Author: Justin Mckibben
When discussing the very real devastation of the opioid crisis some people are still skeptical as to how big of a part prescription opioids play in the problem. While all patients should have access to comprehensive care for conditions relating to severe pain, ignoring the fact that prescription drug abuse is a crucial element of the epidemic is far too careless.
Many states had to face the issue of pill mill clinics and doctor shopping. Now one state, in particular, is now taking massive action in hopes of ending a very serious problem that has only grown over the years. Authorities in North Carolina took a close look at how prescription drugs wind up on the streets.
One of the key factors to narcotic medications hitting the illicit market was doctor shopping.
Doctor Shopping Stats
First, let us explain what doctor shopping is for those unfamiliar with the concept. Innovations in Clinical Neuroscience described the practice of doctor shopping, saying it:
“- entails the scheduling by patients of office visits with multiple clinicians for the same agenda, either for a continuing illness or to procure prescription drugs illicitly. As expected, the explicit definitions in the literature vary considerably, with a significant proportion focusing on a given illness episode.”
Essentially, doctor shopping is when patients visit multiple doctors with the intention of having a prescription given and then filled from each physician, giving them an abundance of medications.
Now in the case of North Carolina, this tactic grew a great deal of momentum as the opioid epidemic spiraled out of control in the past few years. According to WRAL, a Raleigh-based news outlet:
- In 2010, the State Bureau of Investigation says there were 88 doctor shopping cases.
- In 2016, that number rose to 184
- That is a 110% increase in doctor shopping incidents!
According to NBC Charlotte:
- Approximately three people North Carolina die every day in due to drug overdoses.
- Around half of those deaths are due to opioid painkillers.
So now, what moves is North Carolina making to try and fight back?
The Strengthen Opioid Misuse Prevent Act
After realizing just how big of an issue prescription drugs were playing into their current drug problem, officials in North Carolina have decided to put measures in place to try and prevent doctor shopping.
Starting January 1st with the new year, North Carolina enacted a new law, referred to as the Strengthen Opioid Misuse Prevent Act. So what does this new measure do?
- It allows doctors to only give a five day supply of opioids for pain from certain injuries, like broken bones.
- After a surgery, it allows doctors to prescribe a seven day supply.
- Refills can be given as needed, but the first refill will be limited.
North Carolina also gave some thought to protecting those in severe need of pain management resources. The new law does not apply to those with:
Local Authorities Unsure of the Future
The executive director of the North Carolina Board of Pharmacy, Jay Campbell, told reporters that while the action is being taken, it will probably never be completely eliminated. Campbell states,
“We’re certainly hoping that we can radically reduce the scope of drug diversion from pharmacies or any place else. But it is a problem that is never going to go away.”
However, Campbell believes there are certain indications of doctor shopping that pharmacists can keep an eye on as well, such as:
- The patient is visiting a pharmacy far outside their normal location.
- The patient brings in prescriptions from doctors the pharmacy is not familiar with.
Officials trying to stop doctor shopping in the area are asking pharmacists to be alert and ask questions when appropriate. Meanwhile, they are also working to develop other means of drug monitoring, including a system in which North Carolina doctors can register when they prescribe opioids to monitor records and catch patterns of doctor shopping.
There may now be some light at the end of the tunnel. Overdose death rates due to many legal prescription opioids are still rising, but they are rising far more slowly than that of fentanyl and other synthetic opioids according to a CDC report. While it is terrible that the death rates are still increasing, the fact that the rate of progression has slowed noticeably could suggest that many of the recent efforts aimed at curbing widespread over-prescribing practices could be starting to have a positive impact on the extent of the opioid crisis.
Medical Detox for Opioids
An important thing to remember is that for those suffering from substance use disorder or a physical dependency to opioids should always seek safe medical treatment in order to get off these powerful drugs. Opioid abuse presents an inherent risk to the body and the brain. Because of the often difficult and uncomfortable withdrawals, detoxing from opioids is best done in a safe medical environment.
Palm Healthcare Company’s detox facilities will offer a more comprehensive model for recovery from opioid addiction. Medical detox consists of both psychological treatment from professionals for both addiction and co-occurring mental health issues, as well as pharmacological treatment from medical specialists who can decide if there are optional medications to help ease the detox process.
What a medical detox for opioids should always do is provide a trained staff to monitor important vital signs like:
- Respiration levels
- Blood pressure
- Body temperature
- Heart rate
Abruptly discontinuing opioids can be painful or even damaging to the body. Make sure to seek the appropriate help. If you or someone you love is struggling, do not wait. Please call toll-free now. You are not alone.
Author: Justin Mckibben
In Philadelphia, there have been nearly 800 fentanyl overdoses this year.
According to figures released by the US Centers for Disease Control and Prevention (CDC) a sharp rise in drug overdose deaths, which many attribute in part to fentanyl, is causing a drop in American life expectancy.
As 2018 begins, many are afraid of what the future may bring concerning more deadly drugs reaching the streets, overdoses, and deaths. One area, in particular, is the streets of Philadelphia. Now, many in the area are pointing out that heroin is no longer the poison most popular on the illicit market. Fentanyl in Philadelphia is now the main ingredient in the drug problem.
How Fentanyl in Philadelphia is Changing the Scene
Patrick Trainor is a special agent with the Philadelphia division of the Drug Enforcement Administration (DEA). Trainor has kept an eye on the Kensington neighborhood for two decades. When talking about the drastic impact the lethal synthetic opioid has brought to the heroin market, he states,
“Fentanyl has drastically changed the landscape… Sixty-four percent of fatals in Philadelphia County are fentanyl-related. There’s no dope out here now, it’s all fentanyl. Even the old timers are scared of it.”
In areas like Emerald Street, AKA Emerald City, even drug users carry Narcan regularly.
Dangers and Death
Even addicts who are now content with using fentanyl are aware of the risks. But many say that compared to heroin, fentanyl’s rush is intense and immediate.
It is painful to use because it burns the vein. Some choose to chance the elevated risk of abscesses by injecting under the skin. This practice is said to reduce the risk of overdose and prolong the high. Yet, overdoses come almost instantaneously. Beyond that, the comedown of fentanyl is said to be abrupt, and the withdrawal period is a long and difficult one.
Tolerance for the drug builds quickly; dependence on the drug is rapid and pretty much unavoidable. Even those revived by Narcan can fall back into overdose due to the immense strength of the drug.
A lot of the issues related to fentanyl in Philadelphia can be connected to how it hit the street in the first place. According to interviews with drug users in the Kensington area, when fentanyl first started flooding the market the dealers didn’t know how to handle it, and the users didn’t even know about it. They had no idea about the risks of the drug, and overdoses were everywhere.
But then the dealers caught on when customers started dying all over, and so they changed the way they cut the drug in order to keep their consumers. Trainor himself notes,
“You’re paying the same for something that’s roughly 100 times more powerful, so why would you buy heroin? The demand is for the most powerful thing they can get. Heroin will never be able to compete with fentanyl. It just can’t.”
There is no wonder why fentanyl in Philadelphia has become the dealers choice, the economics of fentanyl trafficking are easy to understand.
Unlike with heroin, there is no need to wait for the poppy harvest to start production. To yield a kilo of fentanyl, the chemicals one would need cost less than $5,000. At $55,000-$60,000 per kilo delivered, fentanyl is the about the same price as heroin but earns traffickers far more once it is cut and packaged for the street.
Each kilo of fentanyl can be cut out to approximately 330,000 doses, according to Trainor. A single kilo is enough to kill half of the counties residents.
Two factors make fentanyl in Philadelphia such a difficult drug to get ahead of:
No dominant trafficker
With drug problems in the past, a substance coming into any area would probably be controlled by a single, relatively predictable trafficker or trafficking family, but not with fentanyl.
This incredibly powerful and potentially life-threatening drug is coming from China, ordered over the dark web, or coming up from Mexico. It isn’t being shipped in through the typical channels, and thus law enforcement has found it increasingly difficult to track.
It is easy to modify
Fentanyl is a synthetic drug, therefore it is pretty simple to change the formula. Every time traffickers make subtle changes to the chemical ingredients of their batch, the DEA analysts struggle to adapt and catch on before the recipe has been changed again.
“It used to be just fentanyl but now we’ve noticed eight different analogs in this area and around 40 nationally. Our chemists estimate there could be 200 additional variants.”
One of those variants is Carfentanil. This horrifically hazardous material is a painkiller… for elephants and other large mammals! It is estimated to be up to 10,000 times stronger than morphine. Carfentanil has shown up in other areas in the past, such as Cleveland, Ohio. It is still rare for street consumption, but it has shown up along with fentanyl in Philadelphia medical examiner’s office.
Over the past three years, fentanyl-related deaths across America have increased by 540%. According to the Journal of the American Medical Association, for the first time, the majority of fatal overdoses are fentanyl-related, accounting for nearly all the increases in drug overdose deaths from 2015 to 2016. Part of facing the ongoing opioid epidemic is providing effective and comprehensive addiction treatment opportunities. As more and more people die every day from these insidious substances we have to do all that we can to help fight back. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help!
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Deaths due to drugs like fentanyl and other synthetic opioids continue to rise at a devastating pace in America. Despite the implementation of a special opioid commission to tackle the opioid crisis head-on, and even after the President of the United States issued a public health emergency concerning this ongoing issue, drugs like fentanyl are still finding their way into the country.
So how is it that these dangerous drugs are still getting across our borders?
Mailing Law Loophole
Much of the current flow of fentanyl into America is said to be connected to a major loophole in mail security. As it stands, every day up to one million packages overall get into the US without being screened.
Under the current laws, most international packages must include some general information, such as:
- Information on the sender
- The packages destination
- Contents of the package
These seemingly simple details can, in fact, help authorities track and detect packages containing illicit substances. However, these are not bulletproof methods of detections.
A big part of the problem is a loophole that exists within our current system. According to Alex Wolff, of the bipartisan coalition Americans for Securing All Packages,
“Due to a loophole in the global postal system, packages sent via private couriers (like UPS or FedEx) are required to have the advance electronic data used by law enforcement to screen and stop dangerous material, while packages shipped via foreign postal services are not.”
Wolff explains that when materials are sent through certain channels from outside the country, they are sent without the necessary security data that law enforcement agencies require in order to screen and stop dangerous packages.
Considering that fentanyl and other synthetic opioids are expected to be produced primarily in China, much of the drug is being shipped through this international loophole right into the United States. Thus, law enforcement is essentially flying blind in their efforts to catch a lot of the drug as it slips into the country.
The STOP Act
In an effort to put an end to this exploitation of the mailing system, the Synthetics Trafficking & Overdose Prevention (STOP) Act was introduced to the Senate and House of Representatives in February of 2017. It is currently listed as H.R. 1057, as introduced by Republican Representative Patrick J. Tiberi of Ohio. This bipartisan and bicameral legislation could be a huge step forward. Sponsors for the bill include:
- Ohio Republican Senator Rob Portman
- Wisconsin Republican Senator Ron Johnson
- New Hampshire Republican Senator Kelly Ayotte
Each of these officials represents a state that has been hit hard by the opioid crisis. Surprisingly, almost a year later there has been no further action by Congress to pursue this bill.
Still, Alex Wolff remains optimistic that Congress will act soon to push the bill forward. Now the STOP Act also has the support of:
- The National Council of State Legislators
- Fraternal Order of Police
- The American Medical Association
To clarify, there are a few other prominent “STOP” Acts in the past, including:
TheSober Truth on Preventing Underage Drinking Act (STOP Act) of 2006
This was America’s first comprehensive legislation on underage drinking.
The Strengthen Opioid Misuse Prevention (STOP) Act of 2017
This was a law for North Carolina aimed at curbing the misuse and abuse of opioids.
Putting a STOP to Fentanyl Shipping
Whether having tracking information on international packages seems like a big deal or not, most experts take it very seriously. According to former assistant secretary in the Department of Homeland Security Juliette Kayyem, who is a lecturer on international security at the Harvard Kennedy School,
“You have the demand problem, the public health problem of making sure people cannot be addicted, but on the supply-chain issue, one of the loopholes is clearly the postal system,”
True, not very many drug distributors write “fragile fentanyl shipment: Handle with care” on their postage. However, Kayyem says that collecting data from senders, even those who are less likely to be truthful is important for law enforcement to be able to stop drugs like fentanyl from coming into the country. Kayyem states that even if someone from another country is shipping things in and lies about what is in the package, that lie itself becomes a means to get them in the long run.
Should this bill be pushed into action? Is this enough, or should there be a way to impose even more strict regulations on international mailing to put a stop to the exploitation of the mailing system? Is this the best way to curb fentanyl use and overdose?
In the past few years, overdose deaths due to synthetic opioids like fentanyl have skyrocketed. Over 20,145 people died from synthetic opioids other than methadone in 2016. But the opioid crisis isn’t just about preventing the drug from coming into the US. We also need to support effective addiction treatment options. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135