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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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Sheriff in Ohio Refusing to Use Narcan to Prevent Overdose Deaths

Sheriff in Ohio Refusing to Use Narcan to Prevent Overdose Deaths

Author: Justin Mckibben

Ohio has been a major epicenter of the overdose outbreak. In 2014, Ohio was #2 of states with the most overdose deaths.  Since then, Ohio has topped the list for heroin overdose deaths in the country, and remains in the top 3 states with the highest overdose death rates, both overall AND per capita. In fact, the overdose capitol of America is actually Montgomery County, Ohio, with over 365 opioid-related deaths in the first 5 months of 2017.

So with Ohio being one of the states hit the hardest by the ravishes of the opioid epidemic and the overdose crisis, you would think that Ohio officials would be more apt to adopting progressive and preventative measures for saving lives. In some areas, yes. However, in others… not so much.

Butler County Sheriff Richard K. Jones says his deputies won’t carry Narcan, despite its effectiveness reversing the effects opioid and heroin overdoses.

Butler County Overdose Deaths

Making this a much more controversial issue, drug overdose is killing more people than any other cause in Butler County. According to a statement by Dr. Lisa Mannix’s office, in the first 4 months of 2017 the coroner investigated 175 deaths, and 96 of them were lethal drug overdoses.

The month of April was especially deadly for drug users in the area. According to Mannix, her office-

“- has never seen that many deaths of any kind in a single month.”

In just those 30 days, 30 people died from drug overdose. According to the coroner’s office, 83% of the overdose deaths involved illegal opiate substances. This includes the now infamous synthetic opioids such as:

If this deadly trend continues, the coroners office expects those rates will see a 50% increase from the total overdose deaths in 2016.

The Sheriff Says “I Don’t Do Narcan”

He’s Jones just happens to be the only sheriff in Southwest Ohio whose department does not use the opioid overdose antidote Narcan, or the generic Naloxone. And apparently, he has no intention of starting anytime soon.

Jones was asked about the lack of Narcan use by his police department shortly after the now controversial comments made by a Middletown city councilman suggesting a policy to refuse giving a response to overdose calls. According to the sheriff, local residents and even social workers often ask him why law enforcement continue to revive people who overdose multiple times. His response was simple; his deputies don’t. When interviewed and asked about it, Jones stated:

“I don’t do Narcan.”

Yes… let that just sink in for a second.

This is a man who has the job description of ‘protect and serve’ but when it comes to addicts, he would prefer to do neither.

So what was his justification?

Jones went on to rationalize his opinion by, according to the original report, ‘talking about babies he has seen born addicted to heroin in his jail and mothers who teach their teenage children how to use heroin so they can shoot the mom up.’ When the reporter pressed on about the lack of Narcan in his department, Jones stated:

“They never carried it. Nor will they. That’s my stance.”

The sheriff went on trying to validate his rationale by claiming safety was the primary priority. He argued that people revived from an overdose are often violent and are almost never happy to see the police.

So in short, it sounds like this sheriff would let sick and suffering men and women, even teens, die from overdose rather than save their lives… because they might be upset or aggressive?

What Do You Do?

As expanded access programs to provide Narcan to first responders have become more popular it seems some have gone on to debate how long should tax payer money do to saving lives, and how many times should someone be revived.

This is a tough conversation to have. For some there is no easy answer. Those who are more focus on being monetarily minded and conservative will typically argue that resources should not go to repeatedly paying to save addicts from death. But is it fair for anyone to decide whether someone should die or not simply because they are addicted to drugs? Are we really willing to let people die to boost the government’s budget?

However, for some of us the answer is easy- you cannot put a price on a life. Struggling with substance use disorder does not diminish the value of a person. It should go without saying that if the resources exist to prevent death from overdose, than we should use it. Narcan may not be the cure to addiction, but it might keep just enough people alive long enough to find help and make a difference in the world.

Thankfully, this isn’t how all of Ohio is handling the opioid overdose outbreak in their state. Sheriff’s deputies in surrounding counties carry the opioid overdose antidote, including:

  • Warren County
  • Clermont County
  • Hamilton County

Other expanded access programs in Ohio are going strong and saving a lot of people, but of course the next step to solving the issue is helping to establish sources of effective treatment.

Drug addiction treatment can be the decisive variable that allows for these overdose victims and others suffering with substance use disorder to get a new chance at life. Holistic healing with innovative and personalized recovery programs has the potential not to just save a life, but transform lives. If you or someone you love is struggling, please call toll-free now.

CALL NOW 1-800-951-6135

“Predator” Heroin in Pittsburgh Pushes Overdose Epidemic to Next Level

“Predator” Heroin in Pittsburgh Pushes Overdose Epidemic to Next Level

Author: Justin Mckibben

The overdose epidemic in America is at full throttle and blazing a serious trail with no signs of stopping in the immediate future. A disheartening abundance of live continue to be lost as the nation’s leaders and state authorities scramble for resolutions, while some areas experience more destruction than ever at the hands of heroin. Now a new brand has hit Pittsburgh that seems to be responsible for a series of overdoses, and local authorities are attempting to trace it in order to shut it down.

Already 2 people are dead in the largest wave of heroin overdoses in the entire Pittsburgh area since the batch of fentanyl-laced heroin that according to officials killed almost 2 dozen addicts in 2014, and again it seems there’s some connection between these newest cases.

24 Hours of Overdoses

There was one day in particular in Pittsburgh that had authorities in a frenzy. In a 24 hour period between the morning of Tuesday and Wednesday afternoon there were reports of a dozen heroin overdoses. Police Commander RaShall Brackney reported later on Wednesday that thanks to emergency services having access to Narcan, the overdose antidote drug known for reversing the deadly effects of opioid poisoning, ten people who overdose survived when paramedics administered the lifesaving medicine. Most of the incidences occurred on the South Side and in neighborhoods on the West End. Commander Brackney went on to say,

“This huge spike in the last 24 hours is causing us extreme concern,”

Out of the dozen reported overdoses, not all the individuals were so lucky to have been revived. The 2 men that died of suspected overdoses were:

  • Patrick Byrnes, 38, of Beechview
  • James Nardozi, 31, of Dormont

Allegheny County spokeswoman Amie Downs said that the official cause of death in both cases is still pending, but added that county medical examiner Dr. Karl Williams indicated they appear to be heroin-related.

In Allegheny County alone there were 299 deaths from drug overdoses in 2014, a number that had nearly tripled since the year 2000 when there were 109. In Westmoreland County, 87 people died in 2014, nearly four times the number in 2002. So it is fair to say that a need for more overdose prevention resources and education in this area may be needed while the police try to track down the source of the lethal substance that supposedly is leaving a calling card with stamped bags.

Stopping the Stamps

The police have found a piece of this deadly puzzle to turn their focus toward, as the  bags used to package the drugs involved in a number of these cases were stamped with the word “predator” along with the image of a shark, police Commander Larry Scirotto said. But the two deaths were stamped in different bags, including:

  • A bag labeled “Chocolate” at the scene of Byrnes death.
  • A bag found near Nardozi had the stamp, “Chicken/Waffle”

The Allegheny County Crime Lab is currently examining the stamp bags to verify, but it already appears the heroin came from the same distributor. Commander Scirotto did say,

“It’s hard to predict if this is more potent or if it’s laced with something else,”

With this brand being linked to these deaths, some have asked if the dealer who sold the heroin could face homicide charges, since many states are starting to push for stricter penalties be paid and that dealers be held responsible for the deaths of their customers (if they knowingly sell a tainted product).

Fentanyl is a very potent synthetic opioid that has been highlighted recently for contributing to the overdose deaths of many people, and now the U.S. Attorney’s Office is investigating the source of the fentanyl laced heroin in order to remove these intensely dangerous drugs from the market.

Arming Officials with Narcan

Paramedics now regularly carry Narcan to treat suspected opioid overdose victims on the spot, and in some states people are insisting that these same resources be made widely available to prevent further incidents. In Pittsburgh the city paramedics have been armed with Narcan for at least 20 years, and now the talk is to arm city police officers.

The idea of equipping the police is probably one that will pay off. The Westmoreland County Sheriff’s deputies have been carrying Narcan since last year, and it has been reported that state police troopers will carry it soon.

Narcan initially could only be injected with a syringe, but now it is available as a nasal spray, which makes it easier for law enforcement or family members to administer. Pennsylvania is now among at least 24 states allowing expanded use of Narcan, and actually have a law preventing those who respond to and report overdoses from being prosecuted, while allowing friends and family members of people at risk of overdose eligible for a prescription of Narcan to have in case of emergency.

As officials call out for more availability for the overdose antidote, the city of Pittsburgh is being infiltrated by a toxic trade-mark shark that seems to be just one of a series of labeled poison packages killing addicts in the area. Too many more of those 24 hour overdose outbreaks could do some serious damage, but hopefully authorities can cut off the suppliers, or at the very least be ready to treat those in need.

While drug overdose threatens lives in Pittsburgh, people all over the nation are facing the same threats and looking for hope anyway they can. Too many addicts are dying right now because they don’t know a way out, but it is possible and we at Palm Partners want to help. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135

 

 

Big Pharma Holding Overdose Antidote for Ransom

Big Pharma Holding Overdose Antidote for Ransom

Author: Justin Mckibben

For a while now there have been officials waging war on Big Pharma’s pricing policies. Now we see the fight taking on different meaning as congressional leaders shift their focus to a powerful and life-saving drug that police departments and other emergency services use to treat heroin overdoses. So why is Big Pharma holding it for ransom?

Recently we have seen a change in the way law enforcement agencies have chosen to combat drug abuse, and the heroin overdose antidote is part of that growing support for harm reduction strategies. But now the big concern is that the recent price inflation could put the future of city and state distribution programs in jeopardy.

The Money in the Medicine

Naloxone, a generic drug that’s also known as Narcan, is used to reverse the effects of opioid overdoses by relieving the depression of the nervous and respiratory systems. It also helps someone who may be suffering from an overdose by suppressing symptoms of hypertension.

Data from the Centers for Disease Control and Prevention shows that naloxone access could prevent more than 20,000 deaths in the United States annually. A 2013 study found that distributing the drug could save one life for every 227 kits that are distributed. Empirical evidence has also played a part in authorities’ change of heart. For example, more than 100,000 overdose reversals were reported from 188 naloxone distribution programs in the United States. In these programs, more than 53,000 people had been trained to administer the drug.

Amphaster Pharmaceuticals is the maker of the drug naloxone, and reports state that earlier this week Senator Bernie Sanders and Democratic representative Elijah Cummings made a direct attack on Amphaster in a letter questioning the justification of increasing the price of naloxone during a time when heroin overdose deaths have more than tripled within a three-year period! Sanders and Cummings wrote in their letter,

“Over the past several months, police departments, law enforcement agencies, and public health officials across the country have warned about the increasing price of naloxone, which they use to combat the scourge of heroin abuse,”

Back in April 2014, the Food and Drug Administration (FDA) approved Evzio, a user-friendly naloxone injector. But a sticker price of more than $400 a pop keeps people who most need access to the medication from affording it.

And of course in order for Big Pharma to corner the market, the price of the formula that can be injected nasally also doubled, with Amphaster Pharmaceuticals as the sole producer of the drug.

Medication Monopoly

The sad part is that price manipulation is nothing new when looking at the history of naloxone. Ever since the 1970’s when the drug first came out pharmaceutical companies have frequently manipulated prices according to the demand.

Times of crisis are looked at as business opportunities it seems. In 2008 the Centers for Disease Control and Prevention declared an opioid epidemic, and the drug had cost less than $3 per dose, and the price has increased by more than $1,100 since then.

This seems to be a well thought out plan for the Pharmaceutical companies wallets, seeing as how nearly half of United States has recently passed laws granting wider access to naloxone. Now in those states doctors can prescribe naloxone to friends and family members of opioid abusers, and it’s becoming available in local pharmacies. Recent legislation even removes liability from people who dole out the drug, including police officers.

How bad could it be? Well now law enforcement is struggling with naloxone price spikes of up toward 50% that threaten the potential to curb heroin addiction outbreak. Long before Sanders and Cummings wrote Amphaster Pharmaceuticals, others made efforts to change the price including:

  • Massachusetts Attorney General Maura Healey had inquired about the increased price during a public health emergency in the state, which seemed to be distastefully opportunistic of the company.
  • New York’s attorney general Ed Schneiderman had taken a similar approach and secured an agreement for $6 rebate per dose to agencies in the state for a year.

But lawmakers are not satisfied with these efforts. Sanders and Cummings called on Amphaster in their letter to make across-the-board price changes and subsidies similar to what was done for New York consumers, citing its potential to save lives and noting the rapid price increase as contributing to a serious public health crisis.

The criticism the pharmaceutical companies are experiencing for this monopoly isn’t brand new either. Once before advocates suggested taking the new approach a step further by distributing naloxone over the counter, even before the naloxone price had skyrocketed, foreseeing that failing to do so would further marginalize heroin addicts.

State officials and citizens want to see community groups get the access they need to a drug that during a critical stage of the fight against heroin abuse could mean the changing of the tides, and could mean the difference between life and death for countless addicts. So how far will Big Pharma go to keep the supply limited when death by drugs is what creates the demand?

Now the question is what more can be done to free the nation from the choke-hold that Big Pharma currently has on the overdose antidote the nation most desperately needs. Not everyone gets the treatment they need, but you can. 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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