President Obama recently attended the National Prescription Drug Abuse and Heroin Summit in Atlanta, Georgia. Professionals and concerned citizens used the forum to explore ways to address America’s rising opioid addiction problem.
The President agreed that increased funding is needed to raise access to drug treatment in an effort to simply avoid incarcerating those addicted to heroin and other potentially deadly opioids.
The NBC article referenced here states that over 28,000 people died last year from opioid overdose in the United States. This number has quadrupled since 1999. Many of the overdoses occur from various opioids laced with a powerful prescription pain killer called fentanyl.
Methadone and buprenorphone (the active ingredient in suboxone) are the leading medications used in medication-assisted treatment approaches. Naloxone is another important medication which has been used to reverse opioid overdose. It has saved thousands of lives and is being widely adopted by first responders and police departments across the country due to its proven effectiveness.
President Obama expressed that the U.S. will move toward improved drug treatment access for opioid addicted individuals and that the issue of addiction will be dealt with more as a public health issue as opposed to strictly a criminal act. Included in the proposed legislation is doubling the patient limit such that doctors can treat up to 200 people with buprenorphine (suboxone). The current patient limit is 100.
The Department of Health and Human Services is reported to have committed another $94 million to community health centers to boost their provision of medication-assisted treatment in poor and isolated communities. Many rural areas of the U.S. have very limited availability of opioid addiction services.
Posted in Buprenorphine, Heroin, Heroin Overdose, Methadone, Methadone Clinics, Methadone Maintenance, Opiate Addiction, Opiate Prescription, Opioid Addiction, Prescription Drugs, Suboxone, Suboxone Clinics
Somewhat of a surprise was the recent ruling that the state of Massachusetts cannot ban the powerful new painkiller, Zohydro, from being prescribed in the state. The manufacturer of Zohydro, Zogenix, had argued that the ban was not constitutional and must be reversed.
The state governor, Deval Patrick, had announced his intention to make Zohydro unavailable since the manufacturer’s initial plan was to provide it without a tamper-proof component to deter abuse and potential overdose.
Judge Rya Zobel ruled that the state of Massachusetts had exceeded its authority in banning the drug, and she consequently implemented a preliminary injunction temporarily reversing the ban. The governor expressed disappointment that the public’s safety concerns were not sufficient to halt the sale of Zohydro, but he stated he would pursue other channels for addressing the widespread opioid abuse problem that is continuing to grow in the state and across the country.
Opioid pain medications have become a primary drug of abuse for a number of age groups. Deaths by opioid overdose now surpass deaths by homicide and motor vehicle accidents in numerous states.
While Zohydro may be an effective pain management medication, it will very likely be sought (and purchased illegally) by those with severe opioid addictions trying to avoid daily opioid withdrawal sickness. Sadly, overdose deaths will result from the use of this medication in similar fashion to the problems that surfaced when oxycontin hit the market. Please keep yourself informed, and if you are suffering with opioid addiction and withdrawal sickness, seek treatment immediately. There is opioid detox, methadone medication assistance, and private physicians using suboxone to help patients cope with their addiction.
Receiving 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
Zohydro 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.
A Reuter’s story was just released highlighting a large drug bust in New York City in which 25 people were indicted on drug charges including two physicians. The charges stem from evidence that a healthcare clinic called Astramed dumped $500 million in prescription opioids into New York City’s black market from 2011 through 2014. It is reported that a total of 5.5 million oxycodone pills were sold to local drug dealers via phony prescriptions. The Reuter’s article reports a federal indictment was issued in which 24 defendants were charged with conspiracy to distribute narcotics.
This story is especially disturbing and comes on the heels of other recent stories in the news like the overdose death of Philip Seymour Hoffman and the death of 17 people in Pennsylvania who had used the deadly heroin and fentanyl mixture only weeks ago.
The opioid abuse problem in the United States is reaching unprecedented levels and is causing concern in segments of society that had previously never thought much about addiction-related issues.
As addicted individuals come to grips with the reality of their illness, it will be imperative that they have ready access to detoxification and treatment services.
As a clinician of 25 years in North Carolina, I have witnessed a gradual and steady reduction in both substance abuse and mental health funding over the last decade. When rehabilitation services become no longer available to help people, the vast majority of them either remain in active addiction and die prematurely, or wind up incarcerated for committing crimes in desperation.
Stiff penalties for drug dealers are obviously merited. But treatment is the answer for those with addictive disease. We must also do something about our culture which far too often glorifies drug abuse and partying among the younger generation in our society. Opiates are seriously powerful and potentially dangerous medications. America needs to revisit the necessity of increasing funding for drug education & prevention as well as evidenced-based treatment for opioid addiction. That includes life saving medications like methadone and suboxone administered professionally, ethically, and responsibly.