Monthly Archives: March 2014

Opiate Abuse Epidemic Addressed by Massachusetts Governor

massachusettsThe State of Massachusetts is experiencing dramatic levels of opioid abuse and their Governor, Deval Patrick, is sharply focused on addressing the problem. A compelling Boston Globe article has highlighted the growing problem with heroin and other opiates across the state noting that 185 people died of heron overdose between November 2013 and February 2014.

Also mentioned in the article was the state’s plan to increase funding for drug treatment by $20 million and to prohibit the sale of Zohydro, a highly potent prescription painkiller that has drawn much attention and criticism due to its ability to potentially worsen the opioid epidemic in America.

Governor Patrick has declared the opioid abuse problem a public health emergency and is taking active measures to increase the availability of naloxone to Massachusetts public workers so that they can intervene to save the lives of those experiencing an opiate overdose. Naloxone is a powerful opioid antagonist that reverses the effects of opioid overdose within minutes. Numerous overdose victims have been saved in recent years as a result of medical personnel or bystanders having access to naloxone.

The state also intends to crack down on the over prescription of pain medication and will be requiring physicians and pharmacies to participate in the prescription monitoring program. Participation was previously only voluntary, but will now be mandatory. Prescription monitoring reduces the prevalence of “doctor shopping” and also the diversion of prescription medications to the street where they are resold at a premium.

While naloxone can save lives by reversing the effects of opioid overdose, methadone also saves lives by removing the desperate daily struggle to avoid opioid withdrawal. This daily struggle often leads to premature death or long term incarceration. Suboxone (buprenorphine) provides the same medication-assisted support which allows those lost in addiction the ability to stabilize and move forward again. It is important to emphasize that medication-assisted treatment should always incorporate long term counseling and recovery-building since addiction is not just a physical dependency problem. The psychological component of addiction is what is addressed through counseling and therapy.

Doctors and Prescriptions For Pain Medication

oxycodone-prescriptionReceiving increased attention across the country are concerns about prescription pain medication and to what extent prescribers are using caution and due diligence in administering them.

In addition to opioid addiction treatment centers that often employ methadone, pain management clinics also utilize methadone as well as other beneficial but potentially addictive opioid medications such as hydrocodone for breakthrough pain. Often, in addition to painkiller prescriptions, pain management physicians will prescribe powerful benzodiazepines like Xanax and Klonopin to manage patients’ stress and anxiety symptoms.

The potential problems which can emerge from these medication combinations is fairly extensive. First, uninformed patients can develop a rapid physical dependency on pain meds if not properly educated. Patients also run the risk of accidental overdose when combining powerful drugs like methadone, oxycodone, and xanax. There is a serious risk to the community when a physician overprescribes because powerful pain medications and benzodiazepines have a premium “street value”, and are often diverted and sold to naive, inexperienced users who can easily overdose and die.

A recent article in DrugFree.org cited several State congressional bills being considered which would require physicians treating pain management to receive special education in the prescribing of opioid medication. Pain management clinics have been identified in the last few years as a major source of diverted opiate medications making their way to the black market. The article points to two states, Pennsylvania and New Jersey, that have set-up task forces to explore methods for reducing their states’ presciption drug abuse problems.

For recovering people, pain is a real life circumstance which should be dealt with humanely and sensitively without judgment. From child birth to surgery to cancer treatment, anyone can experience debilitating pain. Managing that pain may require strong medication that carries some risks. While every adult bears obvious responsibility for knowing what they put into their body, it makes sense that doctors would undergo specialized training in regard to the use of opioids to treat pain. This not only provides the physicians themselves with a reduced liability risk, but helps to increase the chances that those receiving strong medication are more thoroughly educated on the benefits and important cautions around use of prescription painkillers.

For information on suboxone-approved physicians, read: Suboxone Doctors

When Emotional Pain Fuels Relapse

grief-and-lossPeople in recovery from addiction face very substantial stresses. The stress of trying to cope with cravings & urges, the stress of facing life and trying to resolve problems, and the common pressure of trying to make ends meet when finances are not in good shape.

While many addicted individuals find that they are more resilient than perhaps they ever believed, loss can sometimes be a particularly crippling experience. People from all walks of life suffer and struggle with losses – divorce, the death of a loved one, the loss of a job, income, security, or health.

A recent New York Times article briefly profiled a young woman released from prison who was trying to stay clean from heroin. She really missed her child who had been removed from her custody. While she loved her baby, she also recognized she was not yet ready to resume the pressures and responsibilities of parenting until she got herself on more solid, sober ground.

With the death of a loved one, the feelings run so deep that coping is sometimes beyond one’s inner resources. Grief has a way of overwhelming the senses and the heart such that making rational choices is much harder than would normally be the case. In extreme emotional situations, thoughts can become paralyzed and feelings intensified. Such a combination can make sobriety incredibly challenging.

Emotional pain is part of life. We have all felt it. Recovery teaches many principles that help to make life more manageable and which can help a person to hold on, to survive the lows of life. And for those that slip, life must go on. All is not lost. In 12 step meetings, they say “keep coming back”. In treatment, they say, “don’t give up”. While these may sound like annoying platitudes, they are generally true and correct sentiments that are there to remind us that pain subsides, and the human heart can find a way to survive and to be happy again.

How this happens varies greatly from one person to another. Support from others can make a huge difference. Prayer and connection with the proverbial higher power can make a difference. We are connected (or can be connected) to good people and good things if we try to open ourselves to them. It is not always easy when we are hurting. Therapy and counseling sometimes point us to answers that we didn’t know even existed. Spiritual support can achieve this as well. Whatever life brings us, good or bad, happy or sad, hopefully we can pause for a few moments to reflect on the small blessings that so often go overlooked and underappreciated.

The message for today is to remember that you are worth it! It can get better. Recovery is always here for you.

Prescription Drug Addiction Among Affluent Women

women-in-addictionAn interesting post was made on the DrugFree.org website related to a recent survey which found that the primary drug of abuse among “affluent” addicted women was prescription opioids or heroin.

The definition of affluent included those whose annual family income exceeded $100,000. Of those who entered treatment for their addiction, 61% of them identified prescription opioids as their predominant addiction problem. 

The survey found that 70% of those who developed an addiction reported that their initial use was related to a prescription of legal medications for the treatment of pain or emotional problems.

The opioid epidemic has shown how universal addiction problems actually are by transcending all types of assumed barriers and biases. Opioid addiction is a very clear brain disease and poses risk, even in prescribed legitimate uses, to those individuals with no prior addiction-related problems or high risk behaviors.

For individuals receiving prescription pain medication, it is imperative that they have a thoughtful and candid discussion with their prescribing physician about the recommended dosage and length of time a particular pain medication is to be taken. Many physicians are highly assertive with their patients and do an excellent job of informing them of potential risks. Conversely, some physicians do not regularly educate patients on key medication issues often providing no more than a printout of medication information.

With prescription opioids, it is essential that medical professionals take the necessary time to fully inform consumers of the potential for developing a dependency on the medication. Patients need to maintain an awareness of a medication’s addictive potential. It is also vitally important that opioid prescriptions in particular be safeguarded from children & teenagers, and then properly destroyed when no longer being taken. See the Flip The Script facebook page for more information on this important topic.

As we move forward through 2014, it seems likely that we will hear more in the news media about the proliferation of opioid addiction and associated costs and consequences. Sharing your concerns with family and friends is one way to help insure that more people remain aware of the risks. Sustaining the discussion on opioid addiction and medication-assisted treatment (methadone, suboxone, naltrexone) is a worthwhile ambition.

Zohydro Pain Medication Causes Alarm

zohydro-opiate-medicationZohydro ER (extended release) is a new opioid-based pain medication just recently approved by the FDA and scheduled to be released for use in March of 2014. More than 40 healthcare organizations, advocacy groups, and physicians have come forward in a desperate appeal to the FDA to revoke the approval of Zohydro ER.

The medication is touted to be many times more potent than standard dosage hydrocodone, and the mounting fear is that Zohydro could lead to immediate abuse and overdose deaths across the country. This concern is in part stemming from the recent explosion in heroin use in the United States and the steady increase in opioid overdose fatalities that has emerged in the last five years.

One characteristic of Zohydro that presents increased risk is that it can be easily crushed and then snorted or injected. The medication was designed specifically for special pain management scenarios in which standard pain management interventions are not effective.

The manufacturers of Oxycontin brought a reformulated version to market some years ago that made if difficult for individuals to crush Oxycontin and misuse it. However, Zohydro was not designed with this tamper-resistant technology included.

Among the professional groups expressing grave concern over Zohydro is ASAM (the American Society of Addiction Medicine). Of particular note too is the fact that 28 State Attorney Generals have urged the Food and Drug Administration to re-examine their decision to approve the drug.

In lieu of the present opioid addiction epidemic that is sweeping the nation, it would seem that Zohydro will likely undergo some modification to insure less abuse potential. To see the drug removed from the market, before it has an irreversible harmful impact, is a goal around which most reasonable people can agree.

For additional reading on the escalation in prescription opioid addiction, review Black Market For Painkillers.