Tag: opioid epidemic

  • Could A Scientific Study Have Slowed The Opioid Crisis?

    Could A Scientific Study Have Slowed The Opioid Crisis?

    Researchers suggest that a recent pragmatic trial could have played a key role in curbing the crisis. 

    While opioids are effective for acute pain relief, the widespread addiction and dependence that have swept up the country have showed that the powerful pills have unintended consequences, even as studies suggest that opioids are less effective for long-term pain than over-the-counter options. 

    Most medications are approved after undergoing a randomized controlled trial, but a different type of scientific study could have showed the real-world problems with using opioids for chronic pain relief, according to Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine who blogs on health research and policy at The Incidental Economist.

    “These different kinds of studies actually exist. They are called pragmatic trials, and a recent one might have helped serve as a brake as the opioid epidemic accelerated,” Carroll writes in an essay for The New York Times

    Whereas randomized controlled studies evaluate whether a drug is effective in ideal circumstances, pragmatic studies measure a drug’s effectiveness in the real world. 

    “A pragmatic trial seeks to determine if, and how, an intervention might work in practice, where decisions are more complicated than in a strictly controlled clinical trial,” Carroll writes. 

    A randomized controlled study of opioids, for example, would compare whether people taking opioids get more pain relief than those taking a placebo. This is challenging, however, because people who are being treated for pain are desperate for relief, and often change treatments hoping to find one that will work. 

    “Under these conditions, it’s hard to get patients to participate, and the same with doctors,” Carroll writes. 

    The Strategies for Prescribing Analgesics Comparative Effectiveness study took a more pragmatic approach to analyzing the effectiveness of pain relief medications, comparing opioids to non-opioid treatment.

    Whether a patient was receiving opioid or non-opioid treatment there were options to progress to stronger pain relief options, which helped people stick with the study long-term, rather than dropping out to try other pain relief. Doctors could also change doses and medications within the same class, tailoring treatment to the individual patients. 

    “That’s how actual care occurs,” Carroll writes. “This way, you can measure how treating someone with opioids might compare with treating someone without opioids for a sustained period.”

    The study eventually showed that adverse symptoms were lower for patients treated without opioids, and those patients were also less likely to become dependent. 

    Although studies like this are important, Carroll writes that they’re unlikely to become mainstream because of their intricacies and expense. 

    “Although drug companies are willing and ready to pay for randomized controlled trials to prove efficacy, it’s not clear who is going to finance studies like these,” Carroll writes. “They use lots of different drugs—which is what happens in the real world—and no company wants to foot the bill for other companies’ products to be evaluated. Certainly no opioid-related companies would want to pay for this trial.”

    View the original article at thefix.com

  • Purdue Pharma Knew About Oxy Misuse Early On, Report Finds

    Purdue Pharma Knew About Oxy Misuse Early On, Report Finds

    The report also alleges that in 1999 company officials learned of a call to a pharmacy describing “OxyContin as the hottest thing on the street—forget Vicodin.”

    Purdue Pharma reportedly knew that the opioid pill OxyContin was being snorted and sold on the street as early as 1999, just three years after the medication’s release.

    However, the company reportedly kept quiet about this knowledge and continued marketing the drug as a safer pain-relief pill.

    The New York Times obtained a confidential Justice Department report that was compiled in the early 2000s, leading up to Purdue’s settlement with the federal government in 2007.

    Purdue executives have testified in Congress that they did now know that the product was being abused until the United States attorney in Maine issued a warning in 2000. 

    “Everyone was taken by surprise by what happened,” Purdue’s top medical officer, Dr. Paul D. Goldenheim, testified in 2001. “We launched OxyContin in 1996, and for the first four years on the market, we did not hear of any particular problem.” 

    However, the Justice Department report shows that this is not true.  

    “We have in fact picked up references to abuse of our opioid products on the internet,” Purdue Pharma’s general counsel, Howard R. Udell, wrote in early 1999 to another company official.

    The report also alleges that in 1999 company officials learned of a call to a pharmacy describing “OxyContin as the hottest thing on the street—forget Vicodin.”

    Federal prosecutors also found the words “street value,” “crush,” or “snort” in 117 internal notes that recorded meetings between Purdue representatives and doctors before 2000.

    The report’s findings were so alarming that prosecutors recommended that felony charges be brought against three of Purdue’s executives. However, Justice Department officials under George W. Bush did not support that and ended up brokering a settlement in 2007 that avoided felony criminal charges and allowed Purdue to continue selling OxyContin

    Now, some people see this as a missed opportunity. 

    “It would have been a turning point,” said Terrance Woodworth, a former Drug Enforcement Administration official who investigated Purdue Pharma in the early 2000s. “It would have sent a message to the entire drug industry.”

    However, another former DEA official told The New York Times that U.S. Attorney John Brownlee ultimately felt that accepting a deal would be best because Purdue had so many resources available to aid in its defense, including the expertise of Rudy Giuliani, who helped craft the deal for Purdue. 

    “He told me he was outgunned,” Joseph Rannazzisi said. 

    Brownlee has said that he felt the deal reached in 2007 was appropriate, but that he thought it would trigger tighter oversight of Purdue, something that did not happen. 

    “I didn’t feel as a lawyer I could be in a position to bar anyone from getting OxyContin. Faced with that decision, I was just simply not prepared to take it off the market. I didn’t feel like that was my role,” he said. “My role was to address prior criminal conduct. Hold them accountable. Fine them. Make sure the public knew what they did.”

    View the original article at thefix.com

  • Overdose Risks During Pregnancy Examined In New Study

    Overdose Risks During Pregnancy Examined In New Study

    The study revealed the need for better addiction recovery support for pregnant women with substance use disorder. 

    A new study has found that the risk of overdose drops in pregnant women but increases after giving birth.

    The study, published in the journal Obstetrics & Gynecology, looked at women giving birth in Massachusetts. In doing so, researchers found a greater number of women with opioid use disorder than had been found in other states. 

    Researchers also discovered that during pregnancy, opioid overdose events went down, the third trimester resulting in the lowest amount. However, after birth, that number rose and became especially high from 6 to 12 months after delivery.

    “Our findings suggest we need to develop extended and long-term services to support women and families impacted by substance use disorder,” said Davida Schiff, a pediatrician at MassGeneral Hospital for Children and the lead author of the paper, according to Science Daily. “We need additional research to determine the best ways to improve retention in treatment and adherence to medication therapy after delivery, and we need to enhance our medical and public health infrastructure to provide support to women in achieving long-term recovery.”

    In many states, opioid overdoses have been “major contributors to pregnancy-associated deaths.” In pregnant women, estimates of opioid use disorder range from .4 to .8%, and up to 2% in all women that fall into the reproductive age category. 

    Pregnancy can drive a woman to seek treatment, Science Daily notes. Often, such treatment includes therapy and potentially medications like methadone or buprenorphine.

    Researchers chose to study a Department of Public Health dataset, which included nearly 178,000 deliveries of an infant 20 or more gestational weeks to Massachusetts women between Jan. 1, 2012 and Sept. 30, 2014. Of those, 4,154 women were found to have likelihood of opioid use disorder within a year before giving birth.

    Additionally, of the women in the dataset, 184 experienced what researchers refer to as an opioid overdose event in the year preceding or following delivery. Such an event means the woman faced admission to a heath care facility for an overdose or death as a result of an overdose.

    Those who experienced an overdose event were “more likely to be younger, single, unemployed, less educated and less likely to have received adequate prenatal care,” Science Daily reported. They were more likely “to have evidence of homelessness or a diagnosis of anxiety or depression.”

    Co-author and Massachusetts Commissioner of Public Health Monica Bhare says that this research is vital in gaining a bigger picture of who is most at risk.

    “These findings help expand the lens from which we view the epidemic and allow us to tailor our policies and programs in ways that will increase opportunities for treatment and recovery for these women and their children,” she said. 

    View the original article at thefix.com

  • CDC Director: I Almost Lost My Son To Fentanyl

    CDC Director: I Almost Lost My Son To Fentanyl

    “It’s important for society to embrace and support families who are fighting to win the battle of addiction—because stigma is the enemy of public health.”

    The director of the Centers for Disease Control and Prevention (CDC) told a private audience last week that the opioid crisis hits close to home for him because his son nearly died after taking cocaine contaminated with fentanyl.

    “For me, it’s personal. I almost lost one of my children from it,” Dr. Robert Redfield Jr. told the annual conference of the National Association of County and City Health Officials, according to CBS News and the Associated Press.

    The AP saw a video of Redfield’s speech, which was given on Thursday in New Orleans. According to AP researchers, Redfield’s 37-year-old son was charged with possession in 2016, but the outcome of the case was not public record.

    Redfield declined to discuss the incident more in depth, but he did release the following statement: “It’s important for society to embrace and support families who are fighting to win the battle of addiction—because stigma is the enemy of public health.”

    During the speech, Redfield was outlining his priorities for the CDC. He said that since becoming director in March, the opioid crisis has been a top priority because it is “the public health crisis of our time.”

    Dr. Umair Shah, the head of Houston’s county health department, said that Redfield’s admission was a powerful statement. “It was definitely an intimate moment that grabbed the audience of public health professionals,” said Shah, who just finished a term as president of the National Association of County and City Health Officials.

    “It was a close-to-home story, and he spoke quite personally,” Shah told The Washington Post. Shah said that it’s relatively uncommon for healthcare providers to talk about their own personal experience with public health issues, but that doing so can be a powerful way to connect with patients.

    “We don’t want to be seen as too vulnerable or too unprofessional,” Shah said. “And here he is sharing such an intimate story.”

    Redfield’s background is in infectious disease and most of his professional work has been done around HIV, a condition that was stigmatized in much the same way that addiction is today.

    Once isolated to the heroin supply, fentanyl is increasingly being used to cut other drugs, including cocaine. In addition, fentanyl is increasingly being abused on its own, rather than being mixed with other drugs. In 2016, the drug was found to be present in 46% of opioid-related overdose deaths.

    View the original article at thefix.com

  • News Groups Demand Opioid Distribution Data Be Made Public

    News Groups Demand Opioid Distribution Data Be Made Public

    Media outlets want access to the info to support their coverage of the opioid epidemic and increase public accountability by manufacturers.

    Some of the nation’s top news organizations, including the Washington Post, are demanding that the federal government release information about the sale and distribution of controlled substances by pharmaceutical distributors and manufacturers.

    The information, which is part of the Drug Enforcement Administration’s (DEA) federal opioid distribution database, was turned over as potential evidence in the hundreds of lawsuits filed against pharmaceutical companies for their alleged role in the national opioid crisis.

    The media outlets want access to the information to support their coverage of the opioid epidemic and increase public accountability by manufacturers.

    As the Associated Press reported, the government consented to submit opioid distribution data culled from 2006 to 2014 from its registry to these lawsuits, but with the requirement that it only be used for legal and law enforcement purposes.  

    But on July 9, 2018, lawyers for the Washington Post and HD Media, which owns West Virginia’s Charleston Gazette-Mail, filed a request in a Cleveland federal court for release of the records. The Associate Press, along with other news groups, has also requested access to the information.

    “Where releasing records would merely bring embarrassment or adverse publicity to a corporation or a government agency, the records must be disclosed,” wrote Post lawyer Karen Lofton in a court filing on July 9. “In this case, disclosure of the distribution data would cause no conceivable harm to patients or other innocent individuals. If anything, their interests would be advanced by the public accountability that would be demanded in the wake of such disclosures.”

    Pharmaceutical manufacturers and distributors are opposed to a public release of the information, as is the government, which argued in a court filing in June that making public the database information would have a negative impact on not only the companies’ distribution methods, but also criminal investigations and state public record laws.

    But lawyers countered by pointing to a 2016 article by the Gazette-Mail that revealed that drug companies made available more than 700 million pills to West Virginia residents between 2007 and 2012, a period in which more than 1,700 individuals in the state died from opioid overdoses.

    The Gazette-Mail obtained the information from drug shipping sales records sent by the DEA to West Virginia Attorney General Patrick Morrissey’s office and made public by a West Virginia district judge.

    The lawyers presented the decision to release the information and the story that resulted as a prime example of why the national distribution data should be made public.

    View the original article at thefix.com

  • Prescription Opioid Use And Its Connection To The Criminal Justice System

    Prescription Opioid Use And Its Connection To The Criminal Justice System

    A new study examined the link between people with a history of prescription opioid use and their involvement with the criminal justice system. 

    Individuals with a history of opioid use are up to 13 times more likely to be involved in some manner with law enforcement or justice system officials, including arrest, parole or probation.

    Those are the conclusions suggested by a new study that explored what NPR described as the “intersection of the criminal justice system and the ongoing opioid epidemic.”

    Data from more than 78,000 respondents to a national survey on drug use found that prescription opioid users were more likely to have some involvement with the criminal justice system than those with no history of opioid use; opioid users were also more likely to suffer from chronic health issues and have higher susceptibility to overdose upon release from the prison system.

    The study authors also suggested that greater access to alternatives to incarceration or treatment within the prison system could have a significant impact on lowering these rates.

    The study, conducted by researchers from New York University, the University of Colorado School of Medicine and Kaiser Permanente’s Institute for Health Research, among other institutions, examined information culled by the National Survey on Drug and Use and Health from 78,976 respondents—all U.S. residents between the ages of 18 and 64—including substance use, socioeconomic status and health.

    Involvement with the criminal justice system was defined by three criteria: whether the respondent had been recently arrested, released on parole or placed on probation.

    The data suggested that only 3% of the general population with no history of opioid use—prescription or other forms, like heroin—fell into those three categories.

    However, 20% of respondents who said that they had a dependency on prescription opioids and 40% of those who reported using heroin had some level of involvement with the criminal justice system.

    The data also revealed that individuals reporting opioid use or dependency were more likely to have some form of health issue, whether a mental illness or chronic health conditions like asthma or chronic obstructive pulmonary disease.

    Using this information, the researchers opined that the criminal justice system needed greater involvement in providing treatment for individuals with opioid dependency.

    They noted that many prison systems do not offer medication-assisted treatment (MAT), which has been regarded as the most effective means of treating opioid issues by several studies.

    Individuals in the criminal justice system who do not receive some form of treatment are more likely to experience a lower tolerance to opioids and in turn, a greater chance of overdose upon release, according to 2012 research conducted with former inmates.

    Study lead author Tyler Winkelman, a clinician-investigator at Hennepin Healthcare in Minneapolis, also suggested that placing individuals in treatment facilities instead of jails may prove more effective in breaking the cycle of dependency and incarceration. “We need a response that will ideally prevent people from entering the criminal justice system,” he noted.

    The NPR coverage cited a 2016 study, which reviewed rates of death by overdose among inmates exiting the Rhode Island Department of Corrections after it began a medication-assisted treatment program for its prison population. The study suggested that overdose deaths dropped by nearly 61% among that demographic—an “unheard of” drop in mortality rates, according to study author Josiah Rich, a professor of medicine and epidemiology at Brown University.

    “At this point of the epidemic, we can’t afford to not put people on treatment,” he added.

    View the original article at thefix.com

  • How One Rural Community Is Fighting to Save Lives from Drug Overdose

    How One Rural Community Is Fighting to Save Lives from Drug Overdose

    “I don’t want another parent to pick out a casket. I don’t want another grandparent to have to look a grandchild in the eye and say ‘your momma is gone.’”

    The Driftwood Motel on Oak Island, North Carolina, has seen better days. All around it, pastel-colored vacation homes with kitschy names like After Dune Delight reel in tourists with promises of beachfront sunsets and shaded hammocks by the pier. Though the Driftwood Motel is also painted in cheerful pastels, the paint is flaking off in dry strips and littering the ground next to cigarette butts and busted beer bottles. Rhonda C. lives on the bottom floor of the Driftwood with her bed, couch and kitchen furniture crammed into a room with dark sheets that cover the windows. She is one of the motel’s many long-term residents – people drawn in by the $100 a week price tag who end up staying far longer than they had planned. A gray-haired, matronly woman, Rhonda looks after the other residents, especially the young ones who drift in and out in various stages of inebriation. She hadn’t been able to offer them much, until she met Margaret Bordeaux.

    Margaret is a petite, African American woman, quiet and unassuming until you get to know her fiery side. As an outreach worker for the North Carolina Harm Reduction Coalition, Margaret runs a mobile harm reduction unit in Brunswick County, a sparsely populated rural community hugging North Carolina’s Southeast coast. Brunswick is also one of the counties hardest hit by drug-related deaths in the state. At least once a week Margaret drives its lonely roads, seeking out places like the Driftwood Motel that collect people who have lost every other home. Thanks to a grant from the Aetna Foundation to combat the opioid epidemic, Margaret has a van stocked with supplies to help reduce drug-related death and disease. She gives out naloxone (a medicine that reverses overdose from opioids such as heroin, fentanyl, and prescription painkillers), syringes, and other resources, and she teaches people how to prevent, recognize and respond to an overdose.

    “I make friends and develop relationships in Brunswick County,” says Margaret. “Many of the people I’ve met here thought that naloxone and clean syringes were magical things only available in [cities]. No one has been coming out here to offer these services until now.”

    Some people are wary when Margaret first pulls up because they have been treated poorly by health care workers and aren’t accustomed to a warm, non-judgmental person offering them free services. But after a few visits, Margaret wins them over.

    “My whole life I have rooted for the underdog and the underserved,” says Margaret. “I want to care for people that society doesn’t care for. People use superficial reasons to ignore each other and I want to remove those reasons and say, hey, there is a person here.”

    Kathy Williams is one of the people whose lives Margaret has touched. A middle-aged, Caucasian woman with a defiant personality, Kathy’s backstory is the stuff of nightmares. She raised two kids as a single mom, Josh and Kirby. As an adult, Josh married a wonderful woman and had two children. Kirby struggled with drug use, and whenever she hit a rough spot, Josh and his wife would take her in and help her get back on her feet. But in 2011, Josh’s car was t-boned by a school bus. He, his wife, and both their young children died in the crash. The loss hit Kirby hard. Her drug use escalated and five years later, she too died of a drug overdose.

    Kathy tells this story completely dry-eyed. It’s as though she has endured so much pain that nothing can faze her anymore. These days she is raising her 14-year-old grandson, Kirby’s child, and also caring for her own aging parents. She is also one of the founding members of B.A.C.K. O.F.F., an organization of Brunswick County families who are fed up with losing their loved ones to drugs. What started as a support group in March 2017 has morphed into an organization with a mission to educate people about the realities of drug use and to help save lives.

    “A mother is not supposed to bury her child,” says Kathy. “I don’t want another parent to pick out a casket. I don’t want another grandparent to have to look a grandchild in the eye and say ‘your momma is gone.’”

    B.A.C.K. O.F.F., which stands for Bringing Addiction Crisis Knowledge, Offering Families Focus, makes and distributes overdose prevention kits containing naloxone to families with a loved one who uses opioids. They also spread awareness about North Carolina’s 911 Good Samaritan law, which protects people from prosecution if they seek medical assistance for an overdose. B.A.C.K. O.F.F. members provide community, resources and support for families impacted by drugs and offer space for honest talk about drug use. No denial, no sugarcoating, no pithy slogans about just saying no. Real talk from real families caught in the same struggle. But not everyone is willing to speak up.

    Elsewhere in Brunswick County, Alex Murillo has been trying to convince Hispanic parents who have lost child to drug poisoning to get involved in B.A.C.K. O.F.F. It hasn’t been easy.

    “Many Hispanics here deny that drug use is happening in their families,” says Alex, who recently lost his 19-year-old nephew to overdose. “If a parent loses a child to overdose, they say they died in their sleep. No one wants to talk about it.”

    A tall, dimpled man with a perpetual smile, Alex’s cheerful demeanor hides a tragic history. Alex is originally from Mexico. When he was brutally raped at 12 years old, his parents threw him out of the house, claiming he deserved to be raped because he “acted gay.” At 15 years old, Alex married a girl, but the marriage made him so miserable that he decided to come to the United States where he hoped to be able to express himself more freely. At the border he was apprehended by a human trafficking cartel and forced into sex slavery.

    “They forced me to take drugs. They beat me and pimped me out,” he says. “I was so shocked. I didn’t think things like that happened in the U.S.”

    Alex eventually escaped. He tried to join a church community but was turned away after admitting he was gay. He attempted suicide, but his brother found him passed out from a bottle of sleeping pills and took him to the hospital. When Alex woke days later, his attitude on life had changed.

    “I was surprised to be alive,” he says. “But I realized that I was still here for a reason and I decided to dedicate my life to helping other people.”

    Today Alex owns a small Hispanic tienda in Brunswick County where he offers help to anyone who comes to his doorstep, whether they are seeking food, advice, or help paying rent. Every year he hosts a multicultural festival in his store parking lot, though other Brunswick County residents have threatened to shut it down because they are unhappy with the area’s growing diversity. He is also happily married to his husband, who works in the store and supports Alex’s outreach efforts. Alex hopes to become more involved in educating the Hispanic community about drugs.

    “We can’t just ignore this problem. The drugs are in our schools. They are everywhere,” says Alex. “We need to do more outreach to the Hispanic community to teach them how to talk about drugs with their kids. They can’t just tell kids not to do drugs. Kids see their friends doing it and they want to try too. We need to have honest conversations as a community.”

    Margaret, Kathy and Alex may be an unlikely team, but together they are working to bring resources and hope to a county that has suffered devastating loss. Little by little, their efforts are making a difference. Margaret has helped people enter drug treatment programs and reconnect with family members where ties had been severed. Alex is making headway on opening up conversations about drugs in the Hispanic community. B.A.C.K. O.F.F. provides Kathy with an outlet to teach families how to help their loved ones who use drugs.

    “I used to look at a person who uses drugs as an addict, but now I look at them as someone’s brother, son or family member,” says Kathy. “I feel that if we had had these tools like naloxone, overdose education, and a support group years ago, my daughter might still be alive today.”

    At a small Mexican diner where we meet for lunch, I ask Kathy what her message is to people in rural communities impacted by drugs. For a moment, she is quiet. Finally she says:

    “I want people to know they are not alone. You might think you are alone, but there are so many of us going through the same thing. We can hold each other up.”

    View the original article at thefix.com

  • Non-Profit Launches Foster Care Program For Kids Affected By Opioid Crisis

    Non-Profit Launches Foster Care Program For Kids Affected By Opioid Crisis

    The Georgia-based program is “designed to help children from newborns to the age of 21 years find a loving home.”

    A Georgia nonprofit called Christian City Children’s Village has plans to begin its own foster care system due to the alarming number of children being left parentless at the hands of the opioid crisis.

    According to a media release on the organization’s website, foster care needs in the state have increased 100% in the past five years, bringing the total number of children to more than 15,000. 

    In February, Christian City introduced the Crossroads Foster Care & Adoption Program, which provides “private and public foster care, foster-to-adoption and public adoption” for children within a 50-mile radius of Union City, Georgia.

    “We wanted to respond to this issue by increasing the number of loving homes available to children in foster care and that is when we decided to launch the Crossroads program,” Len Romano, President & CEO of Christian City, said in the release.

    The program serves newborns to age 21 and provides training, home studies, support and access to the Christian City thrift store for families that are interested in adoption or foster care.

    According to the website, the program is “designed to find and equip wonderful families for children in need of a loving home… Permanency is the ultimate goal for each child through either reunification with the child’s birth family or adoption.”

    “We offer a crisis program for the foster child and adoptive parents. If a caregiver reports to us the child is under distress when acclimating to their new environment, we bring the child back onto the Christian City Children’s Village campus for 48 hours. Here, we give the child the attention and any skills they may need to help them reintegrate into their new home,” Michaela Guthrie, Program Executive for the Crossroads Foster Care and Adoption Program, said in the media release.

    Beginning July 1, Christian City started a contract with the state of Georgia to assist the Georgia Division of Family and Children Services (DFCS) in placing children in appropriate foster or adoptive homes.

    In other words, CBS46 states, children from the DFCS can be referred to the Crossroads Foster Care & Adoption Program. 

    “A lot of children who come into the foster care system have faced various types of trauma, whether it be abuse or neglect,” Guthrie told CBS46. “So, we really want to make sure that the families that will be taking care of them from this point in time and maybe a forever home.”

    View the original article at thefix.com

  • Opioid Crisis In The 1800s Shares Similar Roots With Today's Epidemic

    Opioid Crisis In The 1800s Shares Similar Roots With Today's Epidemic

    Just as modern doctors began using opioids to treat a variety of pain, doctors more than 100 years ago used morphine in the same way, exposing more people to the drug. 

    Aggressive advertising touting the benefits of medications, quick fixes offered by new-found wonder drugs and doctors who didn’t realize the dangers of the medications they were prescribing sound a lot like all the pieces that led to today’s opioid epidemic. However, these are a few of the causes of opioid addiction that spiked in the United States in the late 1800s, according to a report in Smithsonian.

    At the time morphine was a new medication and doctors and patients were equally enamored with it. The drug became an ingredient in everything from teething serums to constipation cures, and by 1889, Boston physician James Adams estimated that about 150,000 Americans were “medical addicts,” addicted to prescription drugs rather than opium that could be smoked. 

    Just as modern doctors began using opioids to treat all types of pain, doctors more than 100 years ago used morphine to treat a variety of ailments, exposing more people to the drug. 

    Morphine became “a magic wand [doctors] could wave to make painful symptoms temporarily go away,” said David Courtwright, a historian of drug use and policy at the University of North Florida and author of the book Dark Paradise: A History of Opiate Addiction in America. “It’s clear that that was the primary driver of the epidemic.”

    One reason for the popularity of morphine among doctors and patients was aggressive advertising. An ad for Mrs. Winslow’s Soothing Syrup for Teething Children, which contained morphine, declared the product was “The mother’s friend.”

    Most Victorians didn’t realize that the medications, which were not regulated at the time, contained potentially dangerous ingredients. When these medications were found to be effective treatment, they became increasingly popular. 

    “If buyers took a spoonful because they had, say, a case of the runs, the medicine probably worked,” Courtwright said. 

    Eventually, doctors began to realize that the heavy use of medications containing opioids was unhealthy and leading to addiction. 

    “By 1900, doctors had been thoroughly warned and younger, more recently trained doctors were creating fewer addicts than those trained in the mid-nineteenth century,” Courtwright wrote in a 2015 paper for The New England Journal of Medicine.

    Government regulation also played a part and regulating the crisis, Courtwright wrote. Medical experts, led by Adams, began pressuring their colleagues to move away from opioids, and states began to regulate narcotic use. This led to a sharp reduction in opioid prescriptions.

    For example, in 1888, 14.5% of prescriptions filled in Boston drugstores contained opiates, but by 1908, only 3.6% of prescriptions filled in California contained the drugs. 

    View the original article at thefix.com

  • Frustrated Pain Patients Meet With FDA About Opioid Access

    Frustrated Pain Patients Meet With FDA About Opioid Access

    A group of pain patients met at FDA headquarters to share their personal stories in a bid to get the agency to ease opioid restrictions.

    The FDA called a meeting in Washington, D.C. to listen to pain patients’ experiences of lacking access to opioids to manage their symptoms.

    A group traveled to the FDA’s headquarters outside the nation’s capital to ask the agency to ease restrictions that they say has made it harder for them to obtain opioids.

    NBC News reported on the stories of some of those who urged the FDA to consider what it is like to have acute or intractable pain and be unable to find relief.

    Dr. Sharon Hertz, director of FDA’s Division of Anesthesia, Analgesia and Addiction Products, told NBC of the informal meeting, “We don’t have expectations for what we are asking. If we thought we knew, we wouldn’t be asking.”

    The Patient-Focused Drug Development Meeting included harrowing stories of suffering. Sandra Flores has a condition called adhesive arachnoiditis, which is an inflammation of membranes in the brain, spine and nerve endings. She has repeatedly attempted to obtain the correct drugs for her pain.

    “I am seeing the true face of medicine,” Flores said. “Now they are throwing me in the trash.”

    FDA Commissioner Scott Gottlieb made an emphatic statement on the plight of pain patients without access to relief. 

    “Tragically, we know that for some patients, loss of quality of life due to crushing pain has resulted in increased thoughts of or actual suicide. This is unacceptable. Reflecting this, even as we seek to curb overprescribing of opioids, we also must make sure that patients with a true medical need for these drugs can access these therapies,” said Gottlieb, according to PatientEngagementHIT.

    The FDA does not regulate physicians’ prescribing habits; states do. As of now, 28 states enforce limits on opioid prescriptions, says data from the National Conference of State Legislatures.

    Although the FDA, CDC and most major medical institutions agree that limiting access to opioid prescriptions is a necessary step in fighting the opioid epidemic, they do not want intractable pain patients to suffer.

    Under the new regulations, many doctors have simply stopped prescribing out of fear of lawsuits. Flores has been unable to find a doctor that will take her on as a patient. “No doctors will fight. They just don’t want to get into trouble. They have forgotten the people that these drugs were made for.”

    Rose Bigham, speaking on behalf of the Alliance for the Treatment of Intractable Pain, said in the Washington meeting, “To the FDA—we are begging you. Correct the CDC’s egregious mistakes. The CDC recommendations have done irreparable harm to people in pain.”

    View the original article at thefix.com