Tag Archives: opioids

The First National Public Opinion Research On Opioids

opioidsThe 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.

Drug and Alcohol Use in America Compared to Europe

drug-useExcessive 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. prevalence-of-opioid-use-once-year-past-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.

House Unanimously Passed Bills Aimed at Opioid Abuse

opioidsLawmakers 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.

Back Pain, Anxiety, and Depression – Opioid Abuse

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 Have Misconceptions About Opioids

doctorPhysicians 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 Cost of Neonatal Abstinence Syndrome (NAS)

opioidsThe 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 50 to 60 percent of opioid-exposed infants developed symptoms of NAS each year of the study, according to the article. Most of the babies (95) were exposed to "opioid agonist" medications, drugs like methadone and buprenorphine, which are given to pregnant women who have an opioid use disorder. The other 65 babies were exposed to prescription opioids used illicitly by their mothers during the pregnancy. When compared to healthy infants, the researchers found that the cost of treating babies born with NAS is 15 to 16 times higher. Each year, the total costs for treating NAS increased dramatically, the article reports.
  • About $1.1 million in the first year.
  • $1.5 million in the second year.
  • $1.8 million in the third year.
Healthy babies typically spend one or two days in the hospital post-birth. Whereas, babies born with NAS are kept in the hospital for an average of 23 days. Babies that are exposed to opioids in utero that did not develop NAS stay in the hospital for about five days. The findings were published in the Journal of Addiction Medicine.

California Emergency Rooms Treating Heroin Poisonings

heroin-overdoseAs 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.

OxyContin Overdoses Drop – Heroin Overdoses Rise

needle-exchangeIn 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.

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.