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
You may remember last week we talked about how some states are pushing to take gun rights away from people prescribed medical marijuana. Of course, this topic has sparked a lot of conversation on how medical marijuana should be addressed. But a lot of the discussion has been on how 2nd amendment rights should be protected. The debate ranges from push-back for individual states, to argue that federal law still considers marijuana a schedule 1 drug, meaning people who use the drug are not allowed to own or possess firearms.
Well, since we have already jumped into the discussion comparing gun rights and medical marijuana, we might as well talk about another interesting story brought about by a Democratic congressman from California.
Concealed Carry Reciprocity
The whole conversation starts with the introduction of the Concealed Carry Reciprocity Act, which is currently being pushed by Republican lawmakers this week. This new piece of legislation would mandate that if someone is able to receive a concealed carry permit for a firearm in one state, that all other states would be required to honor that concealed carry permit. This means even if your state has much more strict requirements for concealing a gun, someone from a state with much more relaxed requirements is still allowed to travel into your state with a concealed weapon.
Now to be clear, there are many states that already honor concealed carry reciprocity. For example, if I were to get my concealed carry permit in my home state of Ohio, the vast majority of states would allow me to carry a concealed weapon.
Also, in the Buckeye State, they actually recognized the concealed carry permits of every other state already.
But Democratic Congressman Ro Khanna argues that it goes against the very idea of state’s rights and federalism. He argues that the Republican Party, which is often the champion for state’s rights, is forgetting that each state should be able to determine what laws are best for their own citizens and that this legislation will essentially federalize concealed carry permits.
The reason we wanted to talk about this is due to the argument used by Congressman Ro Khanna using marijuana to try and make his point.
Congressman Ro Khanna, who represents Silicon Valley area, made a video that argues that if the GOP wants to move forward with making concealed carry permits a national movement, then the same protections should be required by all states to honor marijuana laws.
In the clip posted to Twitter on Wednesday, Khanna states:
“If one state allows the legalization of marijuana, does that mean every state needs to allow the legalization of marijuana?”
Going off of Khanna’s comparison, applying the logic of the H.R. 38 Concealed Carry Reciprocity policy to marijuana would mean someone in California who received a doctor’s recommendation for medical marijuana for anxiety should be able to legally use marijuana in Pennsylvania.
Pennsylvania has more strict restrictions on their medical marijuana laws, with anxiety not being included as a qualifying medical condition.
While Khanna’s comparison is more tongue-in-cheek as part of his opposition to the H.R. 38 bill, it does present an interesting question; should medical marijuana be recognized with reciprocity? One should remember that gun ownership is an actual constitutional right, versus cannabis decriminalization being a recent movement.
Then again, does it make sense to argue “what’s good for the goose is good for the gander” in a context like this? This brings us back to the argument of whether or not the federal government should be putting more effort into federal law against marijuana, or if the states have more a right to decide if they will allow cannabis for medical or recreational purposes.
It is still an interesting argument to make. Should states compare these two concepts in the debate on policy?
Marijuana reform remains a controversial topic. However, the legal status of any medication does not take away from the dangers of substance abuse. Plenty of prescription medications have a high risk of abuse and addiction, and marijuana abuse can be harmful to an individual’s life.
People often mistake marijuana for having no addictive properties. This misconception is because most people consider cannabis a ‘soft drug’ when compared to other ‘hard drugs’ such as crack-cocaine or heroin. While the chemical hooks may not be as drastic or apparent, the truth is that habitual use of any chemical can result in developing tolerance, which can also lead to withdrawal. Symptoms most commonly associated with marijuana withdrawal include:
- Insomnia, nightmares, vivid dreams, using dreams
- Drug craving
- Mood swings
- Loss of concentration
- Weight loss and weight gain
- Digestion problems
- Night sweats
- Decreased sex drive
- Shakiness and dizziness
If you are struggling with cannabis abuse, do not hesitate to get help today. Often time’s people who use one substance develop a habit of abuse with many others.
Be careful not to underestimate the substances you are using. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
Californians expecting to get their marijuana delivered via drone should not hold their breath. A new set of regulations will make it harder for California businesses who try to deliver pot in unique ways.
The legalization of marijuana has raised a host of controversy. For one, the question of who has the right to distribute pot is already a complex issue. However, now there is the question of how these products get delivered.
Pot Drones? Should they be allowed?
California legislators are hoping to get these questions answered before issuing dispensary licenses next year. They came together this month to lay down the rules. Ultimately, it was decided that marijuana could NOT be delivered by drones.
The decision was part of the Commercial Cannabis Business Licensing Program Regulations released by the state.
“Transportation may not be done by aircraft, watercraft, rail, drones, human-powered vehicles, or unmanned vehicles,” the regulations read, according to Ars Technica.
While deliveries will be allowed, they must adhere to the following guidelines:
“Deliveries may be made only in person by enclosed motor vehicle. Cannabis goods may not be visible to the public during deliveries. Cannabis goods may not be left in an unattended motor vehicle unless the vehicle has an active alarm system. Vehicles used for delivery must have a dedicated, active GPS device that enables the dispensary to identify the geographic location of the vehicle during delivery.”
The news will be a major disappointment to the handful of businesses in California who already promised future pot deliveries by drone. One company, MDelivers, said the opportunity to deliver marijuana via drone was “unmistakable.”
Nevertheless, the company CEO did not count on lawmakers forbidding drone deliveries:
“After navigating the complexities of medical marijuana permitting, the state and FAA licensing process was actually pretty simple. Nobody can jump in at the 11th hour and rewrite the laws of aerodynamics,” Chris Boudreau, CEO and founder of MDelivers said in a blog post before the regulations were announced.
With the new policies in place, there is no telling how entrepreneurs will get marijuana to their customers. Even if drones are off the table, there are a variety of other new, interesting methods being considered.
“We may see a vending machine attached to a self-driving car before we see a drone,” Marshall Hayner, CEO of Trees Delivery, told Mashable.
As California prepares to expand its cannabis market, there continues to be challenges among those against marijuana legalization, especially when it comes to the products crossing state lines illegally. This has already been a major concern for states where port had been legal for recreational use such as Colorado and Oregon.
Surrounding states are trying to address the marijuana diversion issue by requiring pot businesses to track their product from “seed to store.” Time will tell how these sorts of issues will be regulated.
Furthermore, there remains to be conflicting ideologies on whether or not marijuana use is beneficials. While there has been proven benefits of marijuana use, there are also negative effects of marijuana use. Like any drug, marijuana has the potential to be abused.
As more and more states legalize marijuana, logistical challenges remain such as how the products can be delivered. Marijuana remains illegal under federal law, where it’s still classified as a controlled substance. This results in a variety of challenges in states like Colorado where recreational marijuana is legal.
The federal government requires that Colorado and any state that legalizes marijuana work together to prevent:
- Distribution of marijuana to minors.
- Transporting marijuana from states where it’s legal to other states.
- Growing marijuana on public lands.
- Marijuana possession or use on federal property.
- Other criminal activity or violence associated with the sale of marijuana.
It is important to remember that like any drug, marijuana has the potential to be abused. Do not feel shame for feeling out of control of your marijuana use. Stigma should not prevent you from seeking treatment. If you or someone you know is struggling with substance abuse, please reach out today. Do not wait. Call toll-free now.
CALL NOW 1-800-951-6135