Tag Archives: overdose

Naloxone: The Price of Life

naloxoneIt’s likely that you may remember Martin Shkreli, the CEO of Turing Pharmaceuticals, who caught the public’s attention and widespread criticism when he unabashedly raised the price of Daraprim by 5000 percent. The drug is used for treating the deadly AIDS virus. The average cost of treatment rose from around $1,130 to over $63,000, with each tablet costing $750.

While it may seem unconscionable to most that a company could unethically put people’s lives at risk by hiking the price of a potentially lifesaving drug to the point of unaffordability, sadly Mr. Shkreli decision to raise the price of Daraprim is not unique when it comes to pharmaceutical companies and lifesaving treatments. Which brings us to the main focus of today’s post—the opioid overdose reversal drug naloxone.

Stemming the Tide

If you have been following the ongoing story of the United States government’s policy changes for addressing the deadly opioid epidemic, then you have probably heard the calls from lawmakers on both sides of the aisle to get a handle on the situation—a scourge stealing the lives of over 70 Americans every day.

Multiple government agencies, including the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA) for instance, at the behest of Senators, Congressman and the White House—are working to make it more difficult to abuse prescription drugs and develop the most effective treatments for treating substance use disorders. The agencies are imploring doctors to write prescriptions with discretion, only relying on drugs like oxycodone when it’s absolutely necessary.

Recently, a bill was put forward in the Senate that would impose a 1 cent tax on every milligram of active opioid ingredient in a prescription painkiller; the money generated from the tax would be used for expanding access to substance use disorder treatment. What’s more, the U.S. Senate overwhelmingly voted in favor (94-1) of the Comprehensive Addiction and Recovery Act (CARA) in March of 2016. The legislation is meant to cover a number of different facets relative to the opioid epidemic, which include:

    • Expanding Prevention and Educational Efforts
    • Expanding Access to Unwanted Prescription Drug Disposal Sites
    • Strengthening Prescription Drug Monitoring Programs
    • Expanding Access to Naloxone

The Price of Life

It is a sad truth that a number of people will die from an opioid overdose every day; however, there are many who will also be saved by naloxone, otherwise known as Narcan. If administered in a timely manner, the drug can reverse the potentially fatal depression of the central nervous system and respiratory system caused by an opioid overdose. In recent years, and with each month that passes, more law enforcement officials and other first responders have been trained to administer the drug. States and municipalities have begun to make it easier for addicts and their loved ones to gain access to naloxone without a prescription, due to the fact that they are often present at the time of an overdose, and time is of the essence.

The drug is a necessity, and with demand comes dreams of profit. In fact, the price of certain forms of naloxone has increased exponentially in the past two years, according to Politico. The year 2014 saw more opioid overdose deaths (28,000), more than any other year during the course of this epidemic. Truven Health Analytics reports that since that year:

      • Kaleo Pharma’s auto-inject version went from $575 to $3,750 per two-dose package.
      • Two injections of Amphastar’s naloxone doubled in price ($66) by the end of 2014.
      • Two vials of Hospira’s generic cost $1.84 in 2005, rising to $31.66 by 2014.

If the price of the drug keeps rising, it will be hard for not only patients, but first responders to afford to equip themselves with this vital medication and people who could have been saved may lose their life. Hopefully, steps will be taken to subsidize the ever growing costs of the drug.

Opiate and Heroin Rehab at PACE

Opiate and heroin addiction treatment options include psychosocial approaches, pharmacological treatment, therapeutic groups, 12-Step recovery, as well as individual and experiential therapy. Our addiction treatment staff also lead psychoeducational groups that cover the disease model of addiction, emotional management tools, relapse prevention techniques, boundaries and healthy relationships, and general life skills that help smooth the transition of clients from active addiction into life.

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.

Major Media Covers the Opioid Epidemic

opioid epidemicA number of major media outlets have taken it upon themselves, and for good reason, to shine a light on prescription opioid and heroin abuse. For over a decade now, our nation has been severely affected by the opioid epidemic, a crisis that takes over 70 lives a day, according to the Centers for Disease Control and Prevention (CDC). While health agencies and lawmakers are working hard to increase access to both the life saving overdose reversal drug naloxone and addiction treatment, there is still a lot more that needs to be done to combat the calamity.

This week, the United States Senate voted overwhelmingly in favor of the Comprehensive Addiction and Recovery Act (CARA). If the bill passes in the House, the legislation will give the Attorneys General the power to award grants to address the national epidemics of prescription opioid abuse and heroin use. The funding will be used for strengthening a number of programs and initiatives, including: addiction education and prevention, prescription drug monitoring and treatment.

CARA is just one effort among a multifaceted interagency approach to addressing the opiate epidemic. The White House, the Substance Abuse and Mental Health Services Administration, the Food and Drug Administration, et al., are all committed to saving lives and providing access to substance use disorder treatment. What’s more, there is still a lot that the American public does not understand about the drug crisis and the true scope of the disease of addiction.

Last month, the Federal Bureau of Investigation (FBI) along with the Drug Enforcement Administration (DEA) released a film: “Chasing the Dragon: The Life of an Opiate Addict”. The film was created mainly for young Americans, and was essentially a call to action for the public to take part in ending the opioid epidemic. Towards the end of February, PBS aired a new “Frontline” documentary “Chasing Heroin.” The film is nearly 2 hours long, and took a year to film. The documentary covers a number of elements of the epidemic, but perhaps the most interesting aspect was the coverage of how law enforcement is addressing the problem. Police officers are acting as social workers and not jail taxis, instead of slapping on the handcuffs they are referring addicts to addiction treatment services. You can watch a short clip below or watch the full documentary by clicking here.

Tonight, ABC News will air a special edition of “20/20” at 10 p.m. ET. “Breaking Point: Heroin in America.” The report covers the ongoing heroin epidemic in New Hampshire.

“When you realize that nearly everyone you meet has been touched by the drug in some way, that’s really eye-opening,” said David Muir. “It helps begin a conversation out there, and the more we can be part of the conversation, the better.”

We hope that everyone, whether the opioid epidemic has touched you or not, will take time to watch the important documentaries. We can all have a hand in the solution to this insidious problem.

FDA Approves Naloxone Nasal Spray

naloxoneThere 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.”

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If you are or a loved one is struggling with prescription opioids or heroin, please contact Pace Recovery Center.

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.

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