Category Archives: Drug Safety

Beware of Fentanyl Effects

While it is fairly common knowledge these days, it bears repeating that fentanyl is leading to dramatic increases in drug overdose deaths. The Families Against Fentanyl group, using three years of CDC mortality data, recently concluded that fentanyl overdose had caused more deaths than the corona virus, automobile accidents, or suicide in the 18-45 age group.

Fentanyl is finding its way into other dangerous street drug combinations, and is consequently posing serious risks to both experienced and unexperienced users.

A December 2021 Wall Street Journal article mentioned that there were 100,000 fatal overdoses in the United States between April 2019 and April 2020. Fentanyl is making its way across the U.S. southern border smuggled in by Mexican drug cartels in a stream of drug trafficking that is yielding a constant challenge to U.S. law enforcement authorities.

Fortunately, community-based drug prevention programs across the country have begun including extensive discussions of the dangers of opioids and fentanyl as a common additive.

Opioid addiction in America will remain a chief concern for many more years to come. Securing local treatment and support has never been more important than it is right now.

Reducing Risk of IV-Related Infections

drug-safetyOne of the risks associated with the progression of opioid addiction is the increased probability of an addicted person moving to injectable heroin as a last resort in dealing with opioid withdrawal. In the early years of methadone’s adoption in treatment centers, it was used primarily to help heroin addicted individuals detox from heroin and eventually remain heroin free.

While heroin is definitely resurfacing, the opioid epidemic of recent years has primarily been about prescription opioids taken orally. Following this pattern of use, users eventually discover that crushing and snorting pills is a more efficient means of getting an opioid into their system. Injecting is typically the last step in this progression of the disease of addiction.

But with injection comes a variety of new risks and health problems such as skin abscesses, localized infection at the site of injection, as well as hepatitis C (a viral infection of the liver) and HIV infection acquired through needle sharing with infected persons. A recent story in the news highlighted a sudden increase in HIV infections in Scott County (Indiana) in conjunction with the rise of opioid addiction there and injectable drug use.

Indiana’s governor has temporarily approved the use of needle exchange programs to help reduce the risk of virus transmission resulting from the use of dirty needles. The story indicated that the number of documented HIV infections had risen month over month. The county is presently trying to locate over 100 people who may have been exposed to the HIV virus in connection with injecting opiates.

Methadone and other medication-assisted treatments have been conclusively proven to reduce heroin/opiate relapse and injection drug use. For many individuals trapped in a daily cycle of perpetual drug abuse, the risk of acquiring a deadly infection increases with every day that they are not in treatment receiving help.

Treatment leads to recovery, and recovery leads to dramatic lifestyle change. Many patients who choose methadone as a tool in their personal recovery never go back to injecting drugs. This obviously is a life saving choice.

Using the data from the long-term and serious studies, we must admit that 60% of men using the drug on a daily basis normalized their erectile function; they had no symptoms of the diseases and felt healthy. It is interesting that after 2 years of use, this indicator remains almost unchanged. This suggests that there is no tachyphylaxis. The data of a large-scale study show that the patients taking PDE5 Cialis 5 mg every day are less concerned with the time of action of the drug, the speed of the effect and spontaneity of sexual activity. The patient doesn’t think about whether the pill will work.

Someone recently stated “If you’re dead, you can’t recovery.” This is a rather blunt way of expressing a profound and meaningful truth. Addiction does rob loved ones, friends, family, and neighbors of life, health, and happiness. Recovery has the ability to restore all of these. Let us keep our minds and hearts open about the value of medication-assisted treatment. It is making a real difference for numerous people around the world.

Naloxone Reverses Opioid Overdose and Saves Lives

naloxone-kitMore communities across the U.S. are facing the devastation of opioid overdose. The impact on families is profound as they often struggle with questions of “Could we have done more?” and ponder what else must be done to address this growing national epidemic.

Highlighted in the news this week was the heroin overdose death of a Louisville cheerleader and the suspected opioid overdose death of a 27 year old man in North Carolina found slumped behind the wheel of his pick-up truck with an empty bottle of painkillers and a spoon beside him.

Naloxone is an FDA-approved medication that reverses the effects of opioid overdose. It is an opioid antagonist and consequently knocks opiates off of the body’s opioid receptor sites thus reversing central nervous system and respiratory depression which are the most dangerous consequences of opioid overdose. In many cases, naloxone quickly restores breathing and allows overdose victims to regain consciousness in a relatively short period of time. Naloxone is administered by injection or intranasally as a mist.

An increasing number of emergency first responders are now carrying naloxone kits as are some police units in select areas of the country. Local government is now more involved too with new legislation having been proposed in the last year to dramatically increase funding for the provision of naloxone kits.

Ideally, naloxone will one day become readily available without prescription to anyone via their local pharmacy. There is no upside to politicizing something as beneficial as naloxone because it simply saves lives. Note that the medication itself produces no drug high.

Methadone and Other Medications

doc66Methadone is FDA-approved for pain management and the treatment of opioid addiction. Methadone is a relatively safe and highly effective medication when used exactly as prescribed. It is currently in use in the United States and around the world following years of conclusive research on methadone’s efficacy and safety.

It is important for patients receiving methadone to know that it can interact with other central nervous system depressants like alcohol and benzodiazepines such as xanax, klonopin, valium, and librium as well as similarly acting non-benzodiazepine agents like ambien (a popular sleep aid). When methadone is mixed with these other medications, there is an increased risk of sedation and loss of consciousness. In extreme cases, individuals mixing methadone and other CNS depressants have gone into respiratory failure.

For those who have chosen to receive methadone in an opioid treatment program, they will discover that a proper dose of methadone not only eliminates opiate withdrawal & cravings, but will also block the euphoric effects of any other opiates. This is typically a positive side effect in that it discourages illicit opiate use or supplementing with street drugs like heroin. Since methadone binds so well to the brain’s opiate receptor sites, any other opiates that are ingested have no means of creating a euphoria or a high since the body’s opiate receptors are occupied by methadone. This removes the incentive to misuse other opiates and can facilitate the process of recovery. I was ordered by his neuropathologist to treat panic attacks. I began to drink them in half, and then I kiss the pill for the night. I drank a tablet of hours at 8 pm – after half an hour I sleep with a child). The effect is very classy: nothing is interesting, nothing is needed, there is no emotion – everything a person needs is just morally tired.) She accepted Klonopin for about four months. The effect was. Somehow I just did not care about panic attacks). They did not care anymore.

There are instances in which a patient’s physician has prescribed a benzodiazepine for anxiety management while also prescribing methadone. Such decisions should always be accompanied by a thorough discussion with one’s doctor of the potential risks & complications. There are other, safer alternatives for treating anxiety such as Buspar and cognitive therapy. These other options should be considered when a patient is already receiving methadone. In addiction treatment, the use of benzodiazepines for anxiety is typically monitored carefully through increased random urinalysis testing and medication counts.

New Opioid Treatment Medication Prepares for Market Release

bunavailSoon to be released is a new oral buprenorphine based product called Bunavail. Bunavail is manufactured by Biodelivery Sciences and is a combination of buprenorphine and naloxone. It is a thin film formulation that is designed to adhere to the inner cheek where it quickly dissolves and is absorbed into the mucosal lining of the mouth.

The medication is touted as delivering about twice as much active ingredient into the patient’s bloodstream compared to sublingual suboxone. Bunavail is scheduled to be released in the third quarter of 2014. A press release by the company mentions that the medication will compete with other products in the $1.7 billion dollar opioid dependency treatment market.

Bunavail is a new advancement in drug delivery technology according to the press release and is reported to produce less constipation than other competing buprenorphine products. Patients can also speak freely while the medication dissolves.

With an estimated 2 million plus people addicted to opioids in the United States, new medication alternatives are welcomed.

Biodelivery Sciences is described as a specialty pharmaceutical company with a focus on pain management and addiction treatment. The company is based out of Raleigh, North Carolina. Bunavail’s FDA approval was announced on June 6, 2014.

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