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Tag: opioid overdose deaths

  • Who Should Be Held Responsible For The Opioid Epidemic?

    Who Should Be Held Responsible For The Opioid Epidemic?

    A new op-ed suggests that to receive “true justice” for the opioid epidemic, “we need to root out all the villains regardless of whether they have famous names.”

    When it comes to the opioid epidemic, no name brings frustration and anger like Purdue Pharma. It is commonly accepted that the maker of OxyContin contributed to the growth of the opioid epidemic by using aggressive and misleading sales tactics meant to get more powerful opioids into the hands of more Americans. 

    The Sackler family, members of which founded the company that would become Purdue Pharma, have also come under fire for their perceived role in the epidemic. Not only did the family profit vastly from the sale of OxyContin, but new court documents assert that they were directly involved with pushing for more sales.

    When it became clear that OxyContin was addictive they even considered making medications to assist in the treatment of addiction, which would have allowed them to double dip, profiting from both ends of the crisis. 

    The actions of Purdue Pharma were reprehensible, Robert Gebelhoff writes in an opinion piece for The Washington Post. However, he argues that in addition to punishing them, the country needs to seek punishment and retribution for others who contributed to the crisis.

    “The opioid epidemic is one of the worst systematic failures of health care in our country. For true justice, we need to root out all the villains, regardless of whether they have famous names,” he writes. 

    Gebelhoff calls for holding the medical community and other accountable. 

    He writes, “Even if states are able to turn these latest charges into some form of punishment for the Sacklers themselves, what about all those who promoted their cause? What about the researchers who accepted funding from drug manufacturers and carried out campaigns to destigmatize opioid painkillers? What about the officials at the Food and Drug Administration who not only approved OxyContin without any clinical studies on how addictive the drug might be, but also approved a package insert declaring the drug safer than its rival painkillers?”

    He also points to government officials who failed to intervene in the crisis, and even made it more difficult for the Drug Enforcement Administration to pursue concerning opioid sales.

    At the same time, government policy made it difficult for people to access medication-assisted treatment, which is widely accepted as the best treatment for opioid use disorder. This pattern continues today, according to recent VA research that shows too few people are getting access to medication-assisted treatment. 

    “Who holds such practitioners accountable?” Gebelhoff asks. 

    Gebelhoff points out that the Sacklers and Purdue are a good target, because they have enough money to help fund access to treatment and other interventions into the epidemic. However, he says it’s important that other entities be held responsible even if they don’t have deep pockets. 

    “The opioid saga — stemming from prescription painkillers — has irreparably damaged the lives of countless Americans over the past few decades,” he writes. “Don’t they deserve better?”

    View the original article at thefix.com

  • Death Certificate Project Goes Too Far, Addiction Specialist Says

    Death Certificate Project Goes Too Far, Addiction Specialist Says

    “Scaring providers into not prescribing opioids, I think that is not the ethically appropriate way to go forward,” said one addiction expert.

    Dr. Ako Jacintho, a family practitioner in San Francisco, says that he saw the opioid epidemic coming. His patients were asking for stronger medications and more pills. Instead of filling their requests, Jacintho trained as an addiction specialist, hoping to head off the problem, according to NPR. 

    However, that hasn’t protected him from an investigation that the California Medical Board is conducting into possible misuse of prescriptions. Jacintho received a letter from the board as part of the Death Certificate Project, which is examining death records in the state and seeking information from doctors who wrote prescriptions that may have contributed to fatal overdoses. 

    In Jacintho’s case, the board wanted to know about a 2012 methadone prescription that he wrote for a patient who later fatally overdosed on methadone and Benadryl. Jacintho reviewed the patient’s records—which the medical board had requested—but stuck by his decision to use methadone to treat the patient’s pain. 

    “If they’re looking for clinicians who are overprescribing, I’m the wrong doctor,” he said.

    Jacintho said that it’s especially unfair to look at prescribing practices from seven years ago in light of our new understanding of opioids. In 2012, when he wrote the prescription, doctors were told to treat pain aggressively, even by the California Medical Board’s own recommendations. 

    “It actually says that no physician will receive disciplinary action for prescribing opioids to patients with intractable pain,” Jacintho said. ”This person had intractable pain.”

    The letter from the board alleged that Jacintho prescribed toxic levels of the medication, but the doctor argues that it’s not that clear cut. “Toxicity is a very subjective word. What’s a toxic level for someone may not be a toxic level for someone else.”

    After the letter, Jacintho further reduced the amount of opioids that he prescribes to patients, something that worries Dr. Phillip Coffin, director of substance use research at the San Francisco Department of Public Health.

    “It’s like leaving a pair of scissors in an abdomen after surgery. If you’re just going to discontinue opioids, basically you’re ripping out the scissors and telling the person: ‘Good luck.’ Let them deal with the intestinal perforation on their own,” he said. “Scaring providers into not prescribing opioids, I think that is not the ethically appropriate way to go forward.”

    Kim Kirchmeyer, executive director of the medical board, said that most of the doctors who have received letters have not faced disciplinary action, although formal complaints have been filed against 25 doctors. She said that despite concern the death certificate project will continue, systematically working through records from previous years. 

    “If we save one life through this project, that is meeting the mission of the board, and that makes this project so worth it,” she said.

    View the original article at thefix.com

  • How Big Pharma's Payments To Doctors Affected Overdose Deaths

    How Big Pharma's Payments To Doctors Affected Overdose Deaths

    A new study examined the link between large payments and gifts to doctors from pharma companies and overdose deaths.

    In counties and states where opioid manufacturers offered large payments or gifts to doctors to promote their product, a new study has suggested that both opioid prescriptions and opioid-related overdose deaths were higher than in other areas.

    Coverage of the study in The New York Times showed that the study culled information from a variety of sources, including the Open Payments database, which tracks payments by pharmaceutical companies to doctors, and data from the Centers for Disease Control (CDC).

    Information from these sources suggested that spending on physicians was most highly concentrated in the Northeastern United States, where certain cities and counties claim some of the highest overdose death rates in the country.

    The study, conducted by researchers from Boston University School of Medicine, Boston Medical Center and New York University School of Medicine, and published in the Journal of the American Medical Association, filtered data from the aforementioned national databases through three criteria: total dollar value of marketing efforts by companies spent on doctors, number of payments and number of physicians that received any marketing. 

    According to the researchers, the pharmaceutical industry spent approximately $40 million promoting their opioid products to nearly 68,000 doctors between 2013 and 2015. The marketing efforts included paid meals, trips and consulting fees.

    By referencing overdose data and opioid prescription numbers from the CDC, they determined that for every three additional payments made to doctors per 100,000 people in a county, overdose deaths involving prescription opioids would rise 18% over a year’s time.

    Marketing to doctors dropped significantly in the period immediately following the years included in the study by 33%, which The New York Times attributed to public pressure on companies after the opioid epidemic began reaching critical levels.

    Cities and counties in the Northeastern US that received some of the largest payments also had some of the highest overdose rates, including Salem and Fredericksburg in Virginia, Cabell County in West Virginia and Lackawanna County in Pennsylvania.

    As The New York Times noted, the study authors also suggested that the number of interactions such as free meals appeared to be more strongly linked to overdose deaths than the amount spent on such interactions. 

    “Each meal seems to be associated with more and more prescriptions,” said study lead author Dr. Scott Hadland of Boston Medical Center’s Grayken Center for Addiction. Hadland and his co-authors also wrote that the study did have limitations: They were unable to differentiate between overdose deaths involving prescribed opioids and those caused by painkillers obtained through illegal means.

    “We acknowledge that our work describes only one part of the very complex opioid overdose crisis in this country,” said Hadland. “Even still, prescription opioids remain involved in one-third of all opioid overdose deaths, and are commonly the first medications that people encounter before transitioning to heroin or fentanyl. It is critical that we take measures now to prevent marketing from unnecessarily exposing new people to opioids they may not need.”

    View the original article at thefix.com

  • Opioid Overdose Deaths Surpass Vehicle Crash Deaths For First Time

    Opioid Overdose Deaths Surpass Vehicle Crash Deaths For First Time

    According to a new report from the National Safety Council, Americans are more likely to die from an opioid overdoses than a car crash.

    An opioid overdose is now a more likely cause of death than even vehicle crashes, according to a recent report. 

    The report on preventable deaths from the National Safety Council found that Americans have a 1 in 96 chance of death due to an opioid overdose, based on 2017 accidental death data. 

    “Drug poisoning is now the No. 1 cause of unintentional death in the United States,” the report reads. “Every day, more than 100 people die from opioid drugs –  37,814 people every year – and many of these overdoses are from prescription opioid medicine.”

    In comparison, NPR states, the chance of death in a motor vehicle crash is 1 in 103. 

    “We’ve made significant strides in overall longevity in the United States, but we are dying from things typically called accidents at rates we haven’t seen in half a century,” Ken Kolosh, manager of statistics at the National Safety Council, said, according to PR Newswire. “We cannot be complacent about 466 lives lost every day. This new analysis reinforces that we must consistently prioritize safety at work, at home and on the road to prevent these dire outcomes.”

    According to the Centers for Disease Control and Prevention, the drug at the forefront of overdose deaths is now fentanyl, which the council addressed in a statement. 

    “The nation’s opioid crisis is fueling the Council’s grim probabilities, and that crisis is worsening with an influx of illicit fentanyl,” the statement read. 

    Causes of death such as motor vehicle crashes and overdoses are different from heart disease and cancer deaths in that they are considered “a preventable, unintentional injury” — a statistic that has increased in the last 15 years, according to NPR. Falls also top the list of preventable causes of death, at 1 in 114, compared to 1 in 119 a year ago. 

    “It is impacting our workforce, it is impacting our fathers and mothers who are still raising their children,” Kolosh said. 

    He added that such deaths often impact people in the “core of their life.”

    “As human beings, we’re terrible at assessing our own risk,” Kolosh said. “We typically focus on the unusual or scary events … and assume that those are the riskiest.”

    Though everyone will die at some point, Kolosh says, action can still be taken to prevent unnecessary deaths. 

    “Your odds of dying are 1 in 1,” Kolosh added. “But that doesn’t mean we can’t do something. If, as a society, we put the appropriate rules and regulations in place we can prevent all accidental deaths in the future.”

    View the original article at thefix.com

  • Grant Provides Medication-Assisted Treatment To Inmates Leaving Jail

    Grant Provides Medication-Assisted Treatment To Inmates Leaving Jail

    Inmates in the treatment program also leave jail with counseling appointments in place and other sobriety supports.

    The Wisconsin legislature is giving out $1.3 million in grant money that counties around the state will use to provide medication-assisted treatment for inmates who are leaving jails. 

    The grants, administered through the Wisconsin Department of Health Services, allow people who are ready to be released to receive an injection of Vivitrol, which can block opioid receptors in the brain and make people less likely to abuse opioids. Inmates in the program also leave jail with counseling appointments in place and other sobriety supports, according to Action News. 

    “This is another great opportunity for an individual who wants to make a change to have the resources to be able to do it, and do it at a cost that they can afford,” said Todd Delain, sheriff-elect in Brown County, Wisconsin, which includes Green Bay. “The Vivitrol is one piece of it. The counseling and ongoing monitoring treatment is the other part of it, because if you don’t have both, they’re probably not developing the skills and tools necessary to overcome it long-term.”

    The program aims to help address the vulnerabilities of people who have just been released from a correctional facility, said Paul Krupski, director of opioid initiatives at the Department of Health Services.

    “Specifically to the criminal justice population, they have a very high rate of opioid overdose and opioid overdose deaths upon release in the first 60-90 day period that they are out,” he said.

    Inmates seem eager to take advantage of the program, according to Correct Care Solutions, which provides health care services to jails. 

    Jessica Jones, the company’s regional operations manager, said, “It really needs to be something the patient wants to do. It needs to be a lifestyle change they’re ready to make. The medication is really 50 percent of this. The psych-social component is what they really need to be ready to dedicate themselves to.”

    A pilot program has been taking place at the Brown County Jail, in partnership with Prevea Health. Over the past 18 months, that program has shown success, said Prevea Health President and CEO Dr. Ashok Rai.

    “I remember the first person, when one of our physicians came to me and said, we had our first graduate and that person got a job,” Rai said. “The whole intent here was to try to help people.” 

    Vivitrol, in combination with therapy, can be a powerful tool for people looking to get into recovery, he said. 

    “To get to the heart of addiction is really to get to counseling and what psychological aspect, as part of that disease, led to the addiction,” Rai said. 

    View the original article at thefix.com

  • Fentanyl Test Strips: Important Tool Or False Security?

    Fentanyl Test Strips: Important Tool Or False Security?

    A recent study suggests that the testing strips should be widely distributed though some experts say the strips are not an adequate prevention measure.

    Last year, fentanyl became the most deadly drug in the country, responsible for more overdose deaths than any other substance. In addition to being found in — or even replacing — opioids like heroin and prescription pills, fentanyl has increasingly been detected in drugs like cocaine, whose users are at increased risk for overdose because they have not built up a tolerance to opioids. 

    That’s why some people say fentanyl test strips are an important tool to help cut back on opioid overdose deaths. Some users say they often have no idea whether the drugs they’re buying contain fentanyl, which is many times more powerful than other opioids and can cause an overdose in even a small amount.

    The test strips are able to detect the presence of the synthetic opioid, empowering users to make an informed decision about whether to take the drugs and about how much to use. 

    “Evidence to date suggests that people who use drugs often do not know whether fentanyl is present in what they are about to consume,” authors of a report prepared by the John Hopkins Bloomberg School of Public Health wrote last year. 

    The school conducted a study that found fentanyl test strips to be effective at detecting the drug. The researchers then interviewed people who use drugs about whether or not they would use the test strips: 84% said they were concerned about fentanyl, and 85% of people who thought they had taken fentanyl in the past said they wished they had known beforehand. Despite the drug’s powerful high, only 26% of users surveyed said that they sought drugs with fentanyl. 

    “Drug checking was viewed as an important means of overdose prevention, with 89% agreeing that it would make them feel better about protecting themselves from overdose. Interest in drug checking was associated with having witnessed an overdose and recently using a drug thought to contain fentanyl,” study authors wrote. 

    The study’s authors suggested that more agencies distribute fentanyl test strips. 

    “Drug checking strategies are reliable, practical and very much desired by those at greatest risk of overdose,” they wrote. “Drug checking services have the potential to facilitate access to treatment for substance use disorders and other essential services, as well as provide real-time data about local drug supplies for public health surveillance.”

    However, Assistant Secretary for Mental Health and Substance Use Elinore F. McCance-Katz wrote in an editorial on the SAMHSA website that fentanyl test strips are not a prevention measure that people should be focused on. 

    “Can’t the nation do better?” she wrote.

    She continues, “The entire approach is based on the premise that a drug user poised to use a drug is making rational choices, is weighing pros and cons, and is thinking completely logically about his or her drug use. Based on my clinical experience, I know this could not be further from the truth.” 

    Like needle exchanges, fentanyl test strips are likely to remain a controversial —but potentially lifesaving — tool. 

    View the original article at thefix.com

  • Doctor Accused Of Prescribing Pills Linked To Overdose Deaths

    Doctor Accused Of Prescribing Pills Linked To Overdose Deaths

    The doctor’s prescription writing was allegedly so extreme that a local CVS stopped accepting prescriptions he wrote. 

    There’s a lot of attention on the so-called “third wave” of the opioid epidemic, synthetic opioids, but the arrest of a California doctor this week for allegedly illegally distributing prescription pills shows that medications are still a dangerous part of the epidemic.

    Orange County doctor Dzung Ahn Pham, 57, who owns Irvine Village Urgent Care was arrested on Tuesday for allegedly providing prescriptions to patients whom he never actually examined, according to a press release issued by the U.S. Attorney’s Office.

    He is facing two charges of illegally distributing oxycodone. At least five people who reportedly received medications from Pham overdosed, and another man who was allegedly using pills from Pham was involved in a fatal car accident.  

    “This case clearly and tragically illustrates the dangers of drug dealers armed with prescription pads,” United States Attorney Nick Hanna said in the press release. “This doctor is accused of flooding Southern California with huge quantities of opioids and other dangerous narcotics by writing prescriptions for drugs he knew would be diverted to the street. Prosecutors in my office, working with their law enforcement partners, will tirelessly pursue everyone involved in the trafficking of opioids as part of our persistent and ongoing efforts to stop the trail of misery that follows these dangerous drugs.”

    Pham’s prescription writing was allegedly so extreme that a local CVS stopped accepting prescriptions he wrote. 

    According to an affidavit, Pham provided medications including Adderall, oxycodone, tramadol, sSuboxone, norco, soma, alprazolam, and hydrocodone bitartrate-acetaminophen to patients who requested them via text message. At least 84 patients had prescriptions within a day or two after sending texts. 

    Last summer, undercover agents from the Drug Enforcement Administration also reportedly received pills from Pham, including a “Holy Trinity, [which] is the combined use of an opioid (such as hydrocodone), a benzodiazepine (such as Valium), and carisoprodol (a muscle relaxer like Soma),” according to the press release. The doctor then reportedly sent the undercover agent to a specific pharmacy that still accepted his prescriptions. 

    The pill mill operation was reportedly lucrative for Pham, who is believed to have deposited more than $5 million into personal accounts over the past five years. He also reportedly deposited $1.7 million into a business account. Investigators say he was charging $100-$150 per visit; it’s not clear how patients who requested prescriptions via text were charged. 

    William D. Bodner, DEA Los Angeles Associate Special Agent in Charge, said that targeting doctors who write prescriptions irresponsibly is a priority. 

    “This arrest should serve as a warning to any physician who utilizes their position to traffic opioids,” he said.

    View the original article at thefix.com

  • Organ Donations Increase As Opioid Overdose Deaths Climb

    Organ Donations Increase As Opioid Overdose Deaths Climb

    “Some refuse due to the stigma but when posed with lifesaving transplants in very sick people, that refusal rate for a quality organ is low.”

    The number of Americans waiting for organ donation is dropping for the first time in 25 years, in part because there are more organs available for donation from people who have died of a drug overdose. 

    “We started noticing the increase in overdose deaths in 2012,” Alexandra Glazier, director of New England Donor Services, which coordinates organ donation, told Vox. “Although it has a silver lining, in terms of its impact on organ availability, or at least it has in our region, it’s still not something we hope continues.”

    “Those people are better off here, having fought their battles with drugs and won, for their families and for their kids,” said Daniel Miller-Dempsey, a family services coordinator with New England Donor Services. “It’s heartbreaking to know that so many people are dying from this.”

    However, organ donation can provide a small silver lining for family members left behind. When David Maleham lost his son Matt to opioid overdose, he was not surprised. “It was a call I had dreaded for years,” he told Vox.

    Matt was in the hospital and his driver’s license indicated that he was an organ donor. Eventually, Maleham and his wife received a letter from the man who received Matt’s organ and felt a connection to his story. Maleham said that knowing his son’s donation gave this man a second chance at life eased the sense of loss. 

    “If it weren’t for that, what a waste. What a pointless death. What did that accomplish?” he said. “The answer would have been nothing.”

    The medical community has also become more willing to accept donations from so-called high risk donors. Federal law now allows donations from HIV-positive individuals. However, many people who die from opioid overdoses don’t have a long history of drug use. 

    Most people who are in dire need of a transplant do not mind having an organ from someone who died from drug overdose. 

    “Some refuse due to the stigma,” said Jay Fishman, who co-directs the transplant program at Massachusetts General Hospital, “but when posed with lifesaving transplants in very sick people, that refusal rate for a quality organ is low.” 

    View the original article at thefix.com