Tag Archives: opioid

Opioid Summit Involves Google and Facebook

opioid

The U.S. Food and Drug Administration (FDA) is hosting an Opioid Summit today, June 27, 2018, in Washington D.C. Government entities, academic researchers, and advocacy groups are attending the event, as you’d probably expect. Unexpectedly, internet stakeholders, as well as senior executives from major search engines like Google and social media platforms such as Facebook and Instagram are also participating. Why would the FDA, led by Commissioner Scott Gottlieb, M.D., invite the movers and shakers of Silicon Valley to such an event? The answer, to combat illicit opioid sales over the internet.

Most people have heard or know a little bit about the “dark web;” home to multiple online marketplaces that allow people to exchange illicit goods. Users can peddle and procure just about anything in the far corners of the world wide web; and, those engaging in such activities are, theoretically, protected by proxy servers and virtual private networks (VPNs). Disguising one’s internet protocol (IP) address allows people to buy and sell things like heroin and counterfeit passports, evading the watchful eye of authorities, most of the time. You have probably heard about the dark web marketplace known as The Silk Road; if so, you know that the FBI shut it down and arrested its founder Ross Ulbricht in 2013. Ulbricht is now serving a life sentence without the possibility of parole, which you’d be right to think should deter others from having similar aspirations. It didn’t!

Today, the internet is home to even more black marketplaces than before. The number of sales and profit generated on the most popular sites people now rely on for illicit goods dwarfs that of the preceding Silk Road, according to findings by RAND Europe and researchers at Carnegie Mellon University.

Hiding In Plain Sight

Not everyone looking to sell opioids online has the know-how to set up shop on the darknet. An even more significant number of people on the hunt for prescription painkillers or heroin do not understand how or have the tools to access dark marketplaces. Many people take a more cavalier approach to purvey and procure opioids over the internet; advertisements for online pharmacies abound on the plain old internet on search engines and social media sites. While some good many websites are scams to harvest private information from the naive, plenty of these sites make good on their promise.

Earlier this month, the FDA reached out to some 53 online pharmacies instructing them to cease and desist, or face severe legal consequences, Wired reports. A study conducted by Carnegie Mellon University shows that online illicit drug sale revenue increased from between $15 and $17 million in 2012 to between $150 and $180 million in 2015. Whether more people are acquiring their drugs from internet pharmacy sites or on the dark web is somewhat irrelevant, what is salient is how to stop the practice.

Addressing the problem of drug dealing on the web is more urgent than ever considering the rise of synthetic opioids like fentanyl, carfentanil, and U-47700 or Pinky. Dealers disguise the substances mentioned above as more popular and less dangerous opioids like OxyContin, and they carry an enormous risk of fatal overdose. On average, 115 Americans succumb to opioid misuse every day in the U.S.

Opioid Summit May Devolve Into A Blame Game

At this point, it is hard to tell what, if anything, will come out of the meeting in Washington today. Reports show that in the days leading up to the summit, tech representatives and lobbyist began tossing blame around. The Center for Safe Internet Prescribing (CSIP) released a report showing that majority of drug sales happen on the dark web, and that open web offers for opioids were more likely to be scams. Libby Baney, an advisor to the Alliance for Safe Online Pharmacies, argues otherwise to Wired:

If all drug sales happening on the internet were on the dark web, I'd throw a party. Then the vast majority of Americans would be safe."

Tim Mackey, an associate adjunct professor at the University of California, San Diego, and fellow researchers found that online links on Twitter and Facebook offering up for sale illegal items originate on the darknet. Professor Mackey, who will speak at the summit, says:

What’s happening on the dark web is a lot of business-to-business sales. The digital drug dealers are sourcing from the dark web and using social media to sell directly to consumers.”

It’s worth noting that Facebook will direct users attempting to purchase opioids to addiction treatment resources, instead. Google played a significant role in the most recent National Prescription Drug Take-Back Day. And, according to CSIP—which is backed by tech giants—117 million ads attempting to sell illicit goods were blocked last year.

Proactive Approaches to Opioid Use Disorder

Dark web, open web, prescribed by doctors or not; lives hang in the balance if significant corporations in the tech sector cannot work together with government agencies to stem the tide of opioid addiction in America. There is an opportunity here to put a stop to illicit online opioid sales. The problem is here, and we cannot afford to ignore it, the United States Senate Permanent Subcommittee on Investigations released a report presenting incontrovertible evidence that average Americans can purchase illicit opioids online. Another report from the National Association of Boards of Pharmacy shows that when searching online for prescription opioids, nearly 91 percent of the first search results led users to an illegal online drug seller offering prescription opioids—regardless of the search engine.

Social media companies, search engines, and domain registrars are in a unique position to nip, at least some of these kinds of practices, in the bud; not only redirecting people to addiction treatment services but having a hand in saving countless lives.

Opioid Use Disorder Treatment

If you or a loved is struggling with opioid use disorder, please contact PACE Recovery Center. We offer clients gender-specific, extended care treatment for males in the grips of progressive mental health disorders.

If you have suicidal ideations, please contact the National Suicide Prevention Lifeline: 1-800-273-8255

Opioid Addiction in America Accountability

opioid

The effort to rein in the prescription opioid problem here in America continues even though there hasn’t been an announcement from the Office of National Drug Control Policy (ONDCP) on how it plans to tackle the issue. While state and Federal lawmakers tirelessly work to bring about change and hold those responsible for their actions, the pharmaceutical industry has been less than cooperative. It probably shouldn't come as a surprise, after all the prescription painkillers are a multibillion-dollar industry in the U.S. Taking even a modicum of responsibility for misleading doctors and patients about the dangers of opioids would be to acknowledge profiting off suffering and death.

All roads lead to the pharmaceutical industry no matter from what angle you examine the American opioid addiction epidemic. There is a plethora of evidence showing the tactics of companies, like Purdue Pharma, beginning in the late 1990s. Methods including promotional videos assuring doctors that the number of patients who might develop an opioid use disorder was statistically irrelevant. Before long, and with the bonus of incentives to prescribe, primary care physicians began doling out drugs like OxyContin for all things pain.

Naturally, the opioid scourge in America wasn’t the doing of just one entity; we need to consider that there are many stops along the way from the poppy fields to the medicine cabinet. The onus of the problem affecting millions of people falls on many private companies, health organizations, and government agencies like the FDA. In fact, some of the companies which profited the most from addiction in America were pharmaceutical distributors, those in the business of getting drugs from manufacturers to the pharmacy. Even a cursory look reveals that wholesalers turned a blind eye to filling suspicious orders.

Opioid Addiction Accountability

Yesterday, the leaders of five pharmaceutical distributors sat before a House panel hearing fielding questions regarding their practices in the state of West Virginia. The population of the “Mountain State” is roughly 1.80 million, according to today’s estimates and yet, 780 million hydrocodone and oxycodone tablets went into the state between 2007 and 2012, CNN reports. The town of Kermit, WV, for instance has a total population of 400 people and yet, over the course of just two years almost 9 million painkillers were sent to one local pharmacy.

At one point during the hearing, House Energy and Commerce Oversight and Investigation Subcommittee chairman, Gregg Harper (R-MS) asked McKesson Corp., Cardinal Health, AmerisourceBergen, Miami-Luken and Smith Wholesale if their companies had a role in the opioid epidemic? All the distributor heads but Dr. Joseph Mastandrea, chairman of the board of Miami-Luken, answered Harper unequivocally, “NO!”

Despite the fact that Rep. David McKinley, (R-WV) was not a member of the subcommittee he was able to sit in and allowed to share some thoughts with the distributors, according to the article. He points to the companies' "lack of attention on your algorithm and your core operation. And deflecting responsibility, saying, 'I just had to fill the order' -- no, you had a role. You had a role." Adding, "And for several of you to say you had no role whatsoever in this I find particularly offensive."

I just want you to feel shame in your roles, respectively, in all this," said McKinley. "I am so frustrated for the people of West Virginia and this country that you all have not stepped up and took more responsibility for this.

Paying for Opioid Use Disorder Treatment

Lawmakers’ ire is fervent toward manufacturers as well, with many reasoning that since the companies had a role in creating the problem, the least they can do is help cover the cost of treatment. Currently, some 15 states have legislation in the works that would tax prescription opioids; the revenue would then fund addiction treatment services, The Chicago Tribune reports. Of course, bringing such laws to fruition is, unfortunately, a David and Goliath scenario given the powerful ‘big pharma’ lobbies. To date, only the state of New York has been able to pass an opioid tax measure.

The industry is up-to-its-eyeballs in lawsuits and protracted litigation, owing mainly to the staggering death toll in the last twenty years. The general public and lawmakers (some of whom have lost loved ones to overdose) want the industry to do what’s right, take responsibility, and be a part of the solution. Such companies can afford to help, especially when you consider the amount of money opioid developers spend in efforts to defeat common sense legislation. The big opioid producers spent $880 million on politics and lobbying from 2006 through 2015, according to AP and the Center for Public Integrity.

So, what is the manufacturers and distributors argument, you ask? The companies contend that an opioid tax is wrong and would lead to patients or taxpayers eating the cost in the long run. As you can probably imagine some lawmakers are at their wit's end with the lack of accountability, state Sen. Julie Rosen (R-MN) walked out of a meeting with big pharma reps, the article reports. She said:

They know that they're spending way too much money on defending their position instead of being part of the solution.

Opioid Use Disorder Treatment

If you are a young man struggling with opioid addiction, PACE Recovery Center can help. Our team of experts can teach you the skills and provide you the necessary tools for leading a productive life in recovery. Please contact us today to learn more about our program.

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.

FBI Film About Opioid Addiction

addictionThere is no question, the opioid epidemic in the United States is both unprecedented and insidious; however, if there is a silver lining to be found it is that the crisis has forced an evolution to occur regarding how we, as a nation, both view and talk about addiction. For years, addiction experts have said that addiction does not discriminate - an assertion that was hard for many lawmakers to accept; however, in the wake of the scourge of opioid addiction affecting practically every demographic throughout the nation for well over a decade - we are now seeing a paradigm shift with how lawmakers believe we should handle this calamity. It has become clear that we cannot arrest this epidemic away, as we tried to do during the 1980’s through the ‘90s with the cocaine problem in America. The use of draconian drug laws to combat addiction focused more on the symptoms of addiction and did little to address the disease of addiction. Addiction cannot be treated with steel bars, solutions can only be found with evidence-based, scientifically accepted methods of substance use disorder treatment. With 44 people dying from overdoses every day, there is a great need for expanded access to both the life saving opioid overdose reversal drug naloxone and to substance use disorder treatment services. In recent months, there has been an inter-agency push to get those struggling with addiction the help they need without fear of prosecution. Overdose survivors do not need to fear be arrested, and are actually being directed to rehabilitation services. In fact, the President is asking Congress for $1.1 billion to expand access to addiction treatment services; in some places, addicts who would like help have to wait up to a month to get a bed at treatment centers. While making treatment more available is huge and has the potential to save thousands of lives, there is also a need for more in the way of prevention through education. Recently, both the Drug Enforcement Administration (DEA) and the Federal Bureau of Investigation (FBI) joined forces to make a film about the opioid epidemic - aimed at youth, The Washington Post reports. The goal is to prevent adolescents from abusing prescription opioids, which is strongly believed to be the link to beginning heroin use. The film: "Chasing the Dragon: The Life of an Opiate Addict" was produced at the insistence of James Comey, the current Director of the FBI. “You will see in ‘Chasing the Dragon’ opioid abusers that have traveled a remarkably dangerous and self-destructive path,” said Acting DEA Administrator Chuck Rosenberg. “I hope this will be a wakeup call for folks. Please pay close attention to this horrific epidemic. Help reverse it. Save a life. Save a friend. Save a loved one.” We hope that you will watch Chasing the Dragon below: If you are having trouble watching the film, please click here.

Need for Naloxone Price Reductions

naloxoneIn the fight against the prescription drug epidemic and subsequent opioid overdose deaths affecting every state in America, no other weapon has saved as many lives as naloxone. The life saving drug, if used in a timely manner, can reverse the effects of an opioid overdose. In many states, law enforcement officials have begun carrying easy to use naloxone kits, giving first responders the tools to save lives. Sadly, seeing the market value of naloxone has caused the drug’s maker to rapidly increase prices, making it difficult to afford for city and state governments. In the epicenter of the problem New York, Amphastar Pharmaceuticals, the makers of naloxone, made a deal with New York attorney general that would provide $6 rebate per dose to New York state agencies, The Hill reports. This move came in the wake of a New York Times article, which reported that the drug’s price had increased by as much as 50 percent. Now, two state legislators are calling for a nationwide price reduction so that the drug can have a further reaching effect. The high price of naloxone has prevented its widespread use, according to the article. “Over the past several months, police departments, law enforcement agencies, and public health officials across the country have warned about the increasing price of naloxone, which they use to combat the scourge of heroin abuse,” Senator Bernie Sanders of Vermont and Representative Elijah Cummings of Maryland wrote in a letter to Amphastar. “Although we are encouraged by your stated willingness to work with other states, it remains unclear why your company has not already lowered its prices in states other than New York,” the lawmakers wrote. “The rapid increase in the cost of this life-saving medication in such a short time frame is a significant public health concern.” As more states pass laws which increase access to naloxone, the need for price reductions will only grow.

Higher Dose Narcotics Increase Depression Risks

OLYMPUS DIGITAL CAMERAThe use of any kind of mind altering substance can have an effect on a person’s mental health, in turn causing a number of complications. One of the more common side effects of drug use is depression. Over the last decade, the United States has seen a dramatic rise in prescription opioid use, which has led to an epidemic. New research suggests that individuals who use higher doses of narcotic painkillers are at increased risk of depression, HealthDay reports. The study followed 355 patients in Texas, who reported low back pain at an initial doctor’s visit, and at one-year and two-year follow-up visits. Researchers initially concluded that those who used higher doses of opioids to manage their pain were more likely to experience depression, according to the article. However continued research indicated that most of the risk of depression is due to the duration of narcotic painkiller use, not the dose - but, higher doses usually were accompanied by longer durations of use. “A strong potential explanation of our finding that increasing opioid dose increases risk of depression could be that the patients who increase dose were the longer-using patients,” said lead researcher Jeffrey Scherrer, an associate professor for family and community medicine at Saint Louis University. “This is logical as longer use is associated with tolerance and a need to increase opioids to achieve pain relief.” Establishing a link between painkillers and depression, as well as what dosage might put patients at higher risk, “may inform prescribing and pain management” by doctors, the article reports. “We hope to find risk factors such as opioid misuse that could be in the pathway from chronic opioid use to new onset depression,” Scherrer said in a news release. “This would expand the targets for intervention to limit the risk of depression in patients who need long-term opioid therapy.” The study’s findings were published in the journal Pain.

Educating Teenagers About Prescription Drugs

prescription-drugsEducating teenagers and young adults as to the dangers of drug use has long been of the utmost importance. While such programs have put up a good fight, the reality is that the young are still losing their lives to overdoses which we all would like to see avoided. The prescription drug epidemic has touched all corners of America, putting high school teenagers at risk and opening the doors to other opioids like heroin. Rather than focus on drug use in general, new programs in Illinois and Pennsylvania designed for middle school and high school students, have set their sights on prescription drug use, Reuters reports. The developers of Narcotics Overdose Prevention and Education (NOPE), say it is more effective to zero-in on prescription opioids, rather than emphasizing a more generalized anti-drug approach. Prescription drugs are fast becoming the drug of choice amongst teenagers. Another new program, Heroin Prevention Education program uses interactive software centered around the life of a recovering teen heroin addict who began abusing opioid painkillers after having his wisdom teeth pulled, according to the article. Like many before, the teen’s addiction to opioids brought him intravenous heroin use. The article points out that these new programs face challenges due to lack of funding. In 2011, funding was cut according to the former Office of the Safe and Drug Free Schools and Communities. "The whole field is sort of in withdrawal," said William Hansen, who runs All Stars, a school drug-prevention provider out of Greensboro, North Carolina. He says that schools have been pouring more money into academic testing and pulling away from drug prevention. What’s more, there has been increased criticism of anti-drug programs in schools, citing program like Drug Abuse Resistance Education (DARE) - a program which has proven ineffective in deterring drug use amongst teens. However, the new programs argue that they have come up with more effective strategies. "Our program really is looking at adolescent brain development, addiction on a brain level," said Christopher Adzia, the program manager at the Robert Crown Center for Health Education.

2016 Budget Focuses on Prescription Drug Abuse

prescription-drug-epidemicThe prescription drug abuse epidemic in the United States has created a new generation of addicts. Years of over prescribing and poor oversight allowed the problem to grow to epic proportions, ushering in a new wave of heroin addiction in America. While moves have been made to get a handle on the problem, some efforts are more effective than others; the reality is that the problem doesn’t appear to be getting much better. The White House's 2016 budget focuses on prescription drug abuse; it includes new measures aimed at reducing opioid overdoses in America, The Hill reports. The Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Administration (SAMHSA) will see increased program funding, as well other agencies working to get control of the problem. Individual states will receive aid to expand their prescription drug monitoring programs, this will allow for better tracking of “doctor shoppers” and “pill mills.” Wider distribution of naloxone is needed, a drug which can save lives by reversing the effects of opioid overdoses. Providing law enforcement with naloxone will strengthen the likelihood of saving a life, due to the fact that they are usually the first to respond. More education is needed regarding the dangers prescription drugs carry with them, many who walk out of the doctor’s office do not understand that these drugs are not only highly addictive - they can be lethal. "Every day, more than 100 people die as a result of drug overdose, and more than 6,700 are treated in emergency departments," a budget summary document stated. "Abuse of prescription and illicit drugs, such as heroin, is an urgent public health concern." Generally the new budget will spend nearly $4 trillion in total, raising the ceiling on the spending limits introduced under the 2011 budget deal, according to the article. It has been estimated that the new budget would cut deficits by $1.8 trillion over the next 10 years.