An alarming amount of women in China are exposed to secondhand smoke, according to a new report, with serious health implications for this generation and the next. Over half of women of reproductive age in the world's most populous nation are exposed to second-hand smoke in the workplace, and almost two-thirds in their homes. The findings, released yesterday, were taken from a survey conducted in China back in 2010 by the Centers for Disease Control and Prevention in China, the US, and the World Health Organization. "There is no safe level of exposure to tobacco smoke," says Michael O'Leary, a WHO representative in China. "Creating 100% smoke-free environments is the only way to protect people from the harmful effects of second-hand tobacco smoke. Tobacco use and second-hand smoke exposure in reproductive-aged women can cause adverse reproductive health outcomes, such as pregnancy complications, fetal growth restriction, preterm delivery, stillbirths, and infant death." A quarter of China's 1.3 billion citizens are smokers—more than the entire US population—and nearly 100,000 people die from second-hand smoke alone each year. China is currently developing a plan for tobacco-free public spaces throughout the country.
- Colorado, Washington Approve Recreational Marijuana Use [NBC]
- Two Election Judges Removed for Being Drunk [CBS]
- One in Five Smokers Lights Up While Hospitalized [Chicago Tribune]
- Dollar Chains Tap Smokes, Booze to Drive Sales [Forbes]
- Pharmacist Accused of Trading Drugs for Sex [WishTV]
- "Teen Mom" Jenelle Evans Admits Her Drug Addiction Was Out of Control [Examiner]
- Herd of Indian Elephants Go On A Drunken Rampage After Mammoth Booze-Up [Metro]
Last week's news that an experimental vaccine against methamphetamine shows efficacy in animal trials made big headlines. It seems a far better bet than any previous anti-meth shots: “This is an early-stage study, but its results are comparable to those for other drug vaccines that have then gone to clinical trials,” said Michael Taffe, an associate professor in The Scripps Research Institute, who co-authored the study. Vaccines have long captured the public imagination as "magic bullets," but whether the news is more hype than hope is a question the coverage largely fails to address. This is peculiar, since a vaccine's progress from success in rats to efficacy in humans requires a quantum leap, and over four decades no vaccine for any drug has made it. Still, Scripps has impressive credentials: the La Jolla, Calif., research center has one of the nation's most robust drug vaccine programs. It also has Dr. Kim Janda, who was a leading pioneer of the concept of addiction vaccines, long before addiction was even viewed as a medical condition.
Most trial addiction vaccines are based on the common adjutant-vaccine model. This approach introduces into the blood a sample (live or lab-made) of the drug molecule, to spark the immune system into mounting an antibody defense against drug use. A major challenge is that most drug molecules are tiny enough to sneak past the immune system. So the molecules have to be artificially bulked up, both in size (by means of a harmless protein “platform”) and in activity (by means of an “adjuvant”—a copycat of the drug molecule that amplifies its effect). This three-piece invader reliably triggers a drug-specific antibody response. "The antibody is like a sponge," Janda said. "The drug comes in and it's soaked up, and you try to soak up as much as you can before it crosses the blood-brain barrier." (Most experts agree that a vaccine for alcoholism is unfeasible, because ethanol molecules are simply too small to spark an antibody response or even to attach a platform or adjutant to.) Block a drug’s access to the brain and you block that drug’s effect. And an absent or reduced high will further incentivize an addict who is already highly motivated (crucially) to abstain. So why has every fledgling addiction vaccine failed?
Climbing the evolutionary ladder from rodent to human is very rare (one in 1,000) for any experimental compound. Weapons that work in rats are usually either too blunt or too toxic to work in the human body's immensely complex and interconnected systems. Addiction vaccines that do work in humans also tend to have a high nonresponse rate, partly because of the great variability in drug-specific antibody formation. For example, the most successful exploratory cocaine vaccine fails to trigger an adequate immune response in 25% of subjects. But the mysteries of the human body may be less problematic than those of the human brain and mind. For one, the drive to experience euphoric highs can be all-consuming. Predictably, many subjects in clinical trials relapse soon after getting the vaccine, and face the added complication that to obtain the desired familiar pleasure state—and override the vaccine's anti-drug blockade—they then need to take higher doses than before. The risks of chasing the old high include overdose, spending excessive amounts of money, and switching drugs—meth for coke, say. In addition, the anti-drug effect of most addiction vaccines is only temporary, meaning periodic shot repeats are required—perhaps monthly in the case of the Scripps meth vaccine—posing a reliability test that many addicts are unprepared for.
That the neurochemistry and the psychology of craving remain out of reach of vaccines' power is a serious stumbling block. So is the glaring fact that no vaccine can soothe the myriad sources of physical and emotional pain that lead to self-medication in the first place. Where is the pill for poverty or violence? Money is, as ever, another obstacle: the drug industry balks at investing in treatments for addicts partly because they are viewed as too risky—impulsive, noncompliant, even criminal. The exception is smokers: several big pharmas have advanced nicotine vaccines into Phase III clinical trials. (A cocaine vaccine that doesn't require redosing has also reached late-stage testing.)
Alcohol is a notorious instigator of bad decision-making, so hitting the bottle before heading to the polls should be discouraged. But in two states—South Carolina and Kentucky—it's actually illegal to sell and serve alcoholic beverages on Election Day. The laws originate from Prohibition era, when swapping drinks for votes was a fairly common practice used to sway already-swaying voters. Seventy-nine years after Prohibition was repealed, these two states have maintained the restrictions, though not without resistance—especially since, for many, drinking is a solution for election-induced stress and anxiety. “The Election Day sales ban is a relic of the Prohibition era when saloons sometimes served as polling stations,” says Ben Jenkins, vice president of the Distilled Spirits Council of the United States. “Repealing the ban would provide consumers with much-needed convenience—whether they’re celebrating election returns or mourning them.” Kentucky Democratic Representative Arnold Simpson has tried to end the ban no less than five times, claiming it is now unnecessary since bribing voters with alcohol is a thing of the past. Also, the law costs the state $4.5 million in liquor store, restaurant and bar sales every year. Since 2008, five other states—Indiana, Delaware, Utah, Idaho and West Virginia—have lifted similar bans on Election Day drinking.
Anheuser-Busch InBev, the makers of Budweiser, have asked for their product's logo to be removed from Flight because the film (about an alcoholic airline pilot) is tarnishing their image. The film has already created a stir for its provocative, realistic portrayal of an addict, played by Denzel Washington, who is seen downing multiple beers (and other alcohol as well)—including while driving, and prior to operating an airplane. "We would never condone the misuse of our products, and have a long history of promoting responsible drinking and preventing drunk driving," said Rob McCarthy, vice president of Budweiser. "We have asked the studio to obscure the Budweiser trademark in current digital copies of the movie and on all subsequent adaptations of the film." But experts say the company's efforts may be in vain. While product placement has become common practice in the movie industry, experts say that trademark laws do not protect companies' rights to displace their products from the screen. "[Trademark laws] don't exist to give companies the right to control and censor movies and TV shows that might happen to include real-world items," said Daniel Nazer, a resident fellow at Stanford Law School's Fair Use Project. "It is the case that often filmmakers get paid by companies to include their products. I think that's sort of led to a culture where they expect they'll have control. That's not a right the trademark law gives them."
Sister Mary Anne Rapp may have said her fair share of Hail Marys over the last few years, but she's now facing judgment day in court. The Buffalo-based nun, who had worked in the area for the last 50 years, is facing grand larceny charges after reportedly stealing $128,000 from St. Mary and St. Mark congregations and using the money to fund her gambling addiction. Kevin Keenan, spokesman for the Roman Catholic Diocese of Buffalo, says the thefts took place from 2006-2010—but a new pastor, who conducted a routine audit, noticed irregularities and turned them over to a county prosecutor. Rapp was placed on leave from her position as pastoral associate in February 2011 and fired that April. Once she was removed from her position, she agreed to get help for her addiction and spent 9.5 months at an inpatient facility. She has since been abstinent from gambling. "These are smaller parishes in a rural part of the diocese," says Keenan. "Regardless of the size (of the church), this would be a significant amount of money for any parish." The Sisters of St. Francis, of which Rapp is a member, say they do not condone her actions but continue to pray for her while she battles addiction. Rapp, who was expected to plead not guilty at an initial court appearance last night, isn't the first holy roller with a casino problem: earlier this year, a Las Vegas priest swindled over $650,000 from his parish to support his gambling addiction.