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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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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.

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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

Drug Dependent Babies Increase in Southwest Florida

Drug Dependent Babies Increase in Southwest Florida

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Justin Mckibben

For a long time there was the notion of ‘crack babies’ that started back in the 90’s. The term included infants born addicted to crack-cocaine with major birth defects and disabilities due to their parents being addicts. While that whole claim has been scientifically disputed, the number of babies that health officials have described as being born hooked on prescription painkillers, commonly referred to as neonatal abstinence syndrome, have reportedly rose to a record high at Lee County hospitals of Florida in 2014.

Neonatal Abstinence Syndrome

Babies exposed to opiate painkiller drugs in the womb can suffer painful withdrawals that frequently must be treated with morphine and the sedative phenobarbital. Neonatal Abstinence Syndrome (NAS) could apply to any kind of narcotic drug exposure in the womb.

Common symptoms of Neonatal Abstinence Syndrome (NAS) include:

  • Nausea
  • Uncontrolled twitching
  • Seizures
  • Excessive and particularly high-pitched crying
  • Problems feeding
  • An inability to sleep
  • Fever

The long-term effects of NAS are not clearly understood at this time. Babies diagnosed with NAS are more likely to suffer serious medical complications, including early births and low birth weights, and often have to spend a month longer in the hospital to receive adequate care.

The Growing Concern

For a while there were hopes in Southwest Florida that the frequency of NAS would have finally stabilized, as they had statewide. Instead instances have jumped nearly 24% between 2013 and 2014, and a whopping 1,325% since 2005. That makes 114 babies, according to Lee Memorial Health System, born drug dependent.

  • 2012 nearly 12 of every 1,000 babies born in Lee Memorial Health System hospitals showed signs of NAS
  • 2014 was nearly 18 per 1,000- more than twice the state average

Dr. William Liu, who is the medical director of the neonatal intensive care unit at the Golisano Children’s Hospital of Southwest Florida, stated:

“We knew it wasn’t getting less. But the numbers show us, quantitatively, that we’re actually seeing more.”

It was estimated that around half of the women delivering these babies had been using methadone, which is considered the safest option for pregnant women addicted to painkillers as part of a drug treatment program since quitting cold turkey actually increases the chance of miscarriage for a recovering addict mother.

Prescription medications such as oxycodone have gotten harder to find on the streets since crack downs on pill-mills and prescription drug restrictions, Southwest Florida addicts, much like addicts all over the country, have turned to illicit drugs such as heroin or the morphine-derivative known as Dilaudid.

According to Florida state records, neighboring counties such as Collier and Charlotte are far lower with NAS rates, and Dr. Liu said he’s unsure why Lee County is seeing more cases than other parts of Florida.

History of NAS

The Golisano Children’s Hospital established its program to identify cases of NAS back in 2002. 8 years later in 2010 an investigation found that NAS cases had risen 800% in the preceding years in Lee alone, and over-all had nearly tripled throughout Florida.

The Attorney General Pam Bondi launched a task force in 2013 to raise public awareness and to encourage hospitals to better screen for such cases. NAS was added to the list of mandatory reportable conditions in June 2014.

Stepping Up

Department spokeswoman Natalie Spindle released a written statement Friday that said Florida public health officials are monitoring the problem and are addressing NAS prevention. The Centers for Disease Control and Prevention (CDC) also looked at Florida’s problem and noted in a report released in March that NAS cases have actually been increasing statewide for the last two decades. In the CDC study they found:

  • Nearly 97% of the new mothers had used some sort of opiate or opiate-mimicking drugs.
  • More than 96% were illicit drug users or using methadone as part of their drug treatment
  • Their average age was 27
  • Mostly non-Hispanic whites
  • The infants averaged 26 days in the NICU after they were born

Dr. Jennifer Lind, a CDC epidemiologist and lead author of the report, stated that even though 90% of women had been drug screened at the hospital, only 10% were ever referred to get drug treatment. ONLY 10%! So why is it that people are turning a blind eye or even a deaf ear to this devastating issue?

This goes on to prove the point that more needs to be done as far as raising awareness about the dangers of drug use during pregnancy, and even more effort needs to be put into properly reporting these issues and getting these addicted mothers the treatment they desperately need.

While infants are innocent regarding their addictions, teens and adults should be held accountable for theirs, and addicted parents have to take the opportunity to take action if they want to change their lives, for them and their children. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135

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