Tag: opioids

Opioids To Blame For 1 in 5 Young Adult Deaths

Opioid-related deaths were responsible for 1.7 million lost years of life in 2016, according to a new study.

In 2016, opioids were involved in 20% of deaths of young Americans ages 24 to 35, according to a new study.

The findings, published in the journal JAMA Network Open, used data from the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death Online Database, which shows the cause of death, age and sex of people who pass away. Researchers looked at the years between 2001 and 2016.

During that time period, deaths that were attributable to opioids increased 292%. In 2016, opioid-related deaths were responsible for 1.7 million lost years of life, according to analysis by the researchers.

Despite the fact that there has been a lot of attention given to the effects of opioids on middle-aged Americans, the impact was most profound for younger people. In addition to the high death rates for people in their 20s and 30s, opioids caused 12.4% of deaths of youth aged 15 to 24.

“Premature death from opioid-related causes imposes an enormous public health burden across the United States,” researchers wrote. “The recent increase in deaths attributable to opioids among those aged 15 to 34 years highlights a need for targeted programs and policies that focus on improved addiction care and harm reduction measures in this high-risk population.”

The opioid-related death rate for people aged 25-34 nearly quadrupled between 2001 and 2016.

“I think that the fact that one out of every five deaths among young adults is from an opioid, if not shocking, should at least create pause for people to realize how huge of an impact this early loss of life is having,” Tara Gomes, an epidemiologist and researcher at St. Michael’s Hospital in Toronto, who led the study, told Tonic.

Overall, researchers found that opioids were responsible for 1.5% of all deaths in the United States, or about 1 in 65. That means that opioids resulted in more lost years of life in 2016 than high blood pressure, HIV/AIDs and pneumonia. In 2001, just 1 in 255 deaths were attributable to opioids.

Men were more likely than woman to die from an opioid overdose, researchers found. In fact, men made up 67.5% of all opioid-related deaths in 2016.

While young people had the highest percentage of opioid-related deaths, the sharpest percentage increase was among older Americans. People over 55 made up 18.4% of opioid deaths in 2016. Between 2001 and 2016 the opioid-related death rate for people age 55 to 64 increased 754%; for people age 65 and older it increased 635%.

View the original article at thefix.com

6 June 2018
Can Sewage Provide Clues On How To Combat Opioid Crisis?

Sewage studies could prove to be more beneficial than hospital data and surveys when it comes to getting a closer look at residents’ drug intake.

As cities continue searching for ways to combat the opioid crisis, some are turning to sewage for answers.

In fact, about six cities have asked Arizona State University to study their sewage for “chemical signatures that may help save lives,” according to Scientific American.

Rolf Halden, who is the director of ASU’s Biodesign Center for Environmental Health Engineering, says sewage is “the information superhighway under your feet.” Since 2003, Halden’s Human Health Observatory has been studying sewage in more than 300 municipalities across the world.

In the past, Scientific American notes, the team has searched for anything that can tell them about a community’s health, such as stress hormones, dietary choices, nicotine presence and hazardous chemicals.

But now, cities have begun asking for help when it comes to the opioid crisis by searching for evidence of opioid use. Currently, Halden and his team provide about six municipalities with monthly data about residents’ intake of substances such as heroin, fentanyl, oxycodone and other opioids.

This could prove more beneficial than hospital data and surveys, as used in the past, since people can’t lie about use through sewage, and it doesn’t take as long to collect.

“History has taught us that when you ask people about drug use, you often don’t get a truthful answer,” Halden told Scientific American. But, he says, “sewage doesn’t lie.”

When it comes to testing the sewage, researchers put it through what is called liquid chromatography, Scientific American states. In other words, the compounds in the sewage got separated and sorted.

Researchers then put a solution through a device that can recognize and measure which drugs are present and how much. Researchers take these numbers and establish an estimate of the number of doses per 1,000 people.

Because it only takes researchers one or two days to test sewage, the results reflect nearly current patterns of drug use.

“If a city shuts down a pill mill—a clandestine operation where medical workers inappropriately prescribe powerful narcotics—or arrests a ring of dealers, it can measure the immediate impact,” Scientific American reports. “If opioids start to disappear from the wastewater, it could be an early indication of success. But if the sewage is suddenly flush with fentanyl, it may indicate that legal users deprived of their prescriptions are seeking street drugs instead.”

This can be beneficial for various reasons. For example, if a large increase in drugs like fentanyl is observed, it allows first responders to be prepared to give the opioid antidote naloxone, and to make sure they have enough on hand.

Another benefit to testing sewage is that it allows officials to determine the impact of drug education programs.

According to Scientific American, sewage testing costs about $10,000 per year for cities, but that number can change depending how often testing is done and what is measured for.

“Right now people are surprisingly skeptical of what one can measure in wastewater,” Halden told Scientific American. But, he added, “I think this will become a common way of thinking in the future.”

View the original article at thefix.com

6 June 2018
Older Americans Among "The Unseen" In The Opioid Epidemic

Opioid misuse nearly doubled for Americans older than 50 over a 12-year span.

The focus of the opioid crisis tends to be on younger generations. But this could be problematic, as, according to the Washington Post, older generations are increasingly at risk to develop opioid use disorders.

This is backed up by information from the Substance Abuse and Mental Health Services Administration (SAMHSA), which states that from 2002 to 2014, opioid misuse decreased in younger age groups, especially in those age 18-25.

However, in Americans older than 50, use just about doubled.

On Wednesday, May 23, the Senate Special Committee on Aging held a session to discuss opioid use by the elderly population.

“Older Americans are among those unseen in this epidemic,” Sen. Robert P. Casey Jr. of Pennsylvania said, according to the Post. “In 2016, one in three people with a Medicare prescription drug plan received an opioid prescription. This puts baby boomers and our oldest generation at great risk.”

Medicare can be problematic in situations such as this, because it funds opioids for patients, but it does not assist with care or medication that can be used to combat the opioid crisis, the Post notes.

William B. Stauffer, executive director of the Pennsylvania Recovery Organizations Alliance, in Harrisburg, Pennsylvania, spoke at the hearing and said one in three older Americans that have Medicare are prescribed opioids.

“However, while Medicare pays for opioid painkillers, Medicare does not pay for drug and alcohol treatment in most instances, nor does it pay for all of the medications that are used to help people in the treatment and recovery process,” he said, according to the Post. “Methadone, specifically, is a medication that is not covered by Medicare to treat opioid use conditions.”

Gary Cantrell, a deputy inspector general at the Department of Health and Human Services, addressed Medicare Part D (prescription medication) beneficiaries, according to the Post.

In 2016, Cantrell says, about 500,000 people “received high amounts of opioids” and nearly 20% of those are at “serious risk of opioid misuse or overdose.”

For the elderly population, problematic use of opioids often starts with prescriptions rather than street drugs.

“Older adults are at high risk for medication misuse due to conditions like pain, sleep disorders/insomnia, and anxiety that commonly occur in this population,” Stauffer said, according to the Post. “They are more likely to receive prescriptions for psychoactive medications with misuse potential, such as opioid analgesics for pain and central nervous system depressants like benzodiazepines for sleep disorders and anxiety.”

Apart from abuse, there are other risks associated with opioid use in older populations, too. The Post states that Sen. Susan Collins (R-Maine) pointed out at the hearing that, “Older adults taking opioids are also four to five times more likely to fall than those taking nonsteroidal, anti-inflammatory drugs.”

Opioid misuse in seniors becomes even more dangerous because doctors can have a harder time recognizing the signs, Collins says.

“Regrettably,” Collins said, according to the Post, “health-care providers sometimes miss substance abuse among older adults, as the symptoms can be similar to depression or dementia.”

View the original article at thefix.com

2 June 2018
Congress "Scared" To Take On American Medical Association Over Opioids

A senator recently called out Congress for not standing up to the AMA for stalling progress on anti-opioid abuse regulations.

A powerful physicians lobby is blocking efforts in Congress to regulate the way certain medications like opioid painkillers are prescribed, according to a new report.

According to the Daily Beast, the American Medical Association has actively lobbied against certain measures that seek to limit the way that doctors give opioid prescriptions. And according to some members of Congress, fellow lawmakers are “too scared” to go up against the massive organization.

This may have to do with the fact that in 2017, the AMA was the seventh highest lobbying spender ($21.5 million), and in 2016 gave nearly $2 million to members of Congress.

The AMA has been forthright in its opposition to measures included in the Comprehensive Addiction & Recovery Act 2.0 (a proposed update to the 2016 law by the same name) that would limit opioid prescriptions to a three-day supply, according to Sen. Rob Portman of Ohio, a co-sponsor of the bill.

The AMA also opposes mandatory opioid education for doctors, as well as the required use of prescription drug databases to check a patient’s history with certain drugs before prescribing a new medication.

Members of Congress are “too scared to take on the AMA,” thus stalling progress on anti-opioid abuse regulation, said Sen. Joe Manchin of West Virginia.

Many of the measures that the AMA is against appear on a list of guidelines issued by the Centers for Disease Control and Prevention (CDC) in 2016.

The guidelines—which do not apply to palliative care, end-of-life care, or cancer treatment—encourage physicians to “start low and go slow” when prescribing opioid painkillers for chronic pain, and to “prescribe no more than needed.”

The CDC also advises physicians to discuss the risk factors of using opioid medication with all patients, and to review each patient’s prescription drug history via the prescription drug monitoring database before prescribing.

But the AMA does not see a solution in mandating these reforms through legislation.

“Limits and one-size-fits-all approaches will not end this epidemic,” the organization said in a statement. “The AMA has urged Congress, statehouses, and payers to cover evidence-based treatment that works. Most patients with opioid use disorder have trouble accessing care as payers and others put up obstacle.”

View the original article at thefix.com

1 June 2018
Philadelphia Grapples With Closing Heroin Camps

The city has promised to move people who are currently encamped in the area into drug treatment and permanent housing.

City officials and charitable groups in Philadelphia are grappling with how best to help people as the city moves to dismantle tent cities that are overrun with opioid abuse.

City officials hope to have four encampments closed by the end of May, and are giving camp residents priority access to housing and drug treatment.

“What I predict is going to happen? This bridge will be cleaned out, Tulip [encampment] will be cleaned out, they’ll go to the other bridges, they’ll go in abandoned buildings,” Nicole Bixler, a social worker, said earlier this month. “The community will be broken up, and they’ll die alone, and no one will know until we smell them in the summertime.”

The camps are home to about 180 people, many of whom inject opioids. Last year, Philadelphia cleaned out its largest heroin encampment, which had become so well-known that it was featured on an episode of The Dr. Oz Show. The camp was home to people with addiction, many of whom moved on to other areas of the city when the camp was cleared out.

This time, the city has promised to move people who are currently encamped in the Kensington area of the city into drug treatment and permanent housing. Each day, city workers visit the camps to try to get people into area shelters or into treatment. In the past two weeks 39 people have entered treatment, more than in the past six months, according to the Philly Inquirer.

“Everybody wants it to work,” said City Councilwoman Maria Quinones-Sanchez, whose district has three of the encampments and two shelters that people are being relocated to. “This is the closest we’ve gotten to breaking down barriers on access to housing and treatment. It shouldn’t have taken this long, but we’re there.”

Still, some residents of the camp are frustrated that it took so long for the city to come up with a viable solution to the housing and drug crisis.

“Why wait until now to do this?” said Ryan Forrest, 28, who has lived in one of the camps for seven months. “Why did they let so many people get frostbite during the winter?”

Forrest wasn’t sure what he was going to do when the camps were cleared, until he realized that he was on the city’s list of camp residents who were being prioritized for treatment and housing.

“I was going to stay until the end. I didn’t really have a plan,” he said. “But they were pushing me to the shelter, and they told me I was on the list, and I went up there.”

People who work closely with the homeless population that lives in the camps are cautiously optimistic that reluctant residents like Forrest may get help with the new programming.

“I’m scared for what may happen,” said Tim Sheahan, an outreach worker with the city’s Department of Behavioral and Intellectual Disability Services. “We’ve gotten as close to treatment on demand as possible.”

View the original article at thefix.com

1 June 2018