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Tag: painkillers

  • Are American Drugmakers Pushing Pain Pills In India?

    Are American Drugmakers Pushing Pain Pills In India?

    “Painkillers are part of the daily routine. They have become more normalized,” says one social worker in India. 

    At home, major drug manufacturers like Purdue Pharma and Johnson & Johnson are facing declining sales and a plethora of lawsuits. Which is—at least in part—why they have turned their attention to India, a country with a growing middle class population and newly relaxed restrictions on opioid pain medications. 

    When Dr. GP Dureja founded the Delhi Pain Management Centre, people told him, “Nobody has time to complain about pain in our country.”

    Now, that mindset has changed, Dureja said. “I’m getting five to seven new patients per day,” he told The Guardian. 

    For decades, Indian law tightly controlled access to opioids, because the country historically had issues with opioid abuse.

    Normalization Of Opioids

    However, in recent years, in part due to lobbying by palliative care advocates, the regulations have been relaxed. Fentanyl and methadone are now readily available for pain relief and are beginning to be abused. 

    Alfiya Mulla, a social worker in India, said, “Painkillers are part of the daily routine. They have become more normalized.”

    American companies are moving in to profit from the change. Mundipharma, controlled by the Sackler family, sells buprenorphine in India, while Johnson & Johnson sells fentanyl patches. 

    Indians—like Americans of the early 2000s—see pain relief as a right. 

    Dr. Dureja summed up the changing mindset: “Don’t listen to your forefathers. They said you should tolerate pain, you should not complain, you should not take painkillers. Now, everybody wants to get rid of pain early.”

    Public health expert Dr. Bobby John is concerned that with public opinion on their side, drug companies will find ways to flood India with opioids. “Are people going to figure out every trick in the game to make [opioid painkillers] widely available? Of course it will happen,” he said. 

    Although Dr. Dureja works in pain medicine, even he is concerned by the proliferation of opioids. “General practitioners have started prescribing these drugs, and we’re not educating the population on when to use and not to use,” he said. 

    Opiophobia

    Yet, people who are in favor of expanded access to opioids argue that reducing regulations is important to providing palliative and end-of-life care to Indians who are living—and dying—with chronic pain. 

    “This is a rather horrible country to die in,” said Dr. MR Rajagopal, an Indian physician who speaks out against what he sees as “opiophobia.”

    Rajagopal shared the story of one patient with lung cancer, who came to get morphine tablets. Rajagopal’s clinic was out of the medication. 

    The patient “told us with outward calm, ‘I shall come again next Wednesday. I will bring a piece of rope with me. If the tablets are still not here, I am going to hang myself from that tree,’” Rajagopal said. “He pointed to the window. I believed he meant what he said.”

    View the original article at thefix.com

  • Woman Testifies About Chronic Pain, Opioids From Cot

    Woman Testifies About Chronic Pain, Opioids From Cot

    “We must invest in the discovery of new, effective, and safer options for people living with pain,” Cindy Steinberg said in prepared remarks.

    It’s heartbreaking to see the faces of the opioid epidemic—young lives cut short by drug overdoses. Yet, this week another tragic but often overlooked face of the epidemic was on display when a woman testified before Congress from a cot, detailing her life with chronic pain. 

    Cindy Steinberg, national director of policy and advocacy for U.S. Pain Foundation spoke before the Senate Committee on Health, Education, Labor and Pensions during a hearing entitled “Managing Pain During the Opioid Crisis.”

    Steinberg’s chronic pain began 18 years ago when filing cabinets and cubical walls fell on her at work. Today, she isn’t able to sit or stand for long periods without experiencing muscle spasms and pain.

    She told the committee that her life is like “being a prisoner in your own body and being tortured,” according to the National Pain Report. 

    Steinberg argued that substance abuse and access to pain management medications for those who need them are two entirely separate issues. She said that rising overdoses has highlighted an existing problem, “underscor[ing] our failure to provide adequate, safe, accessible treatment options for pain relief.”

    “We can and must restore balance to opioid prescribing,” Steinberg said. 

    According to NBC News, Steinberg said in her prepared remarks, “In the near term, we can and must restore balance to opioid prescribing with depoliticized, rational and cleareyed recognition of the risks and benefits of these medications. In the long term, we must invest in the discovery of new, effective, and safer options for people living with pain.”

    Others who advocate for pain patients, including Richard “Red” Lawhern, director of research for the Alliance for the Treatment of Intractable Pain, were happy to see Steinberg’s story in the spotlight.

    “Steinberg directly challenged the lack of resident expertise on pain management at CDC, suggesting that Congress direct the much better equipped NIH to rewrite the guidelines based on recommendations of the HHS (Department of Health & Human Services) Task Force. This is a recommendation I support,” Lawhern said. 

    Committee Chair Senator Lamar Alexander of Tennessee seemed to empathize with Steinberg’s concerns, saying the “massive effort in reducing the supply of opioids has had the unintended consequence of hurting people who need them.”

    This week, research emerged showing that current changes in access to prescription opioids are unlikely to reduce the number of opioid overdoses. The research shows that projected annual opioid overdose deaths will reach 82,000 by 2025. 

    View the original article at thefix.com

  • OxyContin No Longer Covered By Some Insurers

    OxyContin No Longer Covered By Some Insurers

    “This is a whack-a-mole solution… I don’t believe we should be isolating one category of opioid versus another,” said one expert.

    Some insurers are taking a rather bold stand against the opioid crisis by refusing coverage of OxyContin, a popular brand-name opioid painkiller. 

    The decision, according to the Houston Chronicle, has drawn controversy as some people question whether refusing to cover one specific medication will really make a difference. 

    “This is a whack-a-mole solution,” James Langabeer, professor of emergency medicine at McGovern Medical School at UTHealth, told the Chronicle. “On the one hand, it’s good that the insurance industry is weighing in, but I don’t believe we should be isolating one category of opioid versus another.”

    OxyContin, a brand name for oxycodone, is manufactured by Purdue Pharma, a company that has faced a slew of federal lawsuits for its alleged role in fueling the current opioid crisis.

    One concern, Langabeer says, is that denying access to OxyContin won’t necessarily force individuals to stop abusing opioids. In fact, he says, some may even begin using heroin instead, as it’s cheaper and more accessible.

    The Chronicle reports that last week, Blue Cross and Blue Shield of Tennessee announced that it will discontinue coverage at the start of 2019, stating it was “drawing a line that we will not continue to pay for this.”

    Previously, Cigna and UnitedHealthcare also announced the same. 

    A Cigna spokeswoman told the Chronicle via email that Cigna will consider covering the medication in some situations if a doctor feels it is “medically necessary.” She added that those using the medication for hospice care or cancer treatment will be allowed to continue use.

    UnitedHealthcare ceased to cover OxyContin in employer-sponsored plans beginning January 2017, according to the Chronicle.

    “There are therapeutically equivalent, covered alternatives that can be used for pain indications,” a spokesman for UnitedHealthcare told the Chronicle via email.

    Cigna, as well as insurer Florida Blue, will be replacing OxyContin with Xtampza, which they claim is more difficult to abuse. 

    Purdue Pharma has not been silent as insurance companies have rolled out these decisions. The company, according to the Chronicle, argues that it has been working to make the medication harder to abuse. It has also accused insurers of supporting its competitors for “financial gain.”

    “These recent decisions by insurance companies limit prescribers’ options to help address the opioid crisis,” a company spokesman told the Chronicle via email. “Unfortunately, these decisions appear to be more about pharmaceutical rebates.”

    Katharine Neill Harris, a fellow in Drug Policy at Rice University’s Baker Institute of Public Policy, tells the Chronicle that she has mixed feelings about the involvement of insurers. 

    “They do have a role and I don’t think they have done enough yet,” she said. “The easiest way to say we’re doing something is by stopping covering a drug.”

    For Harris, a better alternative is for insurers and doctors to look into long-term solutions for chronic pain, such as physical therapy.

    View the original article at thefix.com

  • Kelly Osbourne Gets Candid About Sobriety, Relapse & Mental Health

    Kelly Osbourne Gets Candid About Sobriety, Relapse & Mental Health

    “What I’ve learnt is that no amount of therapy or medication is going to work unless you want it to.”

    Fighting off stigma and advocating for self-care, Kelly Osbourne opened up to a British tabloid about her ongoing reliance on weekly therapy to help her battle with addiction. 

    “I believe everybody should have therapy,” the 33-year-old told The Sun. “Your mind, body and soul are the full package. I try and go once a week.”

    The former reality star also spoke of her seven trips to rehab and two mental hospital stays, and what was different the last time, the thing that finally got her sober. “What I’ve learnt is that no amount of therapy or medication is going to work unless you want it to,” she said. “Until you want to be a good person, you will never be one.”

    Osbourne—whose father, rock legend Ozzy Osbourne, has also had very public struggles with addiction—also touched on public perceptions around mental health care. “There’s still a huge stigma, especially in this country,” she said. “You work out to keep your body good so you go to therapy to keep your mind good.”

    This isn’t the first time the perpetually purple-haired celeb has dished on her history of treatment and institutionalization; last year, she laid it all out in a book.

    The TV star first got into drugs as a teen, when she started taking Vicodin after having her tonsils removed. “I found, when I take this, people like me,” she later told People. “I’m having fun, I’m not getting picked on. It became a confidence thing.”

    Over the years, her drug use ballooned into a broader problem. “The only way I could even face my life was by opening that pill bottle, shaking out a few pills—or a handful—into my palm, and throwing them down my throat,” she wrote in her 2017 memoir, There is No F*cking Secret: Letters from a Badass Bitch.

    After multiple trips to rehab, she sobered up once—then relapsed while living in Los Angeles. “Every day, I was taking more and more pills, hoping that I wouldn’t wake up,” she wrote.

    But she pulled through it and got off drugs again, eventually going on to pen her book about it all.

    “Now, I manage pain through creativity, friendship and self-care,” she wrote in a final chapter titled, “Dear Rehab.” “The crazier my life gets, the more focused I become on the things that make me feel good.”

    View the original article at thefix.com