Prescription Opioid Tax to Fund Addiction Treatment

prescription opioidsIn the 1990’s the average price of a pack of cigarettes in the United States was just over $1.50. If you happened to be a smoker today, you know all too well that the price has risen exponentially, with an average cost ranging between six and eight dollars. In the state of New York, individuals can pay more than $12.00, the direct result of both state and federal taxes. Heightened cigarette prices have a two-fold effect, they are meant to deter smoking and fund youth smoking prevention campaigns. Every American adult, at least, is aware that cigarettes are unhealthy and can lead to several different forms of cancer. With that in mind, efforts meant to prevent youth smoking are of the utmost importance, as they are the most vulnerable demographic. Over the last couple decades youth cigarette smoking rates have declined dramatically and the trend continues; it would stand to reason that this decline is the direct result of the efforts of both health organizations by way of tobacco prevention campaigns which are partly funded by the high taxes imposed on “cancer sticks.” While both tobacco and alcohol still rank high on the list of leading causes of preventable death in the U.S., holding the number 1 and 3 positions respectively, prescription opioid and heroin abuse have been stealing lives at a staggering rate. In fact, accidental drug overdose is now the leading cause of injury-related death for Americans between the ages of 35-54—and the second leading cause for young people, according to the Drug Policy Alliance. With nearly 44,000 people dying from a drug overdose each year, it is crystal clear that the situation is dire; this has prompted lawmakers from every corner of the government to call for action, via opioid prevention and access to addiction treatment services. Over the last few months legislation was passed in order to make the aforementioned goals a reality, but many argue that despite everyone’s good intentions it will prove difficult to fund the varied programs that rest under the umbrella of the new bills, such as the Comprehensive Addiction and Recovery Act (CARA). Practically everyone is in agreement, curbing the over prescribing of opioid painkillers is vital in the effort to prevent future cases of opioid addiction from ensuing, but such campaigns do little to help those who are already addicted to opioids. In 2014, an estimated 1.9 million Americans of the 21.5 million that had a substance use disorder in the United States were addicted to prescription opioids, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports. In the same year there were an estimated 586,000 who had a substance use disorder involving heroin. Research tells that the majority of today’s heroin users began with prescription opioids, such as OxyContin (oxycodone). Making it more difficult to acquire opioid analgesics doesn’t mean that one’s addiction will just disappear; without treatment and recovery services the cycle of addiction will continue—forcing addicts to seek other avenues to “get well”—i.e. Heroin. A number of states, mainly those who have been hit the hardest by the opioid epidemic, have found it difficult to provide and expand access to addiction treatment services. The issue stems mostly from a lack of funding. If opioid addicts cannot find help, or have to wait incredibly long periods of time between making the decision to go to treatment and actually getting a bed, they are still susceptible to overdose—potentially a fatal one at that. A new bill has been put forward that may be able to generate the desperately needed funds. A group of U.S. Senators have introduced the Budgeting for Opioid Addiction Treatment Act (LifeBOAT). The LifeBOAT Act would establish a permanent funding stream to support efforts to expand access to addiction treatment services, according to a news release from Senator Joe Manchin (D-WV). The new bill, if passed, would generate funds by imposing a 1 cent fee on each milligram of active opioid ingredient in a prescription opioid painkiller.
I’ve heard it time and time again from people waging the battle against addiction: we need more treatment options. But today, those options are only dwindling in the face of ever-shrinking budgets, and the sad result is that those who need the help the most simply aren’t getting it,” said Angus King (I-ME). “It’s my hope that this common-sense legislation can help put a stop to that. By establishing a reliable stream of funding, this bill will bolster treatment facilities across the country, increase the amount of services available, and support people as they fight back against addiction – all while doing so in a cost-effective way. We must step up to lend a hand to those who need our help, and this bill does that.”
The opioid milligram tax would fund:
  • New addiction treatment centers, both residential and outpatient.
  • Expanded access to long-term, residential treatment programs.
  • Recruiting and increasing reimbursement for certified mental health providers providing substance abuse treatment.
  • The establishment of and/or operating support programs that offer employment services, housing, and other support services to help recovering addicts reintegrate into society.
  • The establishment of and/or operating substance abuse treatment programs in conjunction with Adult and Family Treatment Drug Courts.
  • The establishment of and/or operating facilities to provide care for babies born with neonatal abstinence syndrome.
To read the text of the bill, click here. At PACE Recovery Center, our mission is to provide our clients with a safe and supportive environment to help them overcome the challenges they have experienced due to alcohol and drug abuse. We believe that incorporating sound clinical interventions and a lifestyle that encourages health and wellness, in a shame free setting that encourages accountability and responsibility, will help foster long term recovery.

Replace the Stigma of Mental Illness With Hope

mental-illnessWith our nation’s eyes fixed on the television screen and other major media outlets following the primaries, there are a number of other important events happening that are being overlooked—such as Mental Health Month (MHM). Last month, events were held across the country to raise awareness about alcohol, with the goal of educating Americans about how alcohol can impact one’s life which would hopefully prevent people from traveling down a dangerous path towards alcoholism. In May, everyone is being called upon to do their part in ending the stigma of mental illness and advocate for equal care. Mental health disorder is an umbrella term that covers a number of different conditions, including addiction. The disease is recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). There are 20.2 million adults in America who have experienced a substance use disorder, a staggering number which begs everyone’s attention, according to the National Alliance on Mental Illness (NAMI). On top of that, more than half (50.5 percent or 10.2 million adults) had a co-occurring disorder; this is when someone living with addiction also suffers from another form of mental illness, such as: anxiety, bipolar disorder, depression and posttraumatic stress disorder. Mental health awareness is an extremely important topic, especially when you consider that the majority of people living with any form of mental illness do not receive mental health services. In the past year, only 41 percent of people with a mental health condition were able to get assistance, NAMI reports. Mental illness is unlike a number of other health issues, brain diseases currently do not have a cure, which means it is paramount for not only the patient, but society that those who are afflicted get the help they so desperately need. Expanding access to mental health services will only come to fruition if we, as a nation, work together to break the stigma that has for too long accompanied treatable conditions. We all have a vested interest in bringing mental illness out of the darkness, practically every American is close to someone who battles with a mental health issue 365-days a year. Every year, 43.8 million adults in America experience mental illness, approximately 1 in 5. May is Mental Health Month (MHM), and there are a number of things you can do to help break the stigma of mental illness. NAMI is asking people to harness the power of social media platforms to share mental health related information, images and graphics with #StigmaFree or #MentalHealthMonth. You can also take your efforts one step forward by taking a pledge to be ‪#‎StigmaFree‬. It’s quick, easy and could reach the millions of people who are too afraid to seek help due to societal shame. Just follow the steps below:
  1. Take the pledge.
  2. Record your video.
  3. Upload to your YouTube channel and other social media accounts.
  4. Be sure to include #StigmaFree in the title of your video.
If you’d like, take a moment to watch The Big Bang Theory’s Mayim Bialik take the pledge to be #StigmaFree: If you can’t see the video, please click here.

Prescription Addiction: Made in the USA

addictionThere is a lot of information, and unfortunately, deadly misinformation about prescription opioids circulating the internet and other major media outlets. Simply put, there is a lot that the average American adult is unaware of, and what they think they know isn’t always rooted in science. In the United States, we use the vast majority of the world’s supply of prescription opioids—despite the fact that we make only 5 percent of the world’s population. While prescription opioids are abused across the globe, America has the market share of the problem. In an attempt to shed some light on both the opioid addiction crisis and potential solutions—Dr. Sanjay Gupta joins Anderson Cooper of CNN’s "Anderson Cooper 360" for a town hall special—to discuss the prescription drug abuse epidemic in the U.S. The presentation, "Prescription Addiction: Made in the USA" airs tonight, May 11, 2016, at 9 P.M. EDT. It is likely to be more than informative and eye opening for many Americans. Dr. Sanjay Gupta has a remarkable understanding about pain narcotics, addiction and how opioid addiction became a pervasive problem in the United States. The Chief Medical Correspondent wrote an op-ed published today by CNN, which covers many aspects of the epidemic. But, perhaps most intriguing is his belief that doctors were responsible for creating the scourge we face, and it will fall on doctors to spearhead efforts for ending the epidemic. Gupta writes:
The fact is, we have accepted the tall tales and Pollyannaish promises of what these medications could do for too long. As a community, we weren't skeptical enough. We didn't ask enough questions. We accepted flimsy scientific data as gospel and preached it to our patients in a chamber that echoed loudly for decades.”
He points out that while the epidemic is the result of the medical community acting on opioid prescribing recommendations they were not based on fact, doctors continue to recklessly prescribe these deadly narcotics despite knowing that the drugs should be doled out as sparsely as possible. He cites a recent study published in the Annals of Internal Medicine which showed that 91% of opioid overdose survivors managed to obtain another prescription—usually from the physician who prescribed the narcotics the patient overdosed on in the first place. Gupta calls on prescribing physicians to:
  • Engage with patients and discuss treatment with them.
  • Set realistic expectations for patients.
  • Conduct follow-up conversations with patients to gauge treatment efficacy.
“It is not too late. In order for this American-made epidemic to finally end, however, it is the American doctors who must lead the way,” writes Gupta. Remember to tune in tonight, or catch it on DEMAND, to see CNN’s "Prescription Addiction: Made in the USA" May 11, 2016, at 9 P.M. EDT. Join in the conversation and share this family and friends. If you’d like, you can view a short trailer about the town hall meeting by clicking here.

Opioid Withdrawal and Loperamide is Dangerous

opioid withdrawalAnyone who has abused and/or been addicted to opioid narcotics has experienced withdrawal symptoms at one time or another. They can tell you first hand, with the utmost clarity, the hell that is opioid withdrawal and that they would have done just about anything to ease their pain. For those who detoxification was not intentional, their withdrawal is usually the result of running out of drugs or money to purchase more of their drug of choice. People undergoing opioid withdrawal are most commonly outside of a medical setting, which means that they lack access to the drug typically prescribed to mitigate their symptoms, such as Suboxone (buprenorphine) or Ativan (lorazepam). The U.S. National Library of Medicine reports that early symptoms of opioid withdrawal include: agitation, anxiety, muscle aches, increased tearing, insomnia, runny nose, sweating and yawning. Late symptoms of withdrawal include: abdominal cramping, diarrhea, dilated pupils, goose bumps, nausea and vomiting. Clearly, the majority of the symptoms listed above make for an unpleasant time, especially when you consider that some of the symptoms can continue for several weeks. While the behavior is not new, in the wake of the American opioid epidemic a number of opioid addicts have turned to the over the counter (OTC) antidiarrheal drug loperamide (Imodium) to ease their withdrawal symptoms, NPR reports. While it may seem like a harmless practice, in very high doses loperamide fatally disrupts the heart's rhythm. At 10 times the box recommended dose the drug can ease withdrawal discomfort, but in larger doses loperamide can actually create euphoric effects similar to opioid narcotics. At this point you may be wondering how a commonly used OTC medication can cause an opioid-like high and still be purchased without a prescription. Keeping the conversation as “clean’ as possible, a common side effect of opioid narcotics is constipation, a side effect that people experiencing diarrhea would appreciate. It just so happens that loperamide is a opioid-receptor agonist and acts on μ-opioid receptors, but unlike other opioid drugs, loperamide is mostly prevented from entering the blood stream and crossing the blood brain barrier essentially preventing euphoria from occurring, according to a study titled “Poor Man's Methadone: A Case Report of Loperamide Toxicity” published in the American Journal of Forensic Medicine & Pathology. The research showed that in very high doses, loperamide is able to cross the blood-brain barrier gaining access to the central opioid receptors in the brain, causing euphoria and respiratory depression. Until recently, it was fairly uncommon for people to abuse the drug, but with more people than ever abusing opioids in our country, there has been a spike in hospital cases involving loperamide, which at one time was classified as Schedule II of the Controlled Substances Act 1970, transferred to Schedule V in 1977 and then decontrolled in 1982.
Because of its low cost, ease of accessibility and legal status, it's a drug that is very, very ripe for abuse," says William Eggleston, a doctor of pharmacy and fellow in clinical toxicology at the Upstate New York Poison Center, which is affiliated with SUNY Upstate Medical University. "At the Upstate New York Poison Center, we have had a sevenfold increase in calls related to loperamide use and misuse over the last four years."
Eggleston and his co-authors, whose new study was published the Annals of Emergency Medicine, believe that loperamide should be restricted; much like pseudoephedrine was in the wake of the American methamphetamine crisis. If taken in recommended doses, such drugs are relatively harmless, but they carry a high potential for abuse. If you, or a loved one, struggles with opioid addiction, stay clear of OTC medications that people claim will help with withdrawal symptoms. The safest course one can take is contacting a licensed addiction rehabilitation center, such as PACE Recovery Center. We can get you the help you need, and aid you in getting on the road to recovery.

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