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Tag: opioids

  • Opioid Crisis Has Peaked, Former Cleveland Clinic CEO Suggests

    Opioid Crisis Has Peaked, Former Cleveland Clinic CEO Suggests

    The doctor says that while opioid prescribing is down, synthetic opioids are now driving the opioid epidemic.  

    The former CEO of the Cleveland Clinic said that the opioid epidemic has peaked now that more healthcare providers and laypeople are aware of the dangers of opioid painkillers.

    “I think we’ve peaked,” Dr. Toby Cosgrove said on CNBC’s Squawk Box. “I think we’re starting to see the understanding of the problem, and getting to the point where people are certainly prescribing fewer drugs and people are recognizing how serious this is.”

    However, he said that synthetic opioids are continuing to drive opioid deaths. 

    “The other issue is that drugs are now being laced with fentanyl and carfentanil, which are highly potent,” said Cosgrove, a cardiac surgeon who led the Cleveland Clinic hospital for 13 years before stepping down in 2017.

    “Carfentanil is 10,000 times as potent as morphine. We just had an outbreak of deaths in Ohio from drugs being laced with very potent carfentanil and fentanyl,” Cosgrove noted.

    Cosgrove now works as an executive advisor to Google Cloud Healthcare and Life Sciences team, and is a proponent for healthcare reform. During his CNBC appearance he talked about ways to reduce healthcare costs.

    He noted that while the United States has the highest healthcare costs in the world, the country is about average in the amount spent on healthcare and social programs combined. He said that this shows that investing in social programs can help alleviate the burden of healthcare costs. 

    “Social programs, frankly, are driving down the healthcare costs” in other countries, he said. 

    Although there has been some leveling of opioid overdose rates in certain areas, the national overdose rate climbed in many places between 2016 and 2017. In fact, 45 states saw opioid overdoses increase 30% between July 2016 and September 2017, according to federal data.

    During that time period, the Midwest—including the area served by the Cleveland Clinic—saw opioid overdose rates increase 70%, driven largely by an influx of synthetic opioids. In fact, fentanyl is a factor in nearly half of opioid-related deaths. 

    As Cosgrove suggested, opioid prescribing is down. However, this isn’t necessarily linked to a reduction in overdose deaths. In fact, West Virginia decreased the amount of opioids prescribed by 12% between 2016 and 2017, but still saw opioid-related overdose deaths rise. Because of this, some medical experts warn that the opioid crisis could continue to get worse before improving. 

    “I think we have to realize that we’re on a trajectory that may get a lot worse before it gets better,” said Donald S. Burke, dean of the University of Pittsburgh’s Graduate School of Public Health. 

    View the original article at thefix.com

  • New York Sues Purdue Pharma Over Opioid Marketing

    New York Sues Purdue Pharma Over Opioid Marketing

    New York plans to work with other states that are investigating opioid manufacturers and distributors in the US.

    This week, New York became the 27th state to sue Purdue Pharma, a producer of OxyContin, for alleged fraud and deception in its marketing of opioids.

    The Wall Street Journal reported that Purdue is the only defendant listed in the lawsuit, driven by the administration under Governor Andrew Cuomo and New York Attorney General Barbara Underwood.

    The complaint was filed in Suffolk County Supreme Court and charged that a community flooded with opioids has been devastated while Purdue has increased profits and prescriptions.

    The suit charges that as of 2016, over 75% of New York’s opioid overdose deaths were caused by painkillers which include Purdue’s product, OxyContin.

    Governor Cuomo was quoted in Insurance Journal as saying, “The opioid epidemic was manufactured by unscrupulous distributors who developed a $400 billion industry pumping human misery into our communities. This lawsuit sends a clear message (to those) who mislead the public to increase their profit margins that we will hold you accountable.”

    Purdue released a response which called New York’s allegations false, while citing that the company also shares the state’s concerns about the opioid crisis.  

    Purdue noted that the U.S. Food and Drug Administration (FDA) “continues to approve” of scientific and medical information it provides to physicians.

    In the suit, New York is seeking civil fines to be levied against Purdue. The state asks to recoup profits the drug company has made and pay fines for what they allege in the Insurance Journal is “criminal nuisance.”

    In 2007, Purdue and three executives pleaded guilty to misbranding OxyContin. The company was charged with $634.5 million after a U.S. Department of Justice investigation.

    The New York lawsuit against Purdue is part of a trend; a number of U.S. states are suing opioid makers and distributors over opioid marketing.

    New York joined 26 other states, and Puerto Rico, in suing Purdue over their allegedly deceptive opioid marketing practices and the resulting health crisis.

    Cuomo released a statement published in the Wall Street Journal that the country is fed up with the practice of pharmaceutical companies purposefully creating addiction for the purpose of profit.

    Barbara Underwood in the Wall Street Journal said that the complaint is only New York’s first step toward holding pharmaceutical companies responsible. “Our work won’t stop with this lawsuit,” she said.

    New York plans to work with other states to investigate United States opioid manufacturers and distributors.

    View the original article at thefix.com

  • Planned Safe Injection Sites Put On Hold In Canada

    Planned Safe Injection Sites Put On Hold In Canada

    Advocates of safe injection sites called the Canadian health minister’s decision to halt the opening of the facilities “horrifying.”

    A trio of planned safe injection sites in Ontario, Canada have been put on hold while the province’s new health minister conducts a review to determine if such facilities “have merit.”

    Health Minister Christine Elliott said that she remains unconvinced that such sites are effective in reducing drug overdose deaths and the spread of HIV infection; she also cited concerns from neighboring businesses over security and biohazard refuse as core reasons for the review.

    Advocates of safe injection sites and harm reduction policies called the health minister’s decision “horrifying,” that runs contrary to the needs of individuals in the midst of Canada’s opioid epidemic.

    The CBC reported that in a letter sent on Friday, August 10, to health integration networks and health units in the province, Roselle Martino, assistant deputy minister of the population and public health division, said that the approval process for new safe injection sites in the cities of Toronto, Thunder Bay, and St. Catharines would be halted immediately.

    The sites would allow for supervised injection of opioid drugs, grant access to harm reduction support and allow users to safely dispose of needles and other paraphernalia.

    In the letter, Elliott wrote that she will be “reviewing the evidence and speaking to experts to ensure that any continuation of supervised consumption services and overdose prevention sites are going to introduce people into rehabilitation and ensure people struggling with addiction will get the help they need.”

    CTV News also noted that Elliott will address how local businesses have been impacted by existing sites. The network cited concerns by Mark Garner, a member of the Downtown Yonge Business Improvement Area (BIA) in Toronto, who said that his organization has found discarded needles in the area near the Works, the city’s first supervised injection site, which opened in November 2017.

    Garner stated to CTV that while his organization supports efforts to reduce drug overdoses, the businesses in the BIA have felt the need to increase security and allocate funding to clean up discarded needles, especially ones discarded in toilets which have caused plumbing issues.

    “This is the number one tourist destination in Canada,” he said. “How do we integrate that into the neighborhood, what resources are needed, and how do we make it safe for everybody?”

    But harm reduction advocates and health care professionals have expressed alarm at the province’s move, which some described as a decision motivated more by politics than any actual health concern.

    “It’s a complete disaster, and I do worry about people on the ground,” said Marilou Gagnon, an associate professor of nursing and president of the Harm Reduction Nurses Association. “The science is very clear that overdose prevention sites do work, and we’ve known this since the ’80s. [I’m] extremely concerned about a government going against science.”

    View the original article at thefix.com

  • Vets Believe That Some Pet Owners Injure Their Animals To Get Opioids

    Vets Believe That Some Pet Owners Injure Their Animals To Get Opioids

    A new study reveals that 13% of veterinarians believed a client had intentionally injured a pet or made them ill in order to be prescribed a drug.

    A small research study in Colorado had disturbing results: the study found that 13% of veterinarians believe that people are using their pets to obtain opioids—by making them appear to be injured, or by actually injuring the animal.

    Gizmodo interviewed the author of the study, Liliana Tenney, a public health researcher at the University of Colorado Anschutz Medical Campus. Tenney is concerned about the lack of training and education for veterinarians regarding their responsibilities in the opioid crisis.

    “In conversations with these doctors, they often ask: ‘Well, what do we do? We need to treat pets who are in pain but we also need to know how to identify and handle suspicious behavior,’” she said. “But there’s not a lot of resources or training right now to direct these veterinarians.”

    According to Gizmodo, almost three-quarters of vets reported that their veterinary medical school training on opioids was mediocre, poor, or non-existent. Sixty-four percent said that following veterinarian school, they had no further training on the issue.

    Newsweek reported that in the survey of 189 vets; 13% reported that they believed a client had intentionally injured a pet, made them ill, or made them appear unwell, in order to be prescribed a drug. Tramadol is the most common opioid stocked by veterinary practices.

    The emailed survey also revealed that 45% of the vets knew of someone at work or a client who was abusing opioids, and 12% said they knew of a staff member that was giving out opioids.

    Lee Newman, director of the Center for Health, Work & Environment at the Colorado School of Public Health, told Newsweek, “There were also reports of diversion of drugs within the veterinary practices. Doctors [of animals] can prescribe the full range of opioids that are prescribed and administered to humans.

    “In fact, veterinarians have the ability to prescribe, administer, carry, stock, and dispense narcotics in clinics, depending on the pain needs of their animal patients.”

    The survey results indicate that veterinarians have been dramatically undereducated about their role in drug monitoring. Sixty-two percent believed they had a role in preventing opioid abuse, and 40% were unsure if opioid abuse was an issue in their communities.

    To address this gap, Liliana Tenney, along with her team, has built an online education course for veterinary providers. Tenney and others are also working on building a better surveillance program within Colorado, where the survey was conducted.

    View the original article at thefix.com

  • Opioid Use Quadrupled Among Pregnant Women

    Opioid Use Quadrupled Among Pregnant Women

    The prevalence of opioid use disorder present at a hospital delivery rose from 1.5 per 1,000 deliveries in 1999 to 6.5 per 1,000 in 2014.

    Opioid use among pregnant women quadrupled between 1999 and 2014, rising alongside the rate at which opioid use disorder has increased in the general population, according to a new report. 

    “When something is so broad and affects all populations, we also see it reflected in the pregnant population,” Dr. Elizabeth E. Krans, an assistant professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at the University of Pittsburgh, told CNN Health.

    The Centers for Disease Control and Prevention (CDC) published its report on Friday (August 10). The CDC analysis found that nationally, the prevalence of opioid use disorder present at a hospital delivery rose from 1.5 per 1,000 deliveries in 1999 to 6.5 per 1,000 in 2014.

    However, in some states the problem was much more prevalent. In Vermont, for example, opioids are a factor in 48.6 out of every 1,000 deliveries. 

    Data was only available in 28 states, but indicated that opioid use in pregnant populations varies widely. Washington, D.C. had the lowest prevalence in 2014 at just 0.7 deliveries per 1,000, while Vermont had the highest.

    The increase in the prevalence of opioids was also uneven: California and Hawaii saw relatively small increases, while Maine, New Mexico, Vermont and West Virginia saw large spikes in the reported use of opioids among pregnant women. 

    State policies on drug use during pregnancy can affect reporting, since in 23 states and Washington, D.C., using drugs while pregnant is considered child abuse. This might prevent some women from being honest about their drug use. 

    “Data on the impact of these policies are scarce,” the authors wrote. 

    “Pregnancy is a really important time. Women are often worried that invested in their own health and the health of their baby, but they’re also fearful of judgment,” Krans said. 

    Women who are using opioids when they become pregnant are often told to go on medication-assisted treatment throughout their pregnancies, as that is the safest option for mother and baby. “We have effective treatments that are available during pregnancy, and we want to encourage women to seek early care and engage in treatment as soon as possible,” Krans said. 

    Left untreated, opioid use can lead to a variety of pregnancy complications and negative health effects for the child. 

    “Opioid use by pregnant women represents a significant public health concern given the association of opioid exposure and adverse maternal and neonatal outcomes, including preterm labor, stillbirth, neonatal abstinence syndrome, and maternal mortality,” the authors wrote. 

    View the original article at thefix.com

  • Lisa Marie Presley Discusses Past Addiction Struggles

    Lisa Marie Presley Discusses Past Addiction Struggles

    “I was not happy. The struggle and addiction for me started when I was 45 years old. It wasn’t like it was happening all my life.”

    Lisa Marie Presley, daughter of Elvis Presley, recently spoke on the Today show about her personal struggles with addiction.

    Presley spoke with Jenna Bush Hager at Graceland on the eve of the release of Where No One Stands Alone, a new compilation album of her father’s gospel songs. (She co-produced the album and sings a posthumous duet with her father on the title song.)

    Lisa Marie, who is now 50, said that her struggles with addiction began five years ago.

    “I was not happy,” she said. “And by the way, the struggle and addiction for me started when I was 45 years old. It wasn’t like it was happening all my life. I have a therapist and she was like, ‘You’re a miracle. I don’t know how you’re still alive.’”

    In a 2003 interview with Paper magazine, Lisa Marie credited Scientology for getting her clean after one last bender.

    “I was on a 72-hour bender,” she said. “Cocaine, sedatives, pot and drinking—all at the same time. I never got my hands on heroin, but it’s not like I wouldn’t have taken it. I just couldn’t be sober. I don’t know how I lived through it.”

    In 2016, Us Weekly reported that Presley checked into a high-end rehab for an addiction to painkillers.

    Along with her father’s iconic music career, Elvis was also legendary for his own struggles with addiction. Lisa Marie was nine years old when her father died of a heart attack on August 15, 1977 at the age of 42.

    Elvis’s death was a big shock at the time, and is still a strong cautionary tale against the excesses of fame and prescription drugs. Elvis had a personal doctor, Dr. George Nichopoulos, who came under fire for prescribing too many drugs to the singer, and after several medical board inquires his medical license was permanently suspended in 1995.

    According to Biography, the toxicology report from Elvis’s death showed he had high levels of Dilaudid, Quaaludes, Percodan, Demerol, and codeine in his system.

    Yet in the depths of her despair, Lisa Marie reached out to the spirit of her father for help. “I’m not perfect, my father wasn’t perfect, no one’s perfect,” she told Today. “It’s what you do with it after you learn and then you try to help others with it.”

    When Hager asked what she would ask her father, Lisa Marie said, “I would want to know he’s there. Yeah, it would be pretty much, ‘I could use your help right around now.’”

    View the original article at thefix.com

  • SAMHSA Voice Awards Honor Walter Ginter’s MARS™ Project

    SAMHSA Voice Awards Honor Walter Ginter’s MARS™ Project

    Many people on MAT feel unwelcome at meetings, and this sense of alienation and rejection often leads to relapse. That’s where MARS™ comes in. We want people on MAT to be embraced and accepted in recovery.

    Held at Royce Hall on the UCLA campus in Westwood, the 13th annual SAMHSA (Substance Abuse and Mental Health Administration) Voice Awards recognized an essential figure in the national battle against the opioid epidemic. As the founder of the Medicated Assisted Recovery Support (MARS™) Project, Walter Ginter was honored with a Special Recognition Award for his efforts in combating the opioid epidemic and helping people who use Medicated-Assisted Treatment (MAT) stick to the path of recovery. In the greater recovery community– ranging from treatment centers across the country to 12-step groups—many people have a negative view of MAT which has led to a lack of support for people trying to overcome opioid addiction. 

    SAMHSA has been at the helm of national efforts to destigmatize the medications typically used in MAT such as buprenorphine, methadone, and naltrexone. Beyond supporting physicians and researchers, SAMHSA has tried to reduce the negativity associated with traditional perspectives on opioid recovery. According to many loud voices in Narcotics Anonymous (NA), if a person is on medication that has been prescribed to help them overcome opioid withdrawal symptoms or to refrain from using heroin or other illicit opioids, then they are not really clean. In contrast to this judgmental perspective, the SAMHSA website states: “Medicated-Assisted Treatment (MAT) is the use of FDA- approved medications, in combination with counseling and behavioral therapies, to provide a ‘whole-patient’ approach to the treatment of substance use disorders.”

    Indeed, a “whole-patient” approach is what is needed to stem the tide of what has become the greatest drug epidemic in U.S. history. With the introduction of fentanyl and other powerful prescription narcotics to the illegal drug trade, the stakes are higher than ever before. According to the National Institute on Drug Abuse, “Every day, more than 115 people in the United States die after overdosing on opioids.”

    Given such a devastating statistic, Arne W. Owens hopes the SAMHSA Voice Awards can raise awareness by bringing the recovery community together with the entertainment industry. As the Principal Deputy Assistant Secretary, Owens was the highest-ranking member of SAMHSA at the Voice Awards Show on August 8, 2018. Asked by The Fix how the Voice Awards can make an impact on the opioid epidemic, Owens said, “We hope to incentivize more positive portrayals in film and television of treatment and recovery for substance use disorders. We believe hearing positive stories about treatment and recovery helps to inspire others, shifting negative attitudes. For example, it would be good to see writers and directors positively represent MAT in film and television. Beyond raising awareness, such representation would help to reduce stigma.”

    Walter Ginter is an ideal example of someone who has dedicated his life to reducing stigma and raising positive awareness about MAT. Dedicated to improving the recovery community, Ginter has been a board member of both the National Alliance for Medication Assisted Treatment and Faces & Voices of Recovery. In collaboration with the New York Division of Substance Abuse, Yeshiva University and the National Alliance for Medication Assisted (NAMA) Recovery, Walter Ginter became the founding Project Director of the Medication Assisted Recovery Support (MARS™) Project.

    MARS™ is designed to provide peer recovery support to persons whose recovery from opioid addiction is assisted by medication. To be in a MARS™ group through the Peer Recovery Network PORTAL™, a person has to be in a MAT program. As Ginter writes on the MARS™ website, “The Peer Recovery Network was created as a way for peers in recovery to more effectively organize their community, to communicate with each other, and to have a stronger voice for advocacy efforts.”

    In 2012, Ginter helped create the Beyond MARS Training Institute at the Albert Einstein College of Medicine. With a variety of models and options, Ginter created a curriculum where opioid treatment programs and recovery professionals can be trained to implement MARS™. The original MARS™ project has expanded from its beginnings to include 17 programs across the United States and two in Haiphong, Vietnam. Ginter believes this is just the beginning of the expansion, both nationally and internationally.

    On the red carpet before the Voice Awards ceremony, Walter Ginter spoke with us about the struggles he has faced as an early advocate of MAT, revealing both an innate decency and a keen sense of humor. With a smile, he mentioned how people always ask him why MARS™ uses the trademark symbol. Some of them even think that he’s trying to corner the name of the planet for profit.

    But MARS™ has a trademark for a particular reason, Ginter explains. In the vast majority of cases, the organization does not mind when people use the name. They do enforce the trademark, however, when people who are not certified as trainers try to set-up MARS™ groups and conduct MARS™ trainings. In most cases, rather than follow the protocols, they are hijacking the name to do what they want and make a profit. As an organization with a mission that envisions “the transformation of medication-assisted treatment (MAT) to medication-assisted recovery (MAR),” Ginter believes that protecting the integrity of the organization must remain a priority.

    Sitting inside, away from the hot Los Angeles sun and the red carpet, Walter Ginter went into more detail about the early struggles that MARS™ faced. “Very few people come to MAT as their first course of treatment. In the vast majority of cases, they’ve already been to 12-step meetings, particularly Narcotics Anonymous. Although they initially felt welcomed at those meetings, those feelings shift after they start to work a program that includes medication-assisted treatment. Suddenly, you no longer feel welcome at the meetings, and this sense of alienation and rejection often leads to relapse. To fill in the resulting hole, we want MARS™ to give the same type of mutual support that 12-step provides. We want people on MAT to be embraced and accepted in recovery.“

    We asked Walter Ginter to detail this rejection in context. Scratching his chin, he said, “Look, telling people that they are not in recovery is evil. People on MAT were told that they couldn’t share in NA meetings since they weren’t really clean. By not allowing people to talk in meetings, they become alienated. However, it’s worse than alienation because it undermines what they’re doing to get well. The thought process goes something like this: If taking the medication that I need means I’m not in recovery, then why should I act like I’m in recovery? What does it matter if I do a line of coke on the side or have a drink?”

    Walter Ginter saw too many people on the verge of getting well through medication-assisted treatment subvert their recovery with this line of thinking and some other thought processes as well. Not wanting to take any chances, he set up MARS™ as a viable alternative both to treatment centers hostile to MAT and non-supportive recovery support groups like many NA meetings. In the past several years, MARS™ has had remarkable success with people on MAT. It has helped them find true recovery, a fact that has left initial opponents quite frustrated.

    In fact, Ginter ended our talk with a description of one of these encounters. As he told the following story, Ginter’s smile appeared again. “One day an opioid treatment counselor from a local New York rehab burst into my office and banged her fist on my desk. She said ‘What kind of voodoo are you doing here?’ Surprised by such an accusation, I replied “Excuse me?” She went on to explain: “Well. I have a client that wouldn’t stop doing coke. She would get off the heroin, but she always tested positive for cocaine. Since she’s joined your program, now she’s not only off the heroin, she’s no longer testing positive for coke or any other drug. How did you make that happen?’”

    Ginter shook his head as if he’d gone through the same rigmarole many times before. He describes how he sat the recovery counselor down and explained to her quietly: “There’s no magic or voodoo or anything else. We simply gave her medication that worked while telling her that she was now in true recovery. We gave her a vision of medication-assisted recovery, then let her make her own choice. She realized on her own, ‘Well, now I really can be on medication and in recovery. However, I can’t be in recovery if I’m still doing other drugs on the side. Today, I like being in recovery and the future it promises, so I’m going to stop doing the coke. Indeed, I will embrace this path that is set before me.’” 

    Given the promising picture that he painted, it makes perfect sense that Walter Ginter was honored with the Special Recognition Award at the 2018 SAMHSA Voice Awards. After all, how many people are dedicating themselves in such a precise fashion to saving lives by shifting perspectives and offering a viable alternative like Medication Assisted Recovery Support (MARS™)?

    View the original article at thefix.com

  • New Book "Dopesick" Explores The Opioid Crisis From All Angles

    New Book "Dopesick" Explores The Opioid Crisis From All Angles

    “My goal with this book was not to just show you how we got here and what it’s going to take to get out of it but also to inspire people to care,” says author Beth Macy.

    Journalist Beth Macy set out with a mission: to address the opioid epidemic from every possible angle. 

    In her new book, Dopesick: Dealers, Doctors and the Drug Company that Addicted America, she does that through examining the opioid epidemic from the very beginning to its current state. 

    According to NPR, Macy begins the book by detailing the story of Jesse, a 19-year-old whose struggles began with pills and ended with heroin. Jesse is one of the many lives taken at the hands of the opioid crisis.

    “He was one of these rambunctious kids who rarely napped,” Macy told NPR. “As a little boy, he would fall asleep with toys still in his hands. And early on, they put him on ADHD medication. He also had some football and snowboarding injuries when he was 15 and 16 and was prescribed opioid painkillers then.

    “His mother isn’t exactly sure at what point he became hooked, at what point he realized he was dope sick. But he knew he could trade his ADHD medicine for the opioid pills. And one thing led to another. When the pills got harder to get because of doctors cracking down on prescribing, that’s when the heroin started coming in.”

    Initially, Macy tells CBS, Jesse’s mother was unaware of the depths her son’s use had gone to.

    “She said something else that I heard a lot, which is ‘I thought it was just pills,’ and it had progressed to heroin unbeknownst to her, and he never missed a day at work,” Macy told CBS.

    As journalists do, Macy comes at the opioid epidemic from all angles. Her book also details her conversations with a drug dealer named Ronnie Jones, who “ran one of the largest heroin rings in the mid-Atlantic region,” according to NPR.

    Jones had tried a few times to recreate his life after spending time in jail, but with little luck.

    “Ronnie’s story illustrates how little we do for felons trying to re-enter our society. You know, we don’t make it easy for them to get jobs,” Macy told NPR. “They often come out, and they owe lots of fines. And he tries to go legit. And he ends up—you know, he starts out selling weed again, which he had been selling before. But meanwhile, since he’s been in prison, this opioid thing has exploded. And somebody tells him in the break room of George’s Chicken, hey, man, if you want to make the real money, you need to be bringing heroin in.”

    Also in her book, Macy examines the role that Purdue Pharma (the manufacturer of OxyContin) has played in the epidemic. She states that when Purdue introduced OxyContin, it was marketed as being more safe than other painkillers because of its 12-hour time release mechanism.

    For the past three years, Macy says, she has been following Google alerts for articles pertaining to the opioid crisis. However, she says, none of them addressed every angle of the crisis as she hoped to.

    “Each of them only deal with a little piece of something going on right now,” she tells NPR. “And my goal with this book was not to just show you how we got here and what it’s going to take to get out of it, but also to inspire people to care. And I really hope that that’s what I’ve done.”

    View the original article at thefix.com

  • Paramedics Use Laughing Gas In Lieu Of Opioids To Treat Pain

    Paramedics Use Laughing Gas In Lieu Of Opioids To Treat Pain

    “We feel if we can prevent someone from getting an opioid we are ahead of the game,” said one Indianapolis emergency responder.

    Paramedics in one Indiana town have decided to switch from fentanyl to laughing gas in an effort to keep injured patients from taking the drug, a synthetic opioid which has a high potential for addiction. 

    The move comes as fentanyl is tightening its grip on the state’s capital, accounting for nearly 50% of opioid-related deaths in 2017—up from just 14% in 2013. 

    The shift won’t entirely eliminate the Fishers Fire Department’s use of the addictive painkiller, but it could cut it down by about two-thirds, Capt. John Mehling told the Indy Star. 

    “If it hurts a little, why give a lot?” Mehling said. “If you are going squirrel hunting, don’t bring an elephant gun.”

    For some cases—including head injuries and collapsed lungs—paramedics will still give out fentanyl. But when it comes to things like broken bones, they’ll turn to laughing gas instead. 

    “We feel if we can prevent someone from getting an opioid we are ahead of the game,” Mehling told the Indianapolis paper.

    After decades of use in dentistry, it wasn’t until relatively recently that laughing gas started making its way into emergency room settings. It offers some advantages over other painkiller options, including the fact that it’s not addictive and doesn’t require an IV. Also, it typically takes effect within about a minute and has a good safety record.

    But to use nitrous oxide, the patient has to be in good enough condition to put on the mask or tube and inhale to self-administer the gas. Then, three to five minutes later, they’ll need to do it again. Also, there have been some fatalities, and it can still present the potential for abuse, which makes it a potential target for thieves. 

    The shift at the Fishers Fire Department is just the latest in a growing trend. Paramedics in more than two dozen states have already started buying laughing gas for ambulances—though not always in an effort to avoid using opioids, according to the Associated Press.

    For some departments, laughing gas is convenient because it offers a means to combat pain even when medical workers who can legally provide narcotic painkillers are not along for the ride. 

    View the original article at thefix.com

  • Long-Term Opioid Use Linked To Wisdom Teeth Extraction

    Long-Term Opioid Use Linked To Wisdom Teeth Extraction

    Researchers examined whether opioids prescribed to manage pain from wisdom teeth extraction heightened the risk of long-term use.

    Nearly 85% of people will need to have their wisdom teeth extracted at some point during their lives, and a new study shows that this routine dental procedure can have severe consequences—with young people who use opioids after the procedure three times more likely to fill opioid prescriptions long-term. 

    “From our findings, we should strongly consider not prescribing any opioids routinely after wisdom teeth are pulled. Particularly since there is evidence that anti-inflammatories may be just as good, if not better, for pain management after wisdom teeth are pulled,” Dr. Calista Harbaugh, lead study author and a general surgery resident at the University of Michigan, where the research was conducted, told ABC News.

    For the study, published in the Journal of the American Medical Association on August 7, researchers looked at 71,000 insured people from 2009 to 2015.

    About 60,000 filled prescriptions for opioids intended to relieve the pain from the tooth extraction. Researchers then looked at future opioid use and found that young people were most likely to fill additional opioid prescriptions in the future. 

    This is not the first time that researchers have connected dental work with risk for long-term use of opioids. Last summer, another study published in JAMA warned that doctors and dentists should be weighing opioid dependence as a potential complication from surgery. 

    “New persistent opioid use represents but previously underappreciated surgical complication that warrants increased awareness,” they wrote. 

    Harbaugh said wisdom tooth extraction is especially risky because it comes at a time when people may be more likely to become addicted, and it is a very common procedure, with more than 3.5 million extractions taking place each year. 

    “Teens and young adults are an important population to understand the effects of exposure to opioids for predictable reasons, like having wisdom teeth pulled,” she said. “They are vulnerable from the standpoint of ongoing development as well as social pressures.”

    Despite increased awareness about the dangers of opioids, dentists have been accused of over-prescribing painkillers as rates of opioid prescription continue to climb. In March, the American Dental Association announced new guidelines meant to limit opioid prescribing. 

    “As president of the ADA, I call upon dentists everywhere to double down on their efforts to prevent opioids from harming our patients and their families,” ADA President Joseph P. Crowley said in a news release. “This new policy demonstrates ADA’s firm commitment to help fight the country’s opioid epidemic while continuing to help patients manage dental pain.”

    The newest study suggests that these efforts are critical. 

    “It will be important to find areas where we can help eliminate the exposure to opioids in this group to show long-term decrease in opioid use,” said Dr. Chad Brummett, an assistant professor of anesthesiology at the University of Michigan.

    View the original article at thefix.com