Tag: opioid epidemic

Americans Are Unhappy And The Opioid Epidemic May Be A Factor

For the third straight year, the U.S. has dropped in the rankings of the World Happiness Report.

The United States is now the 19th happiest country on Earth, its ranking falling for the third consecutive year.

This is according to the most recent World Happiness Report, released on Wednesday (March 20) or the United Nations’ International Day of Happiness.

The Washington Post reports that the seventh annual report surveyed 156 different countries and took into account six factors: GDP per capita, healthy life expectancy, the freedom to make life choices, social support, generosity and perceptions of corruption.

The top 10 countries in the report were Finland, Denmark, Norway, Iceland, Netherlands, Switzerland, Sweden, New Zealand, Canada and Austria.

“We finished 19th on the list behind Belgium,” Jimmy Kimmel said on his late night show. “The people who feel the need to put mayonnaise on their french fries are happier than we are. Cheer up, everybody.”

While the report doesn’t specify why each country ranked where it did, the authors of the report have speculated in a news release that substance use disorder and the opioid epidemic contributed to America’s ranking.

“This year’s report provides sobering evidence of how addictions are causing considerable unhappiness and depression in the U.S.,” said Jeffrey Sachs, a Columbia University professor and the author of the “Addiction and Unhappiness in America” section of the report.

“The compulsive pursuit of substance abuse and addictive behaviors is causing severe unhappiness. Government, business, and communities should use these indicators to set new policies aimed at overcoming these sources of unhappiness,” Sachs added.

Sachs also noted that the results of the report serve as building blocks for countries moving forward.

“The World Happiness Report, together with the Global Happiness and Policy Report offer the world’s governments and individuals the opportunity to rethink public policies as well as individual life choices, to raise happiness and wellbeing,” Sachs said. “We are in an era of rising tensions and negative emotions (as shown in Chapter 2) and these findings point to underlying challenges that need to be addressed.”

According to the news release, this year’s report specifically honed in on happiness and the community, taking into account how technology, social norms, conflict and government policies have played a role in shaping each country.

“The world is a rapidly changing place,” Professor John Helliwell, co-editor of the report, said in the news release. “How communities interact with each other whether in schools, workplaces, neighborhoods or on social media has profound effects on world happiness.”

View the original article at thefix.com

26 March 2019
Dramatic Rise In Fentanyl Deaths Marks Third Wave Of Opioid Crisis

From 2011 to 2016, Black Americans experienced the sharpest rise in fentanyl-related deaths with a 141% increase.

Fentanyl overdose rates have been rising at very sharp rates among minorities, including African Americans and Hispanic Americans, according to new data compiled by the Centers for Disease Control and Prevention (CDC).

The data looked at fentanyl overdose rates between 2011 and 2016. Researchers found that the fentanyl overdose rate for African Americans rose the fastest out of any ethnic group—increasing, on average, 141% each year.

Hispanic Americans also showed a dramatic increase of 118% each year. Non-Hispanic whites saw their rates of fentanyl overdoses increase 61% each year, on average.

African Americans and Hispanic Americans still have lower overdose rates overall—5.6 and 2.5 deaths per 100,000 respectively. Whites, by comparison, continue to have the highest fentanyl overdose rates at 7.7 deaths per 100,000.

However, lead study author, Merianne Rose Spencer, said it’s important to note that the overdose rate for Black Americans is rising at more than double the rate of white Americans, according to The Washington Post.

Overall, the data showed shocking increases in fentanyl overdoses in all demographics.

“Beginning in the fourth quarter of 2013, the number of deaths increased every quarter. From 2013 through 2014, the death rate more than doubled, nearly doubled again from 2014 through 2015, and more than doubled again from 2015 through 2016,” report authors wrote.

The CDC’s mortality statistics branch’s chief, Robert Anderson, said that the severity of the fentanyl overdose crisis is clear. “We’re seeing it across the board,” he said.

The rate of overdose accelerated in 2014, when, according to Ohio Senator Rob Portman, fentanyl “came on with a vengeance.” “We were making progress, starting to get this stuff in the right direction, and the fentanyl just overwhelmed the systems,” he said this week.

Although the recently released data didn’t cover 2017 or 2018, there are indications that the pace of increase of overdoses has slowed in the last two years. Preliminary numbers show that 70,424 died by August of 2018, compared with 72,287 deaths by November of 2017.

Anderson said the numbers suggest that the rate has plateaued, but is not yet truly reversing. “We would look at that and say that’s pretty flat. We’d be reluctant to call it a real decline,” he said.

Still, Portman said that the numbers show a step in the right direction, particularly after a long period of dramatic increases.

“It is a very significant story that for the first time in eight years we’re not seeing an increase in overdose deaths,” he said. “We feel like it’s still unacceptably high, but we’re cautiously optimistic that we’ve finally turned the corner after eight years.”

View the original article at thefix.com

22 March 2019
How The Opioid Crisis May Negatively Affect The US Workforce

A recent op-ed explored how the opioid epidemic may be driving down the number of employees in the US workforce.

The opioid crisis is affecting the workforce—especially when it comes to men, according to an opinion piece in Bloomberg.

The op-ed, written by columnist Noah Smith, states that the number of men in the workforce has been decreasing for years—especially since the 2000s. Since 2009, women’s participation has also been decreasing.

“Much of the decline is due to educated people taking early retirement, or to people staying in school longer as education becomes more important,” Smith writes. “But a sizable chunk may be due to drug problems, especially among men.”

In 2017, Smith notes, a Princeton University economist named Alan Krueger looked into the relationship between the use of pain medication and not being in the workforce.

Krueger’s findings showed that in early 2010, 43.5% of males aged 25 to 54 who were not in the labor force admitted to using a pain medication the day before. In contrast, Krueger found that for those who were currently working or searching for work, that percentage fell to about 20%.

Krueger also noted that in countries with a higher opioid prescription rate, the number of those in the workforce fell accordingly.

However, Smith points out, it can be difficult to determine the cause in situations like this. “It might be that people started using drugs because they were disabled or had no chance of finding a job, rather than the reverse,” he writes.

Smith also cites a recent study from economists Dionissi Aliprantis, Kyle Fee and Mark Schweitzer at the Federal Reserve Bank of Cleveland which examined the cause more deeply.

The economists argue that if those without a job turn to opioids, then areas affected most by the Great Recession would likely have seen a larger jump in use. But they state that this was not the case, suggesting that drug use is actually the cause of decreasing workforce numbers.

However, Smith points out that the results of their study are by no means conclusive.

“First of all, the authors’ measure of temporary changes in labor demand could have statistical problems that make it unreliable for this sort of measurement,” he writes. “Second, the effect of weak labor markets on drug use might be longer term—people who think they’ll be unemployed only briefly might not turn to drugs, while people who see no prospects might start using heroin or fentanyl.”

In conclusion, Smith notes that evidence points strongly to the idea that the opioid epidemic is negatively affecting the U.S. economy and workforce, and that more action is needed to address it.

“It will be a generation before the impact of the horrendous opioid epidemic fades from the national statistics,” Smith concludes. “But with the right steps now, the U.S. might at least be able to end it more quickly.”

View the original article at thefix.com

22 March 2019
Does Gender-Based Violence Affect Opioid Misuse?

Many women who experience violence and other traumatizing situations use opioids to self-medicate, an expert suggests.

Gender-based domestic violence plays a role in the opioid epidemic—as it relates to why women use opioids, when they access treatment, and how they are treated during overdose emergencies.

Writing for The Conversation, Nabila El-Bassel, professor of social work at Columbia University, said that just like women were at increased risk during the HIV epidemic because of domestic partner violence, they are at increased risk for opioid misuse today.

El-Bassel shared the story of Tonya, who used heroin when she anticipated being abused by her boyfriend.

“Tonya is only one of the hundreds of women I’ve interviewed for my research with similar stories in the span of my nearly 30-year career studying the links between intimate partner violence, sexual coercion, substance use disorders and HIV,” El-Bassel writes.

Many women who experience violence and other traumatizing situations use opioids as a way to self-medicate, just as Tonya did. Women who deal regularly with domestic violence often use opioids as a way to help control their emotional pain.

“Treatment must address the need for escape that these women seek,” El-Bassel writes.

Yet, many women in abusive relationships have trouble accessing treatment. Partners—especially those contending with substance abuse themselves—will often undermine a woman’s attempt to get sober. This becomes yet another way that abusive partners exert dominance over the women in their lives.

“They can control their ability to engage in treatment, deny them potential sources of protection, and jeopardize the custody of their children to maintain control over them and, for some men, have women take care of them,” El-Bassel writes.

Women who are in abusive relationships often don’t feel that they can protect themselves by demanding safe sex or clean needles. Oftentimes, their partners don’t give them a choice in the matter. Because of this, harm-reduction strategies like needle exchange fail to help the most vulnerable, El-Bassel writes.

“Studies have shown that women are often physically or sexually abused when negotiating safe sex or refusing to engage in drug risk,” she said.

Alarmingly, it’s not just intimate partners who put women at higher risk for opioid abuse. Systematic gender biases also affect access to treatment, El-Bassel writes. She points to a recent study that found that women are three times less likely than men to be treated with naloxone during an overdose.

This “is likely due to their being devalued,” El-Bassel writes. “Emergency responders and police officers as well as family members and peers must be trained to overcome this gendered barrier and recognize signs and symptoms of overdose.”

Overall, the treatment community needs to do a better job of understanding risk factors unique to women and providing interventions that work for this population, El-Bassel says.

“These issues must be changed if we are serious on addressing the opioid epidemic among women,” she writes.

View the original article at thefix.com

22 March 2019
Johnson & Johnson Called Opioid "Kingpin" In Oklahoma Lawsuit

The lawsuit names the multinational company as a “top supplier, seller and lobbyist” for prescription opioids.

Johnson & Johnson is being named as a “kingpin” of the opioid epidemic in the first big trial targeting opioid manufacturers, which is set to take place in May 2019.

The lawsuit, brought by the state of Oklahoma, is naming the multinational company as a “top supplier, seller and lobbyist” for prescription opioids, according to a report by Axios.

Although Purdue Pharma is the most commonly cited company associated with the opioid crisis, there are several other pharmaceutical companies being targeted by the many hundreds of lawsuits being brought to court by local governments as well as individuals.

Johnson & Johnson, most often associated with baby powder and lotion products, is classified as a pharmaceutical company.

Prior to the Axios report, Johnson & Johnson came under fire when it was discovered that the brand’s baby powder contained asbestos. The company was ordered by a California judge on Wednesday to pay $29 million to a woman who sued based on the claim that the powder was a “substantial contributing factor” in the development of her terminal cancer.

In addition to everyday home products, Johnson & Johnson “produced raw narcotics in Tasmanian poppy fields, created other active opioid ingredients, and then supplied the products to other opioid makers—including Purdue Pharma,” according to the report.

The company also allegedly boasted about the high morphine content of its poppies, targeted children and the elderly in its marketing, and funded multiple “pro-opioid groups.” A brochure made by one of the company’s subsidiaries even claimed that “opioids are rarely addictive.”

The lawyers representing Oklahoma in the upcoming case have asked a court to release millions of pages of Johnson & Johnson’s confidential documents to the public, based on the fact that the company has divested from the opioid business and therefore shouldn’t have to worry about losing trade secrets.

“The public interest in this information is urgent, enduring and overwhelming,” wrote Oklahoma Attorney General Mike Hunter.

Johnson & Johnson provided Axios with a statement in the company’s defense, claiming that it “appropriately and responsibly met all laws and regulations on the manufacturing, sale and distribution of APIs (active pharmaceutical ingredients) and the raw materials that go into them” and that its “actions in the marketing and promotion of these important prescription pain medications were appropriate and responsible.”

The company claims that it accounted for “less than one percent” of the total market share for opioid medications.

However, the Axios report points out that Johnson & Johnson made $1 billion in 2015 by selling the opioid Nucynta and $2 billion from the fentanyl patch Duragesic, which it still sells to this day.

View the original article at thefix.com

18 March 2019
Opioid Prescriptions Drop Drastically In Ohio

Ohio’s prescription drug monitoring program played a major role in the state’s success.

In Ohio, a state that has been ravaged by opioid addiction, the number of opioid prescriptions has decreased by 41% since 2012, according to new data.

“We all have a role to play in battling this public health crisis, and this continued downward trend in opioid prescriptions demonstrates that Ohio’s prescribers are making significant progress in their efforts to prevent addiction,” Governor Mike DeWine said in a statement reported by 13 ABC News.

“When this crisis first emerged, prescribers were led to believe that opioids were not addictive, but we know today that is not the case. It is encouraging to see such substantial progress to limit opioid prescriptions to stop painkiller abuse and diversion.”

The data was drawn from the State of Ohio Board of Pharmacy’s Ohio Automated Rx Reporting System, which monitors prescriptions being written and filled. The reporting system also showed that “doctor shopping” had decreased dramatically in the state—down 89% last year alone.

Steven Schierholt, executive director of the Ohio Board of Pharmacy, told the Sandusky Register last year that the prescription reporting system is an important part of monitoring the drug crisis.

“In order to fight our way out of this issue, we have to do so with the help of the prescribers,” he said. “There’s too much of a correlation between prescription drugs and illegal drug use to be ignored. Our goal is to provide physicians with the tools to be a part of the solution.”

The monitoring system was established in 2006, but in 2015 it became mandatory for prescribers to use it.

“If you’re a prescriber you can check this system and see what controlled substance prescriptions a patient has been prescribed. That information makes for a better interact[ion] between pharmacy, doctor and patients,” Schierholt said.

He added that part of the reason the Ohio prescription drug monitoring program has been so successful is because it is easy to use.

“Now if you’re sitting with your physician she [can] see your [prescription] history with a click of button,” he said. “We know a doctor’s time is valuable and want to make it easy to check.”

However, some data suggests that prescription drug monitoring is no longer an effective way to reduce overdose deaths, since many people have turned to illicit opioids as prescription pills become harder to access.

One study found that the opioid epidemic will continue to get worse if policy continues to focus only on prescription drug abuse.

“This study demonstrates that initiatives focused on the prescription opioid supply are insufficient to bend the curve of opioid overdose deaths in the short and medium term,” said Dr. Marc Larochelle of the Grayken Center for Addiction at Boston Medical Center in a press release. “We need policy, public health and health care delivery efforts to amplify harm reduction efforts and access to evidence-based treatment.”

View the original article at thefix.com

18 March 2019
Doctors Are Cutting Back On Prescribing Opioids

The number of doctors starting patients on opioid prescriptions also significantly declined.

While overdose-related deaths from prescription opioids have more than quintupled over the past two decades, some encouraging news regarding the number of new opioid prescriptions written during a portion of that period has surfaced in a new study.

Time cited research that examined national claims data culled from Blue Cross Blue Shield, which showed that the number of new opioid prescriptions issued per month dropped by 54% between 2012 and 2017—while the number of doctors issuing opioid prescriptions to patients for the first time also declined by a significant number.

But as the study authors noted, these lower numbers were tempered by the number of physicians who continued to prescribe opioids during this time period, which was often at higher doses and for longer periods of time than the recommended limits suggested for first-time patients by the Centers for Disease Control and Prevention (CDC) in 2016.

Those guidelines served as the focal point for the study, which was conducted by researchers from Harvard Medical School’s Department of Health Care Policy and Brigham and Women’s Hospital’s Department of Medicine, and published in the New England Journal of Medicine.

Issued as the opioid epidemic began to reach critical numbers across the country, the CDC urged physicians to either abstain from using opioids as the first course of pain treatment, or to issue three-day supplies of opioid prescriptions at the lowest dose to first-time patients.

From there, researchers focused on the monthly incidence of new opioid prescriptions, which they determined was the percentage of Blue Cross Blue Shield members who were receiving an opioid prescription for either the first time ever, or for the first time in the previous six months.

Their review of the data found that the number of new prescriptions dropped by more than half between 2012 and 2017, while the number of doctors prescribing opioids—either for the first time or to those who hadn’t received a prescription in the previous six months—declined from 114,043 to 80,462.

“On one hand, we are very much encouraged,” said Nicole Maestas, an associate professor at Harvard Medical School and co-author of the study, to Time. “The study does suggest that every month, fewer people are being started on opioids, which means that the risk of developing opioid addictions and other adverse outcomes is lower because of that. Our enthusiasm is a bit tempered, however. One group of providers didn’t seem to get the message.”

Maestas was referring to doctors who continued to prescribe opioids after the CDC issued the guidelines. Among that group, they found that 57% were prescribing them to first-time patients for longer than the three-day recommended period, and at higher doses. Of that group, 80% were primary care doctors in private practice.

The study also raised another area of concern for Maestas and her team—it highlighted the possibility that doctors were not prescribing opioids for patients whose level of pain required such drugs. About 30% of the doctors whose prescriptions were included in the study time period did not prescribe opioids at all to people who had not used them.

As Time noted, the authors were not able to determine if those patients were given other options for pain management, and suggested that in some cases, pain was under-managed rather than over-prescribed.

Ultimately, the researchers hope that their findings will help hone future prescription guidelines.

“It’s good news that some providers are changing their behavior, but not all providers are,” said Maestas. “The data suggests that some could use additional education around this issue.”

View the original article at thefix.com

15 March 2019
Deregulating Buprenorphine Could Save Thousands Of Lives, Physicians Say

Fewer than 7% of US physicians currently have the DEA waivers necessary to prescribe buprenorphine.

An opinion piece by two physicians published in STAT Tuesday argues that deregulation of the opioid addiction treatment drug, buprenorphine, could save tens of thousands of lives every year.

The authors, University of Rochester Professor Kevin Fiscella and Sarah E. Wakeman, director of the Massachusetts General Hospital Substance Use Disorders Initiative, strongly believe that making it as easy to prescribe buprenorphine as OxyContin or fentanyl is essential to the fight to end the opioid epidemic in the U.S.

According to Fiscella and Wakeman, less than 7% of physicians in the country currently have the DEA waivers necessary to prescribe buprenorphine.

Buprenorphine and methadone are currently the only approved drug therapies for opioid addiction disorders and is considered much safer than prescription opioids used to treat pain.

However, doctors and nurse practitioners must jump through extra hoops in order to obtain permission to prescribe buprenorphine, while all DEA-licensed physicians are allowed to prescribe OxyContin and fentanyl.

According to the Florida Academy of Physician Assistants (FAPA), all physician assistants need only to take a three-hour course in order to obtain a DEA license allowing them to prescribe controlled substances, including opioids. In contrast, physician assistants must go through 24 hours of training in order to prescribe buprenorphine on top of the training for the standard DEA license.

An increasing number of studies have found that the over-prescription of OxyContin and, more recently, the misuse of the incredibly potent opioid fentanyl together have fueled an epidemic that killed close to 50,000 people in 2017 and likely more in 2018. So why, Fiscella and Wakeman ask, is a safer opioid that is approved to treat opioid addiction more difficult to prescribe?

In order to prescribe buprenorphine, medical professionals must complete extra training, apply for a specially marked license, and agree to allow the DEA to inspect their patient records. All of these extra steps both increase stigma against addiction disorders and place unnecessary barriers in front of what is widely considered to be effective treatment for this massive problem.

“Patients often experience barriers trying to fill prescriptions for buprenorphine—told they cannot fill it if the “X” is missing from the prescriber’s license number—or feel shamed when filling buprenorphine prescriptions,” the authors wrote. “Some feel embarrassed telling other doctors they are taking buprenorphine.”

Fiscella and Wakeman conclude that deregulating buprenorphine—essentially making it as easy to prescribe as OxyContin and fentanyl—would increase treatment rates for opioid addiction and cause deaths from overdose to plummet. They cite policy in France which implemented this kind of deregulation in 1995 and resulted in a whopping 80% decrease in opioid overdoses.

“[E]ven if deregulation of buprenorphine prescribing led to ‘just’ a 50% decrease, that would mean 20,000 fewer deaths.”

View the original article at thefix.com

14 March 2019
Mobile Recovery Clinic Provides Vivitrol To Those With Opioid Addiction

The clinic is the brainchild of a registered nurse who has been sober for 13 years.

For many who are living with addiction, it can be difficult to get access to help, and in some rural areas, it can require extensive traveling. Now, a mobile recovery clinic travels to these people who need help.

As CNN reports, the company behind the roving clinic—Positive Recovery Solutions—has been traveling throughout Pennsylvania in an RV, helping and treating people suffering from opioid addiction. According to the U.S. Drug Enforcement Administration, overdose deaths in Pennsylvania have gone up 65% from 2015 and 2017.

In 2017 alone, there were 5,456 overdose deaths in the state, or 43 overdoses for every 100,000 people.

Positive Recovery Solutions was created by a woman named Amanda Cope, who is recovering from alcoholism. She told CNN, “I ended up being 27 years old, drinking two fifths of vodka a day to not be sick.”

Cope hit bottom when she had a blackout seizure in a bar, and she finally went into rehab at the age of 28. “Once I got there, I realized how sick I was,” she continues. “My denial was thick.”

Having the right nurse taking care of her made all the difference. “That was the first time that somebody saw me for what I was and showed me compassion and empathy… I said, ‘I’m going to be that for someone one day.’”

Cope is now a registered nurse herself, and has been sober for 13 years. She founded Positive Recovery Solutions with her cousins, who also battled opioid addiction.

Cope was aware that some of her patients had to travel far to get help, which is one of the reasons why she started the company.

Patients make their way to Positive Recovery Solutions through referrals, and they use Vivitrol in their treatment program. Cope feels that the recovery process “comes from the behavioral health piece. The medication is meant, by our philosophy, to be a safety net… This safety net will keep this patient craving-free while they do the work of recovery, which is developing healthy coping mechanisms, changing behavior patterns and changing people, places and things.”

Stuart Masula, who was addicted to painkillers and got clean with the help of Vivitrol, is now driving for Positive Recovery Solutions.

As he told CNN, “I literally probably have the best job you could ever have. I get to go to work and see people who are trying to change their lives every single day for the better.”

View the original article at thefix.com

12 March 2019
Doctor Sentenced To Life In Prison For Patient's Opioid Death

The judge presiding over the trial said that the doctor had an established record of unscrupulous prescribing practices.

A Kansas doctor will spend the rest of his life behind bars after he was found guilty of writing prescriptions that led to the death of a man in 2015.

“I want this case to send a message to physicians and the health care community,” U.S. Attorney Stephen McAllister said in a news release. “Unlawfully distributing opioids and other controlled substances is a federal crime that could end a medical career and send an offender to prison.”

Steven R. Henson tried in federal court and found guilty of conspiracy to distribute prescription drugs outside the course of medical practice and unlawfully distributing oxycodone, methadone and alprazolam, the use of which resulted in the death of a victim.

He was also found guilty of presenting false patient records to investigators, obstruction of justice and money laundering.

According to KOAM News Now, Henson wrote prescriptions to patients who paid him. He would ask if they were in pain and they would answer “yes,” but he didn’t ask any other questions or perform an exam.

In July 2015, one of Henson’s patients, Nick McGovern, overdosed on alprazolam and methadone that had been prescribed by Henson. The judge presiding over the trial said that Henson had an established record of unscrupulous prescribing practices.

“The defendant kept no medical records, performed no physical examinations or physical tests, gave massive amounts of opioids to patients with little demonstrated need, wrote unneeded, non-controlled prescriptions in order to defeat pharmacy limits on controlled substances, and knew that patients were traveling improbably long distances to receive opioids,” U.S. District Judge J. Thomas Marten wrote. “There was ample evidence that Henson was prescribing opioid medications in amounts likely to lead to addiction, and in amounts so expensive that the patients would likely be forced by economic circumstances to support their addiction by selling some of the drugs to others.”

McAllister said that prosecuting doctors who abuse their ability write prescriptions is an important part of confronting the opioid epidemic.

“The prosecution of cases involving a health professional’s misuse of medical expertise and authority is extremely important to fight the opioid epidemic,” he said. “The vast majority of health care providers are people of integrity who follow their oath to help others, abide by the law, and do all they can to protect patients from becoming addicted. The evidence showed that is not what Dr. Henson did in this case.”

KOAM reported that there was a gasp in the courtroom when the sentence was announced. Henson maintained his innocence.

“I only had one goal in life as a physician and that is to take excellent care of patients and increase functionality,” he said in a statement in court.

View the original article at thefix.com

12 March 2019