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Tag: opioid overdoses

  • DOJ Considered Using Fentanyl For Federal Executions

    DOJ Considered Using Fentanyl For Federal Executions

    A three-page memo filed by the DOJ in 2018 discussed the potential use of the deadly synthetic opioid for death penalty cases.

    A court filing by the U.S. Department of Justice (DOJ) revealed that the federal government actively considered using fentanyl to carry out executions of death row inmates.

    The synthetic opioid—which is 50 to 100 times stronger than morphine and one of the primary causes of opioid-related overdose deaths in the United States—was considered for use in death penalty cases in a three-page memo filed by the DOJ in 2018.

    The memo did not reveal why the government considered and eventually discarded the idea of using fentanyl in favor of the barbiturate pentobarbital, which Attorney General William Barr said would be used when the government announced new executions slated for later this year.

    Coverage by Reuters and other sources noted that the memo was brought to light when a federal judge ordered the DOJ to show its complete “administrative record” on Barr’s decision to use pentobarbital. The full contents of the memo were not made public.

    Department spokesperson Wyn Hornbuckle declined to answer questions in regard to the memo, while Mark Inch, the former Bureau of Prisons’ director, acknowledged that he had written the memo but also did not answer any questions about its contents, stating that it would be in conflict with his current role as the head of Florida’s Department of Corrections.

    A Drug Shortage & Botched Executions

    Reuters and other sources also noted that the department’s consideration of fentanyl might have been due to changes in the availability of drugs used for lethal injections since the last government-ordered execution in 2003.

    Pharmaceutical companies have prevented the use of their drugs for execution, which has resulted in both the federal and state governments using different drugs or combinations of drugs to carry out capital punishment sentences. 

    These “cocktails” have resulted in executions where the prisoners appeared to suffer physical pain. The family of a death row inmate in Ohio sued the state’s director of corrections in 2014 after the prisoner appeared to struggle for air for nearly 25 minutes after receiving a mixture of benzodiazepine and hydromorphone, an opioid, while the 2018 execution of Nebraska inmate Carey Dean Moore, which used a mixture of fentanyl, potassium chloride and a paralytic, was reported by witnesses to take longer than previous executions.

    Ohio Legislator Suggests Using Fentanyl Seized By Police

    Despite these incidents, some lawmakers have called for fentanyl to be used in executions, including Ohio Republican legislator Scott Wiggam, who in August 2019 suggested the use of fentanyl seized by police in criminal cases for lethal injections.

    The state’s governor, Mike DeWine, dismissed the idea on the grounds that it would not pass “constitutional muster.”

    Robert Dunham, director of the Washington-based non-profit group the Death Penalty Information Center, said that he wasn’t surprised that the government would consider fentanyl for lethal injections, given its prevalence in the national news. 

    “But there is something fundamentally wrong about using a drug implicated in illegal activities as your method of executing prisoners,” he added.

    View the original article at thefix.com

  • In Australia, Frustrations Rise As Opioid Crisis Takes Hold

    In Australia, Frustrations Rise As Opioid Crisis Takes Hold

    “We’re living in a country that is oblivious to what’s going on.”

    Jasmin Raggan watched as her brother developed addiction and died of an opioid overdose, and her brother-in-law became addicted to OxyContin.

    Raggan, who lives in Australia, began researching opioids and the toll they were having in the United States, and realized that no one was talking about the real dangers headed Down Under. 

    “If only Australia could understand how quickly this can get out of hand. We’re not immune to it,” Raggan told The Associated Press. “I was screaming from the mountaintops after Jon died and I’d started doing my research. And it was like I’m screaming and nobody wants to hear me.”

    Lack of Awareness

    In Australia, both opioid prescription rates and overdose rates have risen steeply in recent years, but the increase has been largely overlooked. Even Sydney pain specialist Dr. Jennifer Stevens, didn’t realize how bad it was until she tallied up data from her hospital and saw that prescriptions for one specific opioid had risen 500% in eight years. More alarmingly, 1 in 10 patients was still on opioids three months after a procedure, increasing their risk for dependence and addiction. 

    “We were just pumping this stuff out into our local community, thinking that that had no consequences, and now, of course, we realize that it does have huge consequences,” Stevens said. 

    Pharmaceutical Companies’ Aggressive Marketing

    Drug companies are in part to blame for the rise, pushing the same aggressive sales tactics that now have them in trouble in America. It’s illegal for pharmaceutical companies to advertise directly to consumers in Australia, but companies like Mundipharma, the international affiliate of Purdue, have skirted around the laws with “awareness campaigns” that don’t mention specific drugs by name, but still direct consumers to websites with information on the drugs. 

    Stevens recalls Mundipharma marketing aggressively to doctors at her hospital. 

    “Marketing, on the whole, is very clever and very successful — otherwise it wouldn’t be done,” she said. 

    At the same time, the country lacks programs like prescription monitoring databases, which can help prevent overdoses and “doctor shopping.”

    In 2012, Australian Matthew Tonkin came home after serving in Afghanistan alongside American troops. He had been injured, and was also dealing with PTSD after witnessing the death of his best friend. He proudly showed his father David Tonkin the Americans’ solution: a strip of powerful opioid pills. 

    Davis Tonkin recalls his son saying to him “Look, Dad, the Yanks really know how to look after you.”

    At home, Matthew started doctor shopping for powerful opioids, until he died of an overdose in 2014. 

    Not Learning from America’s Mistakes

    Sue Fisher, whose son died of an overdose in 2010, said it’s frustrating to see the lack of policies, especially since Australia can look to the US to see what solutions have worked to help stem overdose deaths — like prescription monitoring and Narcan programs.

    “We’re living in a country that is oblivious to what’s going on,” Fisher said. “Why aren’t we learning from America’s mistakes? Why don’t we learn?”

    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

  • Connecticut EMTs Team Up With Poison Control To Track Overdoses

    Connecticut EMTs Team Up With Poison Control To Track Overdoses

    In May, the system helped detectives identify risk factors in a spate of 11 overdoses in two days.

    In Connecticut, emergency medical personnel are teaming up with poison control to track every overdose in the state in hopes of combatting overdose deaths. 

    The idea started with Peter Canning, who has been a paramedic since 1995. When he first started working in emergency response, he witnessed the occasional overdose. 

    “I responded to opioid overdoses, but I didn’t think anymore of them than I did the shootings or car accidents. It was part of the job,” he told WSHU. 

    Where It Began

    However, five years ago he started responding to more overdoses than any other kind of emergency. He started collecting information that he hoped would help him understand the trend. 

    “I started just writing down the overdoses I did, how old the people were, their gender, how they got started, and then the heroin bags,” he said. “I would write whether or not I saw heroin bags there. And I thought if I was keeping this information, which is really interesting, what if everybody was keeping this information?”

    A few years later Canning discussed his project with the director of the state’s poison control center, who thought his department could be a partner for Canning. 

    “He said, ‘You know poison control, we have operators there 24/7 and this is right up our alley!’” Canning recalled. 

    A pilot program in Hartford showed that the program had great promise, so this year Connecticut’s Department of Public Health secured federal funding to take the program statewide. 

    Tracking Outcomes

    Now, EMTs are required to report information about all suspected overdoses to poison control as part of the Statewide Opioid Reporting Directive (SWORD). The calls take about three minutes as the poison control specialist asks the EMTs 10 questions. After the overdose, the information can be used to track outcomes as someone goes to the hospital. 

    “So when they get transported to an emergency room we follow up for data regarding that to help trend it,” said Lori Salinger, a poison control specialist in the state. 

    In May, the system helped Canning and other detectives identify risk factors in a spate of 11 overdoses in two days. He was able to alert Mark Jenkins of the Greater Hartford Harm Reduction Coalition, who sent out teams with testing kits to help users detect heroin with fentanyl. 

    Jenkins said that initiatives like this can save lives. 

    “When we get information like this it’s a heads up to say watch out for this particular bag, make sure you don’t use alone,” Jenkins said. “If you do use together, don’t use at the same time.”

    View the original article at thefix.com

  • Device To Automatically Stop Opioid Overdoses In Development

    Device To Automatically Stop Opioid Overdoses In Development

    The groundbreaking device would deliver naloxone throughout the body in the event of an overdose.

    Researchers at Purdue University are working on developing a device that can be injected under a person’s skin that will automatically deploy in the event of an overdose, delivering the opioid-blocking drug, naloxone, into their system.

    With this in place, a person’s life could be saved even if they overdose while alone, without anyone to call 911 or administer Narcan—the common naloxone-based nasal spray.

    According to Fast Company, the device holding the drug is being designed to be as simple as possible. The tiny capsule is plugged at one end with material that will melt when the metal touching it becomes hot, releasing the drug. This will require an additional device, about the size of a golf ball, that is worn on the arm just outside of the capsule and monitors the wearer’s vitals. 

    How It Will Work

    During an opioid overdose, the victim’s heart rate and breathing slow to dangerous levels. If this happens, the device would activate a strong magnetic field, heating up the metal touching the plug. The naloxone released into the body will block the opioid receptors in the brain, stopping the drug’s ability to affect the body, and saving the victim’s life.

    “The antidote is always going to be with you,” said Assistant Professor of Biomedical Engineering at Purdue, Hyowon “Hugh” Lee.

    This device is still in the development stage, and it will be at least a few years before it is made available to the public. It needs to be thoroughly tested and gain FDA approval. “If you assume the device is working and it doesn’t, it would be truly problematic,” Lee pointed out.

    However, Lee also believes that the device could be further improved and developed into something like a smartwatch, with the capsule injected in the wrist. It could also be used to administer other medications to people with life-threatening conditions such as severe allergies. Someone suffering a dangerous allergic reaction could have the device automatically administer a dose of epinephrine, eliminating the need for these individuals to carry EpiPens or rely on others to inject them.

    “People with allergies need epinephrine right away. This setup might remove the need for an epi pen,” Lee said.

    More High-Tech Solutions

    Purdue isn’t the only institution responding to the opioid crisis with high-tech solutions. A contractor from Boston recently began deploying a system he developed to create overdose-resistant bathrooms. John King’s invention can alert employees of convenience stores, coffee shops, and other establishments with single-use bathrooms if a person has fallen to the floor and hasn’t stood up for several seconds.

    This system has already allowed employees to respond quickly to overdose cases, ensuring that naloxone can be administered soon enough to save lives.

    View the original article at thefix.com

  • Overdose Deaths Dip For The First Time In Decades

    Overdose Deaths Dip For The First Time In Decades

    The national overdose toll declined by about 3,000 between 2017 and 2018.

    Overdose death rates were slightly lower in 2018 than in 2017, the first time in decades that the overdose rate has declined.

    Despite that positive news brought about by preliminary data released by the Centers for Disease Control and Prevention (CDC) experts emphasized that with more than 69,000 Americans dying of an overdose in 2018 the nation is still in an epidemic.

    Robert N. Anderson, chief of the Mortality Statistics Branch at the CDC’s National Center for Health Statistics told The American Journal of Managed Care that the national overdose toll was reduced by about 3,000 people between 2017 and 2018. That could indicate that “we may have reached a peak in the epidemic,” he said.

    Still, he cautioned, the overdose death rate remains extremely high.

    “That said, the number of deaths for 2018 is still predicted to be nearly 70,000. That is a lot of people dying much too young. Even if the decline holds once the data are final, it is too soon to declare victory,” Anderson said.

    The data is based on preliminary models and predictions of what the final data will look like. Anderson said that the models are usually accurate, however, so the trend will likely be confirmed.

    Increased access to the opioid-overdose reversal drug naloxone may have helped save lives and contributed to the lowered death toll. However, that means many people are still using drugs, and Anderson emphasized that the drug epidemic needs ongoing monitoring and interventions.

    “It is really impossible to predict what will happen for the next few years,” he said. “This may just be a lull in the epidemic or some new deadly drug will be introduced that exacerbates the situation.”

    For example, meth use is becoming more popular among opioid users. While there are established medication-assisted treatment options for opioid use disorder, there are fewer options available for people who abuse methamphetamines.

    Although the national overdose rate declined, that was not universal among states. Some states, like Ohio, saw a significant decrease in overdose rates. Others, including Missouri and New Jersey, had more overdoses in 2018 than they did in 2017.

    In general, the CDC data showed that overdoses increased in the west and southwest, and decreased in the east.

    The overdose rate national remains very high compared with previous decades. In 1999 overdoses accounted for 6.1 deaths per 100,000. In 2018, they made up 20.7 deaths per 100,000.

    View the original article at thefix.com

  • Ohio County Overdose Wave Leaves At Least 3 Dead

    Ohio County Overdose Wave Leaves At Least 3 Dead

    Officials were alarmed when 23 emergency calls involving suspected overdose cases were received in the county in under 24 hours.

    Police officers in Hamilton County reported an unusual spike in overdose cases last weekend that was likely due to a batch of methamphetamine mixed with fentanyl that was sold as ecstasy pills.

    As many as 10 of the overdose cases resulted in death, though the coroner’s office has yet to confirm if overdose was the root cause in all the area deaths that occurred since June 19.

    Regardless, officials were alarmed when 23 emergency calls involving suspected overdose cases were received in the county in under 24 hours. Overall, they fielded 54 calls from early Friday to early Monday.

    On Saturday, the Hamilton County Heroin Coalition sent out an alert to the local populace due to the high number of overdoses. Newtown Police Chief Tom Synan, a co-chair of the Heroin Coalition, believes that the root cause is the highly potent opioid fentanyl.

    “Late in May, Tom Fallon, investigative commander for the heroin task force, said investigators learned that a drug supplier was mixing fentanyl with meth and then adding red, yellow or blue food coloring and pressing the mixture into a pill form to be sold as ecstasy,” reports The Cincinnati Enquirer. “The task force has also found other fake pressed-pills sold on the street as pain pills in recent months that were tainted with fentanyl.”

    Fallon also noted that there’s been a similar problem with crack cocaine being mixed with fentanyl. This has been an increasing issue across the country as drug sellers learn that adding small amounts of the opioid to a batch of drugs can seriously enhance the effects.

    However, since fentanyl is up to 100 times more potent than morphine, just a tiny bit too much can result in a dangerous overdose. Mixing drugs also always increases that risk.

    This problem has led experts to name fentanyl as the key driver in a “third wave” of the U.S. opioid epidemic. A recent report by the Centers for Disease Control and Prevention (CDC) found that deaths involving the drug have doubled every year since 2013.

    Ohio has seen a surge in these kinds of overdoses since April, particularly on the weekends. Because individuals who are addicted to opioids generally can’t wait until the weekend, this tells authorities like Synan that many of the victims are not addicted to this type of drug.

    In fact, those who have not built up a tolerance to opioids are especially vulnerable to fatal overdose if they take fentanyl, which is why fentanyl is only prescribed to individuals who are already opioid-tolerant.

    View the original article at thefix.com

  • Massachusetts Construction Companies Stop Work To Protest Fatal Overdoses

    Massachusetts Construction Companies Stop Work To Protest Fatal Overdoses

    Between 2011 and 2015, construction workers accounted for around 25% of all fatal overdoses among workers in Massachusetts. 

    Construction companies and labor unions across Massachusetts held work stoppages on June 5th to protest rising numbers of fatal opioid overdoses among their members.

    A recent state Department of Public Health report found that construction workers make up nearly a quarter of all opioid-related deaths in the Bay State, and are six times more likely to incur a fatal overdose than other employees. That information spurred labor and trade groups to draw attention to the problem through the work stoppage, and to highlight efforts within their own industry to assist their workers through support programs and extended health care coverage.

    As Boston’s NPR news station reported, tackling the situation is not only a health imperative for Massachusetts, but also a financial necessity: their coverage cited statistics from the Massachusetts Taxpayers Foundation that showed that the state lost more than $15 billion in productivity, health care costs and other expenses due to the opioid epidemic in 2017 alone.

    To that end, trade groups like the Associated General Contractors of Massachusetts are prioritizing safety and health measures for its members. Their opioid safety program, developed in conjunction with Boston Medical Center’s Grayken Center for Addiction, helps employers recognize the signs of drug dependency among workers, provides information on the proper way to respond to an overdose and links them to outside resources for dependency treatment.

    Other organizations are following suit: the New England Carpenters Benefits Funds began covering up to 90 days of substance abuse treatment in a residential facility for union members, and the Massachusetts Laborers Benefit Funds is connecting workers with treatment and other dependency services.

    According to representatives from both groups, 25 workers have been placed in treatment through the Carpenters Benefits Fund, while the Laborers Benefit Fund has assisted more than 130 members and their families.

    Robert Petrucelli, CEO of the Associated General Contractors of Massachusetts, spoke about the need for such programs at one of 50 work sites across the state that participated in the stoppage on June 5th. After reviewing the Department of Public Health report, he said, “It was clear we had to do something. No one talks about this, but it permeates our industry.”

    As WBUR‘s coverage noted, the problem of addiction in the construction business is not unique to Massachusetts. It cited a feature by the Cleveland Plain Dealer from 2017 that found that construction workers in Ohio were seven times more likely to die of an opioid overdose between 2010 and 2016 than workers in any other line of work. 

    View the original article at thefix.com

  • Community Of Responders Campaign Aims To End Overdose Deaths

    Community Of Responders Campaign Aims To End Overdose Deaths

    The program’s goal is for naloxone to be deployed within six minutes of an overdose starting, drastically increasing the chances of the victims’ survival.

    A new campaign growing out of Green, Ohio aims to turn community members into lifesaving first responders who are ready to act in case of an opioid overdose. Combining the efforts of Cover2 Resources, NaloxBox, NaloxoFind, Project DAWN and ODMAP, the Community of First Responders (CFR) is the first of its kind in the U.S.

    CFR was organized by Greg McNeil, founder of Cover2 Resources. McNeil lost his son, Sam, to a heroin overdose and has since dedicated his life to combating the epidemic of opioid overdose in the country.

    His latest endeavor began early this year when he met one of the creators of NaloxBox—wall-mounted boxes similar to those containing AEDs but that contain naloxone, an opioid overdose reversal drug. These boxes can be installed anywhere, including public buildings and businesses.

    McNeil was then connected to the founder of NaloxoFind, an app that allows anyone to find naloxone locations in the area. Combining these two just made sense, but McNeil’s primary concern was that ambulances often take too long to reach individuals suffering an overdose. 

    “When a 911 call comes in about an overdose, first responders have six minutes to respond before there is brain damage,” McNeil explained to The Fix. “In 10 minutes, they’re gone.”

    For maximum life-saving potential, McNeil came up with the idea to recruit members of the public to keep naloxone on their person and respond to overdose cases after being alerted via text message when one is reported nearby. The hope is that this program will allow naloxone to be deployed within six minutes of an overdose starting, drastically increasing the chances of the victims’ survival. 

    Green, Ohio will be the testing ground for this program. McNeil had worked previously with Green Mayor Gerard Neugebauer, who was described as being very supportive of the CFR program. NaloxBoxes have already been approved for parts of the city that are most prone to seeing overdose cases. 

    “The installations will take place over the next two weeks in five hotels along the I-77 corridor covering all three interchanges in the City of Green and at Akron Canton Airport,” said McNeil. “To the best of our knowledge, these are the first NaloxBox installations in hotels and airports in the country.”

    The official launch date for CFR is June 20, when McNeil and other leaders in the fight against the opioid crisis will host a community event presenting the new program, holding a live demonstration, and treating guests to a to-be-announced musical guest. 

    So far, the Green community has been overwhelmingly supportive of CFR even before its launch—and McNeil has set ambitious goals for its future.

    “Our immediate goal is to complete installation and training for all participating hotel and airport personnel by our event launch. After the official launch of the CFR program, our goal will be to double the number of participating businesses by the end of the year.”

    Check out the Cover2 Resources podcast for more information.

    View the original article at thefix.com

  • Improvised Nasal Naloxone Devices Less Effective Than Narcan, Study Finds

    Improvised Nasal Naloxone Devices Less Effective Than Narcan, Study Finds

    The FDA-approved Narcan nasal spray delivers more of the antidote into the blood than the improvised naloxone device

    A recent study conducted by the National Institute on Drug Abuse (NIDA) found that improvised nasal naloxone devices (INNDs) are significantly less effective at administering high enough doses of the overdose-reversing medication than the FDA-approved Narcan.

    Naloxone is the drug that can reverse opioid overdoses that kill tens of thousands of people in the U.S. every year. Efforts to make it available, particularly in the form of Narcan, are a part of the national fight against the deadly opioid epidemic.

    INNDs, according to Psych Congress, “consisting of a prefilled naloxone syringe attached to a mucosal atomization device” and have been used by first responders and others to successfully reverse overdoses for 25 years.

    However, the study, first reported on by NIDA on March 15, found that Narcan does a better job of delivering high enough doses of naloxone to be maximally effective. 

    “Scientists found that the approved naloxone devices deliver higher blood levels of naloxone than the improvised nasal devices,” the report reads. “In fact, levels in the plasma concentration of naloxone are considerably lower when improvised devices are used. The FDA-approved 4-mg dose nasal spray produced the highest blood level of naloxone of all the products tested.”

    Speed and plasma concentration of naloxone are especially important as overdoses of the highly potent synthetic opioid fentanyl have skyrocketed in the past few years. Data from the Centers for Disease Control and Prevention (CDC) found that fentanyl-related overdose deaths doubled each year from 2013 to 2016.

    The fastest way to administer naloxone to counter an opioid overdose is with an IV, but first responders might not have access to the equipment they need to give a naloxone IV when time is of the essence.

    Narcan is a simple nasal spray that does not require assembly and can be administered in one nostril while the patient is lying on their back. Members of the public, including people with opioid use disorders, can be easily trained to administer Narcan, and it is available to anyone without a prescription. Health insurance may even cover some or all of the cost.

    “Using the FDA-approved nasal Narcan spray is a great choice for average consumers, who will likely keep only one or two devices on hand,” said NIDA’s Dr. Philip A. Krieter. “It is smaller, easier to use, and doesn’t require much if any training to use properly. The Narcan spray is a ready-to-use device; the improvised device needs assembly, and lay persons may not able to use it correctly in a panic situation.”

    However, according to TIME, a Narcan kit with two doses costs around $135 without insurance, which may be prohibitively expensive for some.

    Another option is the auto-injection device Ezvio, which has also been approved by the FDA. According to Dr. Krieter, a generic version of Ezvio will become available “later this year for some purchasers.”

    View the original article at thefix.com