Tag Archives: prescription opioids

Heroin Overdoses Among Young Adults

heroin

Researchers from the University of Michigan conduct the Monitoring the Future (MTF) survey every year. The answers that high school students give, provide experts a window into the severity of teen substance use and abuse. The findings can help direct preventive measures in the coming years. The 2016 MTF presented some promising findings, especially regarding prescription opioid use among young people. In fact, past year prescription opioid use among 12th graders dropped 45 percent, compared to five years ago.

The findings are a good sign that we may see reductions in opioid use among 20 something-year-olds in the coming years, an age group that as of late has been using both heroin prescription opioids at alarming rates. The dangers of using opioids of any kind need to be reinforced in young people early on and repeatedly. If preventative measures fall short, more and more young people will succumb to hooks and snares of opioid narcotics. Unfortunately, identifying the groups of people at greatest risk of opioid use initiation isn’t an easy task, partly due to stereotyping.

Heroin Outside City Limits

Heroin, like “crack cocaine,” is often considered to be a drug that primarily wreaks havoc in the inner city. A drug that is used by downtrodden and impoverished Americans. While there is a lot opioid abuse in urban areas, the situation has changed. In recent years, the opioid addiction epidemic has predominantly affected suburban and rural parts of the country. Additionally, many of the young people abusing heroin today, come from white middle class or affluent families. These are young people who have access to financial resources that make it easier to maintain an addiction.

But, even with more resources than the average person of the same age, what often starts as a prescription opioid problem can quickly morph into a heroin problem. The reasons are simple. The price of drugs like OxyContin has only gone in one direction—up! Heroin on the other hand is cheaper, and in many cases, stronger than prescription opioids. Easier to acquire, as well.

One of the unintended consequences of this prescription opioid epidemic has been the increase in heroin addiction and overdoses, in part due to the transition from prescription opioids to less expensive heroin street drugs,” California state health officials report. “Heroin deaths have continued to increase steadily by 67 percent since 2006 and account for a growing share of the total opioid-related deaths.”

In the first quarter of 2016, 412 adults age 20 to 29 went to emergency departments in California due to heroin, according to Los Angeles Daily News. Los Angeles and Orange counties have seen a continued increase in ER cases involving heroin among people in their twenties.

Spotting the Signs

If you have a child in their twenties, frequently they are still living at home, as many Millennials do. But if you have never used an opioid, there is a good chance you would not be able to spot the signs of use. And it isn’t like your child is just going to use right in front of you. So how can you identify signs of a problem? In some cases, you may see track marks from IV heroin use. However, many young heroin addicts do not use needles, opting to smoke or snort the drug. In which case, track marks will not be a signpost you can rely on.

Common signs of opioid use, include:

  • Tiny Pupils
  • Nodding Off
  • Slurred Speech
  • Incessant Itching
  • Complaints of Constipation
  • Diminished Appetite

There are other signs, but those listed are synonymous with opioid use. If you see any of those appearances or behaviors, there is a good chance there is a problem. Such discoveries should prompt further investigation. You can always confront your child about the signs you are seeing, but getting an honest answer is easier said than done. Addiction will lead people to do or say just about anything to continue fueling the fire.

You can also ask if they would be willing to take a drug test. If they refuse, that’s a pretty good sign that you are on the right track. The best results for getting your child into treatment often come by way of interventionists. They are skilled professionals who can help walk you through the process of saving your child’s life.

PACE Recovery Center Can Help

If you know, or suspect that your young adult son is using heroin or prescription opioids, please contact us as soon as possible. With so many young people succumbing to heroin addiction, time is of the essence.

Addiction Epidemic, Not Opioid Epidemic

addiction epidemicThe American opioid epidemic may be misleading to some people. While prescription painkillers and heroin are both addictive and carry the potential for overdose death, the U.S. is not actually in the midst of an opioid drug epidemic. We are, in fact, in the grips of an addiction epidemic. Case in point: Efforts to limit access to prescription opioids have had the effect of making it harder to acquire certain drugs, but people are still dying at unprecedented rates. Why? The answer being that the epidemic we face is not the disease of drugs, but rather the disease of addiction—a debilitating mental illness.

Remove every drug from the equation, and the mental health disorder known as addiction will live on. We could take it even further, arguing that the crisis we actually face is the epidemic of untreated addiction. And if that is the case, it is hard to compare the problem we see to epidemics of the past, such as the AIDS epidemic.

A Waxing or Waning Epidemic

The field of epidemiology, much like addiction, is not an exact science. Experts have a good understanding of both, but there are no guarantees which way things will go. Will the epidemic wax or wane, will the recovering addict continue to improve or will they relapse? Questions that are hard to answer. Attempts to curb the opioid use disorder epidemic stealing lives across the country are extensive, and multifaceted.

  • The adoption of prescription drug monitoring programs for combatting “doctor shopping.”
  • Revising provider opioid prescribing practice guidelines.
  • Expanding access to the opioid overdose reversal drug naloxone.
  • The most important effort of all, increasing access and funding for addiction treatment services across the nation.
The last effort is the most significant. It is the only tactic that addresses the root problem, rather than just the symptoms of addiction, i.e. dependence and overdose. Making painkillers harder to acquire or abuse will only serve to force opioid addicts to find their drugs elsewhere. Naloxone can save lives, but it cannot cure addiction. Treatment is the most effective measure for ending the opioid use disorder epidemic.

Hope On the Horizon

The severity of the American opioid epidemic can be most easily gauged by the death toll associated with abuse, as opposed to opioid addiction rates. If the death toll increases, efforts are not having the desired effect. On the other hand, if fewer people die in any given year, one could argue that the measures implemented have been effective. With opioid overdoses surpassing traffic fatalities, you might think that the crisis is as bad as ever. However, the big picture may tell another story altogether.

Using epidemiological models, researchers believe that there may be an end in sight. At least regarding opioid overdose death rates. A couple of years back, a group of researchers from Columbia University used what is known as Farr’s Law to develop projections regarding the epidemic. Looking at overdose death rate data from 1980 to 2011, it showed that 2016-17 would be the height of the opioid epidemic. According to the models developed using Farr’s Law, the death rate should line up with that of the 1980’s by the year 2034. However, the authors warn:
Although the method we applied originated from studies of infectious diseases, it is unknown whether Farr’s Law applies to epidemics of a non-infectious origin. It is plausible that a non-communicable disease, such as drug overdose, can follow infectious patterns...Mortality data over the next two decades will ultimately test the accuracy of our projections. If the drug overdose epidemic is indeed waning, it may imply that the intensified efforts in recent years, such as enhanced prescription drug monitoring, are working and should be continued.”


Can We See the Forest for the Trees?

It would be nice if their projections hold true. Every life saved is a step in the right direction, even if efforts fail to address the underlying cause of the epidemic—addiction. But if we accept that addiction, while in fact a disease, is something quite different than other health conditions, there is really no way of knowing how things will go. What we can bet on is that expanding access to addiction treatment is a sure way of seeing results. All other efforts are likely to only produce superficial results, merely scratching the surface of the greater problem that is an addiction epidemic.

The greatest life-saving potential can be found in treatment centers and the rooms of recovery for continued maintenance. If you or loved one is in the grips of opioid addiction, please contact PACE Recovery Center.

Synthetic Opioids, A Real Threat

synthetic opioidsSurely, we can all agree that opioid narcotics should be the main focus of substance use prevention efforts in the United States. Americans continue to lose their lives every day from prescription opioid and heroin overdoses; many of those overdose deaths involve young adults caught in the grips of addiction. Opioid use disorder rates are well over 2 million Americans, and some experts believe that that number is actually much higher. Unlike other addictive narcotics, drugs in the opioid family can cause serious respiratory depression. It only takes a little bit too high of dose for one to experience an overdose, and without access to the lifesaving overdose reversal drug naloxone, the outcome can be fatal. While drugs like heroin are already deadly enough, the narcotic is commonly mixed with even more potent synthetic opioids, such as fentanyl. Experts estimate fentanyl to be about 80 times more potent than morphine, and as much as 50 percent more potent than medical grade heroin. It is a drug that was never meant to be used without the close supervision of medical personnel, yet overdose death cases involving the drug are more and more common these days. Unfortunately, naloxone is not as effective with fentanyl-laced heroin as compared with heroin on its own, or with synthetic opioids all together.

Synthetic Drug Epidemic

The prescription opioid/heroin epidemic has proven to be next to impossible to curb, with so many variables to contend with between prescribing practices and the growing demand for heroin in the wake of prescription opioid government crackdowns. The matter is complicated even more by the fact synthetic opioids are becoming ever so common, some of which are not even illegal and can be purchased online by teenagers. Talk of synthetic drugs in the U.S. is usually with regard to “bath salts” or Spice (synthetic cannabinoids), along with a number of other chemically similar variations. There are zero standards in the synthetic drug world, which means that users have no way of predicting how they will react to those types of drugs. It is likely that you have heard the horror stories about violent attacks involving synthetic drugs. Government officials continue to attempt to make it harder for people to acquire such drugs, but is has proved to be a difficult task; every time a chemical formula is banned, chemists simply alter the composition. Teenagers and young adults can easily, and inexpensively purchase synthetic drugs, and they do so despite the dangerous side effects they might experience. While overdose deaths involving synthetic cannabis are relatively rare, when it comes to synthetic opioids that is simply not the case. What’s more, synthetic opioid death rates are likely to go in only one direction, due to the rise in the use of a family synthetic opioids—relatives of fentanyl. Such drugs include:
  • ifentanyl
  • carfentanil
  • furanyl fentanyl
  • U-47700
“Pink,” sold online under the name U-47700, is an unregulated synthetic opioid which could be up to eight times stronger than heroin, NBC News reports. The drug is being purchased online for $5 plus shipping, an appealing price tag for a potent drug.
This stuff is so powerful that if you touch it, you could go into cardiac arrest," said Police Chief Wade Carpenter, Park City, UT. "The problem is if you have a credit card and a cell phone, you have access to it."
Please take a moment to watch the short video below: If you are having trouble viewing the video, you can see it here.

Merging Epidemics

At this point, the line between the opioid use epidemic and the synthetic drug scourge in America is blurring. If it weren’t easy enough already to acquire, try and become addicted to opioids, the surge in online synthetic opioid sales is concerning. The ability to buy drugs online appeals to, already Internet savvy, young adults. Many such users have no idea about the deadly nature of these drugs. If you are a young adult male abusing heroin or prescription opioids, please contact PACE Recovery Center. With each day that passes, there is a greater likelihood that a bag you buy will contain a deadly additive like fentanyl or carfentanil. Recovery is possible, and we can help you achieve it.

Total Cost of The American Opioid Epidemic

opioid epidemicIs it possible to quantify the true impact of the American opioid epidemic? The unprecedented health crisis has left people in the public and private sector scrambling to find desperately needed solutions. With each day that passes—more Americans become dependent on opioids—more people lose their lives to overdose. And while efforts to curb the scourge of opioid addiction in the U.S. have had some effect, without a paradigm shift in thinking regarding prescription opioids—the problem will only continue to disrupt the country. While it is easy for us to look at the staggering death toll to stress the seriousness of the issue, it is important that we all take stock of the societal costs of opioid addiction. With over 2 million Americans living with an opioid use disorder and over 70 people paying the ultimate price for their addiction every day, there is an exponentially greater number of family members who have been affected by the epidemic. It may be impossible to compute the amount of heartache and pain that family members will endure for years, especially if they lost someone to an overdose.

The Cost Of An Epidemic

As you might imagine, there is a heavy price tag attached to the opioid epidemic. The bulk of the cost, naturally, is tied to the burden put on the health care system—whether it be to cover insurance claims for hospitalizations or treatments, or keeping babies born with neonatal abstinence syndrome (NAS) stable—the overall cost of the opioid scourge is daunting to think about. In fact, new research estimates that the epidemic cost is $78.5 billion annually, Newswise reports. Of that estimate, health care accounts for about one-third (over $28 billion) of the total cost. The findings will be published in next month's issue of Medical Journal. Even when opioid use disorder does not result in hospitalization or loss of life from overdose ($21.5 billion), there are other costs to consider as well. Those who are addicted to opioids are often too sick to get to work or hold down a job. The researchers found that loss of productivity accounts for about $20 billion, according to the article. Almost two-thirds of the total economic cost could be attributed to:
  • Health Care
  • Addiction Treatment
  • Lost Productivity
"The costs that we can identify, however, do help increase our understanding of the impact of the epidemic," the researchers conclude. "These estimates can assist decision makers in understanding the magnitude of adverse health outcomes associated with prescription opioid use such as overdose, abuse, and dependence."

Worth The Cost Of Treatment

It is worth pointing out that of the more than $28 billion spent on health care, $26 billion was covered by insurance companies, the article reports. It was not that long ago that it was extremely difficult to get insurance companies to cover mental health disorder treatment, i.e. extended stays at addiction treatment facilities. While there is still a lot more that insurance companies can do to help people with addiction issues, it is good to see that insurance companies are finally insuring people with a history of addiction and paying for some of the bill to help them find recovery. Research overwhelmingly supports addiction recovery services as being the best weapon against the opioid epidemic. Prescription opioids and heroin are extremely difficult to withdraw from and the chance of relapse is especially high among opioid addicts; while those who go to a substance use disorder treatment center have the best chance of achieving sustained recovery in the long run. If you or a loved one is battling opioid addiction, please contact PACE Recovery Center to begin the journey of recovery.

Opioid Epidemic and Money Laundering

opioid epidemicIt has been several years now since the federal government, and state governments alike, began making it harder to acquire prescription painkillers—opioid narcotics such as OxyContin (oxycodone) and Percocet (oxycodone / paracetamol). Drugs of that type are not only addictive, they can be downright deadly, i.e. 78 overdose deaths in America every day related to either prescription opioids or heroin. While it remains a fact that it is still quite easy for some opioid addicts to acquire painkillers (in some cases even after they experience an overdose), the latest opioid scourge sweeping across the nation is heroin. Years of over prescribing opioid painkillers caused Americans to become over reliant on this class of drugs when it comes to pain. This led to an unprecedented rate of opioid addiction, and the opening of a Pandora’s box. When it became more difficult to get such drugs from one’s doctor, faced with certain withdrawal symptoms, many opioid addicts turned to the streets for their drugs.

Prescription Opioids to Heroin

Heroin is cheaper than a tablet of oxycodone on the street, and it is typically stronger or easier to come by. Most of today’s heroin users began by using prescription opioids and then pivoted to heroin. Seeing dollar signs, Mexican drug cartels decided to take advantage of the billion dollar illicit opioid market in America. It is fair to say that cartels trafficking and selling illegal drugs north of the border is nothing new—an exchange that has been happening for nearly half a century. However, never in our history has there been such a high demand for a mind altering substance that can snatch one’s life in the blink of an eye. And if heroin wasn’t bad enough, Mexican cartels are also buying ingredients to synthesize even more powerful opioids, such as fentanyl. In recent years there has been a number of overdose deaths involving an addict who thought they were using heroin, but were actually using fentanyl. Verily, the American opioid epidemic has become a “gold rush” for Mexican drug cartels. That being said, where does all the money go and how does it get to its final destination? It turns out that the answer to that could be a way to combat the crisis we face.

American “Laundry”

A new report conducted by the nonprofit group the Fair Share Education Fund, calls upon legislators to stop allowing the use of anonymous shell companies, The Hill reports. In fact, the United States is among the countries where it is easy for criminals to set up anonymous shell companies to launder their money. Changing the laws that allow for this would make it much harder for drug traffickers to see a return. The effect could have real impact on the opioid epidemic in America.
We should use every tool at our disposal to tackle the opioid crisis, and going after the money is just such a critical tool,” says the Fair Share Education Fund.
The ease in which criminals are able to set up anonymous shell companies is one of the reasons that the Office of National Drug Control Policy (ONDCP) estimates that federal authorities only confiscate 1.5 percent of the money Americans spend on illicit drugs every year, according to the article. Because money can be laundered so easily, it is difficult for law enforcement officials to make cases against drug traffickers.
Authorities may have good reason to suspect someone of being involved in criminal activity,” said the group. “However, without the basic information necessary to show that a suspect is directly linked to a shell company used to facilitate illegal activity, they are unable to make their case, or run out of the time and resources needed to do so.”

Treating the Opioid Addict

Reducing access to opioid drugs, including heroin, is one important step. But treating the addict is also paramount. At PACE Recovery Center 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.

Safe Disposal of Prescription Drugs

prescription drugsThe overprescribing of opioid painkillers in the United States has created an epidemic that many fear will be extremely difficult, if not impossible, to reverse. At the end of the day, all that we as nation can hope for is mitigating the rampant opioid abuse and overdose rates, a class of drugs both illegal and legal that are responsible for over 70 deaths every day. While it has become more difficult to acquire large quantities of such drugs, sometimes from multiple doctors, prescription opioids are still doled out at alarming rates. Efforts to combat the epidemic with effective measures have led to the U. S. House of Representative adopting the Comprehensive Addiction and Recovery Act (CARA) last Friday. Yesterday, July 13, 2016, the U.S. Senate voted 90 to 2 to approve the bill; a move which, if all goes well, will hopefully bring about much needed resources for tackling the multifaceted opioid crisis in America. The legislation covers a number of different areas, including:
    • Expanding access to addiction treatment services.
    • Strengthening prescription drug monitoring programs (PDMPs).
    • Increasing the availability of the opioid overdose reversal drug naloxone.
    • Enlarging the number of prescription drugs safe disposal sites.

Opioids In The Wrong Hands

Historically, when people were written a prescription for particular drugs, the medications were taken until no longer needed. For instance, if you sustained an injury and a doctor prescribed an opioid, then the pills would be taken until the pain dissipated. More often than not, there would be leftover tablets that would reside in one’s medicine chest collecting dust. Such medications were not given another thought and people would continue living their lives. But those were in the times before the epidemic we face today. Today, leftover prescription opioids pose a serious risk to society, as they often end up in the hands of others—sometimes for an injury—sometimes to be abused. Unwanted or unused pain medication can be found in great numbers in medicine cabinets across the country, which some believe to be the result of doctors writing prescriptions for too much of an opioid painkiller. Please keep in mind that the population of the United States is only 5 percent of the world’s population, yet we are prescribed and use the vast majority of the planet’s opioid medication supply. Leftover medication is inevitable. With over 2 million Americans abusing prescription opioids, there is a desperate need to make sure that unwanted medication is disposed of safely—lest the drugs end up in the hands of children or are abused, potentially resulting in an overdose. New research suggest that more than 50 percent of patients’ prescribed opioids have unused medication, according to research published in JAMA Internal Medicine. Despite the fact that most adults are privy to the knowledge that prescription opioids are both addictive and deadly, 20 percent of the research survey participants reported sharing their medication with either friends or family. Perhaps the most troubling finding of the survey was that 50 percent of patients failed to receive information on safe storage or proper disposal of unused/unwanted medication.

Opioid Take-Back Efforts

Federal, state and local governments have made an effort to offer patients with leftover medication access to safe disposal sites for a number of years now. National Prescription Drug Take-back Days result in the collection of millions and millions of pill tablets that would have otherwise sat in medicine cabinets, been flushed down the toilet and/or diverted. Additionally, many pharmacies will take-back your unwanted prescription drugs year round. Nevertheless, whether out of laziness or failing to grasp the severity of the crisis, a significant number of prescription narcotics never make it to safe disposal sites. Simply flushing your pills down the toilet is not a safe form of disposal, evident by the fact that many municipal drinking water supplies contain remnants of prescription drugs. There is now a way to safely dispose of unwanted medication at home. A safe and environmentally responsible method of disposing of prescription meds may be made available to patients across the country in the near future. The Deterra Drug Deactivation System, or Deterra System, is “a simple 3-step process, a user can deactivate drugs, thereby preventing drug misuse and protecting the environment,” according to the product manufacturers website. The system is currently being utilized by:
        • Pharmacies
        • Law Enforcement
        • Healthcare Providers
        • State Agencies
        • Non-Profits
Remember, if you or a loved one are seeking an opiate or heroin rehab and addiction help, please reach out to us today.

Prescription Drug Monitoring Programs (PDMPs)

PDMPsRecently, CNN’s Chief Medical Correspondent Dr. Sanjay Gupta wrote and published an op-ed to coincide with a special report about prescription opioids. Dr. Gupta covered a number of different aspects about the state of the American opioid epidemic and expounded on how the situation became so dire. Perhaps the most interesting aspect about the article was Gupta essentially holding doctors responsible for the market share of the crisis and calling on physicians to do their part to reverse the damage. It is important to keep in mind that there are several different factors that led to the emergence of an epidemic, and while doctors did and continue to overprescribe opioid narcotics, a multifaceted approach from lawmakers, addiction experts and doctors is essential for ending the scourge that claims over 70 lives in this country every day. It is widely accepted that Americans, enabled by doctors, have become far too reliant on prescription opioids—even for pain that could be treated by opioid alternatives. What’s more, while the the vast majority of prescription opioids are written by primary care physicians, few doctors have any opioid prescribing practices training or knowledge about addiction. On top of that, there has not been a huge push from medical organizations urging doctors to acquire the requisite training. Even the American Medical Association (AMA) is resistant to having doctors trained to prescribe responsibly. Hopefully, in the near future doctors will heed the call from Gupta to be a part of the solution, rather than part of the problem. When discussing the American opioid epidemic, the conversation typically is about how bad it is; however, it is important that we take a moment to recognize the strides that have been made in the right direction.

PDMPs

Several years ago, amidst widespread overprescribing by pain management clinics—otherwise known as “pill mills”—and rampant “doctor shopping,” the act of going to multiple doctors in a month to double and triple up on one’s prescription opioids, states began to implement what are known as prescription drug monitoring programs (PDMPs). The programs were designed to give doctors a resource for identifying doctor shoppers and to give authorities a window into which doctors are prescribing suspiciously. PDMPs were met with resistance by some doctors, and to this day there is a significant number of them who do not utilize the resource; but, drug monitoring programs have proved to be an invaluable resource. Today, 49 states have adopted a PDMP of some kind, and there is now evidence that suggests the programs are having the desired effect. In fact, new research from Weill Cornell Medical College has found that, in the states that have implemented a PDMP, a 30 percent decrease in prescriptions for opioids and other narcotics could be seen, NBC News reports. The findings were published in the journal Health Affairs.
This reduction was seen immediately following the launch of the program and was maintained in the second and third years afterward,” writes researcher Yuhua Bao and colleagues. "Our analysis indicated that the implementation of a prescription drug monitoring program was associated with a reduction in the prescribing of Schedule II opioids, opioids of any kind, and pain medication overall.”

Uncertain Conclusions

The news is without a doubt a breath of fresh air, yet in the wake of the death of pop superstar Prince—clearly we as a nation have a long way to go. The research team believes that there could be a number of reasons for the PDMP success. The 30 percent drop in written prescriptions, according to researchers could be that PDMPs:
  • Raised awareness about opioid abuse with doctors.
  • Made doctors more cautious about writing prescriptions that can lead to dependence and addiction.
  • Caused doctors to cut back on prescriptions knowing that they were being watched.
Regardless of the reason for PDMPs causing a reduction, they have had a notable impact which indicates that efforts to curb the problem have had some success. Before PDMPs 5.5 percent of doctor’s visits involving pain management resulted in a prescription for an opioid being written, after drug monitoring programs that number fell to 3.7 percent.

Addiction Treatment

Cutting back on the number of prescriptions written is paramount, unfortunately opioid addicts who struggle to get their pills will more times than not turn to heroin as an alternative. Simply making it harder to get drugs doesn't mean that people will be free of addiction. It cannot be stressed enough just how vital addiction treatment services are to ending the epidemic in the U.S. At PACE Recovery Center, our qualified staff can assist you or a loved one in ending the cycle of addiction. We can show you how it is possible to live a healthy, productive life free from drugs and alcohol. Please contact PACE to begin the life changing journey of addiction recovery.

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 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.

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.