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Tag: opioid overdose deaths

  • Prevent Opioid Overdose Deaths: A Call for Specific Prescribing Laws and Physician Oversight

    Prevent Opioid Overdose Deaths: A Call for Specific Prescribing Laws and Physician Oversight

    Make doctors precisely explain why they are prescribing opioids and why they decided on the pill count and refill allowance for each patient. 

    Recently, a friend’s teenage daughter underwent a procedure common for young adults: she had her wisdom teeth extracted. I had the same procedure performed in the late 1990s, at age 20. Back then, I was given a bottle of ibuprofen for the pain and, for the bleeding, told to apply tea bags. My friend’s daughter was given something just a tad stronger: 

    Vicodin.

    A teenager was given a strong opioid painkiller to numb the pain of a routine tooth extraction. It’s absurd that this is the accepted medication for this procedure when there are no complications, nothing that would indicate breakthrough pain on a level of requiring a narcotic that is given to cancer patients.

    However, the fight against opioid abuse is finally gaining promising victories by wielding an effective weapon: lawsuits. 

    Holding Big Pharma Accountable

    As the epidemic grew, many – myself included – called for state and local authorities to take drug companies to court for knowingly encouraging large-scale consumer usage of highly addictive prescription painkillers such as OxyContin, Vicodin and Percocet. Thousands of lawsuits have now been filed and in August, the $572 million decision won by Oklahoma against Johnson & Johnson became the first large-scale trial ruling concerning Big Pharma’s role in creating the opioid crisis. The state argued that J&J, which had supplied 60% of the opioids drug makers used for painkillers, aggressively marketed the drug to doctors and patients as safe. 

    Most recently the Sackler family – owners of Purdue Pharma, which makes OxyContin – reached a tentative settlement for$10-12 billion, a move that will result in the company’s bankruptcy. 

    They lied, we died, and now they have to pay up. Hopefully these are just the first few drips in an oncoming flood of restitution owed Americans by companies responsible for an unprecedented addiction crisis. They deserve whatever fates come their way – criminal, civil, or, as the 800-pound spoon left at Johnson & Johnson’s headquarters intended, shame-filled. 

    Now, as the overdose death rate shows signs of ebbing but has by no means abated – 68,000 Americans died in 2018 compared with 72,000 in 2017, hardly cause for celebration – it’s time to ask what’s next. 

    For years, drug companies pushed opioids as a panacea for all things pain-related. The result was an absolute avalanche of prescriptions: 191 million in 2017 alone, which averages to 58 opioid prescriptions for every 100 Americans. And despite guidelines intended to discourage opioid painkillers as a first-step approach to easing pain, primary care clinicians – most patients’ initial gateways to healthcare – wrote 45% of all opioid prescriptions. 

    Surgeons also have been implicated in widespread overprescribing. One study of nearly 20,000 surgeons, led by Johns Hopkins School of Public Health researchers, noted the common practice of prescribing dozens of opioid medications even for low-pain operations. Some prescribed over 100 opioid pills for the week following a surgery, along with usage instructions far exceeding guidelines from several academic medical centers. No wonder some six percent of all patients prescribed opioids post-surgery become dependent. 

    The diagnosis is simple: Doctors have proven incapable of, or unwilling to, exercise responsible discretion in determining which conditions and medical procedures necessitate painkillers notoriously linked to addiction, misuse, and overdose. 

    A Painful Backlash

    Complicating matters, the opioid crisis has become a two-way street. 

    In response to the backlash to the initial opioid free-for-all, many doctors have become so wary of prescribing opioids that those who truly need them are unjustly suffering. Much of this hesitancy is a reaction to guidelines issued by the Centers for Disease Control in 2016 that, according to Richard Lawhern, founder of the Alliance for the Treatment of Intractable Pain, has subjected patients with legitimate chronic pain to a “draconian reduction” in doctors willing to meet their needs with opioid-based medication.

    The problem with the CDC’s directive was vagueness of language. The guidelines state that opioids are appropriate for pain caused by cancer, end-of-life care, and “palliative care.” But “palliative” is a subjective term, and therefore confusing for doctors who, understandably, now have their guards up against malpractice suits in addition to opioid addiction and abuse. In a February 2019 reiteration of its guidelines, the CDC clarified that opioids are reasonable for chronic pain but, unfortunately, repeated its ambiguous wording concerning specific conditions. 

    However unintended, the result is patients who rely on opioids for legitimate medical reasons suffering for the sins of Big Pharma and, subsequently, the incompetence of government officials and the inadequacies – including cowardice – of doctors.

    The scale of the crisis and forcefulness of the backlash also has resulted in patients who, through no fault of their own, became dependent on opioids and, at the drop of a guideline, found themselves completely cut off from a highly addictive drug and dropped into a hellish withdrawal. The unsurprising consequence of this overreaction by doctors is patients turning to the streets for unregulated, often fentanyl-tainted heroin. Any laws written to specify opioid painkiller administration must include reasonable ways of relieving already-addicted patients through treatment centers and weaning agents like methadone and buprenorphine (suboxone). 

    However, the conviction permeating the chronic pain community – that doctors rather than laws should be the primary determinant of opioid prescriptions – simply doesn’t hold water. It’s become clear that doctors don’t necessarily know best. We need rules that hamstring the parasitic overprescribers while unhandcuffing the paranoid underprescribers.

    Guidelines Aren’t Enough

    It’s time for legislators to take the mystery out of this branch of medicine. If doctors can’t stop writing opioid prescriptions to those who don’t need them, or refusing to write prescriptions for those who do, then we must enact laws with clear prescribing instructions. 

    We’re all familiar with mandatory sentencing guidelines; we need mandatory dispensing guidelines – laws that bring harsh punishment for overprescribing pain medication when it’s not indicated, while reassuring doctors that they will not be unfairly punished for providing chronic pain patients with the relief they require.

    The time has come for customized ailment and procedure-related opioid painkiller dosing laws, complete with extensive medical rationale requirements. Make doctors precisely explain why they are prescribing opioids and why they decided on the pill count and refill allowance for each patient. 

    We also need to look at something else: ourselves. Especially in post-surgery settings, the opioid overprescribing epidemic was exacerbated by the naïve, altogether modern notion that patients should never feel discomfort or pain. 

    If alternatives to opioids don’t kill 100% of post-procedure pain, the new one-word answer should be “tough.” The idea that we can go through life without ever experiencing pain is not only delusional but, as we’re seeing, destructive. Things heal. Patients will need more, well, patience. 

    Numbing people literally to death is not the answer. It is irresponsible and dangerous to prescribe opioids for an ingrown toenail. Or for carpal tunnel syndrome. Or to a child following a tonsillectomy or, of course, a teenager after a tooth extraction. 

    On the flip side, it is cruel and flat-out stupid to deny patients with serious chronic pain access to a now-demonized family of medicines that for many has meant the difference between functioning and debilitation. 

    The time for general guidelines is behind us. We need strict, specific statutes that greatly diminish doctors’ discretion while placing transparency and responsibility squarely on their shoulders. 

    View the original article at thefix.com

  • New York Overdose Deaths Decline Slightly After Rising For 7 Years

    New York Overdose Deaths Decline Slightly After Rising For 7 Years

    “The decrease in drug overdose deaths is promising but far too many New Yorkers are still dying,” said New York Health Commissioner Dr. Oxiris Barbot.

    The official report for 2018 drug overdose deaths in New York City has been released, showing a slight 2.6% decrease from 2017 after being on the rise for seven years. Last year, there were 1,444 overdose deaths within city limits, compared to just 541 in 2010.

    Experts see this as a promising start after the city put forth millions of dollars in efforts to address this problem, particularly as the opioid epidemic has raged on. However, overdose deaths are still too high for anyone’s liking.

    “The decrease in drug overdose deaths is promising,” said New York Health Commissioner Dr. Oxiris Barbot, according to NBC. “But far too many New Yorkers are still dying.”

    The U.S. has experienced a “third wave” of the opioid epidemic in recent years due to the increasing prevalence of the highly potent fentanyl. This particular drug is often added to other illicit substances such as heroin or cocaine to increase the euphoric effect, and has been attributed to the heightened death toll of the opioid crisis.

    Around 80% of New York’s overdose death cases from 2018 involved an opioid, with around 50% involving cocaine.

    A Little Relief

    Thankfully, preliminary reports on overdose deaths throughout the country have suggested an overall downturn in the number of fatal cases after several years of severe and alarming spikes.

    Much of the nation’s efforts to combat the opioid epidemic have revolved around increasing the public’s access to naloxone, the drug that blocks opioid receptors in the brain, halting the effects of an overdose.

    Campaigns have been launched across the U.S. to install naloxone kits alongside general first aid kits in public places such as airports and hotels and to recruit people to act as “community responders,” using apps and widespread community involvement to save lives.

    Naloxone Access

    New York City alone has distributed around 230,000 naloxone kits in two years. The medication commonly comes in an easy-to-deploy nasal spray, which anyone can purchase from a local pharmacy and carry with them in case they or someone nearby suffers an overdose.

    Local governments have also invested in facilitating access to addiction treatment programs and businesses have contributed by implementing overdose detection technology in customer bathrooms in places like coffee shops and fast food establishments.

    Unfortunately, some possibly overlooked populations still saw a rise in the number of overdose deaths in New York, including among older adults ages 55 to 84.

    View the original article at thefix.com

  • In Recovery, on Suboxone, and in the Weed Business

    In Recovery, on Suboxone, and in the Weed Business

    In print and online, I preached cannabis. In life, I practiced therapy and Suboxone.

    I had a few days left on my Suboxone script when I interviewed Justin “Bong King.” He was a professional bong-racer and self-described champion of the competitive smoking circuit. An affable guy, nonetheless his was an image of American cannabis long past, pushed aside by marketing grads and stay-at-home moms who sold branded CBD and touted the benefits of micro-dosing. 

    But Justin drew a crowd, and an entourage to boot. And his natural talent for hitting the fastest gram of weed would corner me into compromising my recovery.

    Throughout my career as a cannabis journalist, I’ve kept silent about my sobriety. Finding freelance gigs is hard enough without the added burden of having to be that guy. Besides, if I learned anything from active addiction, it was how to lie at my job.

    Covering Cannabis Events and Lying About My Sobriety

    But as time passed, I felt withdrawn and disconnected. My recovery had no place in the cannabis industry. Moreover, medication-assisted treatment (MAT) seemed anathema to its goals, according to experts and the news. Rep. Matt Gaetz openly questioned whether buprenorphine and methadone are “a more effective offramp [to opioid use disorder] than medical cannabis.” CNN announced that CBD cures heroin addiction. And the editors of Leafly figured out how to combat the opioid crisis with medical cannabis two years prior.

    After 20 years, recovery had finally become routine. As a cannabis journalist; as an editor in chief — so had my lies.

    Some lies were easy. Weekly therapy appointments usually coincided with editorial meetings or deadlines. I worked from home, my boss was lax, and anyway, I kept hours around the clock. Monthly visits to my psych and 30-day Suboxone refills upped the number of undisclosed appointments I logged, but still, no one seemed to care.

    On assignment was a different story. I covered cannabis expos or dispensary openings — events where the drug laws were lax and the supply was liberal. At a hotel in Hell’s Kitchen, I spent three nights alone avoiding networking galas and after-parties hosted by music moguls turned industry entrepreneurs. In the world’s largest dispensary off the Las Vegas strip, I dodged more questions than I asked when leaving empty-handed. With hand waves and head shakes and less-than-assertive no’s, I passed over pot by lying about my sobriety.

    But face to face with Justin “Bong King,” there was nowhere to hide — no hotel room to run to, no door from which to make a quick exit. There was a crowd around us, boxing us in as he finished his gram smoking demonstration. I shook his hand and stumbled over my words as I signed off the segment on camera.

    It was either a contact high or placebo effect, or maybe just panic anticipating the piss test I would take in the next few days.

    Intensive Outpatient: 12 Steps and Scoring Drugs

    When I had about two months left in my treatment program, I walked out of group for good. It was an intensive outpatient program; a six-month IOP run by Philly’s NHS that championed the Big Book and 90 days. For a minute it worked, but it’s drug rehab mired in a puritan past. The 12 steps are great, but they shouldn’t be a front-line defense.

    Besides, all I did there was make friends and score drugs. Thirty addicts in a room is an excellent opportunity to network and learn.

    By Easter Sunday that year, I felt broken. I was in a dirty motel on Route 1, hopped up on Benzedrex cottons and a $60 baggie of hex-en I purchased online from China. After 20 years of addiction, I had no drug of choice, save for anything that made me high.

    My wife and kids back home slept together in one bed, a little less worried than the last time I disappeared. I was out of work and estranged from everyone. My best friend joined AA and realized I was one of his people, places, and things.

    All I had was my family, and I was losing them too.

    One lie allowed my addictions to grow without the worry of what would happen tomorrow. It’s the lie I told myself when I stole my ex-wife’s Dilaudid two days after her shoulder surgery. It’s the lie that made me laugh when I snorted enough Adderall to make my nose blue. And it’s the same lie that made me indignant when my ex-girlfriend’s brother became angry that I was a sloppy drunk in front of his small children.

    On the Monday after Easter, I drove home before sunrise. It was dark and muggy and difficult to see through my tears and dilated pupils. When I got home, I faced my wife and children and ended the lie that had followed me through two decades of addiction.

    “I can’t stop,” I whispered. That week, I discussed MAT options with my doctor. I’ve been in recovery since that day.

    Cannabis as the Magic Bullet for the Opioid Crisis?

    Tyler Sash won the Super Bowl in his rookie year with the New York Giants. At the time, he didn’t know he only had a few years left to live. A sixth-round draft pick out of Iowa, he overdosed on a combination of methadone and hydrocodone at the age of 27.

    “[He] asked if he could smoke marijuana for his pain like the other players,” recalled his one-time girlfriend, former Miss Iowa and reality-show contestant Jessica VerSteeg. I interviewed VerSteeg when she was promoting a new blockchain-bitcoin something-or-other product in the cannabis space. She recounted Sash’s tragic tale during our interview, explaining how it became the backbone of her business.

    “I wanted to change the way that other people saw cannabis,” she said.

    VerSteeg’s article drew in readers, as did most CEO and celebrity interviews. Her story reminded me of how lonely my secrecy about my recovery had become. I often wished I could reach out and say that I understood. There are millions of people with substance use disorders, and we’re all so alone.

    But like most of the executive class in the cannabis industry, her hot take on opioids ended up being bullshit. Conventional wisdom in the cannabis industry had run somewhat amok on this topic, and it forced me, I felt, into compromising everything.

    There was the DEA agent who was so disgusted with opioids that he became a cannabis executive. Without irony, he told me that more research would prove the plant’s medicinal value. The head of an “innovation accelerator” in my city held a conference on the role of medical cannabis in the opioid crisis. He quoted research showing that states with medical cannabis laws have lower rates of opioid overdose deaths. Cannabis, they were convinced, would solve the opioid epidemic.

    But Where’s the Evidence?

    “Morphine, when it was introduced, was promised to cure what they called alcoholism at the time,” Dr. Keith Humphreys told me. A professor of psychiatry and behavioral sciences at Stanford University, he’s also worked at the White House Office of National Drug Control Policy under Presidents Bush and Obama. “Then, people got addicted to morphine, and cocaine was introduced.”

    He continued: “In general, there’s been this enthusiasm of if we just add a different class of addictive drug on top then that will drive the other addictions out. Generally, what happens is we get more addiction to that drug, and we still have the original problem.”

    I spoke with Dr. Humphreys after reading his research on cannabis laws and opioid overdose mortality rates. Contrary to conventional wisdom, he found the correlation to be spurious at best. It’s alarming — though not unsurprising — to see the industry ignore his findings. Several states, including Pennsylvania, where I live, approved opioid use disorder as a qualifying condition for medical cannabis.

    “I couldn’t recommend something medically without clinical trials, well-controlled by credible groups [and] checked for safety,” Dr. Humphreys said. He explained that in the case of cannabis, there was little more than these state-level correlational studies. “None of that has been done.”

    “I’m amazed and disappointed that we don’t care more about people who are addicted to heroin [and other] opioids, that we would wave through something like [medical cannabis] without making sure that it will help people, not hurt them,” he continued, noting that cannabis has shown no efficacy as either a replacement for or an adjunct to any MAT therapy.

    Listening to Dr. Humphreys made me realize how little I stand up for what I believe. Sometimes, when you’re an addict and you lie so much, you lose any sense of truth.

    Tyler Sash’s family asked Jessica VerSteeg to stop using his name to promote her business. According to a report in the Des Moines Register, they didn’t want his name associated with drugs anymore, neither opioids nor marijuana. VerSteeg refused, repeating the story she told me to several news outlets.

    For two years, I wrote about and reported on the emerging cannabis industry while hiding my ongoing recovery. In print and online, I preached cannabis while practicing therapy and Suboxone.

    Even in recovery, you can still have regrets.

    View the original article at thefix.com

  • DEA Database Tracked Every Pain Pill Sold In The US, Here's Where They Went

    DEA Database Tracked Every Pain Pill Sold In The US, Here's Where They Went

    The data depicts a clear “opioid belt” comprised of more than 90 counties across West Virginia, Virginia and Kentucky.

    Where the pills went, death followed.

    This is clear to see in a side by side comparison of recently released data showing exactly where—and to what extent—76 billion oxycodone and hydrocodone pills were distributed between 2006 and 2012, and CDC opioid death data from the same time period.

    Record-Making Civil Action

    The DEA’s database tracked the “path of every single pain pill sold in the United States,” the Washington Post reported. The Post and HD Media (the publisher of the Charleston Gazette-Mail in West Virginia) were granted access to the database last Monday (July 15) after a year-long effort to make the data available, in the largest civil action in U.S. history.

    The Post analyzed millions of transactions from 2006 to 2012, and made the data searchable by state or county. It found that 75% of the pain pills (oxycodone and hydrocodone) were distributed by just six companies in this time period—McKesson Corp., Walgreens, Cardinal Health, AmerisourceBergen, CVS and Walmart.

    The Post then compared this data alongside CDC opioid death data. This showed a clear correlation between the number of pain pills that were sent to a region and how many people died of opioid-related causes there.

    The data, visualized in two separate maps, depicts a clear “opioid belt” comprised of more than 90 counties covering Webster County, West Virginia, southern Virginia, and Monroe County, Kentucky.

    Rural communities in West Virginia, Kentucky and Virginia experienced the highest per capita opioid death rate during this time period.

    As the Post reported, the national opioid death rate was 4.6 deaths per 100,000 residents. “But the counties that had the most pills distributed per person experienced more than three times that rate on average.”

    Even more shocking was that “13 of those counties had an opioid death rate more than eight times the national rate… Seven of them were in West Virginia.”

    “What [the drug companies] did legally to my state is criminal,” said U.S. Senator Joe Manchin of West Virginia. “The companies, the distributors, were unconscionable. This was not a health plan. This was a targeted business plan. I cannot believe that we have not gone after them with criminal charges.”

    So far Rochester Drug Cooperative, a drug distributor based in New York, has been the first and only to be hit with felony criminal charges for the illegal distribution of controlled substances.

    Nearly 2,000 lawsuits against drug companies, including Johnson & Johnson and Purdue Pharma, are pending in federal court. The lawsuits claim that the companies irresponsibly marketed and distributed powerful opioid drugs with little consideration for the risk of patients becoming addicted or dying.

    View the original article at thefix.com

  • High-Risk Counties For Opioid Deaths Identified By New Study

    High-Risk Counties For Opioid Deaths Identified By New Study

    For a new study, researchers examined the most high-risk places for opioid overdose and overdose deaths.

    As many as 13% of counties in the U.S. are classified as high risk for people with opioid use disorder, because they have high overdose rates and few treatment options, according to a new study that looked at overdose data from around the country. 

    The study, published in JAMA Network Open, aimed to understand overdoes rates by county in order to better distribute resources for recovery efforts. 

    “We hope policymakers can use this information to funnel additional money and resources to specific counties within their states,” said lead author Rebecca Haffajee, assistant professor of health management and policy at the University of Michigan School of Public Health. 

    Nearly 25% Of Counties Had A High-Rate Of Overdose Deaths 

    Around 24% of counties (751) had a high rate of overdose deaths. Researchers found that 46% of counties did not have a provider who prescribed medication-assisted treatment, while 71% of rural counties did not have a publicly available provider of opioid treatment. 

    “We need more strategies to augment and increase the primary care provider workforce in those high-risk counties, people who are willing and able to provide opioid use disorder treatments,” Haffajee said. 

    In addition to increasing the number of care providers, the researchers pointed out that better job opportunities were linked to lower overdose rates. Counties with more employment, more providers and younger residents had a lower risk of overdose deaths. 

    The balance between overdose rates and available providers played out differently in rural versus urban counties, Haffajee pointed out. 

    “In rural areas, the opioid crisis is often still a prescription opioid issue. But in metropolitan counties, highly potent illicit fentanyl and other synthetic opioids are more prevalent and are killing people,” she said. “That’s likely why we identified metropolitan areas as higher-risk, despite the fact that these counties typically have some (just not enough) treatment providers.”

    Access To Medication-Assisted Treatment Is The Key

    Information like that can help governments to more efficiently distribute money and resources. 

    “Understanding these differences at the sub-state level and coming up with strategies that target specific county needs can allow us to more efficiently channel the limited amount of resources we have to combat this crisis.” 

    The researchers wrote, “Although overall buprenorphine-waivered clinicians and funds for [opioid use disorder] treatment to states have increased in recent years, to have the largest effect on the opioid crisis these resources need to be funneled to local county areas with the greatest unmet need, together with new models of care to reach people with [opioid use disorder].”

    For example, “prioritizing fund allocation and clinician workforce augmentation efforts around [medication-assisted treatment] in nonmicropolitan counties, including in many Appalachian and Mountain regions, could be particularly effective in reducing opioid-related risks,” they wrote. 

    View the original article at thefix.com

  • Two-Thirds Of Global Drug-Related Deaths Were From Opioid Use

    Two-Thirds Of Global Drug-Related Deaths Were From Opioid Use

    The 2019 World Drug Report highlighted the devastating global reach of the addiction epidemic.

    Drug use continues to rise—not only in the United States, where fentanyl and painkillers have devastated many lives, but in the Middle East, Africa and India.

    The numbers are provided in the 2019 World Drug Report released by the United Nations Office on Drugs and Crime (UNODC).

    The report detailed the extent of the drug problem in the United States and Canada. Opioid drugs such as fentanyl, heroin and prescription painkillers contributed the most to widespread substance use disorder (addiction) and death. In 2017, more than 47,000 people in the U.S. and 4,000 Canadians died from opioid overdose, the report showed.

    “Drug overdoses have really reached epidemic proportions in North America,” said UN research chief Angela Me.

    Around 271 Million People Used Drugs In 2017

    Globally, drugs are a problem as well. An estimated 271 million people used drugs in 2017—30% more people than in 2009. The same year, 585,000 people died from drug use—with opioid drugs accounting for two-thirds of global drug deaths.

    And while around 35 million people live with drug use disorder, not enough people receive help for it. “Prevention and treatment continue to fall short in many parts of the world, with only one in seven people with drug use disorders receiving treatment each year,” according to the UN.

    The report found a lack of treatment options across the world, and urged world leaders to do better. “Effective treatment interventions based on scientific evidence and in line with international human rights obligations are not as accessible as they need to be, and national governments and the international community need to step up interventions in order to address this gap,” according to a statement by the UN.

    It was noted that the overall increase in drug use and people with substance use disorder was partly due to improved reporting in India and Nigeria, two of the most populous nations.

    Cannabis Is The Most Widely Used Drug In The World

    Other findings of the World Drug Report included the fact that cannabis is still the most widely used drug in the world with an estimated 188 million people having used it in 2017. And global cocaine manufacturing hit a record high in 2017 with 1,976 tons counted—a 25% increase over the previous year.

    “The findings of this year’s World Drug Report fill in and further complicate the global picture of drug challenges, underscoring the need for broader international cooperation to advance balanced and integrated health and criminal justice responses to supply and demand,” said Yury Fedotov, UNODC Executive Director.

    View the original article at thefix.com

  • Does Cold Weather Increase Opioid Overdose Rates?

    Does Cold Weather Increase Opioid Overdose Rates?

    Researchers investigated whether cold snaps were responsible for increases of overdose deaths.

    Periods of cold weather with temperatures at or below freezing can increase opioid overdose death rates by as much as 25%, according to a recently-published study.

    The study, published in the journal Epidemiology, looked at information on more than 3,000 overdose deaths in New Jersey and Connecticut between 2014 and 2017. The researchers found that “low average temperature over the 3 to 7 days prior to death were associated with higher odds of fatal opioid overdose.”

    Researchers believe there could be a few different explanations for why a cold snap increases the likelihood of overdose.

    There may be a biological explanation: opioids can affect breathing, and it is harder to breath in cold air, so this might be compounded. In addition, people who have taken opioids find it harder to regulate their body temperature because opioids reduce the point at which people start shivering, a biological mechanism that helps increase temperature when a person is getting too cold.

    In addition, cold temperatures could affect the drug supply chain, making it more likely that people get drugs contaminated with synthetic opioids, researchers speculated. Or, people might be more likely to use drugs alone when it is cold out.

    “It is well known that opioids induce respiratory depression, and that’s what causes a fatal overdose,” lead study author Brandon Marshall told Science Daily. “However, there may be a host of other risk factors that contribute to opioid overdose deaths, which could be avenues for effective interventions.”

    Marshall emphasized that the reasons don’t matter as much as the fact that lifesaving interventions could be emphasized during cold snaps.

    “Regardless of what is causing the correlation between cold weather and fatal overdoses, our findings suggest that agencies and organizations should consider scaling up harm-reduction efforts after a period of cold weather,” he said.

    The research showed that the temperature on the day of death wasn’t indicative of increased risk, but that a stretch of cold days was much more likely to affect overdose rates.

    “Thirty-two degrees on just one day is cold, but to maintain an average of 32 degrees for three or four days means there was a long time where it was quite cold,” said William Goedel, who helped analyze the data.

    However, he noted that is it possible that people are more likely to fatally overdose on cold days, but that is harder to prove with the available data.

    “One possibility is that the same-day temperature is based around the recorded day of death, which in some cases is an estimate, especially when a body isn’t found for a couple of days,” Goedel said. “The lack of a strong correlation with temperature on the day of death could be due to the uncertainty of when people actually died.”

    View the original article at thefix.com

  • Legal Cannabis Doesn’t Reduce Opioid Deaths

    Legal Cannabis Doesn’t Reduce Opioid Deaths

    States with medical cannabis programs actually have 23% more opioid overdose deaths than states without medical cannabis, a new study found.

    Since the 2014 release of a study that suggested that states with medical marijuana programs had fewer opioid overdose deaths, proponents of legalized cannabis have argued that it can help save lives amid the opioid crisis. 

    A new, broader study released this week, however, has found that states with medical cannabis programs actually have 23% more opioid overdose deaths than states without medical cannabis. The new results called into concern efforts to paint marijuana legalization as a solution to opioid abuse. 

    “It’s become such a pervasive idea. It would be amazing if it was this simple, but the evidence is telling us now that it’s not,” lead author Chelsea Shover told STAT News. 

    The original study looked at the years 1999 through 2010. During that time, 13 states had medical marijuana programs, and the study found that those states had opioid overdose rates that were 25% lower than states without medical cannabis. 

    When Shover’s team replicated that study, they found the same results in that time period. However, they then expanded the study, looking at years through 2017. During that time, many more states implemented medical cannabis programs, and a handful introduced legalized recreational cannabis.

    During that time period, the researchers found that states with legal medical cannabis actually had higher overdose rates. 

    “Not only did findings from the original analysis not hold over the longer period, but the association between state medical cannabis laws and opioid overdose mortality reversed direction from−21% to +23% and remained positive after accounting for recreational cannabis laws,” study authors wrote. 

    The authors of the new study concluded that the apparent connection between legalized cannabis and opioid overdose deaths was “spurious,” or false.  

    “We find it unlikely that medical cannabis—used by about 2.5% of the U.S. population—has exerted large conflicting effects on opioid overdose mortality,” study authors wrote. 

    Shover emphasized this point. “This isn’t to say that cannabis was saving lives 10 years ago and it’s killing people today,” she said. “We’re saying these two things are probably not causally related.”

    Because opioids and medical marijuana are both commonly used to treat pain, the theory went that people with access to cannabis for pain relief were less likely to get hooked on addictive opioids. Today, states including Illinois allow people to substitute medical marijuana for conditions that they otherwise would be given opioids for. This is based on the assumption that cannabis is safer—and less addictive—than opioids. 

    Neuroscientist Yasmin Hurd, who directs the Addiction Institute at Mount Sinai in New York, said that further large-scale research is needed to examine the link—if any—between access to cannabis and opioid overdoses. 

    “In a time of an epidemic, we have to think differently,” she said. “We have to be more bold in pushing forward clinical trials on a much faster timeline than we have in the past.”

    Although she agreed that cannabis is less dangerous than opioids, she said that marijuana policy should not be pushed forward as a harm reduction strategy for opioids. 

    She said, “Is cannabis less of a mortality risk than opioids? Absolutely. Hands down. But there’s really no research that says cannabis use per se decreases opioid overdose. You can’t make your medical cannabis laws based on that [hypothesis].”

    View the original article at thefix.com

  • People Who Lost Loved Ones To Opioids Invited To Sign Heroin Spoon Sculpture

    People Who Lost Loved Ones To Opioids Invited To Sign Heroin Spoon Sculpture

    Artist Domenic Esposito is using his symbolic sculpture to confront the opioid crisis head-on.

    Since last summer, a giant 800-pound spoon—burnt and bent at the handle—has been drawing attention to the opioid crisis. The massive sculpture is a symbol recognized by people who have been affected by a loved one’s opioid and heroin use. Its sheer size and weight of its meaning make it hard to look away.

    “There’s a negative memory attached in many people’s heads because you think your loved one is doing better, you find a burned spoon and you realize they’ve relapsed,” said artist Domenic Esposito. “It’s the reality of the situation and resonates with a lot of families.”

    Now Esposito has created a brand new spoon that will tour New England—with stops in Massachusetts, Connecticut, Rhode Island and New Hampshire. Esposito has invited people who have lost a loved one to the opioid crisis to come and sign the sculpture.

    “It’s a blank canvas,” said Esposito. “It becomes very therapeutic for people to be there and sign because they know someone is listening—someone is acknowledging that they’ve had to go through all this horror. It’s just like this disease that basically takes entire families with it.”

    The 10.5-foot-long guerrilla art exhibit has confronted drug companies about their role in exacerbating the epidemic of opioid abuse in the United States. Last June, the original spoon sculpture appeared outside of Purdue Pharma headquarters in Stamford, Connecticut. 

    And in February, it was placed outside Rhodes Pharmaceuticals in Coventry, Rhode Island. Last fall, the Financial Times reported that Rhodes was founded in 2007 by members of the Sackler family, who also own Purdue Pharma, just “four months after Purdue pleaded guilty to federal criminal charges that it had mis-marketed OxyContin over the previous decade.” Rhodes is “among the largest producers of off-patent generic opioids” in the U.S.

    “It was really about pointing fingers to, in my mind, the architects of the opioid epidemic,” Esposito told the Concord Monitor.

    More spoons were placed in front of the Massachusetts State House in Boston as a gift to state attorney general Maura Healey for her efforts in holding Big Pharma accountable, and the U.S. Department of Health and Human Services.

    Esposito drew from his own experience watching his brother Danny struggle with heroin addiction to create his sculptures. “The spoon has always been an albatross for my family,” Esposito said last year. “It’s kind of an emotional symbol, a dark symbol for me.”

    Through his installations, Esposito is hoping to “protest and hold accountable the people who in our minds have created this epidemic that has killed close to 300,000 people.”

    View the original article at thefix.com

  • Ohio Officials Issue Warning After Spike In Drug Overdose Deaths

    Ohio Officials Issue Warning After Spike In Drug Overdose Deaths

    Fentanyl is widely believed to be the major cause of a recent overdose wave that hit multiple Ohio counties.

    Ohio law enforcement and health officials are warning residents to be extra cautious around illicit drugs, following a spike in overdoses this week that officials believe was caused by fentanyl found in cocaine and methamphetamine. 

    On Sunday (May 19), officials in Hamilton County, which includes the city of Cincinnati, warned about a spike in overdoses. The county saw at least 15 emergency room visits caused by overdoses in the 24 hours leading up to 6 a.m. on May 19.

    “Fentanyl continues to be a major cause of overdose and is being mixed with cocaine and meth,” Tom Synan, a local police chief, said in a Facebook post sharing the press release. “Stopping fentanyl coming into the country should be the national priority. This will continue until it is. More needs to be done.”

    In the release, officials warned law enforcement to not field test drugs, and to use safety equipment like gloves. The warning encouraged people to carry extra doses of the overdose drug Narcan, and to administer it any time someone was overdosing, even if they didn’t think they had ingested opioids. It also encouraged active drug users to take precautions like never using alone.

    In addition, it warned people not to leave the hospital against medical advice after receiving Narcan, the opioid overdose-reversing drug, since certain opioids can last longer than the drug and people can possibly overdose again hours after receiving it. 

    On May 23, officials in Cuyahoga County, which includes Cleveland, issued a similar warning. There, seven people died from overdoses over two days, according to Fox 8 Cleveland. 

    “The recent spike in overdose deaths, which has also been noted across Ohio, is concerning and still likely a result of fentanyl. Fentanyl is continuing to impact our communities, both in the City of Cleveland and suburbs,” said Dr. Thomas Gilson, Cuyahoga County medical examiner, in a statement on Thursday (May 23). 

    In a post sharing that statement, Synan wrote, “Fentanyl is still cause of immediate OD/deaths on its own in cocaine & meth. Those using any street drugs should carry Narcan. If you use drugs no matter where you live, your race or religion—fentanyl could be in your drugs. Almost half of OD deaths across the country involving cocaine and meth have had fentanyl in it or used with it. You don’t know what’s in your drugs. Even if you do—you are not being ‘safe’ with illicit fentanyl. No illicit drug is ‘safe.’”

    View the original article at thefix.com