Author: Shernide Delva
These are just a few of the incentives doctors have received from prescription opioid companies. Did these goodies get you your last opioid prescription?
Could incentives be responsible for our current opioid epidemic?
That’s exactly what researchers set out to understand.
A recent report confirmed what many have suspected: doctors are receiving incentives from major opioid makers. In fact, one out of every 12 U.S doctors gets money, lunch or something else of value from companies that make opioid drugs, the study concluded.
Furthermore, companies are spending more time and effort marketing opioids to doctors than they are other less addictive painkillers. These finding will help understand why doctors have played such a major role in the opioid addiction crisis.
“A large proportion of physicians received payments — one in 12 physicians overall,” said Dr. Scott Hadland of the Boston Medical Center. “Tens of millions of dollars were transferred for marketing purposes for opioids.”
Dr. Hadland and colleagues went through databases from the Centers for Medicare and Medicaid Services, the federal government office that oversees public health insurance.
The 2010 Affordable Care Act includes the Physicians Payments Sunshine Act. This act required medical product makers to report any offerings or goodies made to doctors or to teaching hospitals. However, incentives are often disguised as something else.
“In some cases, they are money provided directly to physicians — for example, the speaking fees, the consultant fees and the honoraria. In other cases it is reimbursement for things like travel,” Hadland said.
On average, doctors get a single “payment,” usually a mean worth of $15 about once a year. Still, there are a select few doctors that are reaping the most benefits.
“The top 1 percent of physicians (681 of them) received 82.5 percent of total payments in dollars,” the team wrote in their report, published in the American Journal of Public Health.
These incentives could influence doctors to prescribe opioids to their patients:
“One of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” the study notes.
Between 2013 and 2015, the team found 375,266 payments totaling 26 million distributed to more than 68,000 doctors.
While larger fees mostly accounted for speaker fees, more leisurely incentives like food and drink accounted for 94 percent of the payments.
“I do think the practice is exceedingly common. Increasingly, medical schools are restricting the ability of pharma companies to come to speak to medical students and even faculty,” Hadland said.
With all this said, do small incentives really make a difference? After all, can a doctor really be bought for the price of a boxed lunch?
The research indicates that, yes, these little goodies do influence prescribing. Last year, a study revealed that physicians who accepted even one meal by a drug company were more likely to prescribe a name-brand drug to patients later.
This is not the first time investigations were conducted on possible incentives. After earlier controversies and studies, the Pharmaceutical Research and Manufacturers of America issued a voluntary code of conduct to curb the once widespread practice of handing out free mugs, prescription pads, and other swag covered in drug brand names.
Some cities and states especially hit by the opioid abuse epidemic have even sued drug makers saying their practices have helped fuel the problem. The CDC states doctors have contributed to the addiction crisis by prescribing opioids to too many patients. These prescriptions are often prescribed at high doses for too long which only increases the vulnerability to addiction.
The result is deadly.
There were more than 30,000 fatalities in the United States in 2015, the federal government said.
“I think that first and foremost we have known that one of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” said Michael Botticelli, former director of the White House Office of National Drug Control Policy, and now executive director of the Grayken Center for Addiction Medicine at the Boston Medical Center.
According to Botticelli, the answer is independent education, free of the need to promote a specific product.
“At the federal and state level (we may need to) move toward mandatory prescriber education to counteract industry’s influence over prescribing behavior,” he said. “Clearly, guidelines are not enough.”
For a long time, prescribing opioids was one of the first responses to pain management. Now other alternatives are being promoted such as pain management devices and holistic alternatives.
Botticelli agrees that while pain is a major problem, the answer is not more opioids.
“Yes, we want to make sure people’s pain is appropriately treated, but we know that longer and higher doses have significantly added to the addiction problem that we have in the United States,” he continued.
What are your thoughts? Did you know about these incentives? More studies are coming out revealing the back story to what led to the prescription opioid epidemic.
Opioid addiction has become a public health crisis. Now, more than ever is the time to seek treatment. Recovery is possible. You do not have to feel out of control. There is a solution. If you are struggling with substance abuse, call now. Do not wait.
CALL NOW 1-800-951-6135
Author: Shernide Delva
Overconfidence in Recovery:
Confidence is supposed to be an excellent quality. We are always told to believe in ourselves in every endeavor we pursue. Whether it is a sport or a school exam, having confidence is touted as the key to success. However, when it comes to addiction recovery, can too much confidence actually become harmful?
Overconfidence Can Lead to Relapse:
The reality is too much confidence is not great in recovery. While it is great to have confidence in your program, it is important to stay humble. The emotions that arise from overconfidence can block underlying issues. Having an overconfident mindset can hinder your recovery process. It is important to make recovery a priority regardless of how much time you have.
Why Overconfidence Encourages Relapse:
- Distorted Self-Image: A major part of recovery is staying humble. Overconfidence makes someone believe that they are not as bad as newcomers. They may start to feel they no longer need their program and start to ponder if they are an addict at all. Overconfidence encourages the belief that it is not a huge deal to have a drink or use casually, which is far from true for an addict.
- Irrational Thoughts: Overconfidence can lead an addict to believe they deserve certain rewards in conjunction to their success. They might feel they are worthy of a celebration. They quickly convince themselves that one drink is not going to hurt them because they are now “in control” of their addiction. This is risky behavior and can lead someone down a slippery slope.
- Complacent Behavior: This is when an addict starts to believe that their addiction is not nearly as bad as they once thought. They start believing that they can now live normally due to the length of time they have been sober. They think they are cured so they slowly stop going to meetings and stop thinking of themselves as an addict. This leads to new addiction or a relapse.
Signs of Overconfidence Include:
- Rejecting suggestions from others
- Seeking immediate results
- Belief in having all the answers
- Always seeing your situation as unique from everyone else
- Feeling that you deserve preferential treatment
- Feeling “healed” or “in control”
- Always wanting to lead instead of listening
It is crucial to understand that addiction will not simply disappear. Regardless of how long you have been sober, addiction can always creep up again. Addiction is not a curable disease; it is a manageable disease that does not have room for overconfidence.
How We Become Too Confident:
Overconfidence may be a trait acquired in recovery, or it can be a trait a person struggled with before sobriety. In fact, most addicts battle overconfidence their entire life. For example, those times you tried to use and thought no one would notice.
Sadly, this behavior can persist after recovery even after hitting rock bottom. Even those with no history of overconfidence can start to become overzealous in their recovery program. They start to believe that they are above the rest of their friends and family because of the work they have done in their recovery.
Consequences of Overconfidence:
When you act too confident, you hurt yourself and others. You hurt others who are still learning to trust the person you have become. You hurt yourself because overconfidence increases the vulnerability to a relapse. It is important to remember that recovery is something that takes effort every single day. Regardless of how much time you have, stay humble in your program. It is better to be safe than sorry.
Remember to support others struggling, and stay focused on your recovery. Overconfidence is not a quality anyone should strive for. Instead, focus on staying sober every single day. If you are struggling to stay sober, or are currently having issues with substance abuse. Please reach out. We want to help you get back on track.
CALL NOW 1-800-951-6135
Author: Shernide Delva
The controversy surrounding the Megyn Kelly Sunday Night show continues. The first investigation piece on drug addiction focused on issues plaguing the South Florida recovery community.
Now, Megyn Kelly returns to cover addiction treatment, and this time her show is highlighting another polarizing subject: harm reduction programs. On Sunday night, Megyn Kelly’s shows featured The Sinclair Method. The Sinclair Method is a harm reduction treatment program that allows patients who struggle with alcohol use disorder to continue drinking.
The segment introduces viewers to Marisa, a 25-year-old binge drinker. The crew follows Marisa around for day one of her introduction to The Sinclair Method.
First Marisa sees a doctor, who gives her a prescription. Shortly after taking the prescription, she has a drink. According to Marisa, her intense cravings to binge disappears.
“I feel like I could have another drink or not have another drink and be totally fine,” she tells the camera.
The apparent miracle pill is naltrexone, a commonly used opioid antagonist typically used to treat heroin addiction. However, under The Sinclair Method, the drug is used to treat alcoholism.
“The drug blocks pleasure receptors in the brain―a buzzkill,” Melvin explains in a voiceover. “And when combined with psychotherapy sessions, the theory goes, eventually the cravings go away.”
Essentially, the idea behind the program is patients take naltrexone before drinking and over time, the desire to excessively drink diminishes. For Marisa, the unorthodox treatment seems to have worked. Only three months after starting the treatment, she told NBC she had lost her drive to drink.
Still, this approach is far from traditional. The 12-step model of addiction promotes abstinence only treatment. The show highlighted an interview with Hazelden Betty Ford’s executive director, Chris Yadron.
“The 12 steps are crucial because it’s a spiritual program of recovery,” he told Melvin.
Dr. Mark Willenbring who once ran the NIH’s alcohol recovery research defended The Sinclair Method, added that 12-step approaches do not rely on modern science.
“We don’t send someone with diabetes to a spa for a month, teach them diet and exercise and then say, ‘Go to support groups, but don’t take insulin.’ I mean, that’s the absurdity of what we’re doing now,” he said. “We’re still providing the same pseudo treatment that we provided in 1950. And 85% of rehabs in the country are 12-step rehabs. People don’t have any choice.”
The tension between abstinence-based and harm-reduction approaches to treatment has created a long-standing controversy in the recovery community. Throughout the segment, tweets were displayed from people who were for and against harm reduction strategies.
“This is very troublesome to see that some doctors are giving people with a thinking disease a “magic” pill,” tweeted one user.
Others felt the treatment option provides another solution than the standard abstinence-only approach. We’ve seen harm reduction programs like Moderation Management receive massive criticism, specifically after the founder, Audrey Kishline, killed a 12-year old girl and her father while driving in an alcoholic blackout.
Overall, programs like these remain controversial and risky. It is best to get treatment to address the underlying issues behind your addiction. If you are struggling with mental illness or addiction, please 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
Dug and Heidi McGuirk answer “Should I Drink in Front of My Loved One in Recovery?”
Author: Shernide Delva
Dug and Heidi McGuirk, who run the Revolutionary Family program for Palm Healthcare, recently answered, “Should I drink in front of my loved one in recovery?” in their latest video. This question was submitted by a parent with a son in recovery.
My husband and I love craft beers and he’s making a wine right now at home and while we don’t drink around our son or mention it, we were wondering if he moves back to town, although he won’t be living with us, does that mean we have to stop drinking for his sobriety, or just not drink around him? It seems strange to pretend that we have given up drinking. I also ask because when we were visiting, my dad drank right in front of him, and he didn’t say anything, but I was nervous since he’s still new to recovery. I thought other parents might have the same question. I don’t want to treat him differently than any others, but I also don’t want to hurt his sobriety.
This is a common question that many parents and loved one’s of addicts ask especially in the early stages of recovery.
To start off, Dug McGuirk answers that it is important to have an initial awareness of your behaviors around your recovering loved one.
“My initial thoughts are that it’s great that you’re considering it, that you’re being aware, and you have some sensory acuity,” Dug McGuirk affirms. “It’s also fantastic that right now, in early recovery, you’re not necessary drinking in front of him, that’s probably fine. That’s a great decision if you believe in it.”
Still, it’s important to remember that you are not responsible for your loved one relapsing. Your loved one can still relapse regardless of whether you have alcohol around the house or not. Alcohol is everywhere, and eventually, they are going to have to deal with that reality.
“At some point, he’s going to be exposed to alcohol, so what are you going to do? Be co-dependent?” Dug McGuirk asks.
“Being exposed to stimulus doesn’t necessarily make somebody drink,” Heidi McGuirk says. “Your loved one is going to be exposed to the stimulus all the time, and that’s part of life.”
“You could go your whole life and not drink a drop of alcohol in front of somebody, or not have any alcohol in the home around them and they still could relapse,” Heidi McGuirk continues.
Decide What You Believe In:
Ultimately, Heidi McGuirk says it comes down to doing what you believe in. It is important to keep that in mind when making these types of decisions.
“Everybody’s going to be different,” she says. “Don’t do what you think is going to keep somebody sober. Do what you believe in instead.”
You may decide that not drinking around your loved one is a small sacrifice to make. That decision may give you some peace of mind when they are around. You have to determine that for yourself depending on the circumstances.
For Heidi McGuirk, she says if her father, who wrestled with addiction, were still alive, she likely would not feel comfortable drinking around him.
“If he were still here and he was still in recovery, we would not have alcohol around him. I just– I don’t believe in that. I wouldn’t want that for him,” she admits. “Me, not drinking anyway, it’s irrelevant, but if he were staying in my house, I would just do what I believe in. which is not having any alcohol around.”
Heidi McGuirk says her decision would come from a loving place. She compares it to the way she would behave around someone struggling with managing their weight.
“Just for the same reason that if I knew somebody who was managing their weight and they had a gastric bypass, I wouldn’t sit down to a four-course meal of desserts in front of them because I would find them kind of rude, but that’s me! Could I be a little codependent there? Probably. But that’s how I love,“ she explains.
Everyone is Different:
Heidi McGuirk explains how these decisions may simply come from a place of love for your addicted loved one. However, it also good to note how your loved one feels about it. They may feel offended by your decision to not drink or have alcohol around.
“In my own life, I wouldn’t want for one second for somebody not to drink around me,” she admits. “I have lots of friends, lots of family, who drink in front of me all the time, and I don’t take offense to it, and I wouldn’t want them to change their lifestyle. So again, it’s not about keeping somebody sober, it’s finding what you believe in and then practicing what you believe in from a place of your heart versus your mind on what you think is going to keep somebody well.”
“The simple answer is that whether you drink or not is not going to make someone relapse,” Dug McGuirk says. “Cause if someone relapses, it has nothing to do with what they’re exposed to. It has everything to do with: Are they working their recovery?”
Insights From My Relationship
Personally, I related to this question a lot, and agree with the answer Dug and Heidi McGuirk gave. My boyfriend was five years sober when we first got together nearly two years ago. However, I am not in recovery from drugs or alcohol. In the beginning of the relationship, I wanted to ensure he was okay with seeing me consume alcohol.
It turns out; drinking in front of my boyfriend did not bother him at all. In fact, he felt more comfortable when I did not alter my behavior due to his recovery. However, his drug of choice was never alcohol, so drinking was never a trigger for him to begin with.
If needed, I would have abstained from alcohol while he was around, simply from a place of love. Fortunately, I never needed to make that decision. As you can see, these situations really vary from person to person.
Still, whether or not to drink in front of a loved one is a multifaceted question. Communication is essential. In early recovery, drinking or having alcohol around the house might not be a good idea. Later on, it may become less of an issue. Overall, if you have any uncertainty about your loved one’s sobriety, please reach out. We can help. Call now.
CALL NOW 1-800-951-6135