Answer Addiction

Tag: opioid crisis

  • How Germany Averted An Opioid Crisis

    How Germany Averted An Opioid Crisis

    Germany’s success with its multi-pronged approach illustrates that addiction is “a more complex problem” than the current American response has acknowledged.

    KHN correspondent Shefali Luthra reported this article from Germany as a 2019 Arthur F. Burns Fellow.

    HAMBURG, Germany ― In 2016, 10 times as many Americans as Germans died as a result of drug overdoses, mostly opiates. Three times as many Americans as Germans experienced opioid addiction.

    Even as the rates of addiction in the U.S. have risen dramatically in the past decade, Germany’s addiction rates have been flat.

    That contrast, experts say, highlights a significant divergence in how the two countries view pain as well as distinct policy approaches to health care and substance abuse treatment.

    Unlike in the United States, where these pills are commonly dispensed after surgeries and medical procedures, opioids have never emerged as a front-line medical treatment in Germany.

    “Among the most important reasons we do not face a similar opioid crisis seems to be a more responsible and restrained practice of prescription,” said Dr. Peter Raiser, the deputy managing director at the German Center for Addiction Issues.

    Doctors must first try alternative treatments, which the nation’s universal health insurance system typically covers. Before prescribing opioids, physicians must get special permission and screen patients to make sure they aren’t at risk for addiction.

    “Here in Germany, they prescribe opiates if all the other drugs don’t work,” said Dr. Dieter Naber, a psychiatrist and researcher at the University of Hamburg. “It’s much, much, much more difficult.”

    Analyses show that opioid painkillers in Germany are prescribed somewhat more than they were 30 years ago. But that boost hasn’t fueled abuse.

    Research published this spring shows that the number of Germans addicted to opioids has changed only slightly in the past 20 years. In 2016, 166,300 Germans experienced opioid addiction ― about 0.2% of the population. In 1995, between 127,000 and 152,000 Germans were believed to have used heroin, specifically; in 2000, the range of Germans addicted to opioids was estimated between 127,000 and 190,000.

    In the United States, in 2008, the government-administered National Survey on Drug Use and Health found that about 10,700 people took pain relievers or heroin for nonmedical purposes (even if they weren’t necessarily addicted). By 2016, about 2.1 million Americans ― 0.6% of the population ― experienced full-on opioid addiction.

    The contrast speaks to differences in how the two countries approach medical care. Because of Germany’s health system ― which emphasizes primary care and keeps cost sharing low ― people who are prescribed opioids are more likely to keep up with their doctors’ visits. If they exhibit warning signs of addiction, physicians have a better chance of noticing.

    To be sure, illicit drug use also occurs in Germany, and opioids are the main killer in drug-induced deaths. Still, the drug-induced mortality rate has gone down here, per the most recent European figures.

    Even when people here get addicted, they are far less likely to die as a result. In 2016, 21 per million Germans died from drug-induced overdoses (of which most were opioid-induced). That same year, 198 per million Americans died from the same cause.

    Experts said this speaks to differences in how the countries view the issue of addiction.

    Because of Germany’s generous public coverage, it is easier to get treatment ― which, in the United States, can be hard to find, and expensive if you don’t have a health plan that covers it.

    “Money regarding treatment is really not an issue here,” Naber said.

    That said, Canada and Scotland both insure everyone and still face substantial addiction rates.

    But, in Germany, drug addiction is treated with medication and “harm reduction” approaches, including so-called safe-injection sites ― people experiencing addiction take drugs under medical supervision, with clean needles to prevent the spread of disease. These facilities even have protocols in place to prevent overdose. Germany has more than 20 such sites, with four in Hamburg. The approach has “certainly reduced mortality,” Naber said.

    Such strategies are controversial in the United States. A federal judge ruled early in October against a Trump administration effort to block a safe-injection program in Philadelphia. The administration argued that such efforts enable and encourage addiction, and pledged to continue efforts to block safe-injection sites.

    But “harm reduction,” generally, and supervised injection, specifically, have been cited as best practices by the Organization for Economic Co-Operation and Development, a coalition of developed, mostly Western nations.

    “We know harm reduction works in terms of dealing with the problem of mortality,” said Dr. Andres Roman-Urrestarazu, a researcher at the University of Cambridge who studies addiction in the global context.

    He added that Germany’s success with its multipronged approach illustrates that addiction is “a more complex problem” than the current American response has acknowledged.

    The Arthur F. Burns Fellowship is an exchange program for German, American and Canadian journalists operated by the International Center for Journalists and the Internationale Journalisten-Programme.

    Germany’s health system ― which emphasizes primary care and keeps cost sharing low ― people who are prescribed opioids are more likely to keep up with their doctors’ visits. If they exhibit warning signs of addiction, physicians have a better chance of noticing.

    To be sure, illicit drug use also occurs in Germany, and opioids are the main killer in drug-induced deaths. Still, the drug-induced mortality rate has gone down here, per the most recent European figures.

    Even when people here get addicted, they are far less likely to die as a result. In 2016, 21 per million Germans died from drug-induced overdoses (of which most were opioid-induced). That same year, 198 per million Americans died from the same cause.

    Experts said this speaks to differences in how the countries view the issue of addiction.

    Because of Germany’s generous public coverage, it is easier to get treatment ― which, in the United States, can be hard to find, and expensive if you don’t have a health plan that covers it.

    “Money regarding treatment is really not an issue here,” Naber said.

    That said, Canada and Scotland both insure everyone and still face substantial addiction rates.

    But, in Germany, drug addiction is treated with medication and “harm reduction” approaches, including so-called safe-injection sites ― people experiencing addiction take drugs under medical supervision, with clean needles to prevent the spread of disease. These facilities even have protocols in place to prevent overdose. Germany has more than 20 such sites, with four in Hamburg. The approach has “certainly reduced mortality,” Naber said.

    Such strategies are controversial in the United States. A federal judge ruled early in October against a Trump administration effort to block a safe-injection program in Philadelphia. The administration argued that such efforts enable and encourage addiction, and pledged to continue efforts to block safe-injection sites.

    But “harm reduction,” generally, and supervised injection, specifically, have been cited as best practices by the Organization for Economic Co-Operation and Development, a coalition of developed, mostly Western nations.

    “We know harm reduction works in terms of dealing with the problem of mortality,” said Dr. Andres Roman-Urrestarazu, a researcher at the University of Cambridge who studies addiction in the global context.

    He added that Germany’s success with its multipronged approach illustrates that addiction is “a more complex problem” than the current American response has acknowledged.

    The Arthur F. Burns Fellowship is an exchange program for German, American and Canadian journalists operated by the International Center for Journalists and the Internationale Journalisten-Programme.

    View the original article at thefix.com

  • Privilege Lurks at the Heart of Recovery Movements

    Privilege Lurks at the Heart of Recovery Movements

    Making blanket statements that “anyone can recover” whitewashes and overlooks the gross inequities that people of color and marginalized communities face.

    Recovery is possible for anyone, but it isn’t the reality for everyone. We may see an increasing number of people on social media proudly displaying their recovery as badges of honor — which in turn reduces stigma about addiction and a life in recovery — but it doesn’t accurately depict the true picture that recovery isn’t accessible to everyone, it heavily depends on your privilege.

    Recovering “out loud” has gained so much momentum that it’s now a social justice movement: we are now questioning advertisers who normalize the excessive use of alcohol, challenging the use of biased language, highlighting the inequity in authorities tackling opioids but overlooking alcohol as the leading cause of drug-related deaths, and advocating for policy changes that affect people with substance use disorders.

    While this recovery activism should be celebrated, we are still overlooking the inconvenient truth lurking beneath the surface: recovery is, unfortunately, still a privilege. Can we really be part of a social justice movement if we overlook the role privilege plays in the accessibility of recovery? 

    The Role of Privilege in Substance Use Disorders and Recovery

    Many people within the recovery movement believe that recovery is possible in spite of race, ethnicity, economic circumstances, nationality, sex, gender, access to health insurance, and a strong support system — in other words, privilege. This simply isn’t the reality. There are great disparities both in how addiction affects people and how much recovery capital is available to us based on privilege.

    Rates of addiction are higher in oppressed populations, especially among LGBTQ people and people of color. Black women over 45 are the fastest growing population with alcohol use disorder, and the risk of developing a substance use disorders is 20-30 percent higher for individuals who identify as LGBTQ+.

    We don’t hear about those statistics, though; we see an opioid epidemic that is largely affecting white people. When drugs have a detrimental impact on communities of color, the media is less interested in covering it. Advocate Shari Hampton explains “Nobody gave a damn when black lives were being ravaged by crack cocaine in the 80’s. Families were ripped apart; communities were literally destroyed. People were thrown in jail and some of them are still there.”

    She continues, “I’ve witnessed grandparents raise grandchildren right up to their grave while their grown children suffered from a crack addiction or a jail sentence that is so ridiculously long, it might as well be life. But now we have an opioid epidemic. It’s affecting a different demographic. And now, now it’s a treatment issue. This is disparaging and discouraging, especially to the black and brown folks that have never been treated with even a remote sense of compassion compared to what we see today.”

    This disparity continues in access to recovery. Recovery is vastly different for those who lack recovery capital — the resources that can be used to sustain recovery: financial security, education, health insurance, and a support system — which is heavily linked, again, to our privilege.

    Not all people who speak openly about their addiction and recovery are blind to the reality of the effects of privilege. In her recent book Strung Out, author Erin Khar unpacks the role of privilege in her own recovery: “Escaping addiction, and it truly does feel like an escape, requires protective layers of aftercare. I have been incredibly fortunate to have access to the support I’ve needed.”

    She continues, “We don’t have a system in place that makes it simple or easy for people to get help or support. There are financial, social, and racial barriers to getting help. If we are going to see a real downshift in the opiate crisis, support is what is needed — not just from peers and family members, but also the medical community and government.”

    Studies show that African American and Latinx individuals are far less likely than white people to complete outpatient and residential substance use disorder treatment.

    The inequity is also in access to medication. NPR highlighted a recent study by Dr. Pooja Lagisetty, an assistant professor of medicine at the University of Michigan, who stated that “this epidemic over the last few years has been framed by many as a largely white epidemic, but we know now that’s not true.”

    Lagisetty found that as overdose deaths rose between 2012 and 2015, so did though the number of medical visits where buprenorphine was prescribed. However, researchers found no increase in prescriptions for African Americans and other minorities. In fact, the study found that white populations are almost 35 times more likely to have a buprenorphine visit than African Americans even though death rates among people of color were rising faster than white people. Researchers also observed that these visits were paid for by cash (40 percent), or private insurance (35 percent) rather than with Medicaid (25 percent), suggesting inequalities in healthcare. 

    “We shouldn’t see differences this large, given that people of color have similar rates of opioid use disorder,” says Lagisetty. “As the number of Americans with opioid use disorder grows, we need to increase access to treatment for black and low-income populations, and be thoughtful about how we reach all those who could benefit from this treatment.” 

    People of color have less access to treatment not only due to socio-economic circumstances. There is also a disparity in how drug use is viewed in communities of color. Despite similar rates of drug use and sales, people of color are more likely than white people to be arrested and receive harsher punishments for drug-related offenses. 

    Khar reflects on the criminalization based on race: “Some might say it’s a miracle that I never got pulled over, never got caught with that briefcase of drugs. But I see it less as a miracle and more because I was a young woman with passing-white privilege in a Jetta.”

    She continues, “I’ve thought about this often, that had my skin been darker, had I come from less privilege, I have no doubt that I would have been arrested early on. I’ve thought about how that would have changed the trajectory of my life, how early arrests may have kept me forever trapped in a cycle of incarceration. Our drug laws are undeniably skewed to keep people of color and people of less privilege imprisoned and enslaved. And I’ve always been aware of that.”

    The true picture of addiction and recovery inequity are often ignored on social media because our privilege blinds us to these realities. But if we really want to create a social justice movement, we have to change how we relay what substance use disorders and recovery looks like for all.

    Creating a More Impactful Social Justice Movement

    Let me be clear: this article is not intended to shame anyone for their privilege; instead, I’m suggesting that we can’t ignore the true picture in favor of a prettier, more palatable version. Making blanket statements that “anyone can recover” whitewashes and overlooks the gross inequities that people of color and marginalized communities face. 

    Advocate Shari Hampton explains this discomfort that underlies many recovery advocacy conferences. “I went to a conference earlier in the year and the white fragility in the room was nauseating. I literally didn’t understand why even talking about inequality caused so much discomfort. Simply discussing the topic had white folk with pursed lips and clenched fists. White folks can’t bear to examine a system that has entitled them to more, as being broken. It’s like admitting that Jesus was black. It’s not going to happen. To do so would disrupt all things.”

    When asked how we can make a difference, Hampton responds: “America’s history teaches that black people are inferior to white people — that we don’t deserve the same treatment or opportunities. The mindset must shift. Because until we are seen, truly seen as magnificent beings, equal and worthy of the same quality of life and opportunities afforded to whites, very little will change.”

    If we really want to create a more impactful social justice movement, we need to get uncomfortable. We need to be more mindful in our social media posts and consider if what we are portraying is an accurate representation of recovery, and question if our privilege played a role in our access to resources. We need to consider if we are amplifying the voices of those marginalized and oppressed. If not, why not? And in creating events to address addiction, or in going to Washington, DC seeking policy changes, we need to stop and ask ourselves if we have invited the people who are most affected by these policies. If not, we need to ask ourselves why we aren’t amplifying the voices of the people who most need to be heard?

    We cannot divorce recovery from true social justice. Writer and sobriety coach Holly Whitaker says: “For those people who don’t want to ‘dirty up’ or confuse recovery spaces with talk of racism, classism, transphobia, homophobia, ableism, classism, etc. — remember that recovery is about awareness, and that this path is about inclusion, love, and acknowledging wrongs and injustices. If we aren’t talking about the way the system works, and who gets crushed by the system, we aren’t actually talking about recovery. We’re still just talking about our comfort zones, and using our privilege to deny other experiences.”

    View the original article at thefix.com

  • Drugs Found In NFL Player's Home After Woman's Overdose Death

    Drugs Found In NFL Player's Home After Woman's Overdose Death

    Investigators reportedly found pills, marijuana and foil with residue during their search of Montae Nicholson’s home.

    Washington Redskins safety Montae Nicholson and his friend Kyle Askew-Collins dropped off 21-year-old Julia Crabbe at Inova Emergency Room-Ashburn HealthPlex early last Thursday morning. She was pronounced dead at the hospital shortly thereafter. Hours later, investigators performed a search of Nicholson’s home.

    According to the Post, Crabbe and Nicholson had been dating for six months.

    The Investigation Begins

    According to USA Today Sports published info about the search of Nicholson’s home:

    The search warrant states that authorities executed the warrant and searched Nicholson’s home in Ashburn, Virginia, on Thursday, hours after Nicholson and another man — identified in the report as Kyle Askew-Collins — dropped off Julia Crabbe in a car at Inova Emergency Room-Ashburn HealthPlex. 

    The search warrant said that hospital staff reported that Crabbe “appeared to be deceased” when removed from the car at the hospital. There were indications that she died of a drug overdose, according to the warrant.

    The warrant did not specify to whom the drugs belonged. The warrant indicated that police also recovered a safe and black box, an iPhone, a coat and a notebook from the house.

    The Washington Post reports investigators found pills, marijuana and foil with residue during the search. They recovered “a safe and black box, an iPhone, a $20 bill, towels, a blanket, a coat and a notebook” during the search of Nicholson’s home. 

    Nicholson’s attorney Mark Dycio told The Washington Post, “Montae would have no knowledge of the drugs because they belonged to a guest. It’s a tragic story. It’s a tragedy that the news is focused on where she died instead of the drug epidemic ravaging the country.”

    The Night Of

    According to the search warrant, an unnamed source told investigators that on the night in question, Nicholson, Askew-Collins and Crabbe went out to dinner in DC. Later that evening, Crabbe was discovered in the bathroom, unresponsive. Askew-Collins allegedly called an unnamed individual for help with the situation with Crabbe who was described as foaming at the mouth and in the middle of what appeared to be an overdose.

    Nicholson and Askew-Collins never called 911; instead they decided to bring Crabbe to a hospital which was a short distance away from their location. 

    No one has been charged in connection with Crabbe’s death but Loudoun County Sheriff’s Office said their investigation is ongoing.

    Any Given Sunday

    On the Sunday aftter the incident, Nicholson suited up to play the NY Jets. The team lost 34-17.

    When asked by reporters about the team’s decision to let Nicholson play, Washngton Redskins coach Bill Calahan had this to say, “I didn’t get into all of that. (Nicholson) spoke to a lot of other people in the organization relative to that situation. From my perspective, in terms of playing him and the decision of playing him was strictly based on coaching gathered with all of the other information that I had.”

    View the original article at thefix.com

  • Benzos Need To Be Part Of Overdose Discussions

    Benzos Need To Be Part Of Overdose Discussions

    Even under a doctor’s supervision, benzodiazepines can be dangerous and highly addictive.

    With much of the national discourse and resources directed at the opioid epidemic, doctors are warning that people need to be aware of the dangers of benzodiazepines. 

    Dr. Chinazo O. Cunningham, a professor at the Albert Einstein College of Medicine, told CNN that benzos—which include Xanax, Ativan and Kolonpin—are contributing to the overdose crisis in the country. 

    The Opioid and … Overdose Epidemic

    “It’s really not ‘the opioid overdose epidemic’ but the ‘opioid and …’ overdose epidemic,” Cunningham said. “It’s not just one substance, here. The focus has been on opioids but we need to expand the way that we’re thinking about it.”

    Dr. Sumit Agarwal, of Boston’s Brigham and Women’s Hospital, has seen benzo prescriptions become much more widespread for a variety of patients. 

    “I think most of our attention has been on the opioid epidemic and for good reason, but I think benzodiazepines have flown under the radar,” Agarwal said.

    Cunningham has conducted research that shows that the amount of benzodiazepine medicine in a prescription doubled between 1996 and 2013. During the same period, overall prescribing of benzos increased 67%.

    ”I think many of us feel that if we don’t turn our attention to benzodiazepines, if we ignore this pattern that we’re beginning to see, we may very well find ourselves in the same position that we have with opioids,” said Cunningham. 

    Benzo Access

    Dr. Anna Lembke, medical director of addiction medicine at Stanford University, said that benzos are becoming part of the culture in a way that can be dangerous. That’s in part because of easy access to the powerful drugs. 

    “There’s increased availability and increased access, not just through prescriptions but through illicit sources,” she said. “You’ve got this popularization of Xanax in culture and in music, and the availability (of benzodiazepines) on the dark web—all of that is part of the growing problem.”

    Lembke pointed out that even when they are used under a doctor’s supervision, benzos can be very dangerous and highly addictive. 

    “The problem is in the long term, they lead to more problems than they solve,” she said. “People develop a tolerance, and they need more and more to get the same effect. They develop a dependence, finding when they don’t take them their anxiety is worse. And they think, ‘Oh, I need it because I have an anxiety disorder,’ but in many instances they’re actually medicating withdrawal from the last dose, so you can get into this vicious cycle. If they worked long term there would be nothing wrong with it, but they don’t and then they cause all kinds of harm.”

    View the original article at thefix.com

  • From Monster to Mentor: Lexington Outreach Coordinator Offers Free Classes on Addiction

    From Monster to Mentor: Lexington Outreach Coordinator Offers Free Classes on Addiction

    For Timothy Sanders, it’s a chance to use his experience as a person in recovery “to be productive and help people.”

    With heroin overdose rates in the state of Kentucky among the highest in the United States, a man in recovery who became a peer support specialist hopes to use his story to educate his fellow Bluegrass State residents about opioid dependency.

    Timothy Sanders, who serves as the Outreach Coordinator for the non-profit organization Stop Heroin Lexington, is also hosting a free class called “Alternative Perceptions” at area libraries and other locations. 

    The class, which kicked off on September 28 at the Lexington Public Library, is designed to provide information to not only people with addiction but also their families. For Sanders, it’s a chance to use his experience as a person in recovery to “be productive and help people.”

    Sanders, a peer support specialist, told Lexington’s WKYT that heroin addiction in Kentucky has “gotten a lot worse. ODs are high right now. I see a lot of people dying, [and] I see relapse quite often.”

    To that end, he created Alternative Perceptions as a means of reaching out to the public and providing free information about addiction and recovery, a subject that he understands on a personal level.

    From “Menace” To Mentor 

    Sanders overdosed on heroin while he was with his three-year-old daughter, which resulted in not only an arrest but also public shaming when the incident was broadcast on local television.

    “I was blasted all over the news as this monster and drug addict and all that,” he recalled.

    He sought treatment through the recovery program for men at the Hope Center in Lexington, and amassed 28 months of sobriety. He also found himself with a new calling. “I was a menace at one point,” he told WKYT. “Today I’m trying to be productive and help people.”

    The inaugural Alternative Perceptions class offered free information and education to attendees, and enlisted fellow recovery advocates to join Sanders in providing testimony about their paths to sobriety. “I have a team of volunteers that want to be a part of this, to where we can actually have them in all the [Kentucky] public libraries, and we have people that volunteer to get the information out to people.”

    Future Alternative Perceptions events and other information on Sanders can be found on Stop Heroin Lexington’s Facebook page.

    Kentucky has been among the 10 states with the highest rates of drug overdose deaths. However, the state reported that overdose deaths declined in 2018, the first such drop since 2013.

    View the original article at thefix.com

  • Counselor In Recovery Offers Free Drug Education Classes

    Counselor In Recovery Offers Free Drug Education Classes

    For Timothy Sanders, it’s a chance to use his experience as a person in recovery “to be productive and help people.”

    With heroin overdose rates in the state of Kentucky among the highest in the United States, a man in recovery who became a drug counselor hopes to use his story to educate his fellow Bluegrass State residents about opioid dependency.

    Timothy Sanders, who serves as the Outreach Coordinator for the non-profit organization Stop Heroin Lexington, is also hosting a free class called “Alternative Perceptions” at area libraries and other locations. 

    The class, which kicked off on September 28 at the Lexington Public Library, is designed to provide information to not only people with addiction but also their families. For Sanders, it’s a chance to use his experience as a person in recovery to “be productive and help people.”

    Sanders, a peer support specialist, told Lexington’s WKYT that heroin addiction in Kentucky has “gotten a lot worse. ODs are high right now. I see a lot of people dying, [and] I see relapse quite often.”

    To that end, he created Alternative Perceptions as a means of reaching out to the public and providing free information about addiction and recovery, a subject that he understands on a personal level.

    From “Menace” To Mentor 

    Sanders overdosed on heroin while he was with his three-year-old daughter, which resulted in not only an arrest but also public shaming when the incident was broadcast on local television.

    “I was blasted all over the news as this monster and drug addict and all that,” he recalled.

    He sought treatment through the recovery program for men at the Hope Center in Lexington, and amassed 28 months of sobriety. He also found himself with a new calling. “I was a menace at one point,” he told WKYT. “Today I’m trying to be productive and help people.”

    The inaugural Alternative Perceptions class offered free information and education to attendees, and enlisted fellow recovery advocates to join Sanders in providing testimony about their paths to sobriety. “I have a team of volunteers that want to be a part of this, to where we can actually have them in all the [Kentucky] public libraries, and we have people that volunteer to get the information out to people.”

    Future Alternative Perceptions events and other information on Sanders can be found on Stop Heroin Lexington’s Facebook page.

    Kentucky has been among the 10 states with the highest rates of drug overdose deaths. However, the state reported that overdose deaths declined in 2018, the first such drop since 2013.

    View the original article at thefix.com

  • DEA Was "Slow To Respond" To Opioid Crisis, Report Reveals

    DEA Was "Slow To Respond" To Opioid Crisis, Report Reveals

    According to a watchdog report, the DEA allowed the drug crisis to reach a level that could have been prevented.

    The DEA could have done more to blunt the impact of the national opioid crisis, which has claimed more than 300,000 lives in the U.S. since 2000, according to a new report.

    The “harsh” report—released by the Justice Department’s Office of the Inspector General, which is responsible for auditing the DEA—found that despite rising opioid abuse being reported early on before the full-blown epidemic emerged, the DEA failed to act in a timely manner, allowing the drug crisis to reach a level that could have been prevented.

    “DEA is responsible for regulating opioid production quotas and investigating its illegal diversion,” said inspector general Michael E. Horowitz in a video summarizing the report’s findings. “We found that DEA was slow to respond to this growing public health crisis and that its regulatory and enforcement efforts could have been more effective.”

    Opioid Manufacturing Skyrocketed From 1999 To 2016

    The report noted that from 1999-2016, despite increasing reports of opioid abuse, the amount of opioid manufacturing authorized by the agency “also increased dramatically during that same time.”

    It should be noted that during this time period, a number of high-profile events occurred that established opioid abuse as a national public health crisis. From 1997-2002, OxyContin prescriptions for non-cancer related pain increased from 670,000 in 1997 (a year after OxyContin went on the market) to about 6.2 million in 2002, according to a timeline provided in the report.

    In 2007, Purdue Pharma and three company executives pleaded guilty to charges of false branding of OxyContin and were fined $634 million. Meanwhile, the rate of drug overdoses, fueled by opioid abuse, surged.

    Too Little, Too Late

    The agency waited until recent years to scale back opioid production. “It wasn’t until 2017 that DEA significantly reduced the production quota for oxycodone by 25%,” the report noted.

    The report did acknowledge the agency’s recent efforts to tighten up enforcement of drug diversion (when prescription drugs end up being abused in a way it was not intended) but said that more work is needed overall.

    The inspector general offered a list of nine recommendations to improve the DEA’s opioid response. They include developing a comprehensive national strategy that involves better cooperation between federal and local authorities and timely monitoring of emerging drug abuse trends, among others.

    View the original article at thefix.com

  • How Do The Feds Find Pill Mills?

    How Do The Feds Find Pill Mills?

    Although regulations have clamped down some on over-prescribing, authorities are still finding pill mills in operation.

    Since late last year, federal authorities have charged 87 doctors with operating pill mills where they overprescribed opioids. Data collection has allowed the feds to make those arrests and has helped contribute to guilty pleas from nine of the doctors so far.

    Brian Benczkowski, head of the Justice Department’s Criminal Division, told CNN that while traditional tips are helpful, collecting and analyzing data on prescribing practices allow authorities to work efficiently at targeting the most egregious over-prescribers. 

    He said, “I think before we employed a data driven model it was a lot harder to find them in the first instance. You had to rely on local law enforcement providing tips. You had to rely on individuals in the community providing tips. The data tells us exactly where to go very quickly.”

    How They Locate Pill Mills

    The feds look at a few different pieces of information when analyzing prescription data: they see how far patients are traveling to a doctor, how many deaths are linked to that doctor, and the dosage strength that the doctor provides.

    Federal guidelines recommend that doctors not prescribe opioids that measure more than 90 morphine milligram equivalents, or MMEs, per day. However, doctors operating pill mills prescribe up to 500 MMEs per day to patients. When that is outlined in hard data, it’s easy to know who to investigate, because “usually nothing can justify” writing prescriptions for so many pills, authorities say. 

    Once law enforcement knows where to look, spotting a pill mill is easy. 

    “When you go and observe this doctor’s office and you see lines down the block, you see people shuffling around waiting to go into the doctor’s office, you see behavior that looks very much like behavior you see in traditional street corner hand-to-hand drug distribution, it’s stark. It’s readily apparent what’s going on,” Benczkowski said. 

    How Do Pill Mills Work?

    He explained how the pill mill operations work. 

    “They [the doctors] are taking cash and putting it in their pockets. [Patients] go into the doctor’s office, they leave $300 with the receptionist. They have a two-minute consultation with the doctor who writes them an opioid prescription and they walk out the door. And that line is processed like a conveyor belt all day every day. It doesn’t look like a normal doctor’s office.”

    A Drug Enforcement Administration official said that investigating pill mills is a unique operation. 

    “We’ll do surveillance or send a confidential source in, and we’re really looking at the type of prescriptions doctors are writing and then asking medical experts, are these within the norms? It’s more of a chess game in a way than a traditional narcotics investigation. We’re a cross between investigating white collar crime and narcotics.”

    Although regulations have clamped down on over-prescribing, authorities are still finding pill mills in operation, something that frustrates Father Brian O’Donnell of Catholic Charities West Virginia. 

    “I thought the fear of God had been put into doctors in the past few years,” he said. “I’m very disappointed to hear this is still going on.” 

    Patients Not Targeted in Opioid Prescription Crackdown

    Benczkowski emphasized that the feds are focused on charging the doctors, not people addicted to opioids.

    “We recognize that we can’t just prosecute our way out of this problem,” he said. “The individual patients are not criminal defendants, they’re victims. And we wanted to make sure that they had access to appropriate medical care and appropriate treatment resources.”

    View the original article at thefix.com

  • Pennsylvania Giving Away Free Naloxone To Combat Overdoses

    Pennsylvania Giving Away Free Naloxone To Combat Overdoses

    The state is set to give away one free dose of naloxone on September 25th from 9 AM to 3 PM.

    Residents of Pennsylvania were able to claim a free dose of naloxone last Wednesday (Sept. 18), thanks to Governor Tom Wolf and the state’s Department of Health. The medication was made available to anyone who wanted it, whether they used opioid drugs or simply wanted to hang on to a dose just in case.

    Naloxone has made waves as something of a miracle drug, able to instantly reverse an opioid overdose with a single injection or nasal spray. By binding to opioid receptors in the brain, naloxone can and has saved many lives.

    Increasing Access To Naloxone

    Advocates for increasing the accessibility of naloxone believe it is simply a common sense approach that must be undertaken to combat the opioid crisis.

    “Naloxone has one function: to reverse the effects of opioids on the brain and respiratory system to save someone’s life,” Pennsylvania Health Secretary Dr. Rachel Levine said. “It is impossible to get someone into treatment who is dead. In 2018, more than 4,400 people died from a drug overdose. Every Pennsylvanian has a role to play as a potential first responder and can save a life by having naloxone on hand and using it if they come across someone who has overdosed.”

    Another Naloxone Giveaway Is Coming Up

    The lifesaving medication could be claimed for free in 87 locations across the state, including state health centers and municipal health departments. The state will do another round of freebies on September 25th from 9 AM to 3 PM.

    This kind of progressive policy to combat overdoses has been done before in New Jersey, which gave away doses of the stuff for free through select pharmacies on June 18th this year. Such approaches were based on a study that showed that a combination of increased access to naloxone and Good Samaritan laws could save lives.

    “Naloxone access and Good Samaritan laws are associated with 14% and 15% reductions, respectively, in opioid overdose deaths,” read the paper, published in Addictive Behaviors. “Among African-Americans, naloxone and Good Samaritan laws reduce opioid overdose deaths by 23% and 26% respectively. Neither of these harm reduction measures result in increases in non-medical opioid use.”

    Better yet, this was achieved without the negative effects some predicted. Critics of such programs believed that with such a strong safety net, people may use more opioids than before, but the data do not support anything like this happening.

    “The scourge of opioids continues to devastate families and communities across our state, and we must do everything we can to end the opioid epidemic,” said New Jersey Governor Phil Murphy. “Through this initiative, people who are battling with addiction will be able to receive access to this critical medication and help them get on a path to recovery.”

    View the original article at thefix.com

  • Man Who Posed As Doctor Convicted Of Prescribing Thousands Of Opioids At Pill Mill

    Man Who Posed As Doctor Convicted Of Prescribing Thousands Of Opioids At Pill Mill

    The fake doctor wrote prescriptions which had been pre-signed by a registered physician for more than 200,000 doses of hydrocodone.

    A man who pretended to be a physician and issued prescriptions for hundreds of thousands of doses of opioids was found guilty after a five-day trial, the Department of Justice (DOJ) announced.

    Muhammad Arif, 61, is awaiting sentencing for one count of conspiracy to unlawfully distribute and dispense controlled substances and three counts of unlawfully distributing and dispensing controlled substances, which he carried out from late 2015 to early 2016 at an unregistered pain clinic in Rosenberg, Texas, which federal authorities described as a “pill mill.” 

    Though unlicensed to practice medicine, Arif saw patients and wrote prescriptions for hydrocodone and other drugs that were pre-signed by a registered physician. Both the doctor and the owner of the clinic were named as co-conspirators in the case.

    Patients Shell Out $250 Cash For Hydrocodone, Soma Prescriptions

    According to the DOJ release, evidence presented at the trial showed that up to 40 people a day could visit the Aster Medical Clinic, where they obtained prescriptions for over 200,000 dosage units of the opioid pain medication hydrocodone and over 145,000 dosage units of the muscle relaxant carisoprodol, a Schedule IV controlled substance which is also sold under the brand name Soma. 

    “The combination of hydrocodone and carisoprodol is a dangerous drug cocktail with no known medical benefit,” wrote the authors of the DOJ release.

    Testimony revealed that individuals were charged $250 in cash for each visit. “Crew leaders” would recruit individuals to pose as patients and paid for their visits in order to obtain the prescriptions, which were sold on the street.

    Real Doctor Pleads Guilty for His Role in Pain Med Scheme

    The co-conspirators—Baker Niazi, 48, and Waleed Khan, 47—both pled guilty for their roles in the prescription scheme at Aster Medical Clinic, and like Arif, are currently awaiting sentencing.

    The case was investigated by the Drug Enforcement Administration and was brought as part of the Medicare Fraud Strike Force, a joint initiative between the DOJ and the U.S. Department of Health and Human Services.

    Since 2007, the Strike Force, which operates in 23 districts, has charged nearly 4,000 defendants, who have billed Medicare for more than $14 billion.

    The news comes on the heels of the DOJ’s August 28th announcement regarding charges filed against 41 individuals for their alleged involvement in a pill mill network of clinics and pharmacies.

    According to the press release, the owner and pharmacist at one pharmacy allegedly dispensed the second highest amount of oxycodone 30 mg pills of all the pharmacies in Texas in 2019, and the ninth highest amount in the United States.

    View the original article at thefix.com