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  • Opioid Addiction Rates Higher Than Expected In Massachusetts, Study Says

    Opioid Addiction Rates Higher Than Expected In Massachusetts, Study Says

    Nearly 5% of Massachusetts residents may be battling opioid use disorder, according to a new study. 

    Health officials in Massachusetts are expressing concern over the results of a new study, which suggests that more residents are struggling with opioid use disorder than previous research had suggested.

    Using information culled from a database for public health information, the study authors found that the number of individuals in the Bay State who have either received treatment for addiction, or who qualify as addicted but have gone undiagnosed, may be as high as 4.6% of residents over the age of 11.

    That number is significantly higher than previous records, which suggested that addiction rates hovered at just over 1%.

    The study was published in the American Journal of Public Health, and sought to determine the annual prevalence of opioid use between 2011 and 2015.

    To do so, researchers used the Massachusetts Public Health Data Warehouse, which links information on hospital and emergency room visits, prescriptions and insurance claims, among other sources, from more than a dozen state agencies.

    Patients are identified with their own unique number so it is possible to track a single individual who may have been admitted to a hospital or ER or received treatment from first responders.

    Researchers looked at information on individuals who, based on such encounters with the health care system, had been or could be determined as suffering from opioid addiction—and identified 119,000 people, or 2% of the state population over the age of 11 in 2015.

    From there, they used statistical methods to estimate the number of people who would be considered as opioid-dependent but have not received any treatment. 

    That formula brought the total number of individuals up to 4.6%, or 275,000 Massachusetts residents over the age of 11 years. Previous research, which determined the 1% rate, was based on national surveys that interviewed only those people who had sought help from the health care system for opioid-related issues.

    Response from the Massachusetts medical community was largely positive in regard to the study’s findings. The Boston Globe quoted Dr. Joshua A. Barocas, an infectious disease physician at Boston Medical Center, who said, “[The study] is a good wake-up call. Our pool of people who are at risk for overdoses is potentially higher than we thought it was.” 

    The study also drew criticism from Dr. Silvia S. Martins, director of the Substance Abuse Epidemiology Unit at the Columbia University Mailman School of Public Health. Her response stemmed from what she viewed as a broad definition of opioid use disorder, which may have inflated the statistics.

    “The analysis could have been done in a more precise way,” she said.

    View the original article at thefix.com

  • Canadian Pot Companies Use Legal Gray Areas To Promote Product

    Canadian Pot Companies Use Legal Gray Areas To Promote Product

    The companies are not allowed to promote their product with testimonials, glamorous images or mascots, according to Bill C-45.

    As Canada attempts to contend—with varying degrees of success—with the massive demand for cannabis after the country legalized recreational marijuana on Oct. 17, various entrepreneurs have leapt into the fray to connect consumers with product in creative ways.

    Among these is the delivery start-up Eddy Delivery, which is offering a unique promotional campaign to bring visitors to its website. The company offered to deliver free snacks to those who add their information to its mailing list, and add their names to a grand prize drawing for a visit to a licensed cannabis production facility.

    The campaign is intended to help Eddy add delivery of recreational marijuana to its current service, which delivers medical marijuana. 

    Eddy’s website states that customers who sign up for its service would be added to a delivery list, which will be served with free snacks (while supplies lasted) on the first day of legal recreational marijuana sales.

    Those who signed up could increase their chances for a windfall of munchies by sharing the information and tagging friends on Instagram. Participants were also entered into a random drawing for a “Lucky Green Ticket,” which would grant four winners a tour of a licensed cultivation facility—or “local weed factory.” 

    The ultimate goal for Eddy is to branch into recreational cannabis delivery, though it will have to overcome considerable hurdles set in place by the legalization legislation.

    As High Times noted, prospective cannabis companies are not allowed to promote their product with testimonials or mascots, but the specifics of this rule are—according to Scott Hulbert, managing director of the promotional products company Ideavation—”really gray.”

    “It’s a moving target, as far as legalities, restrictions and advertising opportunities,” said Hulbert. “Will it be like tobacco, which is very restricted in its advertising, or alcohol, which has been given more of a carte blanche? We just don’t know.”

    Eddy CEO Ryan Dempsey echoed Hulbert’s understanding of the current bill. “They recently changed regulations to allow Ontario retail stores to be run by private companies,” he said. “They’re still also considering changes for other rules, such as private e-commerce and delivery.”

    As for Eddy’s chances of entering the recreational market, Dempsey said, “Nothing definite at this point, but we’re optimistic.”

    View the original article at thefix.com

  • Is Anxiety The Sixth Stage Of Grief?

    Is Anxiety The Sixth Stage Of Grief?

    One therapist provides compelling examples of the relationship between loss and anxiety. 

    Is anxiety the sixth stage of grief? Therapist and author Claire Bidwell Smith thinks so, and she shares why in a recent column in the Washington Post. 

    Bidwell Smith writes that a few years ago, she began seeing an increased number of patients reporting anxiety after the loss of a loved one. Some of the patients had dealt with anxiety before, but she says for the majority it was a new issue. 

    “Grief and anxiety are inextricably linked,” Bidwell Smith explains. “We experience anxiety after a loss because losing someone we love thrusts us into a vulnerable place. It changes our day-to-day lives. It forces us to confront our mortality, and facing these fundamental human truths about life’s unpredictability causes fear and anxiety to surface in profound ways.”

    When Bidwell Smith began experiencing the increase in patients dealing with anxiety and grief, she began to research. Though she says there was little information about the connection between the two, she was able to use her own experiences with anxiety and grief after losing her mother at age 18. 

    She says she soon came to realize that much of the anxiety in such situations stemmed from not having processed the loss thoroughly due to expectations from society to move on from a loss. 

    “Unfortunately, this is a common experience for many people who lose a loved one,” she writes. “Our culture is not very adept at making space for grief. That was true over 20 years ago when I was going through it, and is still largely true today.”

    Bidwell Smith references one case in particular where a patient in his 40s had lost his father and had come to see her about six months later, as he’d been dealing with panic attacks and bursts of anger. 

    Bidwell Smith worked with the patient to confront his loss, after which he began to feel relief from the anxiety and anger. Additionally, she says it is important to address how loss makes us “confront our mortality.”

    “When we lose someone significant, we are starkly reminded of how precarious life is, how the unexpected lurks at every turn and how wide-ranging the actual impact of loss can be,” she writes.

    According to Bidwell Smith, treating anxiety brought on by grief is doable through cognitive behavioral therapy, deep grief processing and meditation techniques. But it’s also important that the societal narrative around grief begins to change. 

    “Working through these components is vital to healing ­grief-related anxiety,” Bidwell Smith writes. “As a culture, we tend to push away our thoughts, fears and questions about death. Given how reluctant our society is to deeply explore this topic, it’s no wonder that we falter individually when faced with it. After all, at the root of most anxiety is fear. And what are most people afraid of more than death?”

    View the original article at thefix.com

  • Should Liquor Stores & Pot Dispensaries Be Allowed Near Rehabs?

    Should Liquor Stores & Pot Dispensaries Be Allowed Near Rehabs?

    A Boston city council member is proposing that pot dispensaries and liquor stores shouldn’t be allowed to open near addiction treatment centers.

    In East Boston, city officials are considering a proposal to open a pot dispensary on the same block as a healthcare facility where patients are treated for drug and alcohol addiction.

    City Councilor Lydia Edwards is proposing that state law should not allow such close proximity of the two diametrically opposed businesses.

    As the crisis of addiction in the United States continues to escalate with overdose deaths increasing yearly, some believe the U.S. needs laws setting boundaries between pot and alcohol stores and recovery centers.

    In Boston, a half-mile buffer is required between marijuana facilities—meant to protect the city from having entire blocks focused on pot sales—and state law allows municipalities to impose 500-foot buffers on marijuana facilities around K-12 schools.

    However, it’s unclear if this would extend to allowing cities and towns to legally increase the size of such buffers or to include other facilities—such as addiction treatment centers—in the law.

    Edwards said that Boston should consider banning marijuana and liquor stores from opening near addiction treatment centers. She has requested a hearing on the possibility of these zones. Other industry groups responded quickly that “buffer zones” could be illegal.

    According to The Boston Globe, Edwards argues that people trying to recover from addiction require protection from the presence of marijuana and alcohol. Edwards added that she supported the legalization of marijuana—Boston residents voted largely in favor of a 2016 ballot initiative that created a commercial cannabis market.

    “I would equally be concerned if a bar was opening up next to a substance abuse treatment [center], or if a liquor store was,” Edwards told The Globe. “I’m not trying to put in red tape or further convolute the access to this burgeoning industry, but the fights are happening, the tears are flowing, and people are tense about this. I think it’s a citywide conversation we need to have.”

    The marijuana company Omnicann is attempting to open a retail pot shop in a two-story space in East Boston. The North Suffolk Mental Health Association is two doors down and operates an addiction treatment center.

    Omnicann, led by Arish Halani, is offering to meet with North Suffolk leaders and to promise that the marijuana shop will not have its product in window displays.

    “We’d like to be a model for how a cannabis retail facility and an abuse treatment facility can co-exist and maybe even help each other,” said Jim Borghesani, an Omnicann spokesman.

    The direct impact on those seeking addiction treatment who find their treatment center a few doors down from a store that dispenses drugs or alcohol is not proven.

    “As always, there isn’t as much data as we’d like to inform policy,” said. Dr. Eden Evins, the founding director of Massachusetts General Hospital’s Center for Addiction Medicine.

    Edwards said Boston should create a registry of potential marijuana facilities to alert prospective operators that their desired locations are close to another facility.

    View the original article at thefix.com

  • Prohibition Party Reignites Anti-Alcohol Campaign In New York

    Prohibition Party Reignites Anti-Alcohol Campaign In New York

    The state party is focused on pushing back on New York’s flourishing alcohol industry.

    Seems like alcohol prohibition didn’t die with the 21st Amendment. In fact, support for the idea is alive and well in New York state, where a small group of prohibitionists are reigniting the fight for temperance.

    The Prohibition Party of New York (established in 1869) has been dormant since national prohibition—the ban on the manufacture and sale of alcoholic beverages—ended in the United States in 1933. But the group reemerged in 2017 with a small membership, led by state party chairman Jonathan Makeley of Amherst.

    “The motivation for re-establishing our state party organization was to have a positive influence on the condition of our state. To promote good government based in moral principle, ethical public service, and policies to advance the public well-being,” the NY Prohibition Party said to NYup.com. “To promote temperance, to advance policies to deal with the problem of alcohol in our society, and to advance other reforms to help build a better future for the people of New York state.”

    The state party believes that the common anti-prohibition narrative is perpetuated by myths that are “not historically accurate.” For example, the party believes that instead of being a failure, prohibition succeeded in drastically cutting drinking rates and decreasing crime in the U.S.

    The state party is particularly focused on pushing back on New York’s support for its alcohol industry.

    According to NYup, under Gov. Andrew Cuomo, New York has cut fees and regulations for breweries, wineries and distilleries amounting to millions of dollars, which has allowed the number of alcohol producers in the state to double since 2012.

    “Gov. Cuomo is perhaps the worst governor on alcohol issues that our state has had since Herbert Lehman (New York’s governor when Prohibition ended in 1933). His support for the alcohol industry is unethical and has harmed the people of New York,” says the state party.

    It’s also the New York Prohibition Party’s goal to encourage New York towns to stay “dry” or “partly dry” (having some restrictions on alcohol use/sales). Currently there are 8 completely dry towns and 36 more that are partly dry.

    And in addition to ending pro-alcohol policies in New York, the state party also supports more substance abuse prevention efforts and to “expand education on the harms of alcohol and the benefits of teetotalism (complete abstinence from alcohol).”

    View the original article at thefix.com

  • Utah Lawmaker Tries Pot For First Time On Facebook Live

    Utah Lawmaker Tries Pot For First Time On Facebook Live

    “I decided it was about time that at least one legislator knew a little bit about marijuana before we changed all the laws,” said the state senator.

    A Utah state senator decided to do some hands-on research before voting on the state’s marijuana policy in the upcoming November election.

    Jim Dabakis, a Democrat, took to Facebook Live to stream himself trying marijuana for the first time. He ate an edible gummy bear in Las Vegas, where recreational weed is legal.

    “I decided it was about time that at least one legislator knew a little bit about marijuana before we changed all the laws,” Dabakis said in the video. “I don’t think there’s a senator that’s used marijuana. I think maybe nobody has ever smoked marijuana and we’re going to make the laws.”

    Dabakis said “with great sacrifice” he went to Vegas on his own accord to give pot a try. However, he doesn’t like smoke, so he opted for an edible instead.

    “I wouldn’t recommend it as a sheer candy because it’s a little bit bitter,” he said.

    After trying the candy, Dabakis said that the experience wasn’t remarkable

    “It was no big deal,” Dabakis told USA Today. “It was fine. I just felt a little high.”

    In a follow-up video, Dabakis said he “wouldn’t recommend shooting up marijuana to anybody.” However, he called on everyone in Utah to just “mellow out” about marijuana.

    “The people who are terrified by it seem to be the people who have never tried it,” he said.

    In fact, he recommends that all his colleagues takes a moment to familiarize themselves with the issue at hand.

    “I think the reefer madness crowd – you guys, you need to try it. It’s not that big a deal,” he said in the video.

    He reinforced that stance when speaking with USA Today.

    “I want all my colleagues to get amnesty and go get a gummy bear or smoke a marijuana cigarette,” he said. “I think everybody is afraid of what they don’t know about.”

    Utah voters will consider legalizing a medical marijuana program in November. The issue has been fiercely debated in the state, where a heavy Mormon influence has resulted in some of the strictest alcohol laws in the nation. While the proposition to legalize medical marijuana seems to be slightly ahead by voters, the governor of Utah recently said that even if it doesn’t pass the state is headed toward legalization of medical cannabis.

    “The good news here is that whether [Prop 2] passes or fails, we’re going to arrive at the same point,” Utah Gov. Gary Herbert told The Salt Lake Tribune.

    View the original article at thefix.com

  • What’s Actually Happened Since Trump Declared An Opioid Emergency

    What’s Actually Happened Since Trump Declared An Opioid Emergency

    Critics say the emergency declaration was more for show than to actually resolve the crisis.

    A year ago, President Trump declared a national public health emergency because of the opioid epidemic, vowing that doing so would streamline responses to a health crisis that killed more than 70,000 Americans last year.

    However, a new report shows that the declaration has led to little change. 

    The report, prepared by the Government Accountability Office, found that the administration has used just three of 17 available authorities that are activated when the government proclaims a public health crisis. These authorities include, for example, waiving certain administrative processes in order to quicken responses in an emergency.

    The Trump administration used one authority to more quickly field a survey of healthcare providers about their prescription practices. The results of the survey will help inform policy decisions going forward, the administration said.

    Secondly, authorities waived the public notice period for approval of two state Medicaid demonstration projects related to substance use disorder treatment, which was intended to speed up implementation of the projects, allowing the states to test and evaluate new addiction-related services delivered through Medicaid.

    Finally, the Department of Health and Human Services (HHS) increased support for research on opioid use disorder treatments and gave out information on opioid misuse and addiction.

    The Department of Health and Human Services said that more authorities haven’t been used because many of the abilities enabled by the state of emergency declaration are not applicable to the opioid epidemic. Instead, they are designed for response to infectious diseases or natural disaster. 

    “HHS officials determined that many are not relevant to the circumstances presented by the opioid crisis,” the report reads. However, the potential for additional responses will be reviewed. “Officials told GAO they will continue to review the authorities as the opioid crisis evolves and in the context of HHS’s other efforts to address the opioid crisis.”

    Still, critics of the administration say that the fact that so few resources have been utilized shows that the administration’s declaration was more for show than in hope of solving the problem. 

    “Communities are desperately in need of more help to address the opioid epidemic. President Trump, as this report shows, has broken his promises to do his part,” Senator Elizabeth Warren (D-MA) said in a statement reported by Vox. “I’ve asked this administration time and time again to show what actions they are taking to meaningfully address this crisis. No response. To me, it looks like empty words and broken promises. Hand-waving about faster paperwork and speeding up a few grants is not enough — the Trump Administration needs to do far more to stop the opioid epidemic.”

    Disqus comments

    View the original article at thefix.com

  • White House Launches Treatment Program For Moms With Opioid Addiction

    White House Launches Treatment Program For Moms With Opioid Addiction

    The program will streamline care and reduce healthcare costs for mothers and children who are affected by opioid addiction.

    The Trump administration announced this week that it will begin a program to address opioid abuse among pregnant and postpartum women, in an attempt to address health complications related to addiction and reduce the number of infants born dependent on opioids.

    Health and Human Services (HHS) Secretary Alex Azar announced the model during a conference on Tuesday.

    “The M-O-M model, for ‘Maternal Opioid Misuse,’ will partner with state Medicaid agencies to integrate a wide range of services for pregnant and postpartum women struggling with opioid misuse, to ensure not only their health, well-being, and recovery, but protect the health of their children as well,” Azar said, according to Medpage Today.

    In a press release about the program, the Centers for Medicare & Medicaid Services said that it is designed to streamline care and reduce healthcare costs for mothers and children who are affected by opioid addiction.

    “Too many barriers impede the delivery of well-coordinated, high-quality care to pregnant and postpartum women struggling with opioid misuse, including lack of access to treatment and a shortage of providers in rural areas, where the opioid crisis is especially destructive,” Azar said in that release. “The MOM model will support state Medicaid agencies, front-line providers and healthcare systems to help ensure that mothers and infants afflicted by the opioid epidemic get the care they need.”

    The program will be tested in up to 12 states over the next five years. As the opioid epidemic has unfolded, complications from addiction have become a leading cause of maternal death. In addition, the number of babies born dependent on opioids has increased sharply, from 1.19 cases per 1,000 hospital births in 2000, to 5.63 in 2012, according to The Washington Post. Those infants can have lifelong complications from being exposed to opioids in the womb.

    Azar said that the MOM model is the latest step that the Trump administration has taken to make real changes to how opioid addiction is addressed.

    “We believe in evidence-based treatment, we believe in a public-health approach to this epidemic, and we believe in approaching addiction as a disease, never a moral failing,” Azar said.

    The health secretary added that early indications show that opioid overdose deaths seem to be plateauing this year. Although he acknowledged that too many people are still dying from opioid addiction, he said that there are signs of progress.

    “Since President Trump took office in January 2017, the number of patients receiving buprenorphine, one form of medication-assisted treatment, has increased by 21%… [and] from 2015 to 2017, we have seen a statistically significant decline in the number of Americans who misuse prescription opioids,” Azar said.

    View the original article at thefix.com

  • Congress Passes Bill To Penalize, Convict Patient Brokers

    Congress Passes Bill To Penalize, Convict Patient Brokers

    The new bill would impose prison sentences of up to 10 years and fines as high as $200,000.

    A bipartisan bill—passed as part of the SUPPORT Patients and Communities Act on Oct. 24—will impose criminal penalties on individuals or organizations that accept or give payments or other incentives to prospective rehabilitation patients in exchange for referrals to treatment facilities.

    An op-ed piece in USA Today noted that these “patient brokers” connect those seeking treatment with centers or sober homes without proper or reputable means of providing assistance to patients; the result is loss of funds, increased insurance rate and in many cases, greater chances of overdose or death.

    The new bill would impose prison sentences of up to 10 years and fines as high as $200,000.

    S.3254—the Eliminating Kickbacks in Recovery Act of 2018—will allow federal prosecutors to pursue and penalize patient brokers, phone-call aggregators and the companies that allegedly pay them for referrals.

    As USA Today noted, it has been illegal for Medicaid or Medicare facilities to accept kickbacks since 1972, but it remains fair game for treatment centers and sober homes that take private insurance, including policies sold through the Affordable Care Act.

    The USA Today op-ed claimed that patient brokers can be a persistent presence wherever individuals suffering from dependency issues might be found, from drug courts to street corners. The facilities that they promote also maintain a media presence through television and internet advertising, and call aggregators can purport to connect prospective patients to treatment, but actually collect their information to sell to the highest bidding facility.

    A bipartisan group from the Energy and Commerce Committee questioned eight such call aggregators about their business practices in May 2018.

    Avoiding such blatantly predatory entities can be a challenge for the more than 2 million Americans suffering from opioid dependency. While some can consult family medical practitioners or guidelines from the National Institute on Drug Abuse (NIDA) and other organizations, state laws vary on the regulation of treatment centers, so that what may be illegal in some areas can pass in others.

    As USA Today noted, penalizing those that prey on individuals in crisis is an important step in providing proper assistance to those with dependency issues.

    View the original article at thefix.com

  • New Opioid 500 Times Stronger Than Morphine Nears FDA Approval

    New Opioid 500 Times Stronger Than Morphine Nears FDA Approval

    Sufentanil is currently used intravenously in operating rooms in tightly-controlled circumstances.

    The chair of an FDA advisory panel is speaking out against the approval of a powerful new opioid that is even stronger than fentanyl, but despite his public stances it appears likely that the FDA will approve the drug. 

    “Opioids are substantially different than almost any other classification of drugs in that they carry with them the risks of tolerance, addiction, and death, and what we’ve been trying to get the FDA to come to grips with is that this class of drugs needs to be treated differently,” Raeford Brown, Jr., MD, chair of the Anesthetic and Analgesic Drug Products Advisory Committee and professor at the University of Kentucky told MedPage Today. “Some of the methodology they use to manage other drug classes are perhaps not reasonable with this.”

    The drug in question is DSUVIA, a form of sufentanil, a synthetic opioid that is 500 times more powerful than morphine. Sufentanil is currently used intravenously in operating rooms in tightly-controlled circumstances, but DSUVIA would make it available in a tablet that is administered under the tongue.

    On Oct. 12, the FDA’s advising committee voted 10-3 to allow the drug to go to market. 

    However, Brown said that many committee members — himself included — were absent for that vote because they were attending the American Society of Anesthesiologists conference.

    “That’s one of the reasons I felt that I needed to speak up, because people that are regulating this drug need to be very thoughtful about the public health in this particular circumstance,” he said.

    The drug would be approved with a Risk Evaluation and Mitigation Strategy (REMS) program, but Brown said that is not enough of a safeguard. 

    “There’s no indication whatsoever that any of the REMS programs for opioids have been effective in improving the safety,” he said. 

    Brown is so against the approval of DSUVIA that he penned an open letter to the FDA, saying that sufentanil has “substantial risks of respiratory depression, diversion, abuse, and death,” and that its benefits do not outweigh these risks.  

    “It is my observation that once the FDA approves an opioid compound, there are no safeguards as to the population that will be exposed, the post-marketing analysis of prescribing behavior, or the ongoing analysis of the risks of the drug to the general population relative to its benefit to the public health,” he wrote. “Briefly stated, for all of the opioids that have been marketed in the last 10 years, there has not been sufficient demonstration of safety, nor has there been post-marketing assessment of who is taking the drug, how often prescribing is inappropriate, and whether there was ever a reason to risk the health of the general population by having one more opioid on the market.”

    Further information on the approval of DSUVIA is expected in early November. 

    View the original article at thefix.com