There 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.
There is little debate regarding the insidious nature of opioid addiction, a scourge that has been tearing American families apart for over a decade. The prescription opioid painkiller epidemic stems from a change in modalities with doctors and how they manage a patient’s pain. Gauging a patient’s pain is no easy task because pain intensity is subjective. Doctors are required to treat a person’s pain adequately, which has resulted in rampant overprescribing and a subsequent rise in addiction rates. After a decade and a half of overprescribing opioids, both federal and state governments had had enough. In more recent years, practically every state implemented prescription drug monitoring programs (PDMP) to track patients who fill multiple prescriptions of the same types of drugs. Before such programs were put in place, patients could visit multiple doctors in a week complaining of the same ailment - giving them the ability to accumulate more pills than any one person could use in a month. The medications, often paid for by state assistance programs, were then resold at inflated prices to those who would abuse the drugs. Government crackdowns on prescription opioid abuse made it more difficult for addicts to acquire drugs, such as oxycodone (OxyContin ®), due to scarcity and heightened pricing. Curbing painkiller abuse had an unintended consequence, addicts left with few options turned to heroin - a cheaper and often more potent substance. In the last decade, heroin use more than doubled among young adults ages 18–25, and 45% of people who used heroin were also addicted to prescription opioids, according to the U.S. Centers for Disease Control and Prevention (CDC). Opioids, whether by prescription or bought on the street in the form of heroin, are not just highly addictive, misuse can result in a fatal overdose. The CDC reports that 44 people die every day from an overdose. Thankfully, if an overdose victim is discovered in time, their life can be spared. The drug naloxone hydrochloride has life saving potential, reversing the effects of a prescription opioid or heroin overdose. Until recently, naloxone was only approved for use in the form of injection by the U.S. Food and Drug Administration (FDA). Naloxone injections, while effective, requires the administrator to be proficient in giving injections - ruling out the majority of people who are first to discover an overdose victim. This week, the FDA announced the approval of a nasal spray version of naloxone, which first responders say is easier to use, according to an FDA news release. Naloxone nasal kits eliminate the risk of a contaminated needle prick. While unapproved, many first responders, such as EMTs and police officers, used naloxone with nasal spray adapters; now, the nasal spray devices will meet the FDA’s high standards for safety, efficacy and quality. What’s more, the nasal spray does not require extensive training to administer, meaning that a mother, father or even child can save the life of a loved one. A number of states and municipalities have lighten the restrictions on who can have access to the life saving drug, hopefully the new approval will convince other states to follow suit. The majority of overdose victims are discovered by a friend or family member. With overdoses, time is of the essence, the sooner naloxone is administered - the greater the chance of saving a life.
Combating the opioid abuse epidemic is a top priority for the FDA,” said Stephen Ostroff, M.D., acting commissioner, Food and Drug Administration. “We cannot stand by while Americans are dying. While naloxone will not solve the underlying problems of the opioid epidemic, we are speeding to review new formulations that will ultimately save lives that might otherwise be lost to drug addiction and overdose.”___________________________________________________________________________ If you are or a loved one is struggling with prescription opioids or heroin, please contact Pace Recovery Center.
The unprecedented spike in prescription opioid use in America has raised a number of questions with regard to how the country found itself in the grips of an epidemic. Certainly, most people who experience pain which requires an analgesic of some kind; the pain goes away and they stop taking the prescription. On the other hand, many people continue using prescription opioids long after the pain dissipates, resulting in dependence and/or addiction. Many Americans understand that the country is in the midst of a prescription drug crisis, with thousands of overdoses every year and even more people in need of addiction treatment. Some people will use prescription opioids that were prescribed for someone else, despite having the knowledge that opioids are dangerous and addictive. A new study, which may be the first national public opinion research on opioids, has found that in the past year more than one in four Americans took a prescription opioid, ScienceDaily reports. What’s more, fifty-eight percent of those surveyed say they understand that opioid abuse is major public health problem. The study was conducted by researchers at Johns Hopkins Bloomberg School of Public Health.
"This study shows that many Americans have had direct experience using prescription pain relievers and a sizable share have misused or abused these medications themselves or have close friends or family members who have done so," says study leader Colleen L. Barry, PhD, MPP, an associate professor in the Department of Health Policy and Management at the Bloomberg School. "The seriousness of the issue has become salient with the American public."The findings indicate that the American public may be in a unique position to pass bills that could combat the opioid epidemic, according to the article. The public could support:
- Better medical training for safely controlling pain and treating addiction.
- Curbing “doctor shopping” (seeing multiple doctors for the same drugs).
- Requiring pharmacists to check identification.
"We think this is the perfect time to work on passing policies that can truly impact the crisis of prescription pain reliever abuse," says study co-author Emma E. "Beth" McGinty, PhD, MS, an assistant professor in the Department of Health Policy and Management at the Bloomberg School. "The issue has not yet been highly politicized like some public health issues such as the Affordable Care Act, gun violence or needle exchanges, so we may have an opportunity to stem this epidemic."The findings were published in the journal Addiction. ___________________________________________________________________________ If you are or a loved one is abusing opioids, please contact Pace Recovery Center.
Excessive alcohol and illicit drug use are problems that every industrialized country struggles with, albeit they all go about it in different ways. While many argue about which measures are most effective from one country to the next, it turns out that some countries are doing better in the fight against addiction. So, how does the United States compare to the rest of the western world? The easy answer is, ‘not that well’! Using data from the United Nations, a group of treatment professionals worked to create a series of maps to compare drug and alcohol use in the United States to European countries. The findings showed that Americans overwhelmingly lead the way in opioid and amphetamine-type stimulant use. The United States has the most people in substance use disorder treatment and we have the highest rate of overdose deaths per year. Interestingly, the U.S. did not even make the top five when it came to the availability of substance abuse treatment. America tied with Spain for the most cocaine used, and we came in second (per capita) for marijuana use. However, with Amsterdam considered to be a marijuana mecca, the Netherlands failed to make the top five. The data gathered showed that America is in the top five for almost every national measure of drug abuse. Europe, on the other hand, has a long history with alcohol which may be why countries in the EU top the charts for alcohol use in the last year. America, did not make the top five for once, sitting somewhere in the middle. Norwegians came in first, with the most alcohol consumed per capita; with the stereotypical hard-drinking Irish ranking fifth. This data and mapping help experts determine what policies are working, and which are not. It should help us develop more effective measures going forward. ___________________________________________________________________________ If you or a loved one is living with addiction, please contact Pace Recovery Center.
Lawmakers in Massachusetts continue to spearhead an operation against the opioid epidemic devastating major cities and small towns across the nation. Massachusetts is a state that has felt the overwhelming effects of this crisis, a scourge unprecedented in our times. Lead by U.S. Rep. Joseph P. Kennedy III and U.S. Rep. Katherine Clark, the U.S. House of Representatives unanimously passed two bills devised to combat the insidious effects of opioid abuse, the Boston Herald reports. Kennedy said the unanimous support “speaks to the breadth and depth of the opiate abuse epidemic.” The bill that Kennedy co-sponsored reinstates federal funding to states prescription drug monitoring programs (PDMPs). Monitoring programs deter “doctor shoppers,” people who go to multiple doctors every month for the same types of prescriptions. While PDMPs exist in 49 states, the need for a nationwide system is necessary. The funding will also be used for drug screening and substance use disorder treatment, according to the article.
There are few people in this country who have been spared the heartbreak of watching a loved one, neighbor or friend fall victim to opiate addiction,” said Kennedy. “It’s an epidemic striking red states and blue states, small towns and big cities, neighborhoods rich and poor.”Clark’s bill, if passed by the Senate, creates uniform standards for diagnosing and treating neonatal abstinence syndrome (NAS). The syndrome occurs when fetuses are exposed to opioids, after birth they experience withdrawal symptoms which require extra medical care. The bill would become the first law to address newborns exposed to opioid use, the article reports.
Right now there is no standard for treatment with NAS,” Clark told the Herald. “This problem leads to long stays in the NICU and hundreds of millions in Medicaid dollars.”___________________________________________________________________________ If you or a loved one suffers from opioid addiction, please contact Pace Recovery Center.
A large percentage of people who seek treatment for substance or alcohol use disorder also have other mental health disorders on board, such as depression or anxiety. When this is the case, it is referred to as having a co-occurring disorder, and successful recovery hinges on treating both. What’s more, people’s depression or anxiety may play a part in people forming an addiction. In fact, new research suggests that people living with high levels of depression or anxiety, and experience chronic lower back pain, are significantly more prone to developing a problem with prescription opioids, Medical News Today reports. People with chronic lower back pain and high levels of depression or anxiety were 75 percent more likely to abuse opioids than people with low levels, and their back pain was less likely to improve. The researchers involved in the study examined 55 patients with chronic lower back, as well as major or minor levels of anxiety or depression, according to the article. Over the course of 6-months, the patients were given oral forms of morphine, oxycodone or a placebo. The patient's pain levels and the amount of drugs taken were recorded daily. There was 50 percent less improvement and 75 percent more opioid abuse among patients who had high levels of depression or anxiety, compared with patients with low levels. The findings suggest that doctors treating patients with lower back pain, who show symptoms of mental illness, should make sure that the mental illness is being treated rather than "refusing to prescribe opioids," according to lead researcher Prof. Ajay Wasan, at the University of Pittsburgh School of Medicine. This may reduce the likelihood of opioid abuse and reduce pain. “High levels of depression and anxiety are common in patients with chronic lower back pain,” Wasan said in a news release. “Learning that we are able to better predict treatment success or failure by identifying patients with these conditions is significant. This is particularly important for controlled substances such as opioids, where if not prescribed judiciously, patients are exposed to unnecessary risks and a real chance of harm, including addiction or serious side effects.” The study is published in Anesthesiology. ___________________________________________________________________________ If you or a loved one is struggling with opioid addiction and depression or anxiety, please contact Pace Recovery Center.
Physicians who understand the nature of addiction are crucial in the fight against prescription opioid abuse. Unfortunately, a new survey indicates that many doctors have misconceptions about current opioids on the market and lack an understanding of opioid abuse, PsychCentral reports. The findings come from a nationally representative sample of 1,000 primary care physicians. The new survey, conducted by researchers at Johns Hopkins Bloomberg School of Public Health, showed that almost half of internists, family physicians and general practitioners believe that abuse-deterrent pills are less addictive than traditional opioid medications. The researchers contend that this error in reasoning may be contributing to the prescription opioid epidemic plaguing the country. While abuse-deterrent formulations may make it more difficult for addicts to tamper with pills to be used in unintended ways, such drugs are in no way less addictive than their forerunners.
“Physicians and patients may mistakenly view these medicines as safe in one form and dangerous in another, but these products are addictive no matter how you take them,” study leader G. Caleb Alexander, MD, said in a news release. “If doctors and patients fail to understand this, they may believe opioids are safer than is actually the case and prescribe them more readily than they should.”The research showed that one-third of the physicians thought that the majority of prescription drug abuse occurs by means of injecting or snorting the medications, rather than orally, according to the article. However, a number of studies show that most prescription drug abuse occurs via oral use.
“Doctors continue to overestimate the effectiveness of prescription pain medications and underestimate their risks, and that’s why we are facing such a public health crisis,” Alexander said.The findings were published in the Clinical Journal of Pain.
The prescription opioid crisis in America has led to a number of babies being born with what's known as Neonatal Abstinence Syndrome (NAS). Expectant mothers who expose their fetus to opioids of any kind face the risk of giving birth to a child with NAS. The syndrome is the result of withdrawal from the opioid pain medication. Treating infants with NAS is complicated and requires trained medical personnel which can be costly. A new report has found that the costs of NAS treatment for babies have increased dramatically, Science Daily Reports. "At our institution, costs associated with treating infants with NAS are exponentially higher than the costs associated with infants not affected," write Dr. Kay Roussos-Ross, Assistant Professor of Obstetrics and Gynecology, and colleagues of University of Florida College of Medicine, Gainesville. The researchers analyzed cost trends for infants with NAS at one university-affiliated hospital between 2008 and 2011. Over the course of the three year study, Dr. Roussos-Ross and coauthors found 160 opioid-exposed newborns:
- 40 in the first year.
- 57 in the second year.
- 63 in the third year.
- About $1.1 million in the first year.
- $1.5 million in the second year.
- $1.8 million in the third year.
As the federal government and the implementation of state prescription drug monitoring programs make it more difficult for opioid abusers to get their hands on OxyContin ® (oxycodone), many have turned to heroin as an easier, cheaper and stronger alternative. When compared to a decade ago, today it is much easier for opioid addicts to get their hands on heroin - resulting in a surge of heroin overdoses across the country. “Most people who use heroin in the U.S. today used prescription opioids first. Reducing inappropriate prescribing will prevent overdose from prescription opioids and heroin,” said CDC Director Tom Frieden, MD, MPH, in a news release. Heroin overdose deaths nearly tripled from 2010 to 2013 in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC). In California, emergency departments have seen a six-fold increase in heroin poisonings in the last decade, Reuters reports. In 2014 alone, California emergency rooms treated 1,300 young adults between the ages of 20 and 29 for heroin poisoning. "It's consistent with what we're seeing in our narcotic treatment programs - just a lot more young people," said Tom Renfree, who heads substance abuse disorder services for the County Behavioral Health Directors Association in Sacramento. "There's been a real spike." Heroin poisoning is not exclusive to overdoses; it also represents those who used a product ‘cut’ with something potentially lethal, according to the article. Across the country, there has been a rise in heroin cut with the opioid analgesic Fentanyl ®, users are often unaware just how powerful Fentanyl ® (100 times the strength of morphine) is, making dosing extremely difficult. Young adults were not the only age group affected in recent years. During the same period, adults ages 30 to 39 who were seen in emergency rooms for heroin poisoning doubled - from about 300 to about 600. Among teenagers, in 2014 there were 367 teens treated for heroin poisoning - compared with about 250 in 2005.
In the United States, prescription drug overdoses are responsible for taking thousands of lives each year. While efforts to promote abuse-deterrent drugs and the implementation of prescription drug monitoring programs has had some promising results, the drop in prescription drug overdoses and prescribing rates has led to a surge in heroin overdoses, HealthDay reports. In 2010, the makers of OxyContin released a new version of the drug which incorporated abuse-deterrent properties. New research indicates that in the two years following the drug’s new formulation OxyContin related overdoses dropped 19 percent and prescriptions of the drug decreased 19 percent, according to the article. "This is the first time in the last two decades that narcotic prescribing had dropped, rather than continued to increase," said lead researcher Dr. Marc Larochelle, an instructor at Boston University School of Medicine. "With the pill, you used to be able to crush it up and either snort it or dissolve it and inject it. Now if you try and crush it, it doesn't turn into a powder -- it just kind of balls up, and if you try and dissolve it, it turns into a goo," Larochelle explained. Unfortunately, the opioid epidemic exhibits the properties of a hydra, cut off one head only to be faced with another. In the same time period, the researchers found that the rate of heroin overdoses increased 23 percent. "Reducing supply may have led some people who are abusing these drugs to substitute an illicit narcotic like heroin, and it may partially explain why we have seen an explosion in heroin use across the country," Larochelle said. Larochelle points out that simply altering drug formulations will not, in and of itself solve the drug abuse problem. "But it shows supply could be one part of the issue. Abuse-resistant formulations will not cure people who are addicted to narcotics. It could, however, prevent or slow down the number of new people who become addicted, because many people who use heroin may have started with pills," he said. The findings were published in JAMA Internal Medicine.