Answer Addiction

Tag: opioid epidemic

  • Meth Use Rises Among Youth, Heroin Use Declines

    Meth Use Rises Among Youth, Heroin Use Declines

    The results of a new survey from Substance Abuse and Mental Health Administration revealed some positive movement for the opioid crisis.

    In another reminder of how complicated addiction and addiction treatment is, compiled survey results from 67,500 Americans in 2017 found that while new heroin users in certain age groups have almost declined by half, methamphetamine and marijuana use has increased.

    The survey, conducted by the Substance Abuse and Mental Health Administration, (SAMHSA) parsed survey takers by age groups, types of drugs used, amounts of drugs used, and the starting point for the usage or abuse of each drug.

    The most dramatic, positive findings were around new heroin users; 81,000 reported using heroin for the first time in 2017, less than half of the 170,000 reported the year before.

    However, when looking at the age group of 18-25, the decline in new heroin users was “almost imperceptible” according to USA Today. 

    The 18 to 25 category also reported less prescription opioid abuse. SAMHSA estimated that in 2015 8.5% of people in this vulnerable age range misused prescription opioids; In 2017 the percentage was at 7.

    Yet marijuana and meth use for youths 12-17 increased from all previous years. Marijuana use for both youth and adults was associated with opioid use, heavy alcohol use, and major depressive episodes.

    The concerning effects of heavy marijuana use on mental illness has been somewhat put to the backburner as popular culture embraces the positive aspects of the drug. Some research show a direct correlation between marijuana overuse and mental distress and illness.

    With all the publicity surrounding deaths from heroin laced with fentanyl, addiction specialist Sally Satel says most addiction experts had anticipated a move away from opioids and toward another drug.

    “I was waiting for this,” Satel told USA Today, “This is how it works. People still want to alter their mental state. So they look for what’s cheap and what’s available and the reputation of the drug.” 

    Jim Beiting, CEO of Transitions, Northern Kentucky’s largest drug treatment and recovery organization, told USA Today that meth is “magnetic” for people with addiction trying to move from opioids. “It’s cheaper,” he says. “It’s more readily available, (and) the potency is higher than it used to be.”

    Other positive news from the SAMHSA report reveals that more people struggling with heroin addiction are seeking treatment, up 53.7% from previous years. This seems to reflect on the increased funding, country-wide, into access and quality of addiction treatment services.

    The news is mixed but overall illuminates how bad the addiction crisis remains in our country. James Carrol, acting director of the Office of National Drug Control Policy, told the Washington Times, “Use of marijuana, cocaine and methamphetamine are all up. So we aren’t just in an opioids crisis. It’s an addiction crisis.”

    View the original article at thefix.com

  • Roseanne Barr Says Her Character On "Conners" Will Suffer Fatal Overdose

    Roseanne Barr Says Her Character On "Conners" Will Suffer Fatal Overdose

    Barr revealed the alleged fate of her namesake character in a recent interview.

    As the premiere of The Conners nears, fans of the show are that much closer to learning how Roseanne Conner gets written off the show.

    In May, Roseanne Barr was kicked off her own classic sitcom, Roseanne, over a racist tweet that ABC Entertainment President Channing Dungey called “abhorrent, repugnant and inconsistent with our values.”

    The show was revived in 2018 and enjoyed positive reviews, but was canceled in May because of the controversy.

    ABC decided to move on without Barr with its spin-off The Conners, which airs on October 16.

    John Goodman, who plays Roseanne’s husband Dan Conner, hinted at Roseanne’s death in a recent interview with The Times. “I guess [Dan will] be mopey and sad because his wife’s dead,” he said in August.

    While we won’t know Roseanne’s fate until the show airs, Barr said in a new interview that her character dies of a drug overdose. “Oh ya, they killed her. They have her die of an opioid overdose,” she said on the YouTube show Walk Away.

    She’s not happy about it. “It wasn’t enough to [fire me], they had to so cruelly insult the people who loved that family and that show,” she said.

    But the comedian, who was also dropped by her talent agency at the peak of the controversy, is ready to move on from the drama. “There’s nothing I can do about it. It’s done. It’s over. There’s no fight left.”

    According to People, The Conners officially started production in August. The spin-off will follow “the Conner family who, after a sudden turn of events, are forced to face the daily struggles of life in Lanford in a way they never have before.”

    While it’s a rather shocking way to write off the beloved titular character, a drug overdose is plausible for Roseanne after what we saw in the last season. 

    We learn in season 10 that Roseanne is dependent on pain medication. Desperate to put off a costly surgical procedure, she keeps secret stashes around the house to keep her pain at bay. “I got these pills because I’m going to be dealing with this for a long time,” she tells Dan in the episode “Netflix & Pill.”

    “I’m in pain so I take a few extra pills. It’s not like I’m a drug addict.”

    View the original article at thefix.com

  • Doctors Will Be Required To Check Prescription Database In California

    Doctors Will Be Required To Check Prescription Database In California

    The state’s monitoring system has been historically underused by healthcare providers. 

    Beginning on October 2, doctors in California will be required to check the state’s prescription monitoring database before writing a new prescription, in an attempt to provide better care and correct years of underutilization of the system.

    “California created the first system to track prescriptions of the strongest painkillers, but our state fell behind as the opioid crisis grew,” state Sen. Ricardo Lara, who drafted the legislation in 2015, told the Los Angeles Times. “I wrote SB 482 to require that doctors and others consult the CURES system before prescribing these powerful and addictive drugs. This tool will help limit doctor shopping, break the cycle of addiction and prevent prescriptions from ever again fueling an epidemic that claims thousands of lives.”

    California’s monitoring system, called The Controlled Substance Utilization Review and Evaluation System, or CURES, provides a list of patients’ prescriptions, the doctors who prescribed the medication and the pharmacies that filled them. The system was overhauled in 2016 to make it easier for doctors to use, and the new legislation will now require them to do so.

    Under the law, healthcare providers will need to check CURES every time they write a new prescription, or every four months for patients who have an ongoing prescription. There are exceptions, including for emergency room care and hospice patients.

    The legislation is meant to cut back on so-called doctor shopping, as well as ensure that doctors and patients are aware of any risky combinations of medicines that a patient is taking.

    “I think people make the mistake of thinking it’s just for doctor shopping,” said Dr. Roneet Lev, chief of emergency medicine at Scripps Mercy Hospital in San Diego. “Using CURES just makes you a smarter, better doctor.”

    Although some doctors balk at the amount of time that it will take to consult CURES, other believe that using the system will soon become second nature.

    “I think it’s going to be one of those things that a year from now is going to be second [nature] to them,” said Kimberly Kirchmeyer, executive director of the Medical Board of California. “It’s just the first round of it gets hard for them. Any additional administrative task for physicians in the world they live in is difficult for them, and we completely understand that.”

    However, if the requirement helps to protect patients, doctors say that they are willing to spend time using the CURES system.

    “I think every doctor in California will gladly do it as long as there’s a pot of gold at the end of the rainbow,” said Dr. Jason Toranto, chief of plastic surgery at Senta Clinic in San Diego. “As long as the patient is going to do better, that’s what it’s all about.”

    View the original article at thefix.com

  • Doctors Gave No Reason For Writing Opioid Scripts In Nearly 30% Of Cases

    Doctors Gave No Reason For Writing Opioid Scripts In Nearly 30% Of Cases

    A new study uncovered that doctors were prescribing opioids for hypertension and high cholesterol when no pain diagnosis was recorded. 

    A team at Harvard Medical School and the Rand Corp. combed through medical records from 2006 to 2015 and found that physicians gave no explanation for writing an opioid prescription in 29% of the cases.

    According to NBC News, the Centers for Disease Control and Prevention (CDC) has been working to get doctors to pull back on opioid prescriptions, citing careless prescribing as one cause of the opioid crisis. In 2016, more than 42,000 people died of opioid overdose, according to the CDC.

    The new study was led by Nicole Maestas, professor of health care policy at Harvard. Maestas and study coauthors went through tens of thousands of medical records, and then honed in on more than 31,000 physician surveys that included an opioid prescription.

    In two-thirds of the prescriptions, some type of pain diagnosis was present.

    The report, published in the Annals of Internal Medicine, then concluded, “No pain diagnosis was recorded at the remaining 28.5%.”

    “At visits with no pain diagnosis recorded, the most common diagnoses were hypertension, hyperlipidemia (high cholesterol), opioid dependence and ‘other follow-up examination,’” the research revealed.

    This over-prescribing could be unfairly impacting people who do have serious pain conditions and are finding it difficult to access the opioids they need to manage their pain due to new restrictions and doctors who fear that they will be targeted for over-prescribing.

    Dr. Tisamarie Sherry, who worked on the study, was reported in NBC News as emphasizing, “Whatever the reasons, lack of robust documentation undermines our efforts to understand physician prescribing patterns and curtails our ability to stem overprescribing.”

    The study also showed that 24% of youth who appeared with an opioid use disorder did not have a prescription to a medication-assisted treatment (MAT) drug to control their cravings.

    Drugs like buprenorphine and methadone are approved by the Food and Drug Administration for the treatment of opioid use disorder.

    “In this multistate study of addiction treatment and retention in care, we found that three-quarters of youths diagnosed with opioid use disorder received treatment within three months,” researchers wrote in JAMA Pediatrics. “However, most treatment included behavioral health services only, and fewer than one of four youths received timely buprenorphine, naltrexone or methadone treatment.”

    View the original article at thefix.com

  • OxyContin No Longer Covered By Some Insurers

    OxyContin No Longer Covered By Some Insurers

    “This is a whack-a-mole solution… I don’t believe we should be isolating one category of opioid versus another,” said one expert.

    Some insurers are taking a rather bold stand against the opioid crisis by refusing coverage of OxyContin, a popular brand-name opioid painkiller. 

    The decision, according to the Houston Chronicle, has drawn controversy as some people question whether refusing to cover one specific medication will really make a difference. 

    “This is a whack-a-mole solution,” James Langabeer, professor of emergency medicine at McGovern Medical School at UTHealth, told the Chronicle. “On the one hand, it’s good that the insurance industry is weighing in, but I don’t believe we should be isolating one category of opioid versus another.”

    OxyContin, a brand name for oxycodone, is manufactured by Purdue Pharma, a company that has faced a slew of federal lawsuits for its alleged role in fueling the current opioid crisis.

    One concern, Langabeer says, is that denying access to OxyContin won’t necessarily force individuals to stop abusing opioids. In fact, he says, some may even begin using heroin instead, as it’s cheaper and more accessible.

    The Chronicle reports that last week, Blue Cross and Blue Shield of Tennessee announced that it will discontinue coverage at the start of 2019, stating it was “drawing a line that we will not continue to pay for this.”

    Previously, Cigna and UnitedHealthcare also announced the same. 

    A Cigna spokeswoman told the Chronicle via email that Cigna will consider covering the medication in some situations if a doctor feels it is “medically necessary.” She added that those using the medication for hospice care or cancer treatment will be allowed to continue use.

    UnitedHealthcare ceased to cover OxyContin in employer-sponsored plans beginning January 2017, according to the Chronicle.

    “There are therapeutically equivalent, covered alternatives that can be used for pain indications,” a spokesman for UnitedHealthcare told the Chronicle via email.

    Cigna, as well as insurer Florida Blue, will be replacing OxyContin with Xtampza, which they claim is more difficult to abuse. 

    Purdue Pharma has not been silent as insurance companies have rolled out these decisions. The company, according to the Chronicle, argues that it has been working to make the medication harder to abuse. It has also accused insurers of supporting its competitors for “financial gain.”

    “These recent decisions by insurance companies limit prescribers’ options to help address the opioid crisis,” a company spokesman told the Chronicle via email. “Unfortunately, these decisions appear to be more about pharmaceutical rebates.”

    Katharine Neill Harris, a fellow in Drug Policy at Rice University’s Baker Institute of Public Policy, tells the Chronicle that she has mixed feelings about the involvement of insurers. 

    “They do have a role and I don’t think they have done enough yet,” she said. “The easiest way to say we’re doing something is by stopping covering a drug.”

    For Harris, a better alternative is for insurers and doctors to look into long-term solutions for chronic pain, such as physical therapy.

    View the original article at thefix.com

  • Bill Targeting Opioids Sent By Mail Up For Senate Vote

    Bill Targeting Opioids Sent By Mail Up For Senate Vote

    The STOP Act will require the U.S. Postal Service to collect electronic data on packages being shipped into the country.

    The Senate will likely pass a bill this week that aims to reduce the number of fentanyl shipments coming into the country via the U.S. Postal Service (USPS). 

    The STOP Act, which stands for Synthetics Trafficking and Overdose Prevention, will require the postal service to collect electronic data on packages being shipped into the country, including the sender’s and recipient’s addresses and the contents as described by the sender.

    Right now, only private courier services like FedEx, UPS and DHL require this information, which means that people can send opioids through the postal service and be virtually untraceable. 

    Illicit fentanyl can be easily made in China and shipped to the United States, since a small volume is immensely powerful and profitable. 

    “We are being overrun with fentanyl,” Senator Rob Portman (R-Ohio), who led an 18-month study of illegal imports, told the New York Times. “It is 50 times more powerful than heroin. It is very inexpensive. It is coming primarily from China and coming primarily through our U.S. Postal Service, if you can believe it.”

    In addition to requiring that the postal service gather additional information on packages, the bill would make is possible for the government to levy fines to the postal service if it does not comply. The postal service would also have the authority to block or destroy packages that have not been properly identified.

    Right now, the postal service must “obtain a warrant to inspect the contents of suspect parcels,” according to William Siemer, acting deputy inspector general of USPS, who testified before Congress this year.

    President Trump supports the measures, taking to Twitter to voice his enthusiasm. 

    “It is outrageous that Poisonous Synthetic Heroin Fentanyl comes pouring into the U.S. Postal System from China,” he wrote last month in a tweet. “We can, and must, END THIS NOW! The Senate should pass the STOP ACT—and firmly STOP this poison from killing our children and destroying our country.”

    The STOP Act has been languishing after it was introduced nearly 18 months ago, allowing shipments of opioids to continue. However, the House passed a similar initiative over the summer, prompting the Senate to move on the issue.

    In addition to addressing the dangers of opioid shipments, the bill would also expand access to treatment for infants born dependent on opioids, implement more stringent packaging requirements for some medications, and accelerate research into non-addictive painkillers that could potentially replace opioids. 

    View the original article at thefix.com

  • How Fentanyl Changed The Opioid Crisis

    How Fentanyl Changed The Opioid Crisis

    The prevalence and potency of illicit fentanyl has changed the course of the opioid crisis for the worse. 

    While prescription painkillers were previously attributed to the most deaths in the opioid epidemic, they no longer do. Instead, the leading cause of death in this context is now illegal fentanyl, according to a recent Bloomberg editorial.

    The National Center on Health Statistics states that in 2017, illegal fentanyl played a role in 60% of opioid deaths, in comparison to 11% of opioid deaths five years ago. 

    Fentanyl was created in 1960 and was used as a treatment for cancer pain. Illicit fentanyl has become common in the black market because it can be easily manufactured in a lab. Its potency also means it can be put into very small packages that are easy to conceal. 

    “Drug labs in China fulfill online orders from American users, or from traffickers in the U.S. and Mexico who add the fentanyl to heroin and other drugs to boost their effect, or press it into phony prescription-opioid pills,” the editorial reads. 

    Because of this, the editorial states, addressing the issue of illegal fentanyl needs to be focused first on China, which U.S. law enforcement officials claim is the source of nearly all illegal fentanyl. 

    The editorial states that the Obama administration had reached out to the Chinese government to ask for help in policing producers of fentanyl. But, with the Trump administration in place, that cooperation appears to have fallen by the wayside. 

    “What’s needed is a steady and purposeful diplomatic push, along with expert support for fortifying China’s capacity to inspect and regulate its thousands of drug labs,” the editorial board writes. 

    When fentanyl is exported from China, it mainly comes through the mail to both users and dealers. While Congress has allotted Customs and Border Protection more chemical-detection equipment, it is not possible to scan all packages entering the country. 

    “The task would be easier if Congress passed pending legislation to require the U.S. Postal Service to obtain basic identifying information from senders—including the name and address of sender and a description of package contents—as private parcel services do,” the editorial board writes.

    In addition to being sold on the dark web, fentanyl can also be found on regular websites, the board says. Scott Gottlieb, commissioner of the Food and Drug Administration (FDA), has spoken out about the need for internet companies to put more effort into taking down those listings. 

    While this all has to do with the supply, the aspect of demand must also be addressed, the board says. The more than 2 million Americans struggling with opioid or heroin use disorder need access to treatment, specifically medication-assisted treatment (MAT) and behavioral therapy.

    “Fentanyl and other opioids are killing more than 130 people a day. The crisis demands a thorough, well-coordinated national response. What the White House and Congress have come up with so far falls short,” the board concludes.

    View the original article at thefix.com

  • Link Between Suicide And Opioid Use Examined

    Link Between Suicide And Opioid Use Examined

    Researchers hope that the results of a new study will help them better identify those at risk for suicide. 

    A three-year, $1.4 million study will examine the connection between opioid use and death by suicide, in hopes of more effectively identifying high-risk patients.

    “We know that opioid use, opioid overdose and suicide are related, but we need much more specific information to guide our efforts at prevention,” Gregory Simon, MD, principal investigator of the Mental Health Research Network and a co-investigator on the study, told Health IT Analytics. “The findings from this study will be a great asset to the public health community.”

    The goal of the research is to develop predictive models that can help doctors better identify and intervene with patients who are at higher risk of attempting suicide.

    Researchers will analyze data covering about 24 million medical visits, 35,000 suicide attempts, and 2,600 suicide deaths. They will try to predict how likely it is that a suicide will occur within 90 days of the time an individual visits a medical professional. 

    Opioid overdose deaths have increased exponentially in the past decade, while deaths by suicide increased 27% between 1999 and 2015. During that time suicides that involved opioids doubled, and may have increased even more. 

    “We’ve done preliminary work suggesting that 22 to 37% of opioid-related overdoses are, in fact, suicides or suicide attempts,” said Bobbi Jo Yarborough, PsyD, an investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon.

    Despite the rising risks, doctors and mental health providers often have difficultly identifying which patients are at risk for suicide. 

    “While health care settings are ideal places to intervene to prevent suicides, clinicians aren’t able to easily determine which of their patients are at elevated risk,” Yarborough said. “Our ultimate goal is to develop the most accurate suicide risk prediction tools and put them into the hands of clinicians. If our study is successful, clinicians will have a powerful new resource in the fight against suicide.”

    Researchers will look at risk factors including illegal or prescribed opioid use, opioid use disorder, discontinuation or substantial dose reduction of prescription opioids, and prior non-fatal opioid-related overdoses. They will also examine how these factors affect men and women differently in order to understand whether one group is more likely to attempt suicide while using opioids. 

    Healthcare providers say that while suicide is highly stigmatized, talking openly about it can reduce the number of deaths.

    “I have learned that it is important to talk about survivor stories. We know that suicide is preventable,” Dr. Anne Schuchat, the principal deputy director at the CDC, said in June. “We are in a different era right now, with social media increased and also social isolation is high… We think helping overcome the isolation can improve the connectedness.”

    View the original article at thefix.com

  • Former Purdue Pharma Exec May Profit From Opioid Addiction Drug

    Former Purdue Pharma Exec May Profit From Opioid Addiction Drug

    Richard Sackler’s involvement with a new formulation of buprenorphine has drawn a wave of criticism. 

    A new formulation of buprenorphine, a medication used to treat opioid addiction, is due to hit the market—but some have taken issue with one of the inventors’ ties to Purdue Pharma, the maker of OxyContin.

    Richard Sackler is listed as one of six inventors on a patent for a new formulation of buprenorphine issued in January, the Financial Times reported. Sackler is also the former chairman and president of Purdue Pharma, according to the Washington Post, and the son of Raymond Sackler, one of the company’s founders.

    Purdue Pharma is the target of more than 1,000 lawsuits from cities, states, counties and tribes across the United States. The pharmaceutical giant and maker of OxyContin is accused of exaggerating the benefits and downplaying the risk of the opioid painkiller, and fueling the national opioid addiction epidemic.

    “It’s reprehensible what Purdue Pharma has done to our public health,” says Luke Nasta, director of Camelot, a New York-based treatment center. The Sacklers “shouldn’t be allowed to peddle any more synthetic opiates—and that includes opioid substitutes.”

    According to the patent, unlike the tablet or film formulation that’s currently available, the new drug will come in a fast-dissolving wafer that is placed under the tongue.

    According to the inventors, the fast-dissolving formula will make it less likely for the drug to be abused and sold on the black market.

    Colorado recently added to the mounting lawsuits against Purdue Pharma—accusing the company of playing a “significant role in causing the opioid epidemic.”

    “Purdue’s habit-forming medications coupled with their reckless marketing have robbed children of their parents, families of their sons and daughters, and destroyed the lives of our friends, neighbors, and co-workers,” said state Attorney General Cynthia Coffman in a statement. “While no amount of money can bring back our loved ones, it can compensate for the enormous costs brought about by Purdue’s intentional misconduct.”

    Members of the otherwise little known Sackler family have come to light for their ties to Purdue Pharma.

    This past March, a group of about 50 people came together at the Metropolitan Museum of Art in New York City to protest members of the Sackler family’s alleged involvement in perpetuating opioid abuse. Led by artist Nan Goldin, the protestors threw pill bottles marked “OxyContin” into the reflecting pool in the Sackler Wing of the museum, named for the family’s contributions to the museum.

    The family has donated millions of dollars to arts institutions like the Met over the years.

    View the original article at thefix.com

  • Are Moms With Opioid Addiction At Heightened Risk For Overdose?

    Are Moms With Opioid Addiction At Heightened Risk For Overdose?

    A new study examined pregnant women and new moms with opioid use disorder.

    After finding out she was pregnant with her second child while in a Massachusetts prison, Katie Raftery entered treatment for heroin use. She stayed seven months, until her son was born. It wasn’t until he was about six weeks old that she began to feel the familiar urges to return to using.

    According to the Sarasota Herald Tribune, a new study shows that women who use opioids, like Raftery, are at greater risk of an overdose in the year following their child’s birth.

    Rather than return to using, Raftery was able to use her insurance coverage and reach out to her doctor to ask for buprenorphine, a medication that can treat opioid use disorder. But not all women in the country have the ability to take similar actions. 

    According to the Herald Tribune, in states that do not offer expanded Medicaid, low-income women lose their insurance coverage eight weeks after giving birth. Addiction experts say this is concerning, as it makes a relapse during postpartum depression and opioid cravings more likely. 

    “As a whole, women with substance use disorders do quite well during pregnancy, due in large extent to access to care, insurance coverage and attention from social services,” Mishka Terplan, an obstetrics and gynecology physician at Virginia Commonwealth University School of Medicine, told the newspaper. “Where things fall apart is postpartum. We actually abandon women after delivery.”

    Terplan served as the co-author of the study published last month. During the course of the study, researchers kept track of more than 4,000 women with opioid use disorder in Massachusetts, for the duration of the year before and after giving birth.

    The study’s results indicated that deaths from opioid overdoses decrease during pregnancy, but increase in the seven to 12 months following birth. Since all of the women involved in the study resided in Massachusetts, insurance coverage was not a factor.

    Davida Schiff, lead author of the study and a physician at Massachusetts General Hospital, tells the Herald Journal that sustaining care for women well after childbirth is vital.

    “Pregnancy seems to be a time for change. Women tend to make healthier decisions during pregnancy. So, for women with an opioid addiction, it can be a motivating moment,” she said. 

    “We should capitalize on the emotions women feel during pregnancy, and sustain their care or enhance it during the postpartum period, which is arguably the most challenging.”

    The Herald Journal states that while the opioid epidemic has hit the country hard as a whole, it has impacted subgroups, like pregnant women and new moms, especially hard.

    The Centers for Disease Control and Prevention (CDC) found that between 1999 and 2014, the number of pregnant women who used opioids more than quadrupled.

    View the original article at thefix.com