Tag: opioid epidemic

"Hope Stems" Campaign Spotlights How Opioids Affect The Brain Using Flowers

The floral exhibit coincided with the Macy’s Flower Show, and aimed to depict opioid addiction in a different light.

While flowers are typically given on joyous occasions—births, graduations or anniversaries—florists around the nation have also found themselves preparing hundreds of thousands of bouquets for the funerals of people who have died from opioid addiction.

With that in mind, the addiction advocacy group Shatterproof has launched a new initiative, showing a brain made from more than 9,000 carnations, pockmarked by black poppies meant to represent the effects of opioids on the brain.

The exhibit, called “Hope Stems” was on display in Herald Square in New York City from Tuesday to Thursday (April 2-4).

The public was invited to remove a poppy from the bouquet, symbolizing the restoration that happens when someone gets treatment and is able to overcome their opioid addiction.

“As a father who lost his son to addiction, ‘Hope Stems’ gives me so much optimism,” Shatterproof Founder Gary Mendell, whose son died by suicide in 2011 after fighting opioid addiction, told Campaign Live. “This installation will impact how people view those suffering from addiction. It is my sincere wish that this campaign will help end the stigma and encourage those who are suffering to seek treatment. By changing how we think about addiction we can save lives.”

The display is timed to coincide with the Macy’s Flower Show, which runs through Sunday, April 7.

June Laffey, who works as chief creative officer at McCann Health New York, said that the “Hope Stems” campaign is a powerful way to raise awareness and get attendees at the flower show to think about addiction and ways to provide treatment to people who need it.

“This campaign has the power to not only change the way people think about opioid addiction, but to save lives,” Laffey said.

By using the flowers to form a brain, the initiative focused on the fact that addiction is a brain disease, not simply a matter of willpower or choice.

“Opioid addiction is not a weakness,” Laffey said. “It is a disease that changes the brain. There’s science to prove it. With knowledge comes power. With knowledge comes compassion. With knowledge comes hope.”

She continued, “Hope stems from reducing the stigma and speaking with compassion. So let’s all speak with one voice. The more we reduce stigma, the more people will seek treatment and the more lives will be saved.”

After New York, the Hope Stems display will appear in Atlanta from April 22-25 (Monday through Thursday) during the Rx Drug Abuse & Heroin Summit.

View the original article at thefix.com

6 April 2019
Improvised Nasal Naloxone Devices Less Effective Than Narcan, Study Finds

The FDA-approved Narcan nasal spray delivers more of the antidote into the blood than the improvised naloxone device

A recent study conducted by the National Institute on Drug Abuse (NIDA) found that improvised nasal naloxone devices (INNDs) are significantly less effective at administering high enough doses of the overdose-reversing medication than the FDA-approved Narcan.

Naloxone is the drug that can reverse opioid overdoses that kill tens of thousands of people in the U.S. every year. Efforts to make it available, particularly in the form of Narcan, are a part of the national fight against the deadly opioid epidemic.

INNDs, according to Psych Congress, “consisting of a prefilled naloxone syringe attached to a mucosal atomization device” and have been used by first responders and others to successfully reverse overdoses for 25 years.

However, the study, first reported on by NIDA on March 15, found that Narcan does a better job of delivering high enough doses of naloxone to be maximally effective.

“Scientists found that the approved naloxone devices deliver higher blood levels of naloxone than the improvised nasal devices,” the report reads. “In fact, levels in the plasma concentration of naloxone are considerably lower when improvised devices are used. The FDA-approved 4-mg dose nasal spray produced the highest blood level of naloxone of all the products tested.”

Speed and plasma concentration of naloxone are especially important as overdoses of the highly potent synthetic opioid fentanyl have skyrocketed in the past few years. Data from the Centers for Disease Control and Prevention (CDC) found that fentanyl-related overdose deaths doubled each year from 2013 to 2016.

The fastest way to administer naloxone to counter an opioid overdose is with an IV, but first responders might not have access to the equipment they need to give a naloxone IV when time is of the essence.

Narcan is a simple nasal spray that does not require assembly and can be administered in one nostril while the patient is lying on their back. Members of the public, including people with opioid use disorders, can be easily trained to administer Narcan, and it is available to anyone without a prescription. Health insurance may even cover some or all of the cost.

“Using the FDA-approved nasal Narcan spray is a great choice for average consumers, who will likely keep only one or two devices on hand,” said NIDA’s Dr. Philip A. Krieter. “It is smaller, easier to use, and doesn’t require much if any training to use properly. The Narcan spray is a ready-to-use device; the improvised device needs assembly, and lay persons may not able to use it correctly in a panic situation.”

However, according to TIME, a Narcan kit with two doses costs around $135 without insurance, which may be prohibitively expensive for some.

Another option is the auto-injection device Ezvio, which has also been approved by the FDA. According to Dr. Krieter, a generic version of Ezvio will become available “later this year for some purchasers.”

View the original article at thefix.com

4 April 2019
New York Tries To Tax Prescription Opioids Again

Some people argue that the tax could push people to use illegal alternatives if prescription opioids become more expensive.

New York state has passed a measure to tax opioid prescriptions in an attempt to fund addiction-recovery efforts, despite the fact that a court ruled a similar measure unconstitutional last year.

According to WXXI, the state said that the measure, part of the state budget, is intended to raise additional funds to pay for the response to the opioid crisis by taxing manufacturers.

However, some people argue that the tax could have unintended effects, pushing people to use illegal substances if prescription opioids become more expensive.

“While the language of the proposed law attempts to place the burden of the tax on drug manufacturers, in practice market forces determine how the burden of the tax is shared between producers and consumers,” Lewis Davis, professor of economics at Union College, wrote in a report.

The report was prepared last year and paid for by a pharmaceutical lobbying group, but echoed concerns shared by other organizations including the American Cancer Society Action Network.

Davis pointed out that the tax policy could have a number of negative side effects.

“Most of the tax will be paid by non-consuming NY residents in the form of higher insurance premiums and higher taxes to cover public health programs. Second, to the extent that the cost of the tax is passed on to consumers, it will have a high cost to society in terms of reduced access to medically appropriate use of opioids,” he wrote. “Third, by increasing the cost of prescription opioids, the proposed tax will encourage NY residents suffering from opioid dependence to switch to cheaper illegal opioids, including heroin and fentanyl, with increased rates of accidental overdose.”

He continued, “Because it fails to target opioid abuse, the proposed tax is poorly designed policy for addressing the opioid crisis.”

Last year, a federal court struck down the tax because it would violate interstate commerce laws by treating New York residents differently from consumers in other states. The 2019 version of the bill works around that and should stand up in court, according to the state.

Freeman Klopott, a spokesperson for the state budget office, said that New Yorkers who use prescription opioids won’t be affected by the measure, since most of the cost for the tax will be shouldered by insurance companies and drug manufacturers.

“We expect no significant change in the availability of these pharmaceuticals or any diversion to illicit alternatives,” said Klopott.

View the original article at thefix.com

4 April 2019
States Need Long-Term Opioid Response Funding, Report Finds

Areas with the highest overdose rates are receiving funding while rural areas struggle to received adequate funding.

The United States is spending more money than ever on addiction treatment, particularly focused on the ongoing opioid crisis. However, the federal response is hindered by one-time grants and limitations on the programs that they can fund, according to a new report by the Bipartisan Policy Center.

The report found that federal spending on addiction interventions more than doubled between 2017 and 2018, rising from $3.3 billion to $7.4 billion. However, more federal coordination is needed to streamline how these funds are delivered to states and help determine how they can best be used.

“The sheer volume of grants going to the states has made it challenging for state officials to track and coordinate these funding streams and monitor the quality of treatment that is being provided,” Dr. Anand Parekh, the Bipartisan Policy Center’s chief medical advisor, said in a news release. “Congress and the administration must provide greater oversight to ensure these federal resources are better coordinated and well spent, so states can respond effectively to this crisis.”

Looking at how funds were utilized in Arizona, Louisiana, New Hampshire, Ohio and Tennessee, researchers found that the money was making it to areas with the highest overdose rates, but that rural areas received less funding.

One way to avoid this is by having a state system, often directed by the governor, to coordinate opioids response.

“A statewide coordinating body, typically convened by the governor, is an essential part of developing a strategic opioid epidemic response,” the report authors wrote.

“Governors are on the front lines of the opioid epidemic and keenly aware that the crisis is multifaceted and demands the same response,” said Hemi Tewarson, health division director for the National Governors Association.

These state agencies can also help coordinate more in-depth tracking of outcomes for intervention programs.

In addition, the report pointed out problems with the current funding model. With states only getting grants, it’s difficult to plan for a long-term response to the drug crisis.

“With one-time funding, we are treating the problem of addiction in our country as an acute condition rather than a chronic condition,” said Regina LaBelle, a consultant for the policy center and former chief of staff of the White House Office of National Drug Control Policy. “Substance use disorders are not going away. Federal funding must be provided over the long-term instead of in annual budget cycles.”

In addition, the terms of funding need to allow for flexibility in how states handle substance use disorder, she said.

“Flexibility in funding ensures that while states are responding to today’s opioid epidemic, they are also prepared for other emerging drug threats, such as methamphetamine and cocaine,” the report reads.

View the original article at thefix.com

3 April 2019
Why Aren't More Doctors Embracing Medication-Assisted Treatment?

A new op-ed suggests that concerns about “branding” may deter many doctors from offering medication-assisted treatment (MAT) for opioid use disorder.

A new op-ed on STAT News highlights a troubling concern in regard to medication-assisted treatment (MAT).

Author David A. Patterson Silver Wolf, PhD, opined that the reason why methadone, buprenorphine and naltrexone aren’t more widely used to treat opioid use disorders (OUDs) may be due to “branding”—specifically, concern on the part of primary care physicians about the stigma associated with OUDs and its effect on their practice.

But as Silver Wolf noted, the toll taken by the opioid epidemic on individuals and families all but required physicians to undertake the necessary steps to prescribe MAT, despite any qualms they may have.

In the article, Silver Wolf, an associate professor at Washington University in St. Louis, Missouri and faculty member for training programs funded by the National Institute on Drug Abuse (NIDA), wrote that he came to his opinion after participating in a national panel of addiction experts that produced “Medications for Opioid Use Disorder Save Lives,” a report from the National Academies of Sciences, Engineering and Medicine.

In the report, he and his fellow experts noted that while the need for medication-assisted treatment is sizable, and drugs like methadone and Suboxone have been approved as safe and effective treatments for OUD by the Food and Drug Administration (FDA), only a small number of physicians have signed up for the necessary training by the Drug Enforcement Administration (DEA) to be able to prescribe it.

Silver Wolf also cited another STAT opinion piece, which speculated on some of the reasons why more physicians haven’t been lining up to prescribe MAT. One deterrent may be the process for receiving a federal waiver and the specialized training required to administer this treatment.

But he also suggested that concern over the perception of those with substance use disorders by other patients may also color certain medical professionals’ opinions, who fear that the inclusion of such individuals to a patient base may negatively impact business.

“Physicians whose practices focus on patients with opioid use disorder don’t have to worry about their ‘brand’ being harmed because it is tied to this treatment and this patient population,” Silver Wolf wrote. “But a typical primary care physician in Manhattan or suburban Atlanta or rural Nevada might worry about the potential trouble that patients with addictions might cause in their waiting rooms.”

The answer, according to Silver Wolf, is for more physicians to look past financial concerns and stigma, and take the steps to make medication-assisted treatment a part of their practice—even though, he adds, that many will not.

But if individuals and families impacted by the addiction crisis—what the National Academies committee has come to view as an “all-hands-on-deck” situation—then Silver Wolf believes that physicians need to do the same.

View the original article at thefix.com

3 April 2019
Naloxone-Based Antidote For Fentanyl, Synthetic Opioids Is In Development

The naloxone-based antidote has already shown promise in tests involving animal subjects.

The opioid overdose reversal drug naloxone, or Narcan, has proven useful in preventing fatalities from the use of heroin or prescription opioids.

But its duration in the human body – about 30 to 60 minutes – is less effective in countering the effects of powerful synthetic opioids like fentanyl, which can remain in an individual’s system for hours and may require multiple doses of naloxone.

But researchers have begun work on a naloxone-based antidote that may outlast synthetic opioids, and which has already shown promise in tests involving animal subjects.

The results of the test were presented in Orlando, Florida at a meeting of the American Chemical Society on March 31, 2019; there, researchers from Duquesne University, the Allegency Health Network Research Institute and the Edgewood Chemical Biological Center showcased their development of a naloxone-based antidote that used microscopic particles called nanoparticles to deliver a combination of naloxone molecules and a biodegradable polymer, or plastic, called polyactic acid.

As Science News noted, once introduced to an individual’s system, water and enzymes in the body dissolve the nanoparticles and slowly release the naloxone.

According to the researchers, a single dose using this delivery system proved effective in countering the effects of morphine in tests involving mice for up to 96 hours.

Reseacher Saadyah Averick of the Allegheny Health Network Research was quoted as saying that the next phase of testing will involve actual synthetic opioids, such as fentanyl and carfentanil, as well as increased testing to determine if the antidote can prevent a test animal from undergoing overdose.

Data from the National Vital Statistic System’s record of all U.S.-based deaths found that overdose deaths involving synthetic opioids had surpassed overdose fatalities caused by prescription opioids.

A study published in the May 1, 2018 issue of the Journal of the American Medical Association found that of the 42,249 opioid-related deaths in 2016, 19,413 involved synthetic opioids, while 17,087 were due to prescription opioids and 15,469.

More than 79% of synthetic opioid deaths also involved another drug or alcohol, with another opioid and heroin listed as the most commonly co-involved substances (47.9% and 29.8%, respectively).

View the original article at thefix.com

2 April 2019
Former DEA Official Now A Paid Consultant For Purdue Pharma

Insiders wonder if the former DEA official anticipated becoming a paid consultant for Big Pharma when she was with the agency.

Demetra Ashley, former acting assistant administrator and senior official for the U.S. Drug Enforcement Administration (DEA), is currently a paid consultant for one of the top opioid drug manufacturers in the country, according to NBC News sources.

As acting assistant administrator, Ashley warned the Senate in 2017 that a “robust regulatory program” would be needed in order to prevent the misuse of controlled prescription drugs such as Purdue Pharma’s OxyContin and other opioid medications.

She specifically called out the over-prescribing of these drugs as “inextricably linked with the threat the United States faces from the trafficking of heroin, illicit fentanyl and fentanyl analogues,” and by extension, the entire opioid epidemic.

At the same Senate hearing, Ashley argued for a law that made it very difficult for the DEA to use immediate suspension orders against companies like Purdue Pharma to either be revised or repealed.

The Ensuring Patient Access and Effective Drug Enforcement Act, passed in 2016, made it nearly impossible for the DEA to take urgent action against a drug company when it “represents an imminent danger to public health or safety,” she said.

Now, she is being paid by Purdue to advise them via her new consulting firm, Dashley Consulting, LLC. Purdue is currently facing around 2,000 lawsuits for its alleged role in the opioid epidemic via deceptive marketing tactics and encouraging doctors to over-prescribe OxyContin and similar drugs.

After decades of specializing in preventing the diversion of prescription drugs, some are questioning whether Ashley did all she could to combat the alleged role of Purdue Pharma and other companies in the opioid epidemic and whether her new consulting position is a violation of ethics.

While there is nothing technically illegal about this, Washington University law professor and government ethics expert Kathleen Clark says that Ashley’s new role with Purdue raises questions about “whether the prospect of a payday after leaving government tainted the actions of the regulator while still in government.”

“Did this person act differently in government because they anticipated or wanted to get the payday from these very powerful economic actors who have huge amounts at stake?” Clark asks.

When contacted by NBC News, Ashley did not confirm or deny consulting for Purdue Pharma, but acknowledged that she has “been consulting for members of the industry” since June 2018, three months after she retired from the DEA.

She also confirmed that she has been subpoenaed as part of a consolidated lawsuit against opioid companies because of her former role in the DEA.

View the original article at thefix.com

29 March 2019
"192aDay" Campaign Spotlights Heartbreaking Toll Of Addiction

The campaign aims to spread awareness about addiction and offer resources for recovery and treatment options.

Each day, 192 people die from a drug overdose in the United States.

“That’s like a plane crashing each day, day after day,” write the leaders of #192aday, an initiative from the Addiction Policy Forum, an organization that aims to bring awareness to drug addiction and fight for better treatment.

The friends and relatives of people killed by addiction penned an open letter, highlighting the things they wish they had known. “We hope that this knowledge, painfully earned, can help you and your family,” they write.

It’s important that family members and friends familiarize themselves with the signs of addiction. Although they can be hard to spot, follow your intuition if you feel there is something more going on, the family members write.

“We now know that we should’ve been more proactive in the very beginning,” said Barbara. Her son died of a fentanyl overdose at 46, but a teacher had first expressed concern decades earlier, when he was in 8th grade.

Even experimenting with seemingly harmless substances like cigarettes or marijuana can be cause for concern, the family members say.

And once you realize your loved one is abusing drugs, don’t wait until they hit rock bottom to offer them help. “Now with fentanyl, rock bottom was an overdose, a fatal overdose,” said Justin, who lost her son Aaron to an overdose at 20.

When your loved one is ready for help, realize that recovery takes time. “I wish I would’ve known that recovery is not about 3 months, 6 months, a year in rehab. It’s a lifetime. When they release someone from rehab, it’s not the end. It’s the very beginning,” said Karla, whose daughter Alicia overdosed at 28.

Finding quality treatment can be lifesaving, so talk with other families and organizations to identify the best treatment option for your loved one. “Resources are much easier to find these days because people are finally talking about the disease,” said Katie, whose brother died of a drug overdose.

Family members should be open to all courses of treatment, and help their loved one connect with the type of treatment that is most likely to help him or her succeed. “I’d thought medication-assisted treatment (MAT) was ludicrous, just trading one addiction for another, but I was wrong,” Katie said. “Since losing my brother, I often wonder if MAT would’ve helped Zachary succeed. When someone has cancer, we don’t choose between chemo and radiation—we layer treatments.”

Even failures can be important for recovery, or serve as warning signs for the family. Aimee D’Arpino found out after her son died that he had received Narcan at least seven times in prior overdoses. “That is seven missed opportunities to intervene and save our son’s life,” she said.

Although it’s difficult to talk about, family members need to be open about the connection between substance use and suicide, said Jim, whose son Scott died by suicide. “His relapse led to his suicide,” Jim said.

Lastly, no matter how your loved one is doing in managing their recovery, it’s important that family members seek out their own support and resources.

“It feels like you’re drowning when you’re worried about your kid and desperately trying to find help,” said Doug Griffin, whose daughter Courtney died from an overdose. “And the stigma around this disease can mean backlash and judgment from some of the people closest to you, but help does exist. Reach out. There are so many people right next door who are dealing with addiction too and so much support we can give each other.”

View the original article at thefix.com

29 March 2019
Oklahoma Lawsuit Against Purdue Pharma Settles For $270 Million

The bulk of the settlement will go to Oklahoma State University to fund an addiction treatment center and addiction treatment medicine.

The first lawsuit of around 2,000 filed against Purdue Pharma and other drug manufacturers/distributors has settled for $270 million, Reuters reports. The money which will go toward mitigating the opioid crisis.

The lawsuit was filed by Oklahoma Attorney General Mike Hunter and would have gone to court in May.

It accused pharmaceutical companies Purdue Pharma (the maker of OxyContin), Johnson & Johnson, and Teva Pharmaceutical Industries of deceptive marketing that fueled the national opioid epidemic.

The $270 million settlement is with Purdue Pharma only, so Johnson & Johnson and Teva are still expected in court on May 28 of this year.

According to Reuters, the state of Oklahoma was seeking a total of $20 billion in damages caused by opioid addiction and overdose. The bulk of the $270 million from the settlement will be granted to Oklahoma State University to fund an addiction treatment center and addiction-fighting medications.

$12.5 million will be given to local governments to help them recover from the opioid epidemic, and $60 million will be paid in legal fees. Members of the Sackler family who own Purdue Pharma will pay an additional $75 million to the university.

This settlement has been encouraging news for critics of drug companies who believe this is a sign of more settlements to come. Purdue Pharma had been considering bankruptcy as a way to halt the roughly 2,000 lawsuits against it.

However, it appears that Purdue may instead be opting for a far-reaching settlement across the many similar lawsuits. This is how the legal battles against the tobacco industry ended in 1998—with a $246 billion settlement, Reuters noted.

University of Connecticut School of Law Professor Alexandra Lahav believes that the Purdue settlement “may be the start of the dominoes falling” for the company.

According to the White House Council of Economic Advisers, the opioid epidemic has caused over $500 billion in economic damages across the U.S. in the year 2015 alone.

That number likely rose in 2016, when the total number of deaths from opioid-related overdoses jumped from 33,091 to over 42,000.

Between deaths, the costs of treating overdose cases and addiction, missed work by those affected, and crime related to illicit opioids, the crisis has been economically devastating to communities across the nation.

Purdue Pharma and members of the Sackler family have continued to deny its alleged role in fueling the opioid epidemic, stressing that prescription opioids come with FDA warnings about addiction and overdose. This argument, however, has proved to be an ineffective deterrent.

View the original article at thefix.com

28 March 2019
California Jail Guards Get Narcan After Possible Fentanyl Exposure

This is not the first time that an officer has been hospitalized or received Narcan after being exposed to fentanyl.

Two guards at a California jail were given Narcan and taken to the hospital after they began showing symptoms of opioid exposure.

According to SF Gate, guards at Santa Rita Jail in Dublin searched a woman who was being booked in the jail. They found a black substance on the woman, but could not identify the drug. They examined it closely trying to discern what type of drug it was, while wearing gloves.

However, after the examination was complete, one officer began feeling sick and showing signs of confusion. Soon after, the other officer complained of sickness as well. The staff at the jail suspected that the pair had been exposed to an opioid, and administered Narcan before transporting them to the hospital.

First responders and law enforcement officials have been warned about the dangers of accidental fentanyl overdose, and this is not the first time that an officer has been hospitalized or received Narcan after being exposed to the drugs.

“The presence of [synthetic opioids] poses a significant threat to first responders and law enforcement personnel who may come in contact with this substance. In any situation where any fentanyl-related substance, such as carfentanil, might be present, law enforcement should carefully follow safety protocols to avoid accidental exposure,” the Drug Enforcement Administration said in an officer safety alert issued last year.

However, some research indicates that it is unlikely that first responders or others could accidentally overdose on even the most powerful synthetic opioids by touching the substance.

“I would say it’s extraordinarily improbable that a first responder would be poisoned by an ultra-potent opioid,” Dr. David Juurlink, a researcher at Sunnybrook Health Sciences Centre, told The New York Times. “I don’t say it can’t happen. But for it to happen would require extraordinary circumstances, and those extraordinary circumstances would be very hard to achieve.”

According to Vox, reports have shown that fentanyl is not easily absorbed through the skin, so accidental overdose is very unlikely. In one video by harm reduction advocate Chad Sabora, he tries to dispel this myth.

Some people believe that the reports of first responders being harmed by exposure to synthetic opioids can trigger a type of placebo effect. That may have been the case with Scottie Wightman, a Kentucky emergency medical technician who became unresponsive after one call. Wightman was treated with Narcan and was seemingly revived, but drug tests later showed there were no drugs in his system.

Jeremy S. Faust, an emergency room doctor in Boston, emphasized that first responders shouldn’t let fear of opioid exposure deter the care they give to the public.

“I want to tell first responders, Look, you’re safe,” he said. “You can touch these people. You can interact with them. You can go on and do the heroic lifesaving work that you do for anyone else.”

View the original article at thefix.com

27 March 2019