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Overprescribing Opioids: Four Doctors Prescribe 6 Million Pills in 1 Year

Overprescribing Opioids: Four Doctors Prescribe 6 Million Pills in 1 Year

Author: Justin Mckibben

Despite the fact that over 91 people die every day from an overdose due to prescription drugs, some people still struggle to realize that prescription drug abuse is the driving force behind the current opioid epidemic. According to the American Society of Addiction Medicine (ASAM):

  • 4 out of 5 heroin users started out abusing prescription pain medication
  • 94% of people in treatment for opioid addiction surveyed in 2014 switched to heroin from prescription opioids.

One of the biggest issues is that powerful opioid painkillers are being overprescribed. Whether due to aggressive marketing tactics used by Big Pharma companies or the corrupt ‘pill mills’ where doctors were dishing out excessive prescriptions of potent drugs to be sold on the street, prescription opioids flooded the neighborhoods across the nation, helping create one of the worst addiction outbreaks in American history.

But it wasn’t just the fact that drugs were making it onto the streets. In general, even legitimate opioid prescriptions were astonishingly high. While too many people still think the only problem is heroin or street drugs, the facts show us that opioid painkillers were still largely overprescribed in recent years, which contributed to the current crisis.

Too ‘Legit’ to Quit

According to the National Survey on Drug Use and Health, nearly 92 million U.S. adults in 2015 were taking a legitimately prescribed opioid. That translates to 38% of the adult American population.

There were an estimated 240 million opioid prescriptions in 2015, nearly one for every adult in the general population. Even the Deputy Director of the U.S. National Institute on Drug Abuse, Dr. Wilson Compton, said,

“The proportion of adults who receive these medications in any year seemed startling to me”..”It’s an awful lot of people who take these, mostly for medical purposes, but within that, a significant percentage end up misusing them,”

So while a lot of these prescriptions were going to treating serious conditions, how many ended up on the street or being abused at home because they were overprescribed?

The same NSDUH survey found that 11.5 million people misused prescription opioids they obtained through illicit means. Overall, Dr. Compton states that these results indicate medical professionals are doing a poor job of appropriately prescribing these medications.

The trend didn’t end there. According to a new report, nearly 3 million people who had surgery in 2016 became persistent opioid users, taking the drugs 3-6 months after a procedure. The report also states that due to overprescribing, 3.3 billion pills were left unused by patients, which left them open for diversion or misuse.

Some pain management advocates insist that pain may end up being undertreated due to the rising scrutiny of opioid prescriptions.  Many of these advocates say it is extremely difficult to truly know if opioids are overprescribed because pain is too hard to objectively quantify. Therefore, some patients may actually need more relief resources than others.

Yet, prescribing rates are still, at the very least, questionably high. Especially considering by most estimates that over 50% of opioid pills legitimately prescribed are unused by patients, which suggests significant overprescribing certainly exists.

4 Doctors, 6 Million Pills, 1 Year

One recent case in particular that stands out concerning overprescribing of medications is the story of a small northwestern county in Arizona where 4 doctors prescribed nearly 6 million opioid pills in a 12 month period. The data provided by the Controlled Substances Prescription Monitoring Program did not list the doctors by name, but did give detailed information about the prescriptions.

Out of all 4, the top prescribing doctor is responsible for:

  • More than 20,000 opioid prescriptions
  • Equaling out to over 1.9 million pills
  • That comes to 7,350 pills a day

The second-place prescriber is responsible for:

  • More than 15,000 prescriptions
  • Equaling out to nearly 1.6 million pills

The other two doctors totally a combined 2.4 million pills prescribed.

The four doctors in question are located in Mohave County, which as of 2016 is home to approximately only 205,249 people. That comes out to about a 30 opioid supply for every single person in that county.

Now while pain may be hard to objectively quantify, these numbers are obviously unsettling. Even the executive director of the Arizona Board of Pharmacy, Kam Gandhi, could not explain why or how these four physicians were able to issue so many opioid pills.

A spokesperson for Attorney General Mark Brnovich declined to specify exactly what actions are being taken by his office concerning this development. However, according to AZ Central Doug Skvarla, who directs the Controlled Substances Prescription Monitoring Program, said that information has been passed on to Brnovich’s office for “an open investigation.”

Illicit Use of Prescriptions

There are plenty other issues with opioid prescriptions being taken advantage of all over the United States. Pain management advocates often argue that the problem isn’t about opioid prescriptions; it’s the people that misuse and divert the medications. In other words, that the people abusing opioids frequently don’t have a legitimate prescription. A lot of opioid pills being abused are obtained illicitly.

Many people won’t use their whole prescription. Many will actually give pills to a loved one who doesn’t have their own pain treatment. Or they will sell their remaining pills. Pill mills and ‘doctor shopping’ allowed for the even worse spread of excessive opioid prescriptions. Like in Illinois, where one individual received 73 prescriptions for opioid drugs from 11 different prescribers and filed them at 20 different pharmacies. In some cases, the individual filled prescriptions at multiple pharmacies in one day.

There is absolutely a high demand on the illegal drug market for prescription opioid painkillers. As a former addict who spent over 7 years using, buying and selling opioid medications on the street, I can say there is plenty of ways to get these drugs without a prescription.

However, if we back-track a little bit, how did so many potent medications get onto the streets if there is no overprescribing?

Feeling the Pain

Pain management is absolutely necessary. There must be resources and effective medications available for those suffering from serious medical conditions or recovering from life-altering procedures. There is no denying that we have to provide effective pain relief options for patients who desperately need it. So, of course, this is a difficult conversation to have, because many people can take these medications are directed and be fine when they are gone. Some people require long-term pain treatment, but it does not result in a severe addiction.

Still, the fact is that if these medications weren’t being prescribed more than medically necessary, they would have never flooded the underground drug marketplace as rapidly and as abundantly as they did. Between doctors overprescribing (sometimes for kickbacks), patients working the system and manipulating physicians, and the aggressive marketing tactics of Big Pharma going unchecked, there are plenty of elements at play.

Undoubtedly when we examine the opioid epidemic we cannot ignore any contribution. We have to make efforts to combat the spread of heroin addiction. There has to be an intensive effort to deal with the incredibly deadly synthetic opioids like fentanyl and carfentanil, and people also have to acknowledge their own choices and do their part to move forward. It might be a difficult and painful process, but it is necessary.

Still, overprescribing of opioid medications cannot be ignored. We should explore all options concerning prescription monitoring programs, enforce current regulations of drug distribution, and develop innovations in pain management therapy.

According to one report, even just a 10% reduction in surgery-related opioid prescribing would reduce:

  • The number of excess post-surgical pills available for diversion or misuse by 332 million
  • The annual number of patients who go on to persistent opioid use after surgery by 300,000
  • Annual drug costs by $830 million

Not only can we do better to treat those suffering from chronic and severe pain, but we can do better to make sure these potent and habit-forming medications don’t end up in the wrong place. For those who abuse prescription opioids, or who have found themselves using heroin, we need to provide safe and effective treatment options. Palm Partners Recovery Center has been treating people struggling with drug dependence and substance use disorder for decades, focusing on holistic and comprehensive care. If you or someone you love is struggling, please call toll-free now.

CALL NOW 1-800-951-6135

Can You Protect Your Loved Ones in the Opioid Epidemic?

Can You Protect Your Loved Ones in the Opioid Epidemic?

One of the very real difficulties many families face today is trying to overcome issues with substance use and addiction. With opioid overdose resulting in the deaths of over 33,000 people in 2015, a rate of death that has consistently risen in the past several years, the opioid crisis is a very relevant concern. This issue does not only impact those abusing drugs but drastically impacts their families and loved ones.

Watching someone struggle with substance abuse or dependence can be a devastating experience. When it comes to those we are closest to, it only amplifies the turmoil. It is so hard to know how to be there for someone who is struggling without doing something that could be counter-productive to making their life better.

So can you protect your loved ones in the opioid epidemic? Yes. But how?

What are the things that families members and friends need to focus on in order to keep their loved ones safe?

Understand Proper Pain Management

According to the CDC, approximately 20% of patients who visit their doctors for pain receive an opioid prescription.

Another article on Addictions.com talks about how opioid addictions often begin at home. Some people may still assume that drug addiction begins on the illicit market, but what we have seen more and more over the years is that the opioid epidemic has largely been fueled by prescription drugs.

Many people who struggle with opioid addiction began by using opioid-based painkillers due to a doctor’s prescription. These kinds of medication are not all that strange when dealing with pain management. Powerful prescription opioids are used for:

A lot of times these medications are prescribed for short-term use to try and reduce the risk of dependence after extended use. However, even with short-term prescriptions, these potent opioids can develop a physical dependence with uncomfortable or even painful withdrawal symptoms.

Overprescribing has also become an element in the opioid epidemic spreading through prescription drugs. Having an abundance of people prescribed to opioids also adds to the risk of more abuse.

By understanding these risks, people can better protect themselves and each other from developing a serious dependence. If you are aware of what can happen with opioids, even if legitimately prescribed, you can watch for signs and take action to prevent further risk.

Monitor Your Medicine Cabinet

According to a SAMHSA study from 2015, more than 50% of people addicted to painkillers receive the drugs from family members or friends.

Not only are those who receive opioids for medical reasons at some risk of accidentally developing a dependence, those who live with them can also be at risk of abusing opioids and becoming addicted. The overprescribing of opioids has also created stockpiles of opioids in thousands of homes all over the country. Left-over medications are also making a contribution to high rates of opioid misuse.

Some people who receive an opioid prescription may not actually use the entire prescription, but frequently they hold onto the excess supply of their medications. This is often innocent enough, as people will sometimes want to have something on-hand in case of unexpected pain down the road. Sometimes they might even offer these medications to others in an attempt to help manage a friend or loved one’s pain. However, even with the best intentions, this can be very dangerous.

Not only can giving someone a powerful opioid they are not prescribed be dangerous, simply having this kind of drug lying around is dangerous. Your medicine cabinet can be easily accessed by others within your household.

If you want to protect your loved ones in the opioid epidemic, make sure that you keep opioid medications under restricted access in your home. Do not play doctor and offer these kinds of drugs to your friends or family.

Also, make sure you properly dispose of any unused medications. You can take excess opioid drugs to a drug drop-off. Find nearby locations, which are often at pharmacies or law enforcement agencies.

Look for Signs of Dependence

Dependence and addiction are two terms that are relatively similar, but not exactly interchangeable.

Opioid dependence refers to how the body builds a tolerance to opioids over time. This process leads to the individual needing increasingly high doses of the drug to receive the same effect. Where addiction is more psychological, dependence is primarily a physical response.

Opioid users become physically dependent on the drugs when they require certain doses to feel and function “normally,” while also trying to avoid cravings and withdrawal symptoms. All of these effects can contribute to the development of a more serious addiction. Some physical signs to watch for include:

  • Drowsiness/Sedation
  • Confusion
  • Constricted pupils
  • Reparatory depression
  • Loss of consciousness/Nodding off
  • Constipation

Withdrawal signs can also indicate dependence, including minor symptoms such as:

Understanding the signs or addiction, including withdrawal, can be a way to protect your loved ones in the opioid epidemic. If you can recognize the warning signs, you might be able to intervene before it is too late.

Seek Professional and Effective Help

Education is key to prevention, no matter what the situation or circumstances. Whatever the adversity, arming yourself with information makes you more effective. At the same time, seeking help from those with knowledge and experience with treating addiction is invaluable. Having a safe and effective resource that knows how to help your loved one overcome an opioid dependence or addiction can make all the difference.

It can be overwhelming, and none of us can protect everyone. However, you can be part of the support system that works to keep your family, friends and loved ones safe.

If your loved one is already struggling with opioids, the best thing you can do to protect them is to get them the help they need. If you or someone you love is struggling, please call toll-free now. We want to help.

CALL NOW 1-800-951-6135

Gucci Mane Reflects on PTSD and Past Drug Addiction Struggles

Gucci Mane Reflects on PTSD and Past Drug Addiction Struggles

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

 Author: Shernide Delva

Rapper Gucci Mane recently opened up about his struggles with mental health. He discussed his past drug use and decision to get sober in a new interview with ESPN’s Highly Confidential. The 36-year-old also talked about his experience developing PTSD after he was robbed by assailants in 2005.

The rapper, born Radric Davis, said his involvement in the 2005 murder of Henry Lee Clark led to him developing PTSD. Gucci Mane maintains that he did shoot the man, but says it was pure self-defense. The murder charges against him were eventually dropped. The stress of that incident along with the pressure of his music career exacerbated his mental health issues, he admits.

Guilty On Federal Gun Possession Charge

Although Gucci was found not guilty regarding the 2005 murder case, eventually he would find himself behind bars. Eight years later, Gucci was caught with possession of an illegal fire arm.

In December 2013, Gucci faced a possibility of 20 years behind bars. He was charged with two counts of possessing a firearm as a felon. He opened up about his anxiety and paranoia that manifested during this time.

“I felt like I was gonna kill somebody, for trying to kill me,” said Gucci. “I was never afraid. I just kinda, in my mind I felt like someone was going to try to hurt me, try to rob me, do something to force my hand and defend myself and hurt them.”

Prior to entering jail, Gucci says he had a daily routine of using a variety of substances including alcohol and lean (a mixture of soda and codeine/promethazine-based cough syrup).  He ended up going through withdrawals behind bars which Gucci admits made him feel “like death.” However, his motivation to stay sober finally set in during his sentence.

When I was facing 20, 30 years and it was almost on the table, it kind of got worked out where I could only do three years. I felt like I could manage it. I could still have a career when I got out and not lose my whole life. It was like, ‘Let me fix my life,” he said.

“I had time to sit back and evaluate everything, and also dry out from the drugs … I tried to make the time work for me the best I could,” he went on.

“I didn’t want to live the rest of my life in prison. So I was like, one thing that I need to do is be totally sober. I need to have complete clarity. I need to have razor sharp focus on everything I do, every day from when I wake up to when I go to sleep. After you start doing it for like a year, then it turns to two years. Once I got out and start doing it, it makes me a better person, a better artist, it makes me all the way stronger.”

Maintaining His Commitment To Sobriety

In May, after serving three years, Gucci was released from prison. After his sentence, Gucci dropped his album Everybody Looking. More importantly, Gucci continued to stay sober, something he says is an “empowering” feat.

“It’s an extravagant lifestyle I live. And to me it’s kinda being even more cocky. I love to tell somebody, ‘Hey listen, I don’t do drugs. I’m sorry baby, but I don’t want anything to drink. I’ll take a water,’” he said last fall. “I’m proud of doing it. I like doing it. I hope people follow my example.”

Were you aware of Gucci Mane’s drug past? Drug culture is rampant among celebrity culture, and unfortunately the entertainment industry tends to glorify drug use. Time and time again, we see celebrities cycle in and out of treatment. In the past year, we have loss some of our most treasured celebrities to drug-related incidents.

With drug overdoses at an all-time high, should public figures feel responsible? Regardless, the message is clear at this point. The dangers of drugs and alcohol are not anything to glorify. The amount of drug overdoses continues to peak each year. If you are struggling, understand that your addiction does not have to be a component of your life anymore. Please call now. Do not wait.

   CALL NOW 1-800-951-6135

 

Leftover Painkillers Contribute to the Opioid Epidemic

Leftover Painkillers Contribute to the Opioid Epidemic

Author: Shernide Delva

Whether it is antibiotics or narcotics, many people do not throw away their leftover pills when they are finished using them. However, when those leftovers are addictive painkiller prescription, that simple act of carelessness contributes to the opioid epidemic. Leftover pain medication increases the potential for abuse.

When it comes to prescription painkillers, a few leftover pills can cause a host of problems. Since 1999, more than 165,000 people have died due to opioid-related overdoses according to the CDC. The problem was a result of doctors over prescribing drugs like methadone, oxycodone, and hydrocodone.  These patients not only are prescribed these drugs too liberally, but they are also getting way more medication than they actually need. Those leftovers increase the potential for abuse, according to a recent study.

The study was published in the journal JAMA Internal Medicine. The study revealed that six out of 10 patients admitted to receiving way more medication than they actually needed.  The research surveyed 1,032 American adults who had used prescription painkillers in the past year. Half the participants were no longer taking the meds, but 60% still had the pills leftovers! When asked why they did not dispose of the pills, 61.3% admitted they were holding on to them for the future. These responses suggest a possibility of later misuse and/or abuse.

“These painkillers are much riskier than has been understood and the volume of prescribing and use has contributed to an opioid epidemic in this country,” said study lead Alene Kennedy-Hendricks, an assistant scientist in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.  “It’s not clear why so many of our survey respondents reported having leftover medication, but it could be that they were prescribed more medication than they needed.”

The study also found that half of those surveyed did not know how to store away safely their medications at home, out of reach to children, family members, and visitors. Most did not know how to dispose safely of the medications either. Less than 7% knew about “take back” programs across the country, that allow patients to return leftover pills to pharmacies and law enforcement.

The biggest danger is when patients pass their leftovers to friends and family, which increases the risk for abuse. One in five participants surveyed said they had let someone else use their medication. Researchers say their needs to be a new approach to how doctors prescribe prescription painkillers to help curb abuse and addiction. Some solutions are to cut back on over prescribing as well as educate patients on how to properly dispose of their leftovers.

“We’re at a watershed moment,” said senior author Colleen Barry, co-director of the Center for Mental Health and Addiction Policy Research at the Bloomberg School. “Until recently, we have treated these medications like they’re not dangerous. But the public, the medical community, and policymakers are now beginning to understand that these are dangerous medications and need to be treated as such. If we don’t change our approach, we are going to continue to see the epidemic grow.”

One of the changes that has been proposed is lower-dose prescribing. Lower-dose prescribing is a way of minimizing the potential for abuse. In Maine, governor Paul R. Lepage signed a new bill titled “An Act To Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program.”  The bill would mandate all prescribers participate in the Prescription Monitoring Program (PMP) and would set limits on the strength and duration of opioid prescriptions. The bill would require that opioid prescribers undergo addiction training every two years. Short-term opioid use has been considered to have a lower risk of abuse when compared to longer term use.

Many other states in the country are considering bills to limit the amount of prescriptions available. But, will these bills be effective now that the damage has been done? Over all, these laws work as a way of preventing more people from becoming addicted to these drugs. If you are struggling with drugs or alcohol, understand that you need to seek treatment immediately. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.

CDC Urges Doctors to Stop Testing Patients for Marijuana

CDC Urges Doctors to Stop Testing Patients for Marijuana

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

Author: Shernide Delva

The Center for Disease Control and Prevention (CDC) does not believe doctors should test  patients for marijuana. As a result, they have revised their screening guidelines to ensure that physicians only focus on the problem at hand.

Earlier this month, the CDC changed their policy because the marijuana tests presented unnecessary costs. They also are relatively unreliable. A report by the Pain News Network reported in the past that 21 percent of positive results are false and 21 percent of negative results are positive. The CDC found that testing for marijuana resulted in few health benefits and more potential legal consequences for the patient.

“Clinicians should not test for substances for which results would not affect patient management or for which implications for patient management are unclear,” says the updated CDC guideline for prescribing opioids. “For example, experts noted that there might be uncertainty about the clinical implications of a positive urine drug test for tetrahydrocannabinol (THC).”

In the past, routine drug tests were done to chronic pain patients to monitor abusive behavior. However, the CDC has now made it clear that physicians should only drug test on chronic pain patients when it is necessary.

“Restricting confirmatory testing to situations and substances for which results can reasonably be expected to affect patient management can reduce costs of urine drug testing, given the substantial costs associated with confirmatory testing methods,” the CDC added.

A 2014 analysis published in JAMA Internal Medicine found that states with medical marijuana laws had a 24.8 lower annual opioid mortality rate compared to states without medical cannabis laws.  Research shows that many use marijuana as an alternative to opioid painkillers. Chronic pain patients may find they have to take less opioid or stop taking them all together. The Journal of Pain found that chronic pain patients who had access to legal cannabis had a significant decrease in opioid use, an increase in quality of life, and fewer side effects.

All of these studies suggest that marijuana could be a safe alternative to pain killers for some patients. Also, cannabis has no lethal overdose level, while opioid overdoses are killer close to 19 Americans each day.

With all that said, CDC spokesperson Ellen Komp, states that a positive test for THC may not be helpful information for a doctor and could pose legal ramifications for the patient. She continued in saying that testing for marijuana would not “inform patient care decisions” and has more adverse effects than good.

Just like any mind-altering substance, marijuana can be addictive; however for those with chronic pain, marijuana can be a safe alternative to opioid painkillers. Pain is a complex phenomenon made up of various physical, mental and social components. Pain is our body’s way of signaling that something is wro­­ng. However, when that pain does not go away despite treatments, that pain is known as chronic pain.

Chronic pain can have a range of causes and the reasons for chronic pain have been debated for years in the medical community. Pain medications known as non-steroidal anti-inflammatory drugs (NSAIDs) are often the first approach to treating pain. They are non-addictive and relatively efficient. However, NSAIDs are not always strong enough, and that is when more powerful painkiller medications known as opioids are used. Unfortunately, these opioid pain medications have a tendency to form dependency in many people.

The use of marijuana for pain relief has a long history. However, recently cannabis has received increased attention after several clinical trials reveal the benefits marijuana had on managing pain for chronic pain sufferers.

Still, we are just at the beginning of understanding the benefits of using cannabis for pain management. Therefore, do you agree with the new CDC guidelines? Clearly, it could be a potential harm reduction strategy to reduce the amounts of overdoses occurring due to opioid painkillers. Only time will tell. Remember if you are struggling with any form of substance dependency that you are not alone.  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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