Author: Shernide Delva
In an effort to curb what many consider to be the worst public health drug crisis in decades, the CDC has issued a series of guidelines and restrictions intended to reduce the abuse of prescription painkillers. On Tuesday, the federal government released these CDC standards, ending months and months of disagreements with pain doctors, and drug industry groups. However, many are still asking the same vital question: will these guidelines even work?
The CDC guidelines will be the first national standard for prescription painkillers. The guidelines are intended to provide a more sensible approach to prescribing highly addictive medicines. In the past, drugs like OxyContin and Vicodin were easily prescribed to patients. Although efforts have been made to reduce the amount of prescriptions prescribed in the medical community, these guidelines will further limit how opioid medications are distributed.
“This is the first time the federal government is communicating clearly to the medical community that the risks outweigh the potential benefits of these drugs,” said Dr. Andrew Kolodny, head of Physicians for Responsible Opioid Prescribing, which supports the guidelines. “It’s one of the most significant interventions by the federal government.”
These guidelines recommend what many addiction experts have long called for which is pushing doctors to recommend other pain management options. The CDC guidelines also limit the amount of prescriptions a doctor can prescribed at one time.While these new guidelines are non-binding, they are likely to have a huge influence in the medical community.
New CDC Painkiller Prescription Guidelines
Just to give a brief overview, here are some of the main specific guidelines that will be implemented in the next coming months.
- Doctors should first try ibuprofen and aspirin to treat pain prior to prescribing more high-risk drugs such as opioid medications.
- Opioid treatment for short-term pain should last only three days, at the longest seven days. This will be a significant change. Currently, doctors prescribe for anywhere from two weeks to a month of opioid medications for short-term pain management.
- Doctors should have patients undergo urine tests prior to getting prescriptions.
- Doctors are to participate in a drug tracking system to ensure patients are not getting medicine from somewhere else. Currently, 49 states have these systems yet only 16 are required to use them.
- These guidelines will not apply to patients receiving cancer treatment or end-of life treatment.
The new guidelines are a dramatic shift from the ideology of the 1990s. Back then, an initiative to fight for pain management resulted in opioid prescription painkillers soaring in popularity in the medical field. Pharmaceutical companies and medical experts pushed to have these drugs readily available because at the time, they were thought to be effective solutions to treat back pain and arthritis without the fear of addiction. Boy, were they wrong back then.
Now, as overdoses continue to mount, and addiction claims more and more lives each year, the country is desperate for an answer. While these guidelines may have good intentions, other professionals argue that more rules can cause more harm than good. Recent tighter restrictions on painkillers have resulted in the drugs soaring in cost on the black market. As a result, a significant number of addicts turn to heroin to satisfy cravings.
For nearly two years, these standards have been bitterly opposed by Big Pharma and pain doctors who feel that these guidelines will only post unfair hurdles for patients who really do suffer from chronic pain. They argue that drug addicts will simply find another way to get their fix, like heroin. Opponents of the new guidelines also believe that these rules are an incursion into the role of doctors.
Dr. Thomas R. Frieden, director of the disease centers, responded,
“It’s become increasingly clear that opioids carry substantial risk but only uncertain benefits — especially compared with other treatments for chronic pain.”
He continues to support the guidelines, stating they are meant to be “a tool for doctors and for patients to chart a safer course,” describing them as a benchmark for medical practice, not an unbending dictate. The idea, he said, is to balance the risks of addiction with the needs of patients.
“For the vast majority of patients with chronic pain,” Frieden said, “the known, serious and far too often fatal risks far outweigh the transient benefits. We lose sight of the fact that the prescription opioids are just as addictive as heroin. Prescribing opioids really is a momentous decision, and I think that has been lost.”
Essentially, Frieden is saying these new guidelines are meant to help with the addiction crisis and certainly are not meant to prevent those with chronic pain from receiving medications they need. Furthermore, it is uncertain the effects opioid medications have on chronic pain in the long run, so we can not assume that restricting these drugs cause any harm to those patients.
Considering how urgent the addiction epidemic is, something has to be done, and at least these new guidelines encourage conversation. Education and prevention is the key. Each year, the data is increasingly more frightening. There clearly is not a one-stop solution to all of this. Do you think these guidelines will be effective? If your or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Shernide Delva
It turns out a brush with death is not enough to keep addicts from continuing to use. A recent study reveals that 90% of people who overdose on painkillers continue using despite their near-death overdose experience.
The study was conducted by The American College of Physicians and involved data from 3000 patients over a 12-year period collected from a national insurance claims database known as Optum. All the patients had a previous history of having a nonfatal overdose on prescribed opioids originally given to them to treat chronic pain.
Despite nearly dying from these medications, 91% of the patients continued to use the painkillers even after the overdose. Even more surprising, 70% of the patients continued to use the same healthcare provider to refill their prescriptions. Researchers followed up with the patients two years later and discovered that individuals who continued using opioids were twice as likely to have another overdose in comparison to those who ceased after the initial overdose.
Overdoses from Opioids
The opioid and heroin epidemic has gained media attention for being the nation’s biggest challenge for the next coming years. President Obama released a memorandum to combat the opioid epidemic through training medical professionals in understanding drug addiction as an illness and not a crime. Americans wait eager to learn what solution could possible help bring down the numbers of people dying from drug overdoses.
Similar to heroin, prescription painkillers bind to receptors in the brain to decrease the perception of pain. These powerful painkillers create a feeling of euphoria that eventually will result in physical dependence an addiction. Therefore, even with an overdose, a person will still have cravings to continue taking the drug.
As more addicts are entering treatment centers and detoxing, there needs to be increased awareness about overdoses. Research reveals there is an increase in overdoses after treatment since a person’s tolerance to drugs will have decreased. After leaving rehab, an addict may relapse and overdose.
The ability for someone to overdose depends on a wide variety of factors including tolerance, age, state of health and how the substance was consumed. Some people do not make it out of an overdose. Treatment for an overdose may be quick and easy or may include long-term treatment such as an alcohol rehab center or longer hospitalization. Pharmacies like CVS have worked to make the overdose antidote Nurcan available over the counter to reduce the amount of overdose deaths.
Statistics released in September 2014 show that prescription drug deaths have quadrupled in the US between 1999-2011, from 4,263 to over 17,000 and those number show no signs of slowing down. The pharmaceutical industry had contributed to the opioid epidemic by over prescribing painkillers.
“The amount that [opioids] are administered by well-meaning physicians is excessive,” said Dr. Robert Waldman, an addiction medicine consultant not involved with the research. “Most physicians are people-pleasers who want to help and want to meet people’s needs, and they are more inclined to give people the benefit of the doubt until you are shown otherwise.”
The medical profession began transforming the way they approached pain in the early 90s when it was decided that pain would be treated aggressively. Traditionally, opioids were only prescribed for cancer patients and recovering from surgery. However, this new change made it okay to proactively treat patients who suffered from symptoms of pain. In 1995, more powerful drugs like extended release OxyContin was approved for use.
Doctors continued to prescribe pain medications and the medical use of opioids grew by ten-folds in just 20 years. The consequences of the opioid epidemic have been far worse than anyone could have imagined just two decades ago. Opioids are now reported in 39 percent of all emergency room visits for non-medical drug use. Even worse, the direct health costs of opioid users have been estimated to be more than eight times that of nonusers.
The opioid addiction is affecting Americans in every part of the country. Now, there needs to be an increase in awareness in educating on how to prevent deaths from overdoses. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Shernide Delva
A new HBO documentary focuses on Cape Cod’s heroin epidemic. In a recent interview, director and Oscar winner Steven Okazaki elaborated on the documentary which premiered on Monday.
Cape Cod, a town known more for its seafood, beaches and lighthouses than drug addiction, now has a huge heroin problem. Those affected most are middle-class white locals in their early twenties. If you were to follow the stigma of addiction, you never would have guessed a town like this would have such a major heroin problem.
As we know, the drug epidemic is affecting people in every part of the country, and an emphasis is being placed on the middle class. In the documentary Heroin: Cape Cod, USA, it explores the latest heroin epidemic in a wracking yet necessary way. At times gruesome, the documentary gives a two-way mirror perspective of how addicts are managing to live with their habit on a daily basis.
This is not the director’s first film magnifying heroin use. His 1999 HBO documentary Black Tar Heroin: The Dark End of the Street followed drug use in San Francisco’s Tenderloin neighborhood. These users were mostly off the streets, scourging for drug just to maintain a normal state of being.
Furthermore, the document exemplifies how the greatest shift in drug addiction is the change of scenery. Heroin is not just a drug seen on the streets anymore. Recent data suggests the fastest growing group of heroin use is mostly middle-class white kids, 18 to 25 years old.
The Modern Day Heroin User
The main change in heroin users in this generation compared to previous ones is the shift in technology. Now, heroin users do not have to go to sketchy neighborhoods to get their fix. With the invention of smart phones, users can text their dealer and have the drugs dropped off right at their doorstep.
“The iPhone is also good for texting your dealer and getting the drugs delivered to you. You don’t have to go to the sketchy part of town,” Okazaki said.
However, other than the changes in technology, the kids in Cape Cod are the same as addicts anywhere. They steal, lie and cheat for cash to fuel their addiction.
“They do the same hustle for money—steal their mother’s jewelry, tell their father they need new tires for their car, steal stuff from Home Depot and return it for cash, work at strip clubs, go into prostitution, deal, whatever they have to do. The desperation is the same,” Okazaki continued.
The Lost Voices: Parents of Drug Addiction
One of the important areas this documentary tries to focus on is the parents who are affected by their children’s drug use. Okazaki stated that parents who have lost a child to an overdose have some of the strongest voices in activism.
In the documentary, the parents have a group, Parents Supporting Parents, that meets every Monday on the Cape. When Okazaki came to film the documentary, there were no meeting schedules so he asked the mothers if they would be willing to have one for him to film. Over 20 people came eager to talk.
Many of the children featured are very connected to their parents. Some live at home and others talk to their parents every day. The parents featured in the film either enabled their kids or work endlessly to find ways to keep their child sober.
“I was totally taken aback,” Okazaki said in an article. “These parents, they’ve been through it and they’re seeking support from each other and they’re tired of feeling uncomfortable around their neighbors. They were really welcoming and incredibly open.”
During the course of filming, little was done to interfere with what was happening. Staff carried the overdose antidote Nurcan in case of an overdose. In the end, two out of eight of the documentary participants overdosed and died which exemplifies how serious heroin drug use is right now. Many are not surviving. Okazaki says it was difficult at times to deal with this reality while filming and editing the documentary.
“It’s really painful. They were once alive and smiling and laughing. It’s heartbreaking. The two young women who overdosed and died were smart, caring, lovely young people. You never know who’s going to survive and get clean, or go on forever using or die.”
Overall, the overall message of the film is how easily obtainable heroin is and how something desperately needs to be done to prevent these tragedies from occurring again.
There is so much sadness and loss over drug use and as of late, the numbers continue to climb. Watch Heroin: Cape Cod, USA on HBO. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Justin Mckibben
Heroin and other opiate abuse and addiction have been described as a plague across the country. Deaths from overdose have been deemed an outbreak, and the issue with trying to put an end to the suffering has been labeled a public health crisis. So with any illness, there are ways to try and provide treatment. But now some say we could be taking a different approach in prevention… the same way healthcare providers have worked to treat other illnesses… with a heroin vaccine.
So could a heroin vaccine really work? What big change could be brought about if people could be vaccinated for heroin addiction? What if drug addiction could be treated like the flu? What if it could be obstructed by a medicine before it ever even has the chance to take a hold of the person’s life?
Is a heroin vaccine actually possible?
Heroin Vaccine: Addiction is Illness
Kim Janda is a professor at the Scripps Research Institute. He developed this new compound believing that the same nature of the vaccine as intended to treat other sickness can and should be applied to addiction. When discussing the possibility of a heroin vaccine Janda stated:
“One thing people don’t realize is one thing that has probably changed (the) world health outlook of all the things you could imagine is vaccines,”
“We’ve tried this road where we treat drugs with other drugs and that didn’t work for me … Instead of like these wind-up toys that keep walking into the wall, I thought we should turn the toy around so it could start off in another direction. I wanted to come at (addiction) from a different angle.”
Janda also claims to have the data to prove that a heroin vaccine is a very real possibility. Commonly vaccines are designed to use our own immune system to combat an illness, such as:
Janda’s idea is to use the same strategy to combat substance abuse, strengthening the immune system to attack the drugs before they affect the body. He and his research team have developed a heroin vaccine that works by causing the body’s immune system to attack heroin much like it would any other disease. So far it has shown encouraging results in rodent testing.
Janda explained in the study rodents were previously addicted to heroin and went “cold turkey” off the drug. Then some were given the heroin vaccine while others were not. In the end Janda claims that the rodents who did not get the heroin vaccine re-assumed and even escalated their drug intake, while those that were treated did not- suggesting:
“It extinguished their drug-seeking behavior.”
Janda said the vaccine could potentially save lives by preventing overdoses as well as help recovering addicts remain clean.
Heroin Vaccine: Overdose Antidote
According to Janda another astonishing discovery in this process of testing was that the rodents that received the heroin vaccine were actually able to survive fatal doses of heroin – sometimes 20 times the normal dose! This is an exceptionally exciting prospect for such a medicine. Janda went on to say,
“It’s not something that’s been seen in these vaccines in the past. Mostly the vaccines in the past have tried to extinguish the drug-seeking behavior and provide a means for abstinence, but not for overdose cases … Potentially if people take too much and overdose, this could combat that also.”
As of now the heroin vaccine requires several shots over about a month period, currently the effects last for several months. Recovering addicts would need a booster shot when the effectiveness of the heroin vaccine begins to dwindle, but a practical application could be for individuals leaving incarceration to help them overcome temptations that lead to relapse.
Heroin Vaccine: Transforming Treatment
While this is a very thrilling and optimistic concept, Janda is adamant that this heroin vaccine is not meant at all to replace behavioral therapies. So this new heroin vaccine could be eventually developed into a highly advanced and more effective form of medication assisted recovery, but even the scientist behind it believes in behavioral therapy for addicts.
Right now heroin is the only drug they have worked on, but Janda said if it shows to be effective, the method could theoretically be applied to a wide range of dangerous and addictive substances.
This heroin vaccine may be coming to fruition sooner than you think. Janda’s research team recently received a two-year $1.6 million grant from the National Institute of Health’s National Institute of Drug Abuse to conduct non-human primate tests and apply for clinical trials through the FDA.
With all the talk in the media about people so against flu shots and other vaccinations this story might even find its way into that discussion. But it surely is interesting to imagine where this powerful tool might take us… if it actually works.
Around the nation the epidemic rages on. Policy makers, law enforcement and community activists and advocates have been striving to save lives by raising awareness to the issue and inspiring innovation in both treatment and drug policy.
This new heroin vaccine may be a huge leap in the right direction for treating heroin addiction. Even with the vaccine, holistic drug rehab will always be a huge part of lasting recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
Author: Justin Mckibben
It seems most of the nation has finally had their eyes opened to the reality of the situation, there is a very real heroin epidemic in America. This is a sometimes inconspicuous but still intense illness that affects all people, across gender, socioeconomic, age, and ethnic lines. And that’s becoming more and more apparent as a heroin and other opiates continue to take lives in homes across every cultural barrier.
But where did it come from? What caused it and who is to blame?
We could point the proverbial finger at the over-prescribing or crooked doctors, or we could point it at the patients.
We could blame the pharmaceutical tyrants or the faltering politicians that allowed them to run rampant for so long.
We could definitely find some fault in the war in Afghanistan and the policies from a War on Drugs that has failed miserably.
Indeed we should blame all these things.
There is an abundance of reasons we have a heroin/opiate epidemic in this country, and plenty of blame to go around, but let us just focus on one in particular today; the internet!
Easy Access Online
As much as we love them internets, we have to also give it its due responsibility for this plague on our people. The internet created a forum for easy access to prescription drugs without a doctor’s approval, and it can be so easy it is no wonder the epidemic didn’t get worse faster.
According to some reports, all one needs to do to fully understand the complexity of the internet’s black market selling pharmaceutical drugs illegally is to go to StreetRx.com.
This website actually gathers user-submitted information across the country on street prices of diverted prescription drugs, as well as illicit drugs.
Reviews of the site attest that users can anonymously view, post and rate submissions in a format offering price transparency to an otherwise cloudy underground marketplace.
The information provided on this site is actually quite detailed. Just a few examples of information one might find includes:
- $60 Reasonable OxyContin (hard to crush) 60 mg Hartford, CT
- $25 Cheap OxyContin (old OC-crushable) 20 mg Wiscasset, ME
- $3.75 Reasonable Methadone 10 mg Hartford, CT
- $15 Pricey Oxycodone 15 mg Burlington, VT
- $3 Overpriced Oxycodone 5 mg Providence, RI
- $10 Overpriced Dilaudid 2 mg Worcester MA
Evolution of the Dark Web
The Dark Web has seen some serious exposure lately after the arrest of infamous digital drug dealer Ross Ulbricht AKA “Dread Pirate Roberts” who had created the vast online drug den known as Silk Road before being tracked down and having the site dismantled.
Still, plenty of smartphone apps like Instagram have been manipulated for facilitating illegal transactions and making connections with dealers, and plenty of other drugs are bought online through sites just like Silk Road.
The luxury and simplicity by which one can unlawfully purchase mind altering drugs with just a simple click of the mouse has made a substantial contribution and propelled the heroin epidemic. As a result, prescription opiate painkillers are very easily obtained and once someone gets hooked on them for long enough many will switch to heroin, because these days the drug is only getting more pure and cheaper.
Considering this, you can forget what you thought you knew about how this drug has evolved and who the primary consumer it. A heroin addict looks nothing like what most used to assume. Now heroin is a white suburban disease, with women in their 20’s and 30’s among the most rapidly increasing group of heroin users.
Changing the Status
The internet, social media and online shopping have all done their part to turn this virtual world into a viscerally disturbing reality of drugs and disease. But not all the blame should be placed on the internet, and in many ways it has done some good. By utilizing blogs, chat forums, videos and social media there are various organizations and authorities who have taken to the internet to create efforts for raising awareness. Message boards and even hashtags (#) have been linked to these movements to share information and provide resources.
And of course, how could we talk about the internet as if it doesn’t provide us with this versatile platform to have this conversation?
Heroin overdose is killing in rapid numbers, and there is no spyware or control-alt-delete answer for it. But more than the internet is to blame, we have to stop looking around for places to point the finger and ask ourselves what we have done to contribute to a healthy and fruitful future for this country. Click, like and share that.
As a society using the internet for so much of our communication and information, it is no wonder that it has made drug dealing and addiction a more “convenient” and consistent trend. With it comes death in devastating numbers, but it doesn’t have to be. There is help for those who want it. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135