Mexican Researchers Patent Heroin Vaccine

February 24th, 2012

Raw Story

By: Reuters

While Mexico grapples with relentless drug-related violence, a group of Mexican scientists is working on a vaccine that could reduce addiction to one of the world’s most notorious narcotics: heroin.

Researchers at the country’s National Institute of Psychiatry say they have successfully tested the vaccine on mice and are preparing to test it on humans.

The vaccine, which has been patented in the United States, works by making the body resistant to the effects of heroin, so users would no longer get a rush of pleasure when they smoke or inject it.

“It would be a vaccine for people who are serious addicts, who have not had success with other treatments and decide to use this application to get away from drugs,” the institute’s director Maria Elena Medina said Thursday.

Scientists worldwide have been searching for drug addiction vaccines for several years, but none have yet been fully developed and released on the market.

One group at the U.S. National Institute on Drug Abuse has reported significant progress in a vaccine for cocaine.

However, the Mexican scientists appear to be close to making a breakthrough on a heroin vaccine and have received funds from the U.S. institute as well as the Mexican government.

During the tests, mice were given access to deposits of heroin over an extended period of time. Those given the vaccine showed a huge drop in heroin consumption, giving the institute hope that it could also work on people, Medina said.

Kim Janda, a scientist working on his own narcotics vaccines at the Scripps Research Institute in La Jolla, California, said that based on some earlier research papers he had read, the Mexican vaccine could function but with some shortcomings.

“It could be reasonably effective but maybe too general and affect too many different types of opioids as well as heroin,” Janda said.

Mexico, a major drug producing and transit country for drugs smuggled into the United States, has a growing drug addiction problem. Health Secretary Jose Cordoba recently said the country now has some 450,000 hard drug addicts, particularly along the trafficking corridors of the U.S. border.

Mexican gangsters grow opium poppies in the Sierra Madre mountains and convert them into heroin known as Black Tar and Mexican Mud, which are smuggled over the Rio Grande.

Every year, the heroin trade provides billions of dollars to gangs like the Sinaloa Cartel and the Zetas. Since 2006, cartel violence has claimed the lives of over 47,000 people in Mexico.

While Mexico grapples with relentless drug-related violence, a group of Mexican scientists is working on a vaccine that could reduce addiction to one of the world’s most notorious narcotics: heroin.

Researchers at the country’s National Institute of Psychiatry say they have successfully tested the vaccine on mice and are preparing to test it on humans.

The vaccine, which has been patented in the United States, works by making the body resistant to the effects of heroin, so users would no longer get a rush of pleasure when they smoke or inject it.

“It would be a vaccine for people who are serious addicts, who have not had success with other treatments and decide to use this application to get away from drugs,” the institute’s director Maria Elena Medina said Thursday.

Scientists worldwide have been searching for drug addiction vaccines for several years, but none have yet been fully developed and released on the market.

One group at the U.S. National Institute on Drug Abuse has reported significant progress in a vaccine for cocaine.

However, the Mexican scientists appear to be close to making a breakthrough on a heroin vaccine and have received funds from the U.S. institute as well as the Mexican government.

During the tests, mice were given access to deposits of heroin over an extended period of time. Those given the vaccine showed a huge drop in heroin consumption, giving the institute hope that it could also work on people, Medina said.

Kim Janda, a scientist working on his own narcotics vaccines at the Scripps Research Institute in La Jolla, California, said that based on some earlier research papers he had read, the Mexican vaccine could function but with some shortcomings.

“It could be reasonably effective but maybe too general and affect too many different types of opioids as well as heroin,” Janda said.

Mexico, a major drug producing and transit country for drugs smuggled into the United States, has a growing drug addiction problem. Health Secretary Jose Cordoba recently said the country now has some 450,000 hard drug addicts, particularly along the trafficking corridors of the U.S. border.

Mexican gangsters grow opium poppies in the Sierra Madre mountains and convert them into heroin known as Black Tar and Mexican Mud, which are smuggled over the Rio Grande.

Every year, the heroin trade provides billions of dollars to gangs like the Sinaloa Cartel and the Zetas. Since 2006, cartel violence has claimed the lives of over 47,000 people in Mexico.

(Additional reporting by Jorge Lebrija; Editing by Anthony Boadle)

For The Full Story Go To Raw Story

Dope-Smoking, Menstruating Monkey Study Got $3.6 Million in Tax Dollars

June 10th, 2011

CNSNews.com

By: Christopher Neefus

The National Institute on Drug Abuse (NIDA), a division of the federal government’s National Institutes of Health (NIH), has spent $3,634,807 over the past decade funding research that involves getting monkeys to smoke and drink drugs such as PCP, methamphetamine (METH), heroin, and cocaine and then studying their behavior, including during different phases of the female monkeys’ menstrual cycles.

The study also uses “interventions” as “treatment models” for monkeys who have been taught to use drugs.

NIDA wins CNSNews.com’s “What Were They Smoking Award”—symbolized by The Golden Hookah (see video)—for sponsoring an outrageous government spending program that sends taxpayer dollars up in smoke.

Precursor research on drug-using monkeys, also funded by NIDA, discovered that after smoking cocaine monkeys exhibited “dilated pupils and slightly agitated, hyperactive behavior”—which helped researchers conclude that the “physiological effects” of cocaine on monkeys “were similar to those reported in studies of human subjects.”

In yet another federally funded study of drug-taking monkeys, the monkeys were sometimes given “trail mix” after “their daily experimental sessions.”

Back in 2001, the NIH gave $328,364 to a project called “A Primate Model of Drug Abuse: Intervention Strategies.” The principal investigator for the project was Dr. Marilyn E. Carroll, a professor in the department of psychiatry at the University of Minnesota.

The description of the grant published by NIH said: “Goals of the proposed research are to use a rhesus monkey model of drug abuse, to study factors affecting vulnerability to drug abuse and to evaluate behavioral and pharmacological treatment interventions. Routes of administration that have been developed in this laboratory will include oral drug self-administration and smoking.”

“Vulnerability factors to be examined,” said the NIH description, “are sex and phase of the menstrual cycle as well as patterns/duration of access to drugs.”

“The drugs that will be studied,” the NIH said, “are cocaine, ethanol, heroin, methadone and phencyclidine (PCP).”

“The use of nondrug reinforcers as a behavioral treatment will also be compared in male and female monkeys and during 3 phases of the menstrual cycle,” said the description.

“Potential treatment medications will also be examined in male monkeys using a behavioral economic approach.”

A decade later, the NIH continued to provide federal funding to the “Primate Model of Drug Abuse: Intervention Strategies” project at the University of Minnesota. On March 31, the federal agency gave the project its latest award, $386,907 in tax dollars.

A description posted by the NIH for the 2011 version of the project says the first aim of the study is: “To examine the effects of sex and menstrual cycle phase on the reinforcing strength of orally-delivered PCP and METH, and a nondrug control substance, saccharin, as well as smoked COC [cocaine], HER [heroin], and METH.”

“The main objective of this research is to develop nonhuman primate models (rhesus monkeys) of critical aspects of addiction that will yield useful information for the prevention and treatment of drug abuse,” says the description.

“The proposed experiments are designed to evaluate vulnerability factors in drug abuse, such as sex and phase of the menstrual cycle (hormonal status), that are related to the development and persistence of drug abuse,” it says.

“Nonhuman primate models of oral drug self-administration such as phencyclidine (PCP) and methamphetamine (METH) and smoked drugs such as cocaine (COC), heroin (HER), and METH will be used, and behavioral and pharmacological interventions will be applied as treatment models in males and females and in females during different phases of the menstrual cycle,” says the NIH description.

Dr. Marilyn E. Carroll, the principal investigator, explains her research on her webpage at the University of Minnesota.

“My research is directed toward developing behavioral and pharmacological methods of reducing and preventing drug abuse,” she says. “Animals are trained to self-administer drugs that humans abuse, and several phases of the addiction process are modeled, such as acquisition, maintenance, withdrawal, craving, and relapse.”

In April 20, 1990 article in Psychopharmacology (“Cocaine-base smoking in rhesus monkeys: reinforcing and physiological effects”), Carroll and three University of Minnesota colleagues—Kelly Krattinger, Daniel Gieske and Daniel A. Saddoff—described earlier federally funded research (supported by the National Institute on Drug Abuse) involving monkeys. This research, they wrote, was “designed to establish a primate model of cocaine base smoking.”

Click here for the full report from CNSNews.com

NC Police Want Names Of Prescription Med Users

September 9, 2010

News Observer

by Lynn Bonner

Sheriffs in North Carolina want access to state computer records identifying anyone with prescriptions for powerful painkillers and other controlled substances.

The state sheriff’s association pushed the idea Tuesday, saying the move would help them make drug arrests and curb a growing problem of prescription drug abuse. But patient advocates say opening up people’s medicine cabinets to law enforcement would deal a devastating blow to privacy rights.

Allowing sheriffs’ offices and other law enforcement officials to use the state’s computerized list would vastly widen the circle of people with access to information on prescriptions written for millions of people. As it stands now, doctors and pharmacists are the main users.

Nearly 30 percent of state residents received at least one prescription for a controlled substance, anything from Ambien to OxyContin, in the first six months of this year, according to the state Department of Health and Human Services. Nearly 2.5 million people filled prescriptions in that time for more than 375 million doses. The database has about 53.5 million prescriptions in it.

Sheriffs made their pitch Tuesday to a legislative health care committee looking for ways to confront prescription drug abuse. Local sheriffs said that more people in their counties die of accidental overdoses than from homicides.

For years, sheriffs have been trying to convince legislators that the state’s prescription records should be open to them.

“We can better go after those who are abusing the system,” said Lee County Sheriff Tracy L. Carter.

Others say opening up patients’ medicine cabinets to law enforcement is a terrible idea.

“I am very concerned about the potential privacy issues for people with pain,” said Candy Pitcher of Cary, who volunteers for the nonprofit American Pain Foundation. “I don’t feel that I should have to sign away my privacy rights just because I take an opioid under doctor’s care.” Pitcher is receiving treatment for a broken back.

The ACLU opposed a bill in 2007 that would have opened the list to law enforcement officials, said ACLU lobbyist Sarah Preston. The organization would likely object to the new proposal.

“What really did concern us is the privacy aspect,” she said. Opening the record to more users could deter someone from getting necessary medicine because of the fear that others would find out, she said, “particularly in small towns where everybody knows everybody.”

The state started collecting the information in 2007 to help doctors identify patients who go from doctor to doctor looking for prescription drugs they may not need, and to keep pharmacists from supplying patients with too many pills. But only about 20 percent of the state’s doctors have registered to use the information, and only 10 percent of the pharmacies are registered.

Many chain pharmacies aren’t connected to the Internet, said Andy Ellen, a lobbyist for the N.C. Retail Merchants Association. Pharmacy computers work on closed systems so they won’t be vulnerable to viruses that could slow or crash their networks. Pharmacies are trying to figure out a way around that obstacle to the controlled-substance prescriptions list, he said.

Bettie Blanchard, a woman from Dare County whose adult son is recovering from addiction to prescription drugs, said doctors should be required to consult the list when prescribing controlled substances.

She also wants doctors to get more education on prescribing narcotics. Doctors should be required to tell patients that the medicine they are being prescribed can be addictive, she said.

William Bronson, who works in a drug control unit at DHHS, presented what could be a compromise to the sheriffs’ request – allowing local drug investigators to request information related to ongoing investigations, but not let them go in to the computer records themselves.

Eddie Caldwell, lobbyist for the N.C. Sheriff’s Association, said the level of access to the data is up for discussion.

“There’s a middle ground where the sheriffs and their personnel working on these drug abuse cases get the information they need in a way that protects the privacy of that information,” he said. “No one wants every officer in the state to be able to log on and look it up.”

Click here to read the full report

Pharmacists, Doctors Are The New Drug Dealers

August 9th, 2010

Natural News

by: David Gutierrez

Prescription drug abuse is emerging as the new face of the U.S. drug problem, with unscrupulous pharmacists and doctors taking the place of street pushers or other stereotypical visions of the “drug dealer.”

Southern Ohio has emerged as a major supplier of illegal prescription drugs, with 74,000-person Scioto County making the Drug Enforcement Agency’s list of the 10 top prescription drug trafficking locations in the country. Authorities believe that as many as eight pill mills, where people can easily get prescriptions for painkillers written and filled, may be operating in the tiny county at any one time.

The poverty of the Appalachian region is a major driver of the abuse, and Scioto County’s high unemployment rate makes selling prescription drugs an attractive financial option for many desperate residents. Southern Ohio lies strategically near not only the major city of Columbus, but also the high prescription drug-abuse states of Kentucky and West Virginia. Because cross-state drug shipping is hard for authorities to track, the area is an ideal place for pill mills.

Making the problem worse, local officials have a long tradition of looking the other way at the problem, while limited resources make it hard on those few who do wish to tackle the problem.

According to Scioto County sheriffs, the local jails are full of prescription drug abusers and pushers, while in nearby Adams County, the sheriff was recently forced to ship county jail prisoners to confinement in community centers in order to make room for 28 people arrested in a prescription drug bust.

Nearly three million prescriptions for oxycodone painkillers were filled in Ohio in 2008, or almost one for every four residents. An additional 4.8 million prescriptions for hydrocodone painkillers were also filled, or one for every 2.5 residents.

Nationwide, the DEA estimates that the number of people abusing prescription drugs has increased 80 percent in the last decade, to 7 million.

This epidemic comes with a highly visible cost: deaths from prescription drug abuse have increased 280 percent in Ohio over the past 10 years.

“This is crazy, and it has to be stopped,” said Ohio activist Barbara Howard, whose daughter Leslie Cooper died of an accidental overdose. “Someone needs to regulate these pain clinics and stop doctors from handing out drugs to people who don’t need them.

“People are dying in their living rooms, on their front porches and in their kitchens. And they’re dying because they took a pill.”

Records show that Cooper had two painkillers, a muscle relaxer and an anxiety drug in her system. She had driven two hours that day in order to fill a prescription at a pill mill.

“Yes, my daughter was an addict,” Howard said. “But what kind of doctor keeps giving her prescriptions for hundreds of pills at a time? How do they sleep at night? How do they live with themselves?”

The Ohio pharmacy board complains that police, prosecutors and judges regularly fail to follow up when the board reprimands pharmacists or doctors for illicit prescription practices. Police, meanwhile, say that current laws do not give them the authority to target medical professionals.

Officials like Adams County sheriff Kimmy Rogers have called for new measures to track prescriptions and monitor people convicted of participating in prescription drug abuse. But groups like the Ohio State Medical Association complain that such laws would unfairly burden the vast majority of doctors, who are law-abiding.

“People say you can’t do that, or it would take too much money to address the problem,” Rogers said. “Well, if we aren’t going to spend the money to fight these prescription drugs, then we need to be clear. And we might as well start selling them at yard sales.”

Click Here For The Full Article

States Look To Share Patient Prescription Drug Information

May 3, 2010

Yahoo News/Associated Press

By Greg Risling

On his night shift in a busy emergency room, Dr. Jacob Khushigian inevitably finds a few patients more likely to be hunting for drugs than medical attention.

The guy who claims he has severe abdominal pain doesn’t grimace when sitting up. A woman who recently moved to the area fails to disclose she sees a doctor elsewhere. An ambulance patient complaining of a sore leg and back doesn’t reveal she was turned away by another hospital.

There was a time Khushigian’s hunches took weeks to confirm and required phoning or faxing the attorney general’s office to obtain a patient’s prescription drug information. Nowadays, a computer helps him catch cheaters. But it can only reach so far.

While a state online drug database went into effect last year to thwart addicts who bounce from doctor to doctor to feed a habit or make a small fortune peddling meds, there’s now a push to extend it beyond state lines to snare so-called doctor shoppers and curb drug abuse.

“The whole purpose of this is to have states communicating with one another,” said Dr. Laxmaiah Manchikanti, chief executive officer of the American Society of Interventional Pain Physicians. “If you know a patient is abusing, a doctor isn’t going to give that patient a prescription any more.”

Doctors can be hamstrung in making critical decisions about prescribing painkillers if they aren’t able to find out if patients filled prescriptions elsewhere.

A nationwide network might have helped Michael Jackson’s doctor better monitor the medication he was receiving from multiple doctors.

Dr. Conrad Murray, who was recently charged with involuntary manslaughter in the singer’s death, told police Jackson gave few details when Murray repeatedly asked about Jackson’s medications, according to an affidavit. The Los Angeles County coroner said Jackson was killed by a mix of a powerful anesthetic and a sedative.

Police have searched for information in three states to see if Jackson’s medical history played a role in his June death.

Jackson’s death and those of other celebrities such as former Playboy Playmate Anna Nicole Smith and actor Corey Haim highlight the dangers of prescription drug abuse. More U.S. teens used prescription drugs over any other illicit drug except marijuana, the Office of National Drug Control Policy reported.

Forty states have passed legislation to allow prescription drug monitoring programs, but only 34 are operating.

Under the National All Schedules Prescription Electronic Reporting Act signed by President Bush in 2005, more than $50 million has been appropriated to states for programs where doctors and other authorized users, such as police in some cases, can access patient records.

The law aims to have a coordinated national system, but there are no estimates what that would cost and a majority of the federal money hasn’t been allocated.

Joanee Quirk, who runs Nevada’s prescription monitoring program, said having access to other state databases would help stop those from Southern California or Hawaii who come to Las Vegas or Reno to score Vicodin or OxyContin.

Nevada’s four-year-old program has grown to more than 225,000 patient requests in 2009 from about 155,000 in 2008.

Most prescription monitoring programs are voluntary, but Nevada requires doctors to check a patient’s drug history during a first visit.

“If we took it away the practitioners would have a revolution,” Quirk said. “It’s almost like getting a lab test, where the doctors are trying to figure out what is wrong with this person and whether they are trying to get drugs legally.”

Some privacy groups are concerned databases could invade patients’ privacy. Virginia’s database was hacked into in April 2009 and millions of electronic records were stolen by a thief still at large.

“There is a significant intrusion into the lives of individuals who are taking these medications legitimately,” said Pam Dixon of World Privacy Forum, a nonprofit public interest research group. “There needs to be more restrictions about who can access this information.”

The response to having secure, online access to patient records has been overwhelming so far in California. More than 2,300 doctors, pharmacists, physician assistants and registered nurses have used the Web site since September to access more than 134,000 patient reports. The state had averaged about 60,000 requests annually when they received requests by phone or fax.

Katherine Ellis, who runs the database of about 100 million prescriptions, said emergency room doctors would benefit most from a multistate system.

“If there was a way for ER doctors to sign on as they are triaging that patient and see if that person has been doctor shopping, then they may not elect to give them the controlled substances,” she said.

Khushigian, 52, who works at Kaweah Delta District Hospital in Visalia in the Central Valley, is glad he no longer has to rely solely on his gut every night. He uses the database two or three times a night to shut down potential abusers.

“When they get caught, there isn’t much they can say,” he said.

Click here for the full report.

New Rules Promise Better Mental Health Coverage

February 1, 2010

Reuters

By JoAnne Allen

Employer-provided group health plans must offer the same level of coverage for mental illness and drug abuse treatment as for other ailments, according to federal regulations issued on Friday.

The measures, known as mental health parity, ban group health plans from applying different coverage standards for mental health disorders or substance abuse treatment than those for general medical treatment or surgery.

“The rules we are issuing today will, for the first time, help assure that those diagnosed with these debilitating and sometimes life-threatening disorders will not suffer needless or arbitrary limits on their care,” U.S. Health and Human Services Secretary Kathleen Sebelius said in a statement.

Some 150 million Americans are enrolled in employer-provided group health insurance plans, the government says. The new rules, which stem from a bill passed by Congress in 2008, exempt group plans covering 50 or fewer workers.

Under the parity system, group plans that offer mental health and substance abuse treatment cannot charge higher deductibles or place different limits on frequency of treatment than they would for medical and surgical care.

“These rules expand on existing protections to ensure that people don’t face unnecessary barriers to the treatment they need,” said Deputy Treasury Secretary Neal Wolin.

The rules could take effect as early as July 1, after federal agencies review comments from the public, industry and other interested parties.

The National Council for Community Behavioral Healthcare, a Washington-based advocacy group, said the regulations begin the final chapter in an effort to ensure that Americans with mental illness have equal access to health care.

“Now people in need won’t have to go without treatment because of discriminatory insurance policies,” president and chief executive Linda Rosenberg said in a statement.

The rules will implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

The law is named for the late Democratic Senator Wellstone, who was a strong advocate of equal treatment of benefits, and former Republican Senator Domenici, who first introduced parity legislation in 1992.

The late Democratic Senator Edward Kennedy was another driving force behind the bill Congress passed after a decade-long effort by advocates for the mentally ill who said insurers often shortchanged people with conditions ranging from depression to schizophrenia.

Click here for the full report.

ADHD Drugs Abuses by Teens

January 21,2010

Natural News

By David Gutierrez

Inquiries to poison control centers about teenage abuse of drugs for attention deficit hyperactivity disorder (ADHD) increased by 76 percent over the last eight years, indicating a surge in rates of the abuse itself, according to a study conducted by researchers from the Cincinnati Children’s Hospital Memorial Center and published in the journal Pediatrics.

“It’s more bad news on an entrenched problem,” said Steve Pasierb, head of The Partnership for a Drug-Free America, who was not involved in the study.

The researchers reviewed data collected by the American Association of Poison Control Centers between 1998 and 2005. They found that the number of calls by parents, emergency room doctors and others about teenagers abusing ADHD drugs increased from 330 per year in 1998 to 581 per year in 2005, far outpacing the rate of increase in calls about other forms of teenage substance abuse. The majority of teenagers involved in the calls ended up being treated in emergency rooms, and 42 percent suffered moderate or severe side effects. Four of the teenagers died.

Far more teenagers are probably experiencing side effects, the researchers noted, since most cases of abuse don’t end in calls to poison control.

During the time period covered by the study, prescriptions for ADHD drugs rose 86 percent in children between the ages of 10 and 19, from roughly four million to almost eight million.

Pasierb said that many teenagers do not understand that abuse of prescription drugs can lead to potentially fatal side effects. In the case of ADHD drugs, these can include agitation, rapid heartbeat and dangerously high blood pressure.

“They say, ‘It’s FDA approved, how dangerous could it be?’” he said.

Click here to read full report

Donated Organs Not Always Healthy yet Still Implanted

October 29, 2009

NaturalNews

by Mike Adams, the Health Ranger, NaturalNews Editor

Matthew Millington, 31, was an Iraq war veteran who served in the British army. Suffering from an unspecified “serious long condition”, doctors told him he would be dead in two years unless he underwent a lung transplant. With tens of thousands of people world-wide awaiting organ transplants, the young man was one of the “lucky” patients who soon received his lungs from a donor. The problem was he was given lungs riddled with a fast growing cancer — and Millington died less than 10 months after his operation.

This is just a horrible, rare, mistake right? Not necessarily, according to a warning just issued by the UK health service. It specifically lists other examples of diseased and damaged organs being inappropriatedly donated for transplantion — in addition to cancer, these include “fatty” organs, which can be caused by a donor’s obesity or alcoholism and result in cirrhosis in a transplant patient, and organs containing cuts and other damage resulting from the organ retrieval process. Most horrific was a report of a donor patient found to be infected with vCJD, the human form of mad cow disease, as well as hepatitis B. In addition, the report notes problems with patient identification errors and incorrectly matched tissue types.

The British report does not include any information about diseased transplanted organs in the U.S. or other countries. However, it does point out that the quality of transplant organs isn’t always the best, in large part because there is a huge, critical need for transplanted organs. And this organ shortage has hit the U.S., too. For example, according to the U.S. Department of Health and Human Services, around 17,000 Americans have received organ transplants this year but another 104,335 are waiting for organs.

In the UK, according to the British newspaper The Telegraph information has emerged revealing that donated organs are being accepted from drug addicts because of the critical organ shortage in that country. In fact, an investigative report in that publication found a reluctance by patients and transplant surgeons alike to reject any organs offered unless there are extremely compelling reasons.

A spokesman for Papworth Hospital, Huntingdon, where Matthew Millington received his deadly transplant, told The Telegraph: “Using lungs from donors who have smoked in the past is not unusual. During 2008/09 there were 146 lung transplants carried out in the UK. During the same period 84 people died on the waiting list. If we had a policy that said we did not use the lungs of those who had smoked, then the number of lung transplants carried out would have been significantly lower.”

Because of the critical shortage of organs for transplants and the fact more people are needing transplants every year, there is a push world-wide to encourage organ donation. Unfortunately, the same amount of resources and energy doesn’t seem to be directed into preventing the need for transplants in the first place. The U.S. Department of Health and Human Services lists the major reasons for organ failure as being conditions that are almost always preventable or treatable with healthy diets, exercise and other natural measures: obesity, diabetes, high blood pressure, heart disease, stroke, and lifestyle choices ( including drug and alcohol abuse).

Click here for full report