Tag: opioids

  • Chronic Pain Patients Feel The Effects Of Arizona Opioid Legislation

    Chronic Pain Patients Feel The Effects Of Arizona Opioid Legislation

    “They told me because of the new law they had to cut me back. It just hurts, I don’t want to walk, I don’t want to… pretty much don’t want to do anything,” said one pain patient.

    New bipartisan legislation curbing the pharmaceutical use of opioids in Arizona has been put into action. In January, Arizona Governor Doug Ducey signed the Arizona Opioid Epidemic Act, calling it “vital to combat an epidemic felt statewide and across the nation,” according to Reuters.

    However, some chronic pain patients in Arizona are already feeling harmful effects as the law is put into place. NPR reported that although the act was not written around the issues of chronic pain patients, it negatively impacts them, as doctors who are worried about legal trouble curb their patients’ access to the pain-relieving drugs.

    Governor Ducey’s administration had stated that the law would “maintain access for chronic pain sufferers and others who rely on these drugs.”

    This is mostly true: restrictions are written to apply to new patients only. Some were exempted, such as cancer and trauma patients, and patients in end-of-life care.

    However, in practice, some Arizona doctors are pulling back hard on prescribing opioids for all of their patients.

    Dr. Julian Grove, president of the Arizona Pain Society and contributor to the act told NPR that, “A lot of practitioners are reducing opioid medications, not from a clinical perspective, but more from a legal and regulatory perspective for fear of investigation. No practitioner wants to be the highest prescriber.”

    Shannon Hubbard, Arizona resident and chronic pain sufferer (she has a condition called complex regional pain syndrome) had her opioid pain relievers reduced by 10 mg in April. “They told me because of the new Arizona law they had to cut me back,” she told NPR, saying that her pain was now terrible. “It just hurts, I don’t want to walk, I don’t want to… pretty much don’t want to do anything.”

    The legislation created regulations around opioid use, citing that 75% of those addicted to heroin began their use with an opioid prescription. The act includes a limited initial opioid prescription of five days, and for certain extremely addictive painkillers, set a maximum 30-day prescription.

    The law includes $10 million to be spent treating people with opioid addiction who are not insured and ineligible for Medicaid. The “Good Samaritan” provision allows immunity for those reporting an overdose.

    Dr. Cara Christ, head of Arizona’s Department of Health Services and contributor to the state’s opioid response laws, told NPR, “The intent was never to stop prescribers from utilizing opioids. It’s really meant to prevent a future generation from developing opioid use disorder, while not impacting current chronic pain patients.”

    Still, Shannon Hubbard is living with the effects of the law, and not the intentions.

    “What they are doing is not working,” she told NPR. “They are having no effect on the guy who is on the street shooting heroin and is really in danger of overdosing. Instead they are hurting people that are actually helped by the drugs.”

    View the original article at thefix.com

  • Massachusetts Sues Purdue Pharma Over Opioid Crisis

    Massachusetts Sues Purdue Pharma Over Opioid Crisis

    Sixteen individuals are named in the lawsuit, including a few members of the Sackler family.

    The state of Massachusetts is suing 16 current and former Purdue Pharma board members and executives for their alleged role in the continuing opioid crisis.

    Massachusetts Attorney General Maura Healey says this is the first lawsuit brought on by a state that directly names executives and directors in connection with opioid-related deaths. 

    The BBC reports that Judy Lewent, a non-executive director of GlaxoSmithKline, is named in the charges for her involvement with the board of Purdue Pharma until 2014.

    Lewent currently serves as a director in GlaxoSmithKline (GSK), one of the six largest British pharmaceutical companies. In 2012, GSK pleaded guilty to promotion of drugs for unapproved uses, failure to report safety data, and kickbacks to physicians in the United States. The company was sentenced to pay a $3 billion settlement—the largest settlement for a drug company at that time.

    Sixteen individuals are named in the Massachusetts lawsuit, including a few members of the Sackler family.

    Purdue Pharma is owned by the descendants of Raymond and Mortimer Sackler who earned their fortune off of the drug OxyContin, which their company, Purdue Pharma, still produces.

    The Massachusetts lawsuit claims that Purdue Pharma “created the [opioid] epidemic and profited from it through a web of illegal deceit.”

    Judy Lewent was tagged as one “who oversaw and engaged in a deadly, deceptive scheme to sell opioids in Massachusetts.”

    AG Healey addressed the lawsuit in a press conference, “We found that Purdue misled doctors, patients, and the public about the real risks of their dangerous opioids, including OxyContin. Their strategy was simple: The more drugs they sold, the more money they made—and the more people died.” 

    Purdue Pharma “vigorously denies the allegations,” while GlaxoSmithKline declined to “comment on legal matters faced by another company,” according to the BBC.

    Purdue told the BBC, “The Attorney General claims Purdue acted improperly by communicating with prescribers about scientific and medical information that FDA (Food and Drug Administration) has expressly considered and continues to approve. We believe it is inappropriate for the Commonwealth [of Massachusetts] to substitute its judgment for the judgment of the regulatory, scientific and medical experts at FDA.”

    The company added that it shared “the Attorney General’s concern about the opioid crisis,” and that its “opioid medications account for less than 2% of total opioid prescriptions.”

    The state of Minnesota also recently filed a lawsuit against Purdue Pharma over the marketing of OxyContin.

    Purdue Pharma has recently stopped the marketing of opioid-based drugs in Canada, Westfair reported. Purdue already pulled marketing for these drugs in the U.S. back in February. Canada has asked drug companies to suspend marketing and advertising of opioid-based drugs.

    View the original article at thefix.com

  • Opioid Crisis “More Deadly” Than AIDS Epidemic, CDC Director Says

    Opioid Crisis “More Deadly” Than AIDS Epidemic, CDC Director Says

    CDC director Dr. Robert Redfield discussed the parallels between the crises and his plans to combat opioids during a recent interview. 

    Robert Redfield has only been the director of the Centers for Disease Control and Prevention (CDC) since March, but in that time he has made his stance on the opioid crisis known.

    Redfield, 66, tells The Washington Times that the opioid crisis will be worse than the HIV/AIDS epidemic of the 1980s, which he was also involved in fighting. “I would say the opioids-fueled epidemic is clearly already more deadly than the AIDS epidemic ever was,” he told the Times.

    According to Redfield, the CDC is working with pharmacies and states to keep up with the opioid epidemic in real time and collect overdose death data as quickly as possible. He says the goal is to release the figures for 2017 in the fall of 2018. 

    The most recent data, from 2016, has overdose deaths at 42,000. The Times notes that some researchers predict that the newest data will show that overdose deaths have passed the 48,000 HIV/AIDS deaths in 1995 which was the most fatal year of that epidemic.

    Redfield says that when it comes to annual rates, drug overdose deaths have already overtaken those of the HIV/AIDS crisis. “If you look at all overdose deaths, not just opioids deaths, we’re over 60,000 now,” he told the Times.

    The number of deaths isn’t the only similarity Redfield sees between the two epidemics. He tells the Times that with both, there have been empathy gaps, meaning people initially saw the diseases as something that happened because of dangerous behavior.

    “It’s a medical condition. It’s not a moral choice,” Redfield told the Times. He added that as with the HIV/AIDS crisis, combating the opioid crisis will take new scientific innovations and “public health efforts.”

    In June, Redfield told the Wall Street Journal that the CDC would be increasing efforts to fight the opioid crisis. He stated the organization would be developing new guidelines for opioid prescriptions for acute pain, as well as introducing a new system to track emergency department data. 

    Redfield also told the Wall Street Journal that he has personal experience with the opioid crisis, as a close family member had struggled with opioid use. “I think part of my understanding of the epidemic has come from seeing it not just as a public-health person and not just as a doctor,” he told the Wall Street Journal. “It is something that has impacted me also at a personal level.”

    Redfield also called stigma the “enemy of public health” and stated that it’s vital to find “a path to destigmatize” opioid use.

    “We were able to do it to some degree for HIV, and I think pretty successfully, but it’s not over,” he said.

    View the original article at thefix.com

  • Dope Sick: Breaking Down Opioid Withdrawal

    Dope Sick: Breaking Down Opioid Withdrawal

    The strength it takes for a broken down, tormented person, feeling sick and hopeless every single day, to say, “No more” to their source of relief is something many people cannot even fathom.

    Dope sickness (from opioid withdrawal) or even just the fear of dope sickness can trigger a desperation and panic unlike any other. This fear, in large part, drives the addiction that has led to the opioid epidemic, which claimed 64,000 overdose deaths in 2016 and is now classified as a public health emergency. Or some say it’s the high that keeps opioid users chasing the dragon all the way to hospitals, jails, and institutions. Much like an abusive relationship that long overstays its welcome—often by years and even decades—it starts with love and butterflies but then transforms into a much darker animal, tethering a person in place not with love but with the fear of what happens when you leave it behind.

    How does someone know when their dose is wearing off and they need another fix? They’ll start to feel hot and cold at the same time, getting goose bumps and perspiring simultaneously; their eyes begin to water and they yawn repeatedly; they feel intense cravings coupled with severe anxiety, and their stomach starts to turn. These early onset symptoms of withdrawal work like an internal alarm in the brain, signaling to the nervous system that it desperately needs what is missing. These symptoms typically occur 6-12 hours after the last dose, and their intensity varies based on how often and how much of the drug the person is using. Opioid (painkillers such as oxycodone, vicodin, and codeine, as well as heroin) addiction is a progressive disease in which tolerance builds, so the required dose grows larger, and the withdrawal worsens. The deeper you are in the hole, the farther out you must climb.

    Once someone begins to experience the first stage symptoms of withdrawal, panic sets in. There is an overwhelming sense of impending doom because, as most seasoned junkies know, the only thing worse than the first stage of opioid withdrawal is the second. Muscle aches, pains, and spasms can cause a person to kick their legs and flop around like a fish out of water. Just as a fish longs for water to breathe again, the person in opioid withdrawal longs for a hit to end their agonizing race toward what feels like death. Vomiting, diarrhea, and severe stomach cramps keep them crawling to the bathroom, if they even make it, if they even have access. These physical symptoms are paired with deep depression, anxiety, and the torture of knowing that the hell could simply cease if they get their fix. And this typically goes on all 24 hours of each day that it lasts—typically just over a week—because insomnia prevents any relief that sleep would bring.

    It is the fear of that torment, which words can’t really do justice, that shackles people to a substance which indefinitely curses them with relief and pain. It is also that fear that compels them to lie, cheat, and steal. People who have become addicted to opioids wake up one day, deeper into their addiction then they’d ever anticipated, and look in the mirror only to see a stranger. They look at childhood photos of themselves and feel overcome with sadness, asking themselves, What happened? Their mothers do the same thing, looking at their baby’s photos and asking themselves where they went wrong. It’s difficult to separate the person from the addiction: although one entity does seem to overtake the other, that can be reversed and they are, in fact, two distinct realities.

    In most cases, a rotten egg is not born into this world destined to be a thief, robbing to feed their addiction. What once was a promising honor student, the girl next door, the boy working behind the deli counter, or the kid who loved fishing has now slowly, pushing the limits a bit farther each time, transformed into that thief overcome with fighting the terror of withdrawal. It’s as if they’ve sold their soul to the devil, stealing for it, lying to loved ones, to anyone, cheating people just to survive, just to feel well. When someone with an addiction hits rock bottom, and they hate themselves at this point, they think they’ve had enough and they want their soul back. But they can’t just stop. There’s a debt to pay.

    The strength it takes for a broken down, tormented person, feeling sick and hopeless every single day, desperate enough to do things they’d never imagine themselves capable of doing, to say, “No more,” is something many people cannot even fathom; it is standing up to the fear of the agony of withdrawal, of feeling like you’d gladly crawl out of your own skin if you could. For many people, it’s also facing the fear of life unaltered, buffer-less, possibly for the first time.

    There are different methods of withdrawing from opioids. Doctors sometimes offer benzodiazepines or clonidine, a blood pressure lowering drug, to temper the misery. There’s the good old fashion “cold turkey” which comes from the cold flashes and goosebumps you experience, or “kicking dope” which comes from kicking your legs around in weird spasms for over a week. And of course, we can’t have this discussion without mentioning the two big whoppers, Suboxone and methadone. These are known as medication assisted treatment (MAT), and they work wonders for many people. But one day you might want to get off of them, and that’s another opioid detox.

    Something worth mentioning about MAT is that if you take it long enough, you have the chance to rebuild a “normal” life. You can go to school, kickstart your career, do all the things that being a full-fledged junkie makes impossible. Stay on as long as you need; I even heard about one guy who got himself through law school on Suboxone. So there are upsides, incredible advantages really, but at the end of the day, after you’ve obtained your PhD, you still have to pay that debt.

    I once heard someone say, close your eyes and picture an addict. Whatever picture came into your mind, that’s the stigma of addiction. But there’s not just one static image, because addiction comes in layers. There’s the first layer, how it originated. Maybe a doctor prescribed Norcos for an ankle sprain and neglected to mention what you might be signing up for. According to drugfree.org, almost 80% of people who shoot up heroin started with the misuse of prescription medication. The next layer is when the drug takes over, and your identity—who you are—is now overwhelmed by the addiction, hiding your actual self somewhere beneath. And finally, hopefully, there’s the detox—the week or two of pure hell as the drug leaves your system and you start learning how to function without it.

    But when you do, finally, make it to the other side, however worn and broken down you may feel, it feels like the first day of the rest of your life. It’s a terrifying feeling, but you come out triumphant, and victorious.

    View the original article at thefix.com

  • Kids, Parents & Grandparents All Face Strain Of Opioid Crisis

    Kids, Parents & Grandparents All Face Strain Of Opioid Crisis

    One expert estimates that for every child in foster care due to a parent’s addiction there are 18 to 20 children who have been informally taken in by family members. 

    When parents are living with opioid addiction—or even trying to establish their lives in recovery—it can take a toll on the whole family, from kids to grandparents, as roles are redefined. 

    Donna Butts, the executive director of Generations United, a Washington, D.C.-based organization, has seen how families have coped with drug epidemics fueled by cocaine or meth. This time, she told CBS News, feels different. 

    “With the opioid epidemic, it seems so much more severe and, in some ways, more hopeless,” she said. “Which is why I think the grandparents and other relatives that are stepping forward are playing such a critical role because the hope is with the children.”

    Oftentimes family members will step up to care for the children of people who are addicted without going through the formal foster care system, making it difficult to get an estimate on how many families have been rearranged because opioid addiction.

    The foster care statistics themselves are overwhelming; Butts estimates that for every child in foster care because of a parent’s addiction there are 18 to 20 children who have been informally taken in by family members. 

    This has financial implications for the family member taking responsibility for the children, usually the grandparents. Twenty percent of grandparents raising grandchildren are living in poverty, and 40% are older than 60, which often means they are retired or semi-retired and living on a fixed income. 

    In addition, many children have been exposed to trauma, and their grandparents have been through their own traumatic experiences in seeing their child battle addiction. 

    “What they really need is to understand the impact of trauma on the children and try to help support them as they deal with that. Also, they need to have access to trauma-informed services, the services that can really help them to overcome what they’ve experienced,” Butts said.

    However, she noted that having stable grandparents can really help children overcome the harms of having a parent battling addiction. 

    Even for parents who are working to get clean, keeping custody of the children can be challenging. 

    Jillian Broomstein, of New Hampshire, was in a methadone program when her son was born. Because the baby tested positive for opioids, he was taken by the Division for Children, Youth and Families. Broomstein had just one year to be off opioids and in a stable housing situation, or she would risk losing custody permanently, according to WGBH

    “I cannot stress enough that 12 months is a really short window for somebody who’s in early recovery,” says Courtney Tanner, who runs a New Hampshire recovery home where pregnant women and new moms can live with their babies while getting sober. 

    Situations like Broomstein’s are too common, she said. 

    “Here in New Hampshire what I have seen is a mom can be enrolled in this program and compliant in treatment and they are giving birth to a child and that child is still being removed and put into foster care.”

    However, given the right resources, people in recovery are able to be reunited with their children. 

    “We see a lot of that,” said Dr. Frank Kunkel, the president and chief medical officer of Accessible Recovery Services. “We see a lot of people that spin out of control. They’re involved with the judicial system and all that. And we see grandma have the kids for a while. Then they’ll get back on track with things legally, and they’ll get on our medications, and they’ll get in seeing their therapist, and they’ll turn their life around. We see that every day.”

    View the original article at thefix.com

  • Opioid Makers Cut Back On Marketing Payouts To Doctors

    Opioid Makers Cut Back On Marketing Payouts To Doctors

    In 2016, Big Pharma shelled out more than $15 million to doctors for opioid-related marketing—33% less than the year prior.

    Drugmakers are cutting back on opioid-related marketing payouts to doctors, according to a data analysis by ProPublica

    The newly released figures come as the latest update to the nonprofit news site’s Dollars for Docs online tool that tracks payments to physicians from drug companies and other medical companies. 

    In 2016, the latest numbers show, Big Pharma shelled out more than $15 million to doctors in exchange for opioid-related speaking and consulting work. That was 33% less than the 2015 figure and 21% less than the 2014 figure. Repeatedly, research has drawn a link between marketing and prescribing practices. 

    “Given the deluge of media attention with the opioid epidemic, I think we’ve seen the pendulum swing in the opposite direction,” Michael Barnett, an assistant professor of health policy and management at Harvard, told ProPublica. “If this is actually a result of manufacturers actually saying, ‘Holy crap, people actually care about opioids being used responsibly’ and they’re aware that their advocacy and payments to physicians could be seen as pushing these medications in a way that is ethically dubious, then that’s a beneficial development and something I’d like to see more of.”

    The shift comes amid a growing number of lawsuits against drug companies accused of downplaying the risks of painkillers in aggressive marketing campaigns over a yearslong uptick in opioid use. 

    It’s not clear exactly what’s driving the changing numbers, though, experts said. 

    “It’s possible that the pharmaceutical companies voluntarily reduced their marketing, realizing that they may have been contributing to overprescribing,” Dr. Scott Hadland of Boston University School of Medicine told ProPublica.

    At the same time the marketing dollars decreased, the number of opioid prescriptions started on the downswing as well. But, so far, the fall in marketing funds has outpaced the reduction in prescriptions.

    OxyContin maker Purdue Pharma cut off its speaker program for the drug in 2016, and this year the company halted all physician-targeted promotional efforts of its addictive painkillers and laid off sales reps. 

    “While the development of important new medicines will be the company’s priority going forward,” the company said last month, “we will continue to support our opioid analgesic product portfolio while continuing our commitment to take meaningful steps to reduce opioid abuse and addiction.”

    The FDA greenlit OxyContin in 1995 and since then it’s been Purdue’s biggest financial success, even amid the rise of generic alternatives and the growing popularity of other opioid painkillers. 

    View the original article at thefix.com

  • Kratom Draws Support And Controversy As Opioid Addiction Treatment

    Kratom Draws Support And Controversy As Opioid Addiction Treatment

    “It’s like a cruel joke that I finally found something that works and the FDA and DEA want it banned,” said one kratom user. 

    A controversial supplement, kratom, could have benefits when it comes to treating opioid use disorder, according to a new study. However, there is still much controversy around it due to safety concerns.

    Kratom is a psychoactive drug that comes from the leaves of Mitragyna speciosa, which is an Asian plant in the coffee family

    Some believe it is effective for treating substance use disorders, but organizations such as the Food and Drug Administration (FDA) and the Drug Enforcement Administration are wary of that. In fact, the DEA even attempted to ban the substance.

    In February, FDA commissioner Scott Gottlieb spoke against kratom, saying “there is no evidence to indicate that kratom is safe or effective for any medical use.”

    Scott Hemby, a professor of pharmaceutical science at High Point University in North Carolina, led a new study recently published in Addiction Biology, which found that kratom may in fact have some benefits.

    Kratom has two main ingredients: mitragynine (MG) and 7‐hydroxymitragynine (7‐HMG). MG accounts for 60% of the compound in the plant while HMG is about 2%. Using rats, Hemby’s study examined how both these ingredients affect the brain. 

    Hemby and other researchers allowed rats to self-administer both components of kratom. They found that the rats quickly began self-administering HMG, but did not have interest in MG.

    “In other words, while one of kratom’s main compounds appeared to be addictive, the other wasn’t at all—in fact, it appeared to have the opposite effect,” Business Insider reported

    Because kratom affects some of the same receptors in the brain as opioids, the FDA announced in February that it would be called an “opioid.” But others believe kratom could be beneficial and treat cravings while reducing symptoms of withdrawal and the likelihood of relapse.

    The results of the study suggest that it could be beneficial to breed the plant to have higher concentrations of one compound versus the other. However, the results are preliminary because the study was not done on humans.

    Some people, such as 26-year-old Bryce Avey, began using kratom because they could not get access to other opioid treatments like buprenorphine and naltrexone. “It’s like a cruel joke that I finally found something that works and the FDA and DEA want it banned,” Avey told Business Insider

    David Juurlink, professor of medicine at the University of Toronto, told Business Insider that the use of kratom makes sense, as it affects the same brain receptors as opioids. “It makes sense that this product would mitigate the symptoms of opioid withdrawal or allow someone to transition from a higher dose to lower dose, or help get them off of opioids altogether,” he said.

    Business Insider notes that concern about the supplement arises because there is no “quality oversight of kratom,” meaning people don’t know what the pills actually contain.

    “Personally, I would never take this stuff,” Juurlink told Business Insider. “When you go to a pharmacy, you know there’s quality control, you know precisely how much you’re getting, and you know exactly what you’re getting. With this, it’s impossible to know.”

    View the original article at thefix.com

  • Too Often, Insurers Cover Opioids But Not Addiction Treatment Meds

    Too Often, Insurers Cover Opioids But Not Addiction Treatment Meds

    “Buprenorphine and methadone are incredibly effective medications… So I really do think it’s a stigma issue.”

    As is the case for many people battling opioid addiction, Mandy’s dependency started at home. She was prescribed an opioid for back pain, and her insurance company gladly covered the cost of the pills.

    However, after Mandy became dependent on opioids and was prescribed buprenorphine to help with her rehabilitation program, her insurer stepped back, unwilling to pay.

    “It makes me want to go out and use [drugs],” Mandy said when she spoke to Vox. The 29-year-old who lives in the Chicago area asked that only her first name be used. “It’s way easier to get opiates or heroin… It’s so much easier than dealing with this bullshit.” 

    Many Americans who had no problem getting their insurance companies to pay for addictive opioid pain pills have found that getting insurers to cover treatment—particularly medication-assisted treatment (MAT) that relies on pharmaceuticals like buprenorphine—is an uphill battle despite the fact that the drugs have been proven effective. 

    “Buprenorphine and methadone are incredibly effective medications,” said Tami Mark, a health economist at RTI International, a non-profit that conducts policy research. “If you had any other drug with their kind of effect size, it would be immediately covered… So I really do think it’s a stigma issue.”

    For people in early recovery, like Mandy, refusals to cover medications or delays in getting prescriptions approved can be deadly.

    “The risk of relapse is incredibly high,” said Sara Ballare-Jones, a social work case manager at the University of Kansas Health System. She often has patients wait three days to get their medications approved because they require prior authorization from the insurance companies.

    In Mandy’s case her claim was denied, leaving her to pay out of pocket for buprenorphine, which costs nearly $3,000 each year. The 29-year-old said that is a huge amount to have to pay while also handling daily expenses like student loans and rent.

    “I’m feeling all these old issues and all this shit, and then it’s just more bullshit,” she said. “I’m just trying to reenter society… It’s really hard.”

    It’s also incredibly frustrating for Mandy, who knows firsthand how easy it is to get insurers to cover opioids. “I never paid a dime for my opioids. Those were always covered,” she said. “But I’m paying all this money for the treatment.”

    Mandy’s doctor, Dennis Brightwell, said that he usually sees issues with private insurance companies. While Medicaid is required to cover most medication-assisted treatments, most private insurers balk at covering them, putting vulnerable patients in an awkward position.

    “If you send a commercial patient to the pharmacy, you don’t know until they get there how it’s going to go,” Brightwell said. “Sometimes it’s not such a problem. Sometimes it’s a prior authorization that is pretty straightforward. Sometimes it’s very difficult to get them to approve it. And there’s not an easy way to find out upfront what medications they approve.” 

    View the original article at thefix.com

  • Drug Shortages Affect Hospitals Across US

    Drug Shortages Affect Hospitals Across US

    The national drug shortage has been severe enough for the FDA to allow Pfizer to sell products that normally would have been recalled.

    Emergency departments across the United States are feeling the strain of drug shortages that are affecting physicians’ ability to treat pain and other ailments.

    According to the New York Times, some hospitals, like Norwegian American Hospital in Chicago, have been “struggling for months” lacking crucial drugs like morphine, epinephrine (adrenaline) and diltiazem, a heart medication. Norwegian has not had morphine since March of this year, the Times reported.

    According to a May 2018 survey of 247 emergency doctors, conducted by the American College of Emergency Physicians, 9 in 10 said they did not have access to important medicines, which they said negatively affected nearly 4 in 10 patients.

    While the Times notes that while the reason behind the drug shortage is complex—including the fact that drug companies have little incentive to manufacture drugs that are difficult to make but “cheaply priced”—much of it has to do with manufacturing issues at Pfizer, which produces the majority of generic injectable drugs in the U.S.

    “Most of the time, the problem is some type of quality issue related to machine or raw materials,” said Erin Fox, senior director of the University of Utah’s drug information and support services, according to CBS News. “It could be contaminated particles, bacteria, metal shavings, glass particles—all kinds of things. There’s a real quality control problem.”

    Pfizer has received multiple warning letters from the Food and Drug Administration regarding issues of quality control, forcing it to slow down production while it addresses these issues. The company estimated that many of its drugs, like morphine, will not be available until 2019, according to the Times.

    Incredibly, the drug shortage has been severe enough for the FDA to allow “Pfizer to sell products that normally would have been recalled: In May, Pfizer released morphine and other drugs in cracked syringes, with instructions to health care providers to filter the drugs before injecting them,” the Times reported.

    Being the largest pharmaceutical company in the nation, Pfizer’s shortage issues have carried over to competitors who have struggled to fill the void.

    The lack of pain medications has been a “huge issue,” according to one emergency room doctor at Norwegian American Hospital. “[Patients] are often disappointed and frustrated that the system is not functioning at the level it should be.”

    Fox, who studies drug shortages, explained that the shortage of pain medications not only has to do with manufacturing issues, but opioid restrictions put in place by the government in response to the drug abuse epidemic.

    View the original article at thefix.com

  • Tougher Laws, Stricter Prescription Limits For Opioids In Tennessee

    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