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.
CALL NOW 1-800-951-6135
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.”
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
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Shernide Delva
The opioid epidemic continues to worsen year after year. In 2015, painkillers and heroin killed more than 33,000 people, according to the CDC. About half of those overdoses involved prescription pain medication.
New policies and laws introduced in recent years aim to prevent the number of opioid prescriptions distributed. However, these stricter policies come riddled with negative consequences. For example, chronic pain sufferers are finding it more and more difficult to manage their pain with opioids now that some of these laws have been implemented.
An article in The Tennessean references a woman named Bridget Rewick. Rewick has experienced pain for all of her adult life. At 56 years old, she is on disability. She does not work and worries about the strain on her body from being out. Pain swells through her body causing her to need a cane to walk.
She has avascular necrosis, which means her bone tissues are dying faster than her body can repair it. Rewick uses opioid painkillers to manage her pain. However, these days, when she goes to the pharmacist, she says she gets looks. She admits she feels judged by the increasingly conscious medical community.
“I am almost afraid to go to the doctor sometimes to say I have pain,” Rewick says. “Because I don’t want be seen as a pill seeker.”
Unfortunately for Rewick, she has more than judgment to worry about. The recent federal crackdowns on drug abuse have resulted in stricter guidelines on the use of opioids to address chronic pain.
Opioid Limits State by State
In Tennessee, there is now a limit set by the Department of Health on how many daily doses of opioids doctors may prescribe. New guidelines spell out protocols for giving drugs to women of child-bearing age and establish certification requirements for pain medicine specialist.
Tennessee is not the only state seeing these types of policies. Across the country, new legislatures limit the amount of opioids and range of opioids that can be prescribed. Therefore, chronic pain patients are finding it increasingly difficult to manage their pain, without having to overcome assumptions and red tape.
In fact, some doctors have opted to stop prescribing opioids completely.
This leaves those with legitimate chronic pain with fewer places to turn to. While most chronic pain patients agree that it is absolutely necessary to tackle opioid addiction issues, they still believe there are legitimate pain sufferers who struggle to find relief.
“This epidemic has destroyed people’s lives, and I think the motivation (to regulate) is appropriate,” Rewick says. “But they don’t understand the ramifications of how pain affects people every day. … I am not expecting to be completely without pain, but I have the right to have quality of life.”
In the United States, at least 100 million adults suffer from common chronic pain conditions. Chronic pain is defined as pain lasting longer than 90 days. Chronic pain can range from disease to injury. Sometimes the cause of chronic pain is unknown.
Sadly, chronic pain reduces quality of life and productivity. It disturbs sleep and can lead to anxiety and depression. Chronic pain is the leading cause of long-term disability.
Building Relationships and Trust
Furthermore, it is difficult for doctors to know if a patient is authentic. No one can look a patient and know for sure if their claim of pain is insecure.
Dr. John Guenst, an internal medicine doctor with Saint Thomas Medical Group, sees chronic pain patients all the time. He believes the relationship is the most important factor.
“You have to listen to their story; you have to examine them, you have to start from scratch without your bias and turn over every stone that is reasonable,” he said. “You are giving patients the benefit of the doubt.”
Guenst said his opioid prescription rate “is very low compared to my peers, but I am not afraid to use them.”
Clinics Say No to Opioid Prescriptions?
Still, some medical professionals have decided not to prescribe all-together. Last year, Tennova, one of the largest health systems in Tennessee, decided to no longer prescribe long-term opioid pain medications to patients at two pain management clinics.
This was a response to recent CDC guidelines. Although the guidelines set by the CDC are voluntary, many doctors around the country are adopting them and are weaning patients off opioids or choosing not to prescribe them at all.
These sudden changes come with good intentions; however, it remains a tricky manner. Untreated chronic pain is connected to depression, mental illness, financial problems, and even further substance abuse.
What is the solution to this? Time will tell. However, it is clear this is a serious problem with an even more complicated solution. If you are currently struggling with substance abuse, please call now. We want to help.
CALL NOW 1-800-951-6135
Why is Everyone Talking about Turmeric?
No really, I want to know.
Recently, we published an article about the connection between chronic pain and addiction. The article garnered a variety of comments, and many people suggested that those with chronic pain use turmeric to treat their symptoms. Truthfully, this is far from the first time I have heard turmeric suggested for medical purposes.
Where is all the hoopla about turmeric coming from? Is turmeric the new kale?
Not exactly. In fact, turmeric has been used for centuries for its medicinal properties. In India, turmeric was used for thousands of years as a spice and medicinal herb.
It was not until recently that scientists caught on to what Indians have known for a long time: turmeric contains strong medicinal properties. It helps with virtually all types of medical problems.
What is Turmeric?
Turmeric is the spice that gives curry its yellow color. The compounds in turmeric are called curcuminoids; the most important is called Curcumin. Curcumin is the active ingredient in turmeric. Curcumin is known for its anti-inflammatory effects and is a very strong antioxidant.
Surprisingly, the Curcumin content in turmeric is not that high. It’s estimated to be around 3% by weight. Therefore, if you want the full medicinal benefits of turmeric, it is recommended to take turmeric extracts that contain mostly Curcumin itself. Otherwise, it would be challenging to reach these levels on your own simply by using turmeric spice.
Curcumin is not absorbed into the bloodstream, so it is recommended to consume black pepper with it. Black pepper contains piperine, a natural substance that enhances the absorption of Curcumin by 2000%.
To sum it up: Turmeric contains Curcumin, a substance that has potent anti-inflammatory and antioxidant properties. Recently, the spice gained a huge following from those who benefit from its medicinal properties. As we enter an era where more people are opposed to prescription medications, natural alternatives are making a major comeback.
Turmeric Medicinal Benefits
There have been thousands of peer-reviewed articles proving the benefits of turmeric and the healing compounds Curcumin. In fact, turmeric is the most frequently mentioned medicinal herb in all of science! Other popularly studied herbals include garlic, cinnamon, ginseng, ginger and milk thistle.
Compared to conventional medicine, the benefits of turmeric equal to that of many pharmaceutical drugs. In fact, some studies report that using Curcumin is more advantageous than certain prescription drugs.
Health Benefits of Turmeric:
Turmeric offers similar benefits to painkillers, anti-depressants, anti-inflammatory drugs, cholesterol drugs, and so much more.
Some specific benefits are:
Preventing Blood Clotting
Turmeric is shown to offer the same benefits as medications intended to slow and prevent blood clots such as aspirin, Clopidogrel (Plavix) and warfarin. Unlike some of these drugs which pose serious health risks like excessive bleeding and hemorrhage, turmeric has no known side effects unless taken in very heavy doses. Since the mid-1980s, the Curcumin in turmeric has been suggested by researchers as a better alternative to those with vascular thrombosis.
While there are not many studies conducted on humans, dozens of trials have proven that turmeric is especially effective in correcting depression symptoms in laboratory animals. Curcumin was found to be as effective as antidepressants in managing depression. More studies are needed to understand the mood enhancing properties of Curcumin fully.
Arguably the most powerful and popular use of Curcumin is its ability to control inflammation. The journal Oncogene revealed several anti-inflammatory compounds. The study found Curcumin to be among the most effective anti-inflammatory compounds in the world, even compared to aspirin and ibuprofen. Diseases today like cancer, ulcerative colitis, arthritis, high cholesterol and chronic pain are partly related to inflammation.
As mentioned below, Curcumin helps with inflammation. A study conducted compared the benefit of Curcumin in turmeric to arthritis drugs that had side effects like leaky gut and heart disease. The study found the highest improvement in patients who took Curcumin compared to the rheumatoid arthritis medication. Since there are fewer side effects in the use of Curcumin, this could be a better option for patients struggling to manage their arthritis.
One of the most widely accepted properties of Curcumin is the pain management properties. Research released discovered that Curcumin naturally activates the opioid system in diabetics rap. Typically manipulated by painkillers, this natural process serves as the body’s inherent pain-relieving response. However, Curcumin does not have the risk of opioid dependency like painkillers such as oxycodone do, therefore the risk fo dependency diminishes.
Could Turmeric Help Combat Opioid Epidemic?
The benefits of turmeric go so much further than this article. Of course, is always crucial to talk about different treatment options with your doctor. Do not attempt to change your regimen without professional guidance.
Still, turmeric could help with pain management, which may improve the risk of opioid dependency overall. What are your thoughts? Could turmeric really make a difference? Have you used it?
Nevertheless, if you are struggling with addiction or mental illness, please reach out. We want to help you. Do not wait. Call now.
CALL NOW 1-800-951-6135
Author: Shernide Delva
Chronic pain can be extremely difficult to manage. Pain management involves a variety of treatment options, but one area that desperately needs attention is the psychological impact of chronic pain. According to researchers, about half of adults with chronic pain also experience anxiety or mood disorders like depression.
The findings, published online in the Journal of Affective Disorders, highlight the need to offer treatment and resources to those struggling with the psychological impact of chronic pain.
“The dual burden of chronic physical conditions and mood and anxiety disorders is a significant and growing problem,” said Silvia Martins, MD, Ph.D., associate professor of Epidemiology at the Mailman School of Public Health, and senior author.
The research examined data to analyze the associations between mood and anxiety disorder and self-reported chronic physical conditions. 5,037 participants in São Paulo, Brazil participated in the interview process.
Among individuals with mood disorders, chronic pain was reported by 50 percent, followed by respiratory disease at 33 percent, cardiovascular disease at 10 percent, arthritis by 9 percent, and diabetes by 7 percent.
Anxiety disorders were also common among those with chronic pain reported at 45 percent, and respiratory at 30 percent, as well as arthritis and cardiovascular disease, each 11 percent.
“These results shed new light on the public health impact of the dual burden of physical and mental illness,” said Dr. Martins. “Chronic disease coupled with a psychiatric disorder is a pressing issue that health providers should consider when designing preventive interventions and treatment services — especially the heavy mental health burden experienced by those with two or more chronic diseases.”
Chronic Pain and Painkiller Addiction
One common treatment for chronic pain is the use of prescription painkillers. Opioids like Vicodin, OxyContin, and Percocet affect specific parts of the brain that reduce the perception of pain. However, along with reducing the perception of pain, these medications also release feel-good chemicals in the brain, often leading to dependence.
With this study, it is clear why chronic pain sufferers are susceptible to opioid dependence due to a variety of factors including the need for feel-good chemicals like dopamine. Chemicals like dopamine and serotonin are lacking in those with depression and anxiety.
Many patients who take prescription painkillers do so without forming any dependence. In some, opioid use generates negative side effects such as nausea, making them more unwilling to use the drug’s long-term. Still, some individuals are so desperate for pain relief, that they take larger doses than prescribed more frequently. Not long after, a full-blown addiction develops.
It is important to note that there is no way to know whether a prescription painkiller user will develop an addiction to opioids. However, factors like having a family history of addiction, struggling with mood disorders such as depression or anxiety, or experiencing a past trauma, such as physical or sexual abuse all increase the risk. Those who have struggled with previous addiction are at a higher risk as well.
Another dangerous aspect of opioid addiction is that it often leads to heroin use. Health officials confirm that this is not uncommon. Because painkillers are more difficult to obtain and more expensive, many users turn to using heroin. Heroin is in a similar drug classification as opioids and is easy to obtain for cheap on the street.
Overall, this study says a lot about the way mental disorders and addiction often go hand in hand. That’s why so many treatment centers offer a dual diagnosis program. Therefore, if you struggle with mental illness, addiction or both, please call now. We want to help.
CALL NOW 1-800-951-6135