide pain relief and as a substitute for opiate detoxification. It is said to provide a euphoric feeling to users.

Kratom Strains Based on Location

kratom abuse

Kratom strains based on location are as follows:

Maeng Da

This is one of the most well-known forms of kratom. Maeng Da literally means “The Pimp”, and was named almost 20 years ago. It was believed that this strain was genetically modified to be able to provide its effects.

It is a popular choice among working men. It has forced growers to produce exceptionally potent and stimulating kratom to be able to provide for the demanding needs of laborers. Grafting became a popular technique in some Indonesian plantations, with the goal of producing the strongest kratom.

This type of kratom has white, green and red varieties, wherein the white and green are more popular.  Maeng Da is popular with those two varieties because it provides powerful mind-boosting and energy boosting effects accompanied with analgesic effect.

This strain has mood-lifting effects. Unfortunately, individuals may develop tolerance easily because its effect builds up quickly.


A large part of kratom supply comes from this island, second to Maeng Da in popularity. It has four strains where the red and green strains are the most popular.

  • Red Borneo: This strain has a sedating and soothing effect. It is a popular choice for pain management.
  • White Borneo: This is fairly popular to alleviate feelings of lethargy, depression, and lack of focus.
  • Green Borneo: This is the most popular of all Borneo strains because it helps enhance over-all mood to a euphoric level. It is known to remove aches and pains in chronic conditions.
  • Blended Borneo: This is a combination of all three strains. The individual effects of each strain complement one another.


This is commonly confused with Borneo kratom, which is more popular. It has three kratom varieties, with the red and green being more popular.

It is one of the most potent and cheapest strains of kratom, which makes it widespread. Some Borneo strains are shipped from the southern or western Borneo and are labeled as Bali as it would refer to the shipping hub of the strain.

  • Red Vein: This is the most popular of all Bali strains because of its effects, including analgesia, relaxation and anxiety relief, which is very similar with the Borneo strain.
  • Green Vein: Its effect is similar to the red vein variety but with less potency. This is good for those who want pain relief without wanting to have such high level of sedation.
  • White Vein: It is the least popular because of its low potency.

Indo kratom

The White Indo Kratom is the most popular among the three strains of Indo Kratom. This type of kratom can be found in Indonesia and some parts of Bali and Borneo.

There are different strains that grow in various regions with varying effects.

  • Super Indo: It is a very unique strain because it seems to retain the pain killing and relaxing effects of a red vein, as well as providing some very mild energetic effects.
  • Red Vein Indo: It has a very powerful analgesic, sedating and mood-lifting properties.
  • White Vein Indo: It is known for its “clean” analgesic effect, which helps in dealing with mentally strenuous tasks easier.


Malaysian strains are not as popular as the Indonesian strain because it is illegal in the country. The Super Green Malay strain is very popular for its bright green appearance as well as for proving energetic and mind-boosting effects.

  • Super Green Malaysian: It has a variety of effects and well-balanced properties such as anxiety relief, mood-lifting property, focus, pain relief, and energy boost.
  • Red Vein Malaysian: This strain provides more pain relief and sedating properties than the Super Green Malaysian variety.
  • White Vein Malaysian: It has the most stimulating and energetic effect among all Malaysian strains.


This is the less popular strain of Kratom because it is illegal in Thailand.  Most of the Thai-labeled kratom comes from Indonesia. Banning of kratom has nothing to do with its use but rather as a competition to opium business in the 1940s.

  • Red Vein Thai: This is most popular strain among all Thai strains because of its analgesic effect.
  • White and Green Vein Thai: These are helpful in treating depression.


This type of strain is less well-known among all strains. It is often a difficult strain to characterize by effects due to the differences in vein type effects. Among its uses are pain relief, insomnia treatment, anti-stress and mood-lifting properties.

  • Red Vein Sumatra: This variety has anti-stress properties, pain relief, insomnia relief, relaxation and a more sedating effect than the white variety.
  • White Vein Sumatra: A smaller dose of this variety will provide a stimulating and energetic effect. At large doses, it provides relaxation and pain-killing effect.


It is a province located in Borneo. The difference of this strain from the Borneo kratom is not well-known.

  • Red Vein Kalimantan: This can provide a calming effect that can last for a few hours even with just a low dosage. It is one of the well-known strains that provide a very relaxing effect.
  • Green Vein Kalimantan: It is becoming a widely accepted recreational sedative, and analgesic by users in the U.S. It aids in muscle relaxation and provides energy-boosting properties.
  • White Vein Kalimantan: This is the least well-known of all Kalimantan varieties.


This type of kratom is processed in a different way and because of this, it provides a different kind of flavor and an increased in alkaloid percentage.  This is a very rare strain of all varieties but is slowly gaining popularity in the market.

It is also known as the “Tropical Blend” for its calming and relaxing characteristics. It is also helping in improving sleep. Its length of efficacy is much longer compared to other strains.

[NOTE: This article is meant for informational purposes, and not a promotion of kratom or its various strains and forms.]


Substance Abuse

What is alpha-Methyltryptamine and Why Is It Dangerous?

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Psychoactive drugs have made the news rounds in recent years, as more people get hooked on these substances. In this article, we will discuss alpha-methyltryptamine, its addictive effects, and the dangers of abusing it.

What is Alpha-Methyltryptamine?

Alpha-Methyltryptamine (α-Methyltryptamine or AMT) is a psychedelic drug that belongs to the tryptamine family. This drug is commercially known as Indopan, IT-290, IT-403, U-14,164E and 3-IT.  It is a long-lasting psychoactive drug and euphoric stimulant.  Its mode of mechanism has resemblance to that of serotonin.

This substance was developed in the 1960s as an antidepressant by workers from Upjohn but gained its popularity in the 1990s. This was legally used in Russia under the brand name Indopan until it was banned.

It was said that a 5-milligram dose of this drug can be helpful in treating depression.

History of Alpha-Methyltryptamine Development

The following timeline shows the development and rise to infamy of the controversial drug:

  • March 1968: The Bureau of Drug Abuse Control mentions in Microgramthat AMT (IT-290) is available on the street as a “new” hallucinogen.
  • 1997: AMT is briefly available for purchase on the internet through CRSB.
  • Autumn 1998: More research chemical websites emerged as AMT becomes more widely available.
  • January 2003: There was an urgency in scheduling both AMT and 5-MeO-DIPT by the Drug Enforcement Agency.
  • April 2003: Due to an increase in use and health hazard, both AMT and 5-MeO-DIPT are placed into Schedule I through the emergency scheduling procedure. This makes both chemicals illegal to buy, sell, or possess without a DEA license.
  • September 2004: AMT is placed permanently into Schedule I of the U.S. Controlled Substances Act.

Why is alpha-Methyltryptamine being used?

Just like other psychoactive drugs, its effect has been sought after by individuals especially those who might be trying to escape from their personal problems or just merely wanting to belong to a group.

These drugs have the ability to alter the thoughts and moods of an individual. Examples of most common psychoactive drugs include ecstasy, cannabis, amphetamine, alcohol, heroin and cocaine.

How is alpha-Methyltryptamine taken?

The substance is available in orange crystalline powder form, and can be dissolved in water for easier ingestion. It can be taken orally as tablet or capsule in 10 mg to 100 mg. It can also be smoked with dosages ranging from 2mg to 20mg.

Between the two methods of administration, smoking the drug can produce a faster effect than ingestion.

These drugs are often purchased from chemical companies through the internet.

How is alpha-Methyltryptamine used?

AMT is typically consumed orally up to 40 mg in dosage. It will take about 3-4 hours before the hallucinogenic effects can be felt and may last up to 12-24 hours. In some instances, when higher doses are taken, the effect may last until two days.

This drug is popular among teenagers and young adults who frequent parties, raves, concerts and music festivals where the use of club or party drugs such as MDMA or ecstasy are common.

What are the effects of alpha-Methyltryptamine?

The effect of this drug varies depending on the amount or dosage used. This means that a higher dose that an individual takes will result to increased euphoric or psychedelic effecs.

Using 20-30 mg dose, an individual may experience:

  • Empathy
  • Euphoria
  • Psychedelic effect

These effects may last up to 12 hours.

What are the side effects of using alpha-Methyltryptamine?

As the effect of the drug takes place, a user may experience the following symptoms:

  • Anxiety
  • Headache
  • Pupil dilation
  • Muscle tension
  • Nausea
  • Vomiting
  • Jaw tightness
  • Tachycardia
  • Altered state of mind
  • Hallucinations
  • Emotional distress
  • Increased energy
  • Blurry vision
  • Restlessness
  • Nervousness
  • Irritability
  • Tension
  • Insomnia
  • Diminished inhibitions
  • Death

Why is alpha-Methyltryptamine dangerous?

When alpha-Methyltryptamine is used in conjunction with other substances, it can cause a high risk of danger to an individual. This includes other forms of substances such as alcohol or other drugs.

  • The individual may experience a negative feeling of anxiety or discomfort, which can result to have an outrage. This may last up to several days and can severely affect one’s mental state, thus leading to the inability to perceive well or to make decisions.
  • The effect of the drug can provide a euphoric effect to the user and at the same time cause harm to self and others because of disorientation. Several cases involved users forcing themselves to jump off roofs of buildings or run naked in the middle of the street without realizing what they are doing.
  • Long-term use of any kind of psychedelic drugs can lead to permanent psychosis. Those who may have a history of mental illness are more prone to succumb to such condition. In worse cases, this can also lead to death.
  • The use of psychedelic drugs can lead to several other mental conditions like anxiety, depression and depersonalization.

Over-all, the use of this psychoactive drug can affect the health of the individual as well as his social behavior wherein relationships among family members and friends are slowly being eaten away because of the effect of the drug in the user’s brain.

What is the drug’s effect on the brain?

These psychoactive drugs have the ability to alter the normal functioning of the brain wherein some drugs may mimic or block the effects of neurotransmitters.

The brain is organized into different regions that serve specific functions such as:

  • The hindbrain is responsible for breathing and wakefulness.
  • The midbrain is responsible for learning and reinforcing behaviors such as eating and drinking.
  • The forebrain is very complex. This is responsible for abstract and critical thinking.

When these regions of the brain have been affected due to use of psychoactive drugs, the normal function is altered. Too much brain activity – such as the increase in dopamine release – may lead to a euphoric effect that can be uncontrollable most especially if the user has taken in large doses. Hyperactivity or too much secretion of hormones can be fatal.

The normal functioning of the brain may no longer occur after an individual has become heavily dependent on certain drugs. For this scenario, a proper detoxification process may be used to resolve the issue.

On extreme cases, psychological conditions may be irreversible. In other words, the treatment given to a user may only be able to arrest physical or other medical irregularities.

Is alpha-methyltryptamine addictive and prone to abuse?

An individual may start out as being curious of the drug. The euphoric effect may be a welcoming feeling to the user as he feels numb or out of control without any worries or inhibitions. After some time of taking the drug, though, he may not feel the same kind of effect that he used to.

The next step would probably be taking a higher dose until the certain degree of “happiness” may be achieved. At this stage, the user may have such tolerance to the drug to a point that it leads to addiction.

Diagnosis of alpha-methyltryptamine abuse

Any form of inappropriate usage of drugs can lead to permanent mental health condition or even death. That is why it is best to intervene immediately when a person whom you know is involved in using AMT.

Early diagnosis is a move to save not only the user’s life but also the lives of people who surround him. Individuals under the influence of drugs can do drastic things without thinking of the repercussions of their actions.

If you suspect some powder in your home or location as AMT, you may use drug identification test kits to check the identity of the substance in question.

Treatment for alpha-Methyltryptamine addiction

Treatment for AMT addiction is similar to other types of drug addiction. The patient may be confined to a drug rehabilitation facility where he will undergo a medically supervised detoxification process which will aid the individual in getting rid of the drug inside his system.

After detoxification, the patient may need to undergo behavioral therapy accompanied by substance abuse counseling and therapy. The length of treatment will depend on the patient’s diagnosis and progress.

Continuous research and development of drugs designed to help people suffering from specific medical conditions is under way. However, when these drugs fall in the wrong hands, they may be prone to abuse. If you are in possession of drugs that may have a high potential for abuse, the best way to prevent recovering addicts from having access is to dispose of the drugs properly.

More than wanting to ban these dangerous drugs, there should be a comprehensive public awareness campaign about its dangers and risks to avoid future problems.

Legality of alpha-Methyltryptamine use

AMT is currently categorized under Schedule I of the Controlled Substances Act. This means that it is illegal to manufacture, buy, possess or use this drug. It has a high potential for abuse and has no legitimate medical purpose. Other drugs under this schedule are cannabis, ecstasy, heroin, and amphetamine.

Fatality due to AMT Intoxication

The drug has become popular among high school students and young professionals. The use of this substance has become widespread since it was easily bought through the internet prior to the scheduling on April 2003.

Miami-Dade County Medical Examiner Department revealed one of the first known fatalities in the U.S. associated with AMT, back in February 2003. Prior to the victim’s death, he informed his roommate that he was taking hallucinogenic drugs from which he was able to “discover the secret of the universe”. Twelve hours later, the young college student was found dead lying on his bed.

There was a 1-gram vial recovered from the scene. It was sent to the laboratory and its initial screening of urine by enzyme-multiplied immunoassay technique found that it has traces of amphetamine. Further research established the definitive cause of death as the presence of large doses of AMT on different organs of the body.

This case of AMT overdose, among many others, prompted the Drug Enforcement Agency (DEA) to have an emergency scheduling of the drug.

Statistics on Illicit Drug Use

About 200 million worldwide are known to be using some form of illicit drugs such as cannabis, heroin, amphetamines, opioids and cocaine. About 8% of youth in Western Europe and more than 20% from the USA are reported to having used at least one type of illicit drug other than marijuana.

Similarly, the increase in the number of individuals using these drugs through injection has aggravated the spread of HIV worldwide.

The exact number of AMT users has not been established as some cases may have not been properly identified due to AMT not being one of the drugs that can be determined easily through regular drug testing. Standard drug tests usually identify the following substances:

  • Amphetamines
  • Cocaine
  • Marijuana
  • Opiates
  • Phencyclidine (PCP)