Author: Shernide Delva
These are just a few of the incentives doctors have received from prescription opioid companies. Did these goodies get you your last opioid prescription?
Could incentives be responsible for our current opioid epidemic?
That’s exactly what researchers set out to understand.
A recent report confirmed what many have suspected: doctors are receiving incentives from major opioid makers. In fact, one out of every 12 U.S doctors gets money, lunch or something else of value from companies that make opioid drugs, the study concluded.
Furthermore, companies are spending more time and effort marketing opioids to doctors than they are other less addictive painkillers. These finding will help understand why doctors have played such a major role in the opioid addiction crisis.
“A large proportion of physicians received payments — one in 12 physicians overall,” said Dr. Scott Hadland of the Boston Medical Center. “Tens of millions of dollars were transferred for marketing purposes for opioids.”
Dr. Hadland and colleagues went through databases from the Centers for Medicare and Medicaid Services, the federal government office that oversees public health insurance.
The 2010 Affordable Care Act includes the Physicians Payments Sunshine Act. This act required medical product makers to report any offerings or goodies made to doctors or to teaching hospitals. However, incentives are often disguised as something else.
“In some cases, they are money provided directly to physicians — for example, the speaking fees, the consultant fees and the honoraria. In other cases it is reimbursement for things like travel,” Hadland said.
On average, doctors get a single “payment,” usually a mean worth of $15 about once a year. Still, there are a select few doctors that are reaping the most benefits.
“The top 1 percent of physicians (681 of them) received 82.5 percent of total payments in dollars,” the team wrote in their report, published in the American Journal of Public Health.
These incentives could influence doctors to prescribe opioids to their patients:
“One of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” the study notes.
Between 2013 and 2015, the team found 375,266 payments totaling 26 million distributed to more than 68,000 doctors.
While larger fees mostly accounted for speaker fees, more leisurely incentives like food and drink accounted for 94 percent of the payments.
“I do think the practice is exceedingly common. Increasingly, medical schools are restricting the ability of pharma companies to come to speak to medical students and even faculty,” Hadland said.
With all this said, do small incentives really make a difference? After all, can a doctor really be bought for the price of a boxed lunch?
The research indicates that, yes, these little goodies do influence prescribing. Last year, a study revealed that physicians who accepted even one meal by a drug company were more likely to prescribe a name-brand drug to patients later.
This is not the first time investigations were conducted on possible incentives. After earlier controversies and studies, the Pharmaceutical Research and Manufacturers of America issued a voluntary code of conduct to curb the once widespread practice of handing out free mugs, prescription pads, and other swag covered in drug brand names.
Some cities and states especially hit by the opioid abuse epidemic have even sued drug makers saying their practices have helped fuel the problem. The CDC states doctors have contributed to the addiction crisis by prescribing opioids to too many patients. These prescriptions are often prescribed at high doses for too long which only increases the vulnerability to addiction.
The result is deadly.
There were more than 30,000 fatalities in the United States in 2015, the federal government said.
“I think that first and foremost we have known that one of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” said Michael Botticelli, former director of the White House Office of National Drug Control Policy, and now executive director of the Grayken Center for Addiction Medicine at the Boston Medical Center.
According to Botticelli, the answer is independent education, free of the need to promote a specific product.
“At the federal and state level (we may need to) move toward mandatory prescriber education to counteract industry’s influence over prescribing behavior,” he said. “Clearly, guidelines are not enough.”
For a long time, prescribing opioids was one of the first responses to pain management. Now other alternatives are being promoted such as pain management devices and holistic alternatives.
Botticelli agrees that while pain is a major problem, the answer is not more opioids.
“Yes, we want to make sure people’s pain is appropriately treated, but we know that longer and higher doses have significantly added to the addiction problem that we have in the United States,” he continued.
What are your thoughts? Did you know about these incentives? More studies are coming out revealing the back story to what led to the prescription opioid epidemic.
Opioid addiction has become a public health crisis. Now, more than ever is the time to seek treatment. Recovery is possible. You do not have to feel out of control. There is a solution. If you are struggling with substance abuse, call now. Do not wait.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Big Pharma has been called out several times in the past couple years for pricing, aggressive marketing and misrepresenting their products. Big Pharma companies have also been called to court a few times for the contribution prescription opioid drugs have made on the opioid epidemic that has damaged the country. The financial and emotional toll of the opioid epidemic has hit hard in several states. South Florida is no exception. Delray Beach has experienced their fair share of strain from the opioid problem, especially when it had been an epicenter of the huge illegal pill mill problem.
Now community leaders in Delray Beach are seeking restitution from the Big Pharma empires, making it the first city in Florida to take this shot at holding Big Pharma accountable.
The Big Suit
That’s why the Delray Beach commission Tuesday decided to sue drug makers for the part they played in the heroin crisis. The city has enlisted the national law firm of Robbins Geller Rudman & Dowd from their office based in Boca Raton. So far the suit has set its sights on at least 8 major drug makers and distributors. Two of these have already seen similar cases; Purdue Pharma and McKesson Corp.
Mayor of Delray Beach, Cary Clickstein, has stated:
“With virtually no help from our federal government and little from our state … cities like ours are now frantically searching for answers for our own population,”
“We’re right for turning our eyes to those who are known conspirators in this ongoing atrocity.”
According to the law firm representing Delray Beach, the Big Pharma companies being pursued are responsible for:
- Downplaying the addictive nature of opioids
- Forcing the burden of dealing with the resultant overdoses on state, county and city governments
One of the more impressive features of this case is that the lawsuit won’t cost the city of Delray Beach. The expenses will be covered by Robbins Geller. However, the case supposedly has the potential to garner millions in damages for the parties pressing the matter.
According to a partner of the law firm, who compared the Big Pharma tactics to the now infamous tactics of Big Tobacco,
“They went out and said that opioids are less than 1 percent addictive. That is obviously not true.”
The Mayor and the law firm seem hopeful, while other states have been laying the groundwork for these powerful fights.
States VS Big Pharma
Back in 2015, two counties in California sought damages against 5 Big Pharma companies for the same reasons, and in no time at all the case had been dismissed. However, recently one of these drug company agreed to pay 1.6 million for substance abuse treatment to settle the lawsuit. 4 others remain as defendants in this ongoing battle.
In 2014, Chicago’s Mayor Rahm Emanuel took a similar stance, but in 2015 the case was also dismissed. However, the court did state in one of these cases:
“The Purdue entities made misstatements about opioids on their own websites with the intention that Chicago doctors and consumers rely on those misrepresentations are sufficient to state claims against the Purdue entities for violations…”
And while U.S. District Judge Jorge L. Alonso dismissed many of the complaints, the battle over whether these companies deliberately misrepresented the drug benefits and risks continues.
Even recently Ohio Attorney General Mike DeWine announced the state is suing 5 pharmaceutical companies, including:
- Purdue Pharma
- Endo Health Solutions
- Teva Pharmaceutical Industries and subsidiary Cephalon
- Johnson & Johnson and subsidiary Janssen Pharmaceuticals
- Allergan, formerly known as Actavis
There are numerous other suits that have been filed against Big Pharma companies.
- Four counties in New York
- The Cherokee Nationfiled a lawsuit against distributors and pharmacies in tribal court over the opioid epidemic.
- The city of Everett, Washington
While some of these suits may go over better than others, the fact is Big Pharma is under some serious scrutiny.
Delray Beach Making a Case
The Delray Beach lawsuit will seek damages based on the claims that drug makers and distributors violated laws of:
- State consumer protection
- Public nuisance
- Unjust enrichment
According to city officials, every overdose in Delray Beach costs the city about $2,000 in manpower and lifesaving materials. With 690 overdoses last year, that puts the bill around $1,380,000. The only problem is finding a way to prove that pharmaceutical companies can be linked to these overdoses. While many, if not all, of those overdoses were heroin-related, the city may still have grounds to go after opioid drug makers in Big Pharma because these dangerous drugs are considered an underlying problem in the opioid epidemic.
Between 72 and 82 opioid prescriptions are written for every 100 people in Florida, the law firm reports.
While the law firm anticipates other governing bodies will join as plaintiffs, Delray Beach leaders insist they will not wait for other plaintiffs to join the lawsuit. At this point there is not telling how long the lawsuit will last.
There should definitely be accountability for the damage that has been done thanks to the misrepresentation of drug risks and benefits. The misguided and underestimated use of powerful opioids has destroyed countless lives over the years. But beyond holding Big Pharma accountable, there should also be some effort put forth by the state and community officials to promote safe and effective addiction treatment. Innovative and holistic recovery programs can make a huge impact. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Suboxone is a medication meant to treat opiate and opioid withdrawal. It is one of two forms of the medication buprenorphine, which is an opiate agonist originally developed to treat pain problems. Suboxone works by binding to opiate receptors in the brain, which are the same receptors that morphine, heroin and other opiates bind to.
Is Suboxone Safe: How Suboxone Works
In order to better understand the risks of Suboxone use, it is important to understand how this medication works. Let us be clear, Suboxone is a narcotic. It is a semi-synthetic opioid made from a combination of two drugs:
This compound is intended for the treatment of pain, as well as for combating opioid addiction. However, what many people don’t realize it that buprenorphine is itself an opioid.
DEA reports show that the substance can be 20-30 times more potent than morphine as an analgesic; like morphine buprenorphine can create a dose-related euphoria. Like other opioids commonly abuse, buprenorphine is capable of producing a significant “high” and thus has been abused in various ways.
Now, all products containing buprenorphine are controlled substances. Given the nature of this powerful opioid, the other primary compound of Suboxone is added.
Naloxone is a pure opioid antagonist medication used to block the effects of opioids. It works by reversing the depression of the central nervous system and respiratory system. Narcan is a brand name for the medication that is commonly utilized as an overdose antidote.
But beyond being used to reverse overdoses, the addition of naloxone to products like Suboxone is with the intention of blocking the euphoric high resulting from the abuse of opioids by injection, like buprenorphine.
So when a drug like Suboxone is taken orally, just the opioid has affect. Naloxone blocks the impact of the opioid when it is injected. The primary purpose of naloxone in Suboxone is to deter intravenous abuse.
Is Suboxone Safe: How is it used?
Suboxone acts as a partial opioid agonist and diminishes cravings as well as prevents other opioids from reacting to the brain’s receptors. The drug has become a frequently utilized substance for trying to combat opioid addiction. Suboxone can come in tablet form, or in the form of a film taken sublingually, meaning dissolved under the tongue.
When taken orally or sublingually as directed, the naloxone is not absorbed and the buprenorphine acts uninhibited. However, the formulation still has potential for abuse. Published data has shown that the opioid receptor’s binding affinity to buprenorphine is higher, so the opioid typically overrides the antagonist, causing many reports to argue that naloxone is an insufficient deterrent for the injection of Suboxone for recreational abuse.
Serious dangers of Suboxone
While Suboxone may have become a mainstream tactic for combating opioid addiction, the question has become if it is as safe and effective as producers would have us believe. So when presented with the question of ‘is Suboxone safe?’ must look at a few factors.
Is Suboxone Safe: Adverse side-effects
The fact remains that Suboxone is an opioid narcotic. Therefore, the side-effects of Suboxone are essentially the same as other opioids.
Most common minor side-effects include:
- Mild dizziness
- Stomach pain
- Redness, pain or numbness in the mouth
- Trouble concentrating
Most common major side-effects include:
- Cough or hoarseness
- Feeling faint or lightheaded
- Feeling of warmth or heat
- Fever or chills
- Lower back or side pain
- Painful or difficult urination
Major side-effects suggest the individual should check with their doctor immediately.
Is Suboxone Safe: Withdrawal symptoms
The irony is that Suboxone is typically used because people are trying to stop abusing other illicit or prescription opioids but want to have something to curb the withdrawal symptoms. Yet, Suboxone is known to have its own withdrawals, and for some they are even worse.
Symptoms of Suboxone withdrawal can include:
- Body and muscle aches
- Difficulty concentrating
- Drug cravings
- Digestive distress
The physical withdrawals can peak in the first 72 hours after the last dose, and some of the more psychological symptoms can last much longer.
Is Suboxone Safe: Interactions with other drugs
Taking other drugs while on Suboxone, especially other opioids or sedatives, can actually be fatal. Combining Suboxone with other drugs can cause a very dangerous reactions that many also ignore. Drugs that are particularly dangerous with Suboxone are:
- Benzodiazepines (Benzos) such as Xanax
- Older Antihistamines
- Antipsychotics such as Zyprexa
Cocaine is also an extremely hazardous drug to combine with Suboxone because they are opposites on the spectrum of stimulant vs depressant. When you combine cocaine with Suboxone, it actually reduces the amount of buprenorphine that is in your bloodstream. With less buprenorphine in the body the effects of opioid withdrawal symptoms can be felt.
Combining cocaine with Suboxone also increases the risk of overdosing on cocaine.
If you would like more information on Suboxone, download our free E-book: 5 Things No One Tells You about Suboxone.
DOWNLOAD FREE E-BOOK
Is Suboxone safe?
Suboxone may be a legal and popular alternative to some other opioids, but that doesn’t necessarily make it all that ‘safe’ to rely on. It is of course possible to overdose on Suboxone. As we said before, Suboxone combined with other drugs can also be incredibly dangerous. And at the end of the day, you can still become psychically and psychologically dependent on the drug.
In truth, Suboxone has been useful to some who have tried to get off of drugs like heroin and other dangerous opioids by providing a buffer and some method of harm reduction. But the often overlooked aspect is that Suboxone is only intended for short-term use and not long-term maintenance. When individuals use the substance for long periods of time, they become dependent on it just like any other potent narcotic. Experts insist that Suboxone and similar drugs are only effective in combination with comprehensive treatment or cognitive behavioral therapy.
For more information, read our
A safer and far more healthy and sustainable approach to recovery from opioid addiction is with holistic treatment that offers much more than an opioid substitute with its own adverse effects. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Many months back, when President Trump was still on the campaign trail, he was asked about the opioid epidemic in America during a Q&A in Ohio. He said the solution was about cutting it off at the source through the southern border. President Trump continues this narrative in a more recent solo press conference, suggesting the United States is becoming a “drug infested nation,” and he added,
“Drugs are becoming cheaper than candy bars.”
So what is President Trump’s plan to fight addiction, and will it help addicts?
President Trump on Cartels
By now we all know President Trump believes there is a direct correlation between the drug epidemic in America and what he calls an epidemic of illegal immigration. In the past he has pointed to the infamous border wall as the answer to cutting off the heroin trade into America, which he seems to believe is the primary source of the problem. During his press conference he adds,
“We’ve ordered the Department of Homeland Security and Justice to coordinate on a plan to destroy criminal cartels coming into the United States with drugs,”
President Trump went on to say,
“We have begun a nationwide effort to remove criminal aliens, gang members, drug dealers and others who pose a threat to public safety.”
To be fair, we must acknowledge the relevance of cartels in the drug trade. Since the 90’s some statistics show that the primary supplier of heroin to North America is pretty consistently Latin America and Mexico.
However, to believe that Mexican cartels are the only element of the opioid epidemic is a mistake we can’t afford to make. And blaming an entire country for drug dealers and gangs is a bit out of step with the history of drugs and gang violence in America. While it cannot be denied that Mexican cartels have a role in all this, solving the addiction problem is a lot bigger than that. Besides the fact that heroin is not only from Mexico, heroin is definitely not the only problem.
President Trump on China
For example, what do you know about fentanyl? That is, the incredibly dangerous opiate that has created such a overwhelming panic as a result of steep spikes in overdoses and deaths. Did you know it originates from Chinese suppliers?
According to some lobbyists, there are some clues that could imply President Trump plans to prosecute drug traffickers and close shipping loopholes that include drugs coming in from China and other areas.
So far, however, there isn’t much mention out there about these ideas. It seems the majority of the statements being made openly are singling out Mexico. It might be time to talk more on these other areas they plan on addressing. There is some value to stopping these dangerous drugs from getting here, but we also have plenty of problems here already.
President Trump on Opioid Epidemic
President Trump did release details during his campaign about his intentions for taking on the opioid epidemic, stating he plans to:
- Increase Naloxone access- the opiate overdose medication
- Encourage state and local governments to provide treatment options
- Speed FDA approval for abuse-deterrent painkillers
Yet some people are concerned because there hasn’t been much more talk about this since late in the campaign trail. President Trump has referenced a move to expand access to drug courts and raise the cap on how many patients that doctors can prescribe medication-assisted treatments. These may be very effective strategies for providing multiple opportunities for exposing addicts to recovery. But we aren’t hearing enough about those either. When the subject comes up, we should hope for more accurate information to know if addicts will get this help, instead of hearing about immigration.
Again, many still want the President to talk more openly about the contribution made by Big Pharma and prescription drugs to the issue, specifically concerning the opiate epidemic. We can only blame so much of our problems on outside influence. We have to hold our own drug companies accountable.
President Trump and Big Pharma
Trump did say throughout his campaign he would be fighting the Big Pharma companies in order to get rid of outrageous price-gouging on medications. He made a statement at one point that,
“Pharma, pharma has a lot of lobbies and a lot of lobbyists and a lot of power and there’s very little bidding on drugs,”
“We’re the largest buyer of drugs in the world and yet we don’t bid properly and we’re going to start bidding and we’re going to save billions of dollars.”
This much isn’t off base. According to the Center for Responsive Politics, drug companies and their industry allies spent more than $186 million lobbying for their interests in a year, and $1.12 billion since 2012.
Yet, the Republican Party did a great deal in 2003 under President George W. Bush to prevent federal government from interfering in negotiations between drug companies and pharmacies that participate in taxpayer-funded Medicare Plan D prescription drug benefits.
Hopefully, having a Republican Congress that isn’t constantly at odds with their President will help things move along easier; especially concerning healthcare reforms. So beyond making drugs cheaper, the question becomes what can we do about preventing dangerous and addictive drugs from getting even more out of control.
ACA and CARA
With healthcare reform, many addiction recovery advocates insist that the Comprehensive Addiction and Recovery Act (CARA) should be a priority. Many say the CARA is the most significant federal legislation pertaining to addiction in years. Still, it does not include a specific allowance of funding for the programs it has created.
Once CARA is funded, more programs will be put in place to help fight addiction. Without the funds it is a Cadillac with no engine or wheels.
Then there is the major point President Trump ran on; repealing the Affordable Care Act (ACA). This action could eliminate coverage for many Americans in recovery who had previously been uninsured. Specifically, if the government repeals the ACA without a plan to replace it or to maintain coverage for those depending on it. If President Trump and the GOP come up with a program to replace it, we may still avoid this tragedy. Still, as it stands, the idea makes plenty of people nervous.
For instance, Medicaid, the federal-state insurance for low-income people, payed for about $60 billion worth of mental health services in 2014. That assistance is now expected to shrink as a result of healthcare reforms under President Trump.
After Republicans have pledged to make some major cuts in federal spending, there is still hope out there that agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) would not see their funding severed. This would potentially be another devastating blow to the efforts already in place to battle addiction in America. Will President Trump defend these programs to help addicts?
What Will Help?
Some of the ideas this administration mentions do have some hope behind them. My opinion, we might want to hear more about the expansion of treatment options and access to life-saving resources. The strong focus on border control and President Trump’s cries for “law and order” and aggressive investigations sound extremely reminiscent of the War on Drugs that failed so many families and people suffering.
As the former drug czar Michael Botticelli stated,
“Any drug policy that’s going to be effective has got to be based on science and research,”
So President Trump has his work cut out for him, but some still say we need to see more being done with healthcare and providing resources. More advocates want to hear plans on healing people; on how we plan to save lives. Assure people by taking real action to show they will not be without insurance or treatment.
So this does not mean to say the President’s plans are not good. Essentially, we just want to hear more about them besides borders. If his plans do involve expanding current resources, and if the ACA is effectively replaced; if we see adequate funding appropriated for the CARA and if we make this about more than just immigrants and law enforcement, then the plan could make a difference. So far only time will tell.
Drug abuse and addiction is a devastating and deadly disease, and providing effective and compassionate treatment makes a lifelong difference. If you or someone you love is struggling with substance abuse or addiction, think about who you want to be working with to find a real solution. Please call toll-free now.
CALL NOW 1-800-951-6135
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
The growth of medical marijuana reform in America continues to make headway. Some new states are beginning the process of establishing new regulations and policies concerning medical marijuana, and others have already begun to debate fringe issues like drugged driving or workplace drug tests. Medical marijuana is no longer as taboo as it once was, and now innovations are beginning to reinvent the way marijuana is used medically. Something else you may not know about medical marijuana technology is the cannabis transdermal patch.
A few months ago there was the story of the new cannabis inhaler, utilizing the same kind of device that people use for asthma. This unique method of administration has nothing else like it so far. There is enthusiasm about how this could change how people utilize medicinal marijuana to fight cancer and other serious diseases. It may even change how some people view the use of cannabis for medical reasons. So looking at the concept of cannabis transdermal patch, it sparks some curiosity.
Cannabis Transdermal Patch: How Patches Work
To explain, a transdermal patch is basically an adhesive attached to the skin which allows medication to be absorbed through the skin. Of course, transdermal patches already exist for all types of other medications. The nicotine patch is probably one of the most popular forms of transdermal medication. The extremely potent and potentially lethal drug Fentanyl has also been used in the patch form before.
The cannabis transdermal patch would release certain chemicals over time to combat the neurological nerve pain for many patients. According to initial reports from one company, Cannabis Science, so far the research has shown no notable negative side effects.
Cannabis Transdermal Patch: Mary’s Medicinals
This actually isn’t a brand new concept. Since 2013, Mary’s Medicinals is a company that has been focused on medical cannabis. The company was the first to ever offer a cannabis transdermal patch as a method of delivery.
The cannabis transdermal patch from Mary’s has actually won numerous awards at the CannAwards in 2015. In defense of their intentions with the product, they have even said,
“We don’t cater towards the recreational market”
One report says that 80% of the companies products don’t even contain THC. THC is the chemical in marijuana responsible for the “high” people experience.
Cannabis Transdermal Patch: Cannabis Science
The cannabis transdermal patch was created by a company called Cannabis Science. According to one statement from the company about the cannabis transdermal patch,
“An advantage of a transdermal drug delivery route over other types of medication delivery, such as oral, topical, intravenous, intramuscular, etc. is that the patch provides a controlled release of the medication into the patient, usually through body heat melting thin layers of medication embedded in the adhesive which will be containing high potency cannabinoid (CBD) extract that slowly enters into the bloodstream and then penetrates the central nervous system of the patient delivering the pain relief sought.”
So essentially the idea is to create a controlled dosage system for medical cannabis extract that can eliminate other complications of administration. The CEO of Cannabis Science also states,
“The development of these two new pharmaceutical medicinal applications are just the tip of the iceberg,” then later adding, “We are also busy researching more potential needs for cannabis related medical applications and developing the methods for delivery of these medications.”
So it would seem that this team believes the future of medical marijuana could very well be in finding new ways to apply the substance and administer it in a medicinal capacity.
Cannabis Transdermal Patch: Can it be Abused?
So as an individual in recovery and when looking at news in the field of drug abuse, medication and addiction treatment, of course my question is could these patches be abused. As with most people, when you hear anything to do with marijuana you have the stigma attached to it that has become so standard. But in reality, we have seen science support that there are uses for the substance medically.
Same can be said for Xanax or OxyContin, but these are still powerful drugs and with the nation facing an opioid crisis it is probably safe to say that even legal medicine with good intention has the capacity to destroy lives.
So, can the cannabis transdermal patch be abused?
Surely some could be. Depending on the chemical make-up the patch could probably be used as a sneaky way for people to get high. Surely there will be people who go out of their way to figure out how to misuse the cannabis transdermal patch. Still, for most companies the idea behind them has been to specifically develop a method of administering medical marijuana extracts without the “high” side effects.
Regardless of the legal standing of a medication, marijuana or otherwise, the dangers of substance abuse are very real. So perhaps as the use of the cannabis transdermal patch becomes more relevant more research about abuse.
Any substance can be abused and develop into an addiction, even marijuana. If you are struggling with marijuana addiction, do not hesitate to get help today. You are not alone! If you or someone you love is struggling with substance abuse or addiction, please call now.
CALL NOW 1-800-951-6135