Next time you are shopping around online and come across a deal on your prescriptions, take a closer look.
With the crackdown on opioids happening all over the nation, many people are finding new ways to try and get their hands on these powerful prescription drugs. Some may be illicit drug traffickers looking for a new way to get their supply and reduce the risk. Meanwhile, others may be everyday people looking for a cheaper, easier method to get their pain management medications. Either way, if you are getting your drugs online, it’s more than likely you’re breaking the law.
Online Opioid Pharmacies or Digital Drug Dealers
The internet is famous for making our lives more convenient. Whether we are shopping for new shoes, movie tickets, or even our weekly groceries, the internet has found a way to let it be a mouse click or touch-screen tap away. So of course, many would be willing to believe you could order plenty of your much-needed medications online. Yet, with a new report by the Center for Safe Internet Pharmacies (CSIP) we find most of these sales are actually illegitimate.
The report was initially released on opioid sales on the darknet. However, during the research, the CSIP found that people on both the Dark Web and “surface web” sell drugs like opioid painkillers. The distribution of these potent medications is being done through online opioid pharmacies. Nonetheless, according to the FDA:
97% of online pharmacies operate illegally
Just to break things down a little bit, let us explain two key terms.
The surface web is the portion of the world wide web as we know it that is readily available to the general public. This is where you do most of your online shopping, social media activity, and probably where you are reading this article right now.
Strangely, even though people would think that anything on the surface web is probably safer, the CSIP report states that “surface websites” actually involve higher risks for scams. For example, this would be non-delivery schemes where the site takes your money without producing a product, or credit card and identity theft.
This is the World Wide Web content that exists on “darknets”. These are networks that use the internet, but require specific software, configurations or authorization to access. The dark web forms a small part of the “deep web”, which is the part of the internet not indexed by search engines.
The Dark Web is where a lot of the internet’s most illicit activities actually happen. It is a modern digital underground.
Many of these so-called online opioid pharmacies are only click-baiting people into the illicit drug trade. In reality, these are drug-dealing websites set up to look like they simply sell prescription pills to those in need. Some even go as far as to offer prescriptions for the drugs. CSIP’s report also states that these online pharmacies will attempt to use social media platforms to advertise their products, including:
Some of these online opioid pharmacies will claim on their website that they are legitimate and legally approved. However, CSIP’s executive director Marjorie Clifton says that’s impossible for most of them. In one interview Clifton states:
“It’s absolutely illegal to buy opioids on the internet.”
Now, it is not entirely illegal to operate a pharmacy online. Clifton said that some non-opioid-selling pharmacies are legal. However, these entities do have to follow certain rules. For example:
- They must have a brick-and-mortar location
- Must be licensed in every state that they sell to
You can verify that the pharmacy that you’re buying from is legal by using tools created by the CSIP.
Not only is it risking legal action to use these illegitimate sources, it is also a serious health risk. Online opioid pharmacies may seem like an economical and efficient way to get medication, but non-certified pharmacies present significant danger because there is no way of knowing what you are getting. Clifton states:
“One, you might not get the concentration you thought you were going to get, it could be a placebo.”
“There have been cases when it’s rat poison or lead paint. So you have no idea what you’re taking if you’re not buying from a certified pharmacy.”
It is already dangerous enough for getting these medications illegally on the street. Over the years there have been countless reports of other powerful and toxic substances being pressed into forged pill forms. That risk is very real when buying drugs from an anonymous source over the internet.
Internet Associations Fighting Back
CSIP is an organization made up of representatives of companies like Google and Microsoft. Clifton says there are no ties between this tech industry collaboration and the pharmaceutical industry. The organization says it is committed to reducing harm from illegitimate online opioid pharmacies. Clifton also says that the issue of drug addiction is personally devastating, adding that several board members have lost loved ones to addiction.
So far, CSIP has removed more than 100 million ads and social media posts. The organization has effectively shut down thousands of illegal online opioid pharmacies. Many of these sites were functionally the same illegal pharmacies operating with different URL’s, but belonging to the same scammers.
Even though increased regulation resulted in a small jump in darknet sales, the vast majority of prescription drug abuse comes from prescriptions written by actual doctors. Overall, the CSIP report found that less than 5% of opioids purchased in the US came from anywhere on the internet. CSIP reports were also utilized in the Online Opioid Summit hosted by the FDA last month when top names in internet stakeholders got together with advocacy groups and other government officials to discuss the role internet companies play in combatting the opioid crisis. Most of the tech industry insists they should not be blamed for the opioid crisis.
Still, the organization is trying to play a part in eliminating online opioid pharmacies. Beyond that, we should also focus on promoting safe medical detox opportunities, along with dual diagnosis programs and holistic drug treatment options.
When we talk about fighting the spread of addiction, one thing we have to remember is to make sure people looking for help get all the information they need. Palm Partners Recovery Center believes that we should also focus on using our digital footprint to help people learn about the risks associated with substance abuse, and give them the opportunity to learn about safe and effective treatment. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
Tomorrow morning, June 27, the FDA Commissioner Scott Gottlieb, M.D. will host a one-day Online Opioid Summit. The guest list to the summit includes:
- Internet stakeholders
- Government entities
- Academic researchers
- Advocacy groups
The aim of the event is to discuss ways to collaboratively take stronger action in combatting the opioid crisis by reducing the availability of illicit opioids online. And when it comes to the internet, there are no bigger names in America than Google, Twitter, Instagram and Facebook. There will be presentations by the Food and Drug Administration and other organizations. A webcast will be available of the Opioid Summit for the general public.
So what will the FDA, Google and the biggest names in social media have to talk about?
Online Opioid Markets
Over the past decade, opioid-related deaths have continued to climb. According to data from the Centers for Disease Control and Prevention and FDA:
- In 2005 there were around 12,900 opioid-related deaths
- In 2016 there were well over 42,000
More recent figures show that on average, 115 Americans die every day from opioid abuse. There are a few elements that have contributed to this devastating trend, including the over-prescription of painkillers like Oxycontin and an influx of heroin into the country.
So what does the place you get your sponge-bob square-pants memes have to do with opioid abuse in America?
When we’ve taken a closer look at the opioid crisis, we have discovered that illicit sales of either prescription medications, illegal narcotics or synthetics like fentanyl from overseas have found a home in online marketplaces. According to a study by Carnegie Mellon University, revenues from illicit drug sales online have grown substantially over the last several years.
- 2012- online illicit drug sales were between $15 and $17 million
- 2015- those illicit drug sales online shut up to between $150 and $180 million
The National Association of Boards of Pharmacy conducted research by searching online for prescription opioids across the three major search engines. They found that nearly 91% of the first search results led users to an illegal online drug distributor offering prescription opioids.
Needless to say, those numbers show there are still dark corners of the internet dealers exploit for drug trafficking. In fact, when Facebook CEO Mark Zuckerberg testified before Congress in April, one of the big questions he was repeatedly confronted with was how Facebook intended to fight illegal drug sales on their site. This Opioid Summit is about a collaborative effort to do better about restricting online drug sales.
While dark websites like the notorious Silk Road have been a major component to digital drug dealing, social media sites, and search engines have found their formats being abuse for these activities as well. Between illegal online pharmacies, drug dealers and other criminals the use of the internet to distribute opioids with minimized risk has steadily increased.
The Opioid Summit will address the state of the opioid crisis and invite Internet stakeholders to present how their companies are working to fight the sale of opioids on their sites and protect their users. A statement by the FDA adds:
“One critical step to address this public health emergency is the adoption of a far more proactive approach by internet stakeholders to crack down on internet traffic in illicit drugs.”
Facebook has already announced new efforts to prevent the sales of opioids through their site. The approach by Zuckerberg and his team is actually unique. Facebook users who try to buy opioids or search for addiction treatment will be redirected toward information about finding free and confidential treatment referrals. Users will also be directed to the Substance Abuse and Mental Health Services Administration National Helpline.
On the Opioid Summit agenda, there are a few important discussions, including:
This will include a brief opioid crisis overview from Donald Ashley, J.D., Director, Office of Compliance, FDA. There will also be a presentation on the DEA Internet Investigation. And different experts will present research regarding the ease of purchasing opioids online.
This discussion will include a number of presentations, including one from the Center for Safe Internet Pharmacies. Even the Vice President of MasterCard, Paul Paolucci, will be part of the roundtable.
It is important to note that only the FDA speaker presentations will be webcast to the public.
The takeaway here is that hopefully as the illicit drug market evolves, using search engines and social media to try and carve out a space for trafficking, the biggest names in internet will also be working to actively prevent these illegal industries from flourishing on their sites. Hopefully, the summit will introduce new measures to make it harder for dealers to take advantage of social networking tools. Social media is for bringing people together. Sadly, some still use it to sell the drugs that tear communities and families apart. Next, there should be more discussion about comprehensive addiction treatment.
It is important that those with the ability to reduce drug trafficking take action where they can. An even more crucial aspect of putting an end to the ongoing opioid crisis is safe and effective treatment resources. For over 20 years, Palm Partners Recovery Center has been actively helping people struggling with addiction to transform their lives and heal. 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
These days it is pretty much impossible to In case you missed it, the latest news concerning opioid overdoses in America is not good. Just this week a report was released by the Center for Disease Control and Prevention (CDC) that only reminds us of just how horrific the opioid epidemic is. In most of the country, this crisis continues to get worse.
While we still don’t have a complete picture of the death toll in 2017 concerning opioids, the most up-to-date data shows that overdoses have spiked nationwide. Examining reports from hospital emergency rooms, the report compares the overall increase in opioid overdoses from the third quarter of 2016 up until the third quarter of 2017.
According to this data, opioid overdoses to increase by 30% in only a year.
Rising Overdose Rates by Region
In every age group, with both men and women, opioid overdoses are increasing, according to CDC Director Anne Schuchat. The Midwest has been the hardest hit region in that 12 month period. According to the CDC report:
- 7% increase in opioid overdoses in the Midwest
- 3% increase in the West
- 3% increase in the Northeast
- 2% increase in the Southwest
- 14% increase in the Southeast
All this may not come as much of a surprise for many Midwesterners. When you look at the last few years, the opioid crisis has not been kind to these communities. Of the counties with the highest overdose death rates per capita over the last few years, we consistently find some of the top spots going to states like West Virginia, Ohio, and Kentucky.
Needless to say, these devastating figures aren’t exclusive to the Midwest. A few more examples include:
- 109% increase of opioid overdose in Wisconsin
- 105% increase in Delaware
- 6% increase in Pennsylvania
- 34% increase in Maine
Luckily, not all areas are experiencing record highs. Some states are actually fortunate enough to see a slight decrease in overdoses, including:
- New Hampshire
- Rhode Island
Even in Kentucky, which has been a Midwestern state hit pretty hard over the years, the CDC analysis saw a 15% drop.
The CDC report does not specify as to why certain regions are experiencing overdoses differently, but one factor experts say has most likely played a key role is the availability of more potent opioids. The synthetic opioid fentanyl has been making its way onto the streets more and more over the last couple years, and supply of drugs like fentanyl has increased much faster in certain areas, which probably has a lot to do with the difference in overdose rates per region.
Analyzing Opioid Crisis
The recent report was meant to take a closer look at the opioid crisis by analyzing overdose reports in emergency rooms instead of opioid deaths like the CDC had previously focused on. CDC Director Anne Schuchat said these numbers lag behind the emergency room reports, and that the agency wanted “more timely information” to work with.
The data utilized for this analysis came from:
- Approximately 90 million emergency room visits
- Reports from July 2016 to September 2017
- 52 jurisdictions in 45 states
- 142,577 suspected opioid overdoses
That survey found an increase of 29.7% in opioid overdoses. The research also analyzed:
- 45 million emergency department visits
- Reports from July 2016 to September 2017
- 16 States
- 119,198 suspected opioid overdoses
This analysis shows a 34.5% increase during the same period, but those increases vary drastically from state to state.
At the end of the day, there are a lot of opinions on how to look at this mountain of information and see a way through it. But many experts are convinced that so far we have been failing those who are suffering the most. Dr. Andrew Kolodny, co-director of opioid policy research at Brandeis University, states:
“It is concerning that 20 years into this epidemic, it is still getting worse. The number of Americans experiencing opioid overdoses is still increasing.”
Jessica Hulsey Nickel, president and chief executive officer of the Addiction Policy Forum, is one of many voices who are advocating for a more compassionate and supportive system. Those like Nickel believe that the key element to changing the opioid crisis is better integration of addiction treatment into a more comprehensive and effective healthcare system. Some, including Nickel, believe even emergency room staff should be better prepared to help get follow-up addiction treatment for people with substance use disorder.
Addiction isn’t going away anytime soon, and perhaps one of the most tragic parts of the problem is that so many people never get the help they need. Too many are afraid to ask for help, and plenty more still don’t know how to get help. Providing safe and effective substance use disorder treatment isn’t just useful, but vital to our future. So taking advantage of these programs and supporting expanded access to addiction treatment should be at the forefront of the conversation if we hope to break this trend and save lives. If you or someone you love is suffering from substance abuse or addiction, please call toll-free now. You are not alone.
CALL NOW 1-800-951-6135
This may seem like a big leap, but some people still manage to make it. So we thought maybe we should take a look at both sides of this argument to understand the issue.
The Attorney General for the Trump Administration, Jeff Sessions, consistently comes into conflict with advocates for cannabis in America. His stance has been about the same for as far back as his career in politics, and recent actions by Jeff Sessions have caused a stir with those in support of legalization, whether medical or recreational.
Now, it seems Sessions believes that cannabis use is actually why we have an opioid crisis.
Looking at Opioid Stats
Recently, Jeff Sessions was speaking at the Heritage Foundation to the Reagan Alumni Association this week. As part of the conversation, Sessions did put a lot of focus on cutting prescriptions for opioid painkillers as a critical element to fighting the crisis. So many people who use illicit opioids like heroin or fentanyl start with prescription drug abuse. This much has been shown in several studies, such as one from 2017 published in Addictive Behaviors which found:
- 9% of people getting opioid use disorder treatment in 2015 started with prescription drugs
- This is an improvement from 84.7% in 2005
Some would argue that better regulations put into practice over the last several years have helped to curb that trend.
However, Sessions went on to say,
“The DEA said that a huge percentage of the heroin addiction starts with prescriptions. That may be an exaggerated number; they had it as high as 80 percent. We think a lot of this is starting with marijuana and other drugs too.”
It was that last comment that caught a lot of attention. It wasn’t all that shocking, considering Sessions never been a supporter of cannabis use. Still, some people found this commitment to the gateway drug mentality to be a little out of touch.
So, we should look into the argument from both sides.
Can You Connect Cannabis and Opioids?
A recent paper in the American Journal of Psychiatry shows Mark Olfson and a research team delves into data concerning the gateway drug concept.
The team uses data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to examine the association between:
- Cannabis use reported in the 2001-2002 survey
- Non-medical use of prescription opioids 3 years later
In relation to the survey the term ‘non-medical use of a prescription opioid’ is defined as using the drug “without a prescription, in greater amounts, more often, or longer than prescribed, or for a reason other than a doctor said you should use them” during the previous 12 months.
Olfson and his group claim that according to the data:
Cannabis users more often ended up using opioids
People who used cannabis in the 12-month period prior to the initial interview were at increased risk of non-medical use of prescription opiates 3 years later.
They even checked the variables, and found this was true even when the data were adjusted to control for:
- Family history variables
- Antisocial personality disorder
- Other substance use disorders
- Mood or anxiety disorders
Those studied who used marijuana were still at higher risk of opioid use.
Increased cannabis use correlated with increased opioid use disorder
According to the researchers, the percentage of people with Incident Prescription Opioid Use Disorder at the second interview increased as the level of cannabis use reported at the first interview increased.
To clarify, Incident Prescription Opioid Use Disorder was defined as use that occurred after the first interview that qualified to be considered opioid use disorder, restricted to people who had no prior lifetime history of opioid use disorder.
So essentially, the people who reported to using more cannabis at the beginning of the study were more likely to show signs of opioid use disorder 3 years later.
But Does Connection Equal Causality?
One thing the authors do acknowledge outright is that the majority of adults who use cannabis do NOT start using or increase use of prescription opioids.
Another thing the researchers acknowledge is that their study isn’t proof that cannabis use causes opioid use. The association of marijuana use with non-medical prescription opioids after 3 years in no way means that marijuana use is proven to actually cause opioid use.
The researchers do have a few ideas though.
Some animal studies seem to have shown that it is possible for cannabis to lead to changes in the brain that make individuals more susceptible to opioid misuse.
Another argument is that there are several non-biological factors that can elevate the risk of opioid use. Those who regularly use marijuana may be more likely to interact with people who have access to opioids.
Correlating Drug Use
Many researchers have actually cautioned that there’s no solid evidence that marijuana use causes harder drug use.
In fact, a lot of experts and advocates argue that while marijuana use can easily correlate with harder drug use, so can alcohol and tobacco.
The first drugs many people ever use are alcohol or tobacco, which are both legal for adults and fairly easy to get. Yet, no one automatically assumes drinking or smoking cigarettes will lead to heroin use. However, if the same data and logic used by Olfson and his group were applied to alcohol and tobacco, we would probably see a huge correlation. So many advocates argue why should cannabis use be treated any different?
A 2002 report by RAND’s Drug Policy Research Center (DPRC) suggests that it is not marijuana use, but individuals’ opportunities and unique propensities to use drugs that determine their risk of initiating hard drugs. The Institute of Medicine came to a similar conclusion to the ‘gateway drug’ concept back in 1999.
So, no evidence thus far has been conclusive, only correlational.
The Anti-Gateway Affect?
There are also those out there that believe marijuana legalization would actually have the anti-gateway affect, meaning studies have suggested there is evidence that access to marijuana actually reduces some opioid use.
This growing body of investigation indicates that medical marijuana legalization, in particular, can lower the number of people misusing opioids. Some insist it is because cannabis can help to treat chronic pain instead of opioids. Others even think access to marijuana would cause people to substitute their alcohol use. However, research in this area is still finite. Now it’s far too early to tell if this would actually be an effective strategy.
There is even a new study from David Powell and Rosalie Pacula of the RAND Corporation and Mireille Jacobson of the University of California Irvine that examines how medical marijuana legalization- particularly in states with the most access- impacts opioid-related deaths. These researchers concluded,
“These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.”
So while there are those who would put the data behind marijuana being a big part of the problem, there are those who avidly believe it is actually a huge part of a different strategy to overcome the opioid crisis.
What Can We Do?
Whichever side of this argument you’re on, there needs to be more time and energy put into exploring both perspectives. If the correlation between cannabis and opioids were ever proven to be more than meets the eye, then more needs to be done to make sure that legalization or decriminalization efforts co-exist with addiction treatment and support options.
If medical cannabis is found to be useful to help treat some who otherwise would be at elevated risk of chronic pain issues, opioid use disorder or even opioid-related death, then more should be done to make sure this method of treatment is safely studied and developed.
Either way, we must continue to work toward helping every individual suffering from substance use disorder of any kind. Whether it is marijuana use disorder or opioid use disorder, there should be safe and effective treatment options available.
There should always be resources available to help people who suffer from abuse. Supporting addiction recovery means breaking the stigma and offering holistic and effective solutions. Palm Healthcare Company is here to help. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
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