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Are Opioid Overdose Death Rates Actually Much Worse Than We Think?

Are Opioid Overdose Death Rates Actually Much Worse Than We Think?

Author: Justin Mckibben

It hasn’t even been one week since I wrote about the Center for Disease Control and Prevention (CDC) reporting opioid overdoses increased by 30% in only one year, and already a new story from The Washington Post suggests that these numbers are actually being highly undercounted! So in reality, the increase could be skewed by the fact that the real rates of overdose deaths are tragically misrepresented.

This new study reveals that the government has actually been undercounting opioid overdose deaths by anywhere between 20% and 35%!

So how is this happening? How much worse is the overdose outbreak?

A Closer Look at Coroner Reports

The reason the study says this underreporting is happening is due to how the current numbers are actually determined. In order to estimate national trends in opioid overdose and opioid-related death, the federal Centers for Disease Control and Prevention amasses data from over 3,000 coroner’s offices across the US.

However, the issue is that coroners function independently, so their available resources vary from case to case. The same goes for their reporting practices.

Christopher Ruhm, a professor at the University of Virginia, took a closer look at tracking trends and found that a lot of coroners do not specify the drug when documenting a fatal overdose. Ruhma states that from 1999-2015, of all fatal overdoses 23.1% did not have a drug specified on the death certificate.

The CDC cannot control local coroners, so it is the states and counties responsibility to improve their overdose reporting practices. If we want a more accurate reading of how opioids are harming a community, there has to be efficient documentation.

Unfortunately, the political incentives are not very supportive of accurate reporting. Officials may be concerned that by spending money on better overdose recording, they will have paid for the chance to look like their opioid problem is actually getting worse. The incentive just isn’t there from a political stance. However, that isn’t a good enough reason to botch the records. Communities still deserve to have a comprehensive idea of the issues they are facing.

Tracking Overdose Death Trends

The inference of coroners not including the drug in the report is that there are a lot more overdoses that do not get included in the official figures released at the federal level. There could be thousands of more deaths from opioids that go unaccounted for. To take a shot at tracking trends, Ruhm studied the records of coroners who did record specific drugs for overdose deaths. Based on this tracking, he was able to attribute a “corrected count” of opioid overdoses. In his report, Ruhm states:

“Corrected rates were obtained by using information from death certificate reports where at least one drug category was specified to impute involvement for cases where none was specified.”

There are many elements to how Ruhm came up with her corrections, and I encourage everyone to read the full analysis, which is published by the Society for the Study of Addiction (SSA). The report makes some pretty intense claims about what overdose deaths opioids should account for. For example in 1999 the CDC figures show:

Yet, Ruhm’s corrected count shows 1999 saw:

  • 10,232 overall opioid deaths
  • 3,421 synthetic opioid deaths

In 2015, the CDC figures say:

  • 33,091 overall opioid deaths
  • 19,884 synthetic opioid deaths

But Ruhms count pushes that up to:

  • 39,999 overall opioid deaths
  • 23,857 synthetic opioid deaths

Finally, when we look at the 2016 CDC figure, it said 42,249 opioid overdose deaths nationwide. But the corrected count figure puts 2016 at 49,562 opioid overdose deaths nationwide

What we can take away from Ruhm’s research is simply that the severity of the opioid crisis is being underestimated. From 1999-2015, Ruhm’s corrected counts for overdose deaths were 21% to 35% higher for all opioids. With corrected counts involving heroin and synthetic opioids were 20% to 30% higher.

So when we look at these stats, even if we leave some room for calculation errors, it is still a troubling thought. Since 2009, the leading cause of injury-related death in America has been drug overdoses. For years now, opioids have been public enemy number one concerning drug policy. Everything from prescription painkillers to synthetics being shipped halfway across the world has contributed to this crisis. If all we know about the true devastation of this epidemic is merely our best guess that still doesn’t take it all in, now is truly the time to urge officials and community leaders to take significant steps toward real, lifesaving solutions.

One of the most important resources that we need to take advantage of is providing safe and effective treatment to those who are struggling. Palm Partners Recovery Center has offered innovative and holistic treatment options for over two decades. If you or someone you love is struggling, please call toll-free now. We want to help.

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Opioid Crisis Continues to Get Worse: Overdoses Increase Nationwide

Opioid Crisis Continues to Get Worse: Overdoses Increase NationwideAuthor: 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:

  • Massachusetts
  • 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.

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CDC Director Steps Down after Conflict of Interest Controversy

CDC Director Steps Down after Conflict of Interest Controversy

The Director of the Centers for Disease Control and Prevention (CDC) resigned last week, only a day after a POLITICO report was released stating that she had purchased stock in the tobacco industry after taking the position. The move has garnered a lot of public attention recently, as many view it as a glaring conflict of interest for someone in such an important position.

Conflicting with CDC Mission

When Dr. Brenda Fitzgerald took the position as Director of the CDC, she should have known that tobacco is one of the very drugs she is supposed to be fighting against. The slogan of the CDC is:

“24/7: Saving Lives, Protecting People.”

To many, this is in direct opposition to the tobacco industry, with cigarette smoking being the leading cause of preventable death in America. This year alone cigarettes will result in the deaths of approximately half a million Americans. So how could someone in charge of an organization that is supposed to save people invest in something that kills so many?

Before taking office, Fitzgerald owned stock in tobacco companies:

According to the initial report that was released last Tuesday, Fitzgerald purchased “tens of thousands of dollars in new stock holdings in at least a dozen companies,” including one of the largest tobacco companies in the entire world, Japan Tobacco. So before getting rid of a lot of these assets in October, she had her hand in 4 out of the “Big Five” tobacco companies in the world.

As if that were not suspicious enough, the very next day after purchasing these stocks, Fitzgerald reportedly took a tour of the CDC’s Tobacco Laboratory. This is the entity that researches the harms of tobacco’s chemicals on human health. Then, almost as if to add insult to injury, news outlets have looked back to Fitzgerald’s statement in November when she said,

“Too many Americans are harmed by cigarette smoking, which is the nation’s leading preventable cause of death and disease.”

She then vowed to “continue to use proven strategies to help smokers quit and to prevent children from using any tobacco products.”

For someone with such substantial monetary involvement in tobacco companies’ interests, it wouldn’t be very beneficial for her to follow through on her promise to fight the use of tobacco products, would it?

According to the Wall Street Journal, Fitzgerald claims that she did not make the investments herself. She says the stocks were purchased by someone working for her investment manager, and that she directed them to sell the stocks when she did find out about the purchase.

Stocks and Scandals

Dr. Fitzgerald is definitely not the only official to be facing backlash for investments that seem to be in conflict with their official responsibilities. While executive branch employees are forbidden to work on issues in which they have a financial interest, members of Congress don’t play by the same rules.

Lawmakers are allowed to write and vote on bills that would impact themselves financially. They are required to disclose their financial positions and report when the assets are bought and sold. This includes holdings of their spouse and dependent children. But when you take a close look at some of these instances, it is kind of rattling.

Last month, Democratic Senator Patty Murray had claimed Fitzgerald’s ability to perform her role was hindered by conflicts of interest. And yet, when Murray was the top Democrat on the Committee on Health, Education, Labor and Pensions (HELP) her husband owned an account with a manager who bought and sold stock in Reynolds American, another tobacco company.

Aides to Senator Murray state,

“The disclosure form shows the liquidation of an account managed by a broker without guidance.”

Even the most senior Republican in the Senate, Orrin Hatch from Utah, who is also a member of the HELP committee, owned stock in Marlboro manufacturer Philip Morris International. In late 2012 Hatch was a joint owner with between $15,001 and $50,000 of stock in Philip Morris.

Fitzgerald had also recently procured stocks in two Big Pharma giants, Merck and Bayer. While the CDC does not regulate the pharmaceutical industry, their recommendations and policies do have an impact on drug manufacturers.

To be fair, there is no evidence thus far that Fitzgerald has committed any wrongdoing; there is no indication her financial ties influenced her leadership, and she has denied she was aware of the purchases being made in her name. The same goes for Murray and Hatch.

However, the fact that this shake-up is making headlines for all the wrong reasons has some people wondering how many politicians involved in public health are using stocks to bet against healthcare getting better.

How could private investments indirectly impact other areas of healthcare, like pharmaceutical drugs or mental health and addiction treatment resources? How could the issues currently surrounding the CDC end up impacting the fight against addiction and the opioid crisis?

The CDC and other health agencies play a big part in helping fight the opioid epidemic and other serious issues pertaining to drug addiction. The more resources we have, the more chances we have of turning things around. The same goes for people trying to recover from drugs or alcohol. The more resources you have, the more chances to get better. Palm Partners Recovery Center offers personalized holistic treatment options to help you transform your life. If you or someone you love is struggling, please call toll-free now.

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Florida Governor Pushing for 3 Day Limit on Prescription Opioids

Florida Governor Pushing for 3 Day Limit on Prescription Opioids

While the entire country has been impacted by this ongoing issue, more options for prevention and treatment have become paramount to changing the tides. Just this week Rick Scott, the governor of the state of Florida, proposed a strategy for fighting the opioid epidemic that has gained a lot of attention. Scott has decided to ask local lawmakers to impose a three-day limit on opioid prescriptions during the upcoming legislative session. This latest development is one new piece of recent initiatives to combat the opioid crisis.

Florida Governor Opioid Initiatives

During two press conferences on Tuesday, the Florida Governor announced a pushback on an abundance of opioid prescriptions, while also introducing other ideas for fighting addiction.

One of the initiatives Rick Scott is pushing is to require all health-care professionals who prescribe controlled substances to participate in the Florida Prescription Drug Monitoring Program, also known as the PDMP. This database involves health-care professionals to report important information on patients receiving powerful narcotic medications, including:

  • Name of the doctor
  • Patient name
  • Prescription information after the prescription is filled

But this is not the last of Florida Governor Scott’s opioid initiatives. His office also plans to seek additional reforms such as:

  • Fight unlicensed pain management clinics
  • Requiring education on responsible opioid prescribing
  • Creating more opportunities for federal grants

Scott apparently plans to put some more investments toward helping those already struggling. He is also pushing for more than $50 million for services including:

Part of this initiative is also boosting up the budget of the Florida Violent Crime and Drug Control Council.

At the moment the finer details of the Florida Governor’s proposals are not yet available. However, what it does tell us is that Scott is not ignoring the contribution Big Pharma makes in this current crisis. What we can tell from this outline is that Rick Scott says he is aiming to address prescription opioid pain medication, recognizing it as a key source of the growing problem.

Why 3 Days?

It has been reported time and time again that we should be paying attention to how powerful opioid medications impact rising addiction rates. Now the Centers for Disease Control and Prevention (CDC) has released a recent study showing how quickly someone could get hooked on these kinds of drugs. In this study it is shown:

  • After three days of use, about 6% of patients were still using opioids a year later.
  • Five days into use, about 10% of patients were still using opioids a year later.
  • After 11 days of use, it jumps to 25% of patients still taking opioids a year later.

So it would seem that between 3-5 days, the chances of continued use almost doubled. Then between 5-11 days the chances of use more than doubled. This development may have helped inspire the idea to limit prescriptions to 3 days.

Back in March, Bradley Martin of the CDC, one of the study authors, told Vox magazine:

“There’s nothing magical about five days versus six days, but with each day your risk of dependency increases fairly dramatically,”

So while day 5 and day 6 may not be a dramatic leap over the edge, some may see this proposed limit as an attempt to at least slow a process down.

The Opposing Argument

The Florida Governor will probably face strong criticism, or at least skepticism, from crowds such as:

The opposition is still very real. This isn’t even the first time Florida lawmakers have seen something like this brought to the table. Just last year Florida legislatures quietly rejected an effort last year to impose a five-day cap on opioid prescriptions for acute pain.

Legislatures and doctors are the only concerns Florida Governor may have to tangle with in order to push this idea through. Other potential obstacles standing against this proposal include:

  • Additional out-of-pocket co-pays that patients will incur
  • The ability of patients with chronic pain and terminal illnesses to refill prescriptions

The Florida Society of Interventional Pain Physicians will discuss caps on prescriptions during a board meeting today. Dr. Sanford Silverman is a past president of the Florida Society of Interventional Pain Physicians. In regards to the 3 day limit he stated:

“We don’t think the cap is reasonable since it is a completely arbitrary number,”

“A better idea would be to mandate usage of the PDMP prior to writing an opioid for acute pain.”

Similar Strategies

Other states have created caps on prescriptions, although some may not seem as strict as the 3 day rule.

  • Massachusetts limits the supply to seven days.
  • New Jersey set it so that first-time prescriptions for acute pain cannot exceed a five-day supply. Also, patients being treated for cancer or under hospice care are exempt.
  • Ohio caps distinguish between patients with chronic pain and those with acute pain.

At the end of the day, similar strategies may not be left up to the lawmakers. If pharmacies decide to impose their own limits on certain prescription drugs the Florida Governor might not have to push very hard to get the limits he is looking for.

CVS announced Friday that the company plans to:

  • Limit the daily dosage of pain pills based on their strength
  • Require the use of quick-release painkillers before extended-release opioids are dispensed
  • Limit opioid prescriptions to seven days for certain conditions

This restriction will specifically apply to patients who are new to pain therapy.

Only time will tell how far Florida Governor Rick Scott’s new pitch will go, but it seems one thing people can agree on is that the opioid crisis does require some new approaches to prevention.

With more prevention we may be able to slow down the rising rates of opioid addiction. Meanwhile, the need for safe and effective treatment still means a lot for helping those already suffering. Real treatment resources matter. If you or someone you love is struggling, please call toll-free now. We want to help.

CALL NOW 1-800-951-6135

CDC Fighting Opioids with Millions in Funding to 44 States

CDC Fighting Opioids with Millions in Funding to 44 States

Author: Justin Mckibben

The Center for Disease Control and Prevention (CDC) announced on September 5th it would be allocating more than $28.6 million in funding to assist dozens of states, not to mention the District of Columbia, with overcoming the issues they face concerning opioid abuse, addiction, overdose and opioid related death. Many states are still struggling to make headway in the uphill battle. Thanks to the CDC fighting opioids with such a large contribution people in these areas have a better chance of gaining access to crucial resources.

It All Adds Up

The Omnibus Appropriations Bill in 2017 added funding for fighting the opioid epidemic with a $103 million dollar contribution. Combined with this new money from the CDC there will be even more support for things such as:

  1. Addiction prevention programs

  2. Drug monitoring programs

  3. Improved toxicology testing for medical examiners/coroners

This isn’t the first time this year the CDC has dropped a big sum into the opioid outbreak.

Just a few months back in July the CDC fighting opioids led to a $12 million pledge to state overdose prevention efforts. This contribution was made as part of the plan from the Department of Health and Human Services’ (DHHS) in response to the nationwide opioid epidemic.

Who Gets the Money?

So which states are receiving funding through this latest pledge, and why? This money is being distributed out to various states that participate in the CDC’s Overdose Prevention in States Program (OPiS). The OPiS program includes 3 unique programs designed for prevention efforts:

Prescription Drug Overdose: Prevention for States (PfS)

This program will provide $19.3 million in funding to 27 states to expand various of their prevention programs, which also use community outreach.

Data-Driven Prevention Initiative (DDPI)

$4.6 million will go through DDPI to 12 states and Washington, D.C. for similar programs. Other states getting funds through the DDPI include:

  1. Alaska

  2. Michigan

  3. New Jersey

  4. South Dakota

Enhanced State Opioid Overdose Surveillance (ESOOS)

Across the country around $4.7 million will go to medical examiners and coroners in 32 states and D.C. to track and prevent overdoses. The top 5 states on the list of highest rates of overdose death will receive funding, which includes:

  1. West Virginia

  2. New Hampshire

  3. Kentucky

  4. Ohio

  5. Rhode Island

-as well as-

  1. Delaware

  2. Florida

  3. Maine

  4. Washington, D.C.

How is CDC Fighting Opioids?

Not only is the OPiS program a big portion of the plan to fight opioids from the DHHS, but there are 4 other key components to these efforts.

  1. Naloxone expansion programs

  2. Improving public health data related to opioid crisis

  3. Advancing practices for pain management

  4. Greater research and support on addiction and pain

DHHS Secretary Tom Price states that the funding expansion was made possible through legislation signed by the Trump administration earlier this year. He insists it is an important part of committing help to states combating opioid addiction and overdose.

Many are hopeful that this will be the beginning of a trend for allocating funds toward more resources for CDC fighting opioids and the damage they cause across America. Advocates are still hopeful to receive more support, but for now there is at least some hope that something is being done. As far as each individual, recovery begins with taking advantage of any opportunity in front of you to do better. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.

CALL NOW 1-800-951-6135

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