Tag: opioid-related overdoses

Overdose Death Rates Skyrocket Among Middle-Aged Women

Overdose death rates among women aged 30 to 64 years rose by 260% between 1999 and 2017.

A recent news story from KNXV-TV adds a human perspective to recent statistics from the Centers for Disease Control and Prevention (CDC) about a demographic on the rise for national drug overdose deaths.

The Phoenix, Arizona-based ABC affiliate profiled several area women who developed dependencies on drugs or alcohol between the ages of 40 and 64.

Addiction treatment centers in the Phoenix Metropolitan Area reported an increase in admission for women in that age group, which coincides with the CDC’s report that overdose death rates among women aged 30 to 64 years rose by 260% between 1999 and 2017.

To determine this statistic, the CDC reported in January 2019 that it had examined overdose death rates for this age group during the aforementioned time period, and categorized these fatalities according to drug subcategories, including antidepressants, cocaine, heroin, prescription opioids and synthetic opioids (except methadone).

From this data, they determined that the unadjusted drug overdose death rate increased from 6.7 deaths per 100,000 population (or 4,314 total drug overdose deaths) in 1999 to 24.3 (or 18,110 deaths) in 2017.

The rate of overdose deaths involving any opioid increased 492% during this time period, while nearly all subcategories of drugs saw increases in deaths, save for cocaine, which decreased significantly between 2006 and 2009. The highest death rate increases involved synthetic opioids (1,643%), heroin (915%) and benzodiazepines (830%).

Those figures reflect the experiences of the women profiled in the KNXV piece. Pamela Aguilu became dependent on prescription opioids after undergoing spinal surgeries. “I would say that I got addicted right away,” she said. “I was taking massive amounts of oxycodone.”

Aguilu expressed gratitude that she had not become one of the overdose statistics cited by the CDC. But she certainly came close. After confronting a police officer who had been sent by her landlord, Aguilu said, “The last thing I remember is the ER physician saying we need the Narcan now, and then I was out. I was out for two days.”

KNXV also cited Cheryl Hawley, a clinical director at the Valley Hope alcohol and drug treatment center, who said that women between 30 and 64 often put their roles as mother, wife and homemaker ahead of their own health, and then refuse to share their struggles with their families.

Aguilu agrees. “You hit middle age, and you think you’ve got it all figured out,” she said. “We live in a society where we take pills for everything.”

View the original article at thefix.com

31 May 2019
Doctor-Turned-Sober Home Owner Describes Descent Into Addiction

The former small town West Virginia doctor described how his own addiction and poor prescribing habits changed his life forever.

Dr. Lou Ortenzio popped his first opioid pain pills in 1988, long before most Americans knew what an opioid was.

Over the next 15 years, the small town doctor in West Virginia saw more and more patients asking for powerful painkillers, while he himself became more addicted.

Whereas older generations in Appalachia had lived with ailments and pain, never wanting to seem “complainy,” in the 1990s Ortenzio began to see a shift in patient perspective.

“The new generation that came in the 1980s, those kids began to have the expectation that life should be pain-free,” he told The Atlantic. “If you went to your physician and you didn’t come away with a prescription, you did not have a successful visit.”

Between 1995 and 2005 the number of pharmaceutical sales reps nearly tripled and Ortenzio began to have more and more sales reps knocking on his door pushing the latest painkillers.

“It went from a dozen [salesmen] a week to a dozen a day,” he said. “If you wrote a lot of scrips, you were high on their call list. You would be marketed to several times a day by the same company with different reps.”

Throughout the late 90s and early 2000s Ortenzio found himself writing more and more prescriptions. As he became known as a doctor who would easily prescribe pills, more patients sought him out.

At the same time he was taking more pills, even asking a friend to fill prescriptions for him. When he tried to quit he would experience symptoms of withdrawal, which gave him understanding for the predicament that many of his patients found themselves in.

He said, “I couldn’t be away from my supply.”

In 2004, after his wife divorced him, Ortenzio got sober following a religious experience. Other doctors turned to The Physician Health Program, run by the West Virginia State Medical Association, which has helped more than 230 doctors in West Virginia get sober.

Yet Ortenzio’s sobriety wasn’t the end of opioids ruining his life. Soon after he stopped using, federal agents raided his office, and in 2006 Ortenzio pleaded guilty to fraudulent prescribing. He paid $200,000 in restitution, lost his medical license, and had to complete 1,000 hours of community service while under supervised release for five years.

Once a promising physician, Ortenzio was 53 and delivering pizzas, but he was at peace. After years of volunteering with a recovery center, Ortenzio opened a sober living home, which now serves six men, with plans to expand by opening another center for women.

Although he will never be able to practice medicine again, Ortenzio is happy where he is today, sustaining his own recovery and helping other people get sober.

“I made pizza deliveries where I used to make house calls,” he said. “I delivered pizzas to people who were former patients. They felt very uncomfortable, felt sorry for me. It didn’t bother me. I was in a much better place.”

View the original article at thefix.com

30 April 2019
Virginia Eases Suboxone-Prescribing Restrictions

The policy change will increase access to the medication and reduce delays in treatment.

Prior authorization will no longer be required for Virginia physicians to prescribe a form of the opioid addiction medication, Suboxone, to patients.

The state’s Department of Medical Assistance Services (DMAS), which oversees the Virginia Medicaid program, has removed the authorization requirement for Suboxone film (a film applied to the tongue). Suboxone is a brand of buprenorphine that assists individuals in reducing or quitting their dependencies on heroin or prescription opioids.

Acting chief medical officer of the DMAS, Dr. Chethan Bachireddy, said in a press release that his agency has “a responsibility to understand and to meet the needs of our members and the providers who treat them.”

Before the policy change, Virginia physicians were required to obtain prior authorization from DMAS or one of its contracted health plans to prescribe Suboxone film.

According to the Virginia Mercury, the change will increase access to the medication and reduce delays in treatment.

The Virginia Mercury also cited a recent study by Virginia Commonwealth University that found that the expansion of Medicaid—approved by voters in 2018—will provide as many as 60,000 uninsured Virginians with access to treatment services for dependency issues, including 18,000 with opioid dependency.

In all, 400,000 Virginia residents are expected to gain access to coverage in 2019.

Data culled from the office of the state’s chief medical examiner in January 2019 found that 1,229 Old Dominion residents died as a result of opioid-related overdose in 2018—the same number of fatalities that occurred in 2017. However, the total number of 2018 fatalities will not be available until this spring.

The revision of the authorization requirement applies only to Suboxone film, but not to other forms of buprenorphine that are not on the Medicaid preferred drugs list.

But buprenorphine, often in conjunction with counseling, has proven to be effective in lowering death rates among those who have suffered a previous overdose. The DMAS press release cited a study that suggested that among overdose survivors, there was a 40% decrease in the death rate of those who used Suboxone, compared to those who did not.

Bachireddy described the revision as one of several “effective, proactive strategies that are putting Virginia at the forefront in the fight against the opioid crisis.”

View the original article at thefix.com

22 March 2019
Link Between Suicide And Opioid Use Examined

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

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

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

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

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

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

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

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

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

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

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

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

View the original article at thefix.com

12 September 2018
Tougher Laws, Stricter Prescription Limits For Opioids In Tennessee

The state’s TN Together opioid plan is a multi-faceted initiative with three areas of focus: prevention, treatment, and law enforcement.

In Tennessee, Governor Bill Haslam has put together a new plan to fight the opioid epidemic, called TN Together.

New laws just passed in Tennessee include policies from Governor Haslam’s plan, intended to both decrease access to opioids and to incentivize treatment for those suffering from dependence, according to WSMV News.

Beginning July 1, the laws include Henry’s Law, created by the family of Henry Granju, a teenage boy who died in east Tennessee from an opioid overdose.

Henry’s Law requires that a person convicted of second-degree murder resulting from unlawful distribution of Schedule I or II drugs where the victim is a minor be punished from within one range higher than they would normally be charged. Henry’s Law creates tougher laws for people convicted of second-degree murder by distributing drugs to minors.

Henry’s mother, Katie Granju, told The Fix, “I’m a harm reduction supporter who also believes that drug-induced homicide prosecutions are vital in addressing the opioid epidemic.”

Katie Granju’s son Henry was being supplied opioids at age 18 by adult dealers before his fatal overdose.

Tennessee will begin limiting a first opioid prescription to a five-day supply with daily dosage limits of 40 MME.

Exceptions will be made for major surgical procedures, cancer and hospice treatment, as well as treatment in certain licensed facilities.

The TN Together plan also intends to provide every Tennessee state trooper with naloxone for the emergency treatment of opioid overdose.

The Tennessee Municipal League states that the TN Together plan is a multi-faceted initiative with three areas of focus: prevention, treatment, and law enforcement. Haslam said the initiative will include legislation, executive actions, and task forces.

The $37.5 billion Tennessee state budget sets aside more than $16 million to fight the opioid epidemic through additional services.

On June 29, Haslam tweeted about the bill, “My final bill signing ceremony today was an important one: the @TNTogether legislation is critical to fighting the opioid crisis in Tennessee. Thank you to the many partners across the state who will work together through this initiative to address opioid abuse.”

According to The TN Municipal League, the number of opioid-related overdose deaths in the U.S. has quadrupled since 1999; Tennessee remains one of the top 15 of all states in drug overdose deaths.

Tennesseans are more likely to die of an opioid-related overdose than in a vehicle crash. Three people die of overdose in Tennessee each day.

“It is an epidemic. It has reached this state,” Brian Sullivan with Addiction Campuses in Nashville told WSMN News. “We believe this is a step in the right direction.”

View the original article at thefix.com

6 July 2018