Category Archives: Addiction

FDA considering pricey implant for opioid addiction

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Tablet Thumb BlueBy Martha Bebinger, WBUR
Kaiser Health News

Amid a raging opioid epidemic, many doctors and families in the U.S. have been pleading for better treatment alternatives.

One option now under consideration by the Food and Drug Administration is a system of implanted rods that offer controlled release of buprenorphine — a drug already used in other forms to treat opioid addiction.

Because it’s implanted in the skin, this version of the drug can’t easily be sold on the illegal market, proponents say — a key treatment advantage. The FDA is expected to decide whether to approve the device — called Probuphine — within a week.

The implant system includes four rods, each about the size of a match stick, explained Dave, a paramedic in a small town outside of Boston; he was one of the patients recruited to test the device last year. Dave’s worried about reprisal if co-workers find out he is addicted to opioid pain pills, so NPR agreed to use only his first name.

“My implants were placed in my left arm, just above my elbow on the inside,” he explained. He’s been in recovery for four years — previously with the help of daily buprenorphine pills. Last year, he agreed to be part of an experiment that delivered regular doses of the drug to him via an implant instead. He’s sold on the new approach.

“I felt completely normal all the time,” he said. Continue reading

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In Prince’s age group, risk of opioid overdose climbs

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Prince - Photo: imieye from flickr.com

Prince – Photo: imieye from flickr.com

By Kristin Espeland Gourlay, RINPR
Kaiser Health New

Evidence is mounting that opioid pain medication may have played a role in the death of pop legend Prince.

While the medical examiner hasn’t yet released the results of the autopsy and toxicology tests in this case, opioid overdose in middle age is all too common.

In 2013 and 2014, according to the The Centers for Disease Control and Prevention, people ages 45 to 64 accounted for more than 40 percent of all deaths from drug overdose.

Prince died on April 21 at his home and music studio Paisley Park in Minneapolis. He was 57.

Experts say there are a number of scenarios that increase risk of overdose, which is often accidental, for people over 55.

Imagine you are in that age group and you injured your shoulder a while back. It just hasn’t gotten better, so you take prescription painkillers — an opioid like OxyContin — to help with the pain. Let’s say you’ve been taking it for a couple of years. Your body has built up a tolerance to the drug, and now, you need to change it up to get the same amount of relief.

When it comes to the potential for overdose, said Boston Medical Center epidemiologist Traci Green, this is one of the most dangerous crossroads. Continue reading

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Americans want more action against drug abuse, poll

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By Lisa Gillespie
Kaiser Health News

The fight against the growing abuse of prescription painkillers and heroin is not robust enough at any level — not federal and state governments’ efforts or those of doctors and users themselves, according to most Americans in a new poll out Tuesday.

Lack of access to care for those with substance abuse issues is a major problem, said 58 percent of those surveyed by the Kaiser Family Foundation. (KHN is an editorially independent program of the Foundation.)

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The poll found that Americans had somewhat different views of heroin and prescription drug abuse. More than a third called heroin abuse an extremely serious health problem in the U.S., while just over a quarter of those surveyed said the same about the abuse of strong prescription painkillers. In contrast, fewer than a fifth regarded alcohol abuse in the same way.

The fight against opioid abuse has generated heavy news coverage in recent months, as well as government concerns. President Barack Obama recently proposed adding $1 billion to the federal budget for treatment programs. Yet more than 60 percent of respondents generally faulted federal efforts as too little. Similar shares were dissatisfied with state governments’ actions and those of doctors who prescribe painkillers, the Kaiser poll found.

But more than 70 percent believed drug users themselves aren’t doing enough. Continue reading

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Opioid epidemic fueling hospitalizations, hospital costs

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Tablet Thumb BlueBy Shefali Luthra
Kaiser Health News

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse: the funeralsthe broken families and the patients cycling in and out of treatment.

Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.

The research comes as policymakers grapple with how to curb the increased abuse of these drugs, known as opioids.

Hospitalizations related to use and dependence on opioids have skyrocketed, from about 302,000 in 2002 to about 520,000 a decade later.

State legislators in New YorkConnecticutAlaska and Pennsylvania have tried to take action by adding new resources to boost prevention and treatment.

In addition, President Barack Obama laid out strategies last month intended to improve how the health system deals with addiction. Continue reading

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Synthetic drugs send states scrambling

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By Sarah Breitenbach
Stateline

626a9a5d49384bf599c632587887dc1a (1)Vials of a confiscated synthetic amphetamine called flakka that killed 61 people in Broward County in a little more than a year. States have been reworking drug laws to make it easier to classify synthetic drugs as illegal.

It’s been four months since anyone in Broward County, Florida, has died from an overdose of alpha-PVP, known as flakka, a crystal-like synthetic drug meant to imitate cocaine or methamphetamine. But the drug has already taken a deadly toll, and left health and law enforcement officials scrambling to stem a new public health crisis.

In small doses, flakka elicits euphoria. But just a little too much sends body temperatures rocketing to 105 degrees, causing a sense of delirium that often leads users to strip down and flee from paranoid hallucinations as their innards, quite literally, melt. If someone survives an overdose, they are often left with kidney failure and a life of dialysis.

Because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them.

Flakka is among a growing number of addictive and dangerous synthetic drugs being produced easily and cheaply with man-made chemicals in clandestine labs in China.

But because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them. Now legislators, health professionals and police are trying to eradicate the drugs by making it easier to qualify them as illegal and ramping up the criminal penalties for selling them.  Continue reading

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Opioid treatment model spawns imitators

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Two white tabletsBy Christine Vestal
Stateline

BALTIMORE — Dr. Kenneth Stoller held court on the sidewalk outside the Broadway Center for Addiction on a sunny afternoon last week, chatting with a troop of lingering patients.

He beamed as he patted a young man on the shoulder and said he’d see him tomorrow.

“It’s important for patients to see this as a place that’s safe and accepting,” he said. “For some, it’s the first place they’ve gotten positive reinforcement in their lives.”

Operated by Johns Hopkins Hospital and located two blocks from its main campus, the Broadway Center — or “911” as it’s called because of its address at 911 N. Broadway — has provided methadone maintenance therapy for people with opioid addiction for more than two decades.

But unlike most of the roughly 1,400 methadone clinics across the country, the Broadway Center offers not only methadone, but the two other federally approved addiction medications, buprenorphine and naltrexone, and a full complement of mandatory addiction counseling and group classes. In most other places, addiction treatment is fragmented, leaving patients to shop around for the care they need or settle for whatever is offered at their local opioid treatment clinic.

Unlike most of the roughly 1,400 methadone clinics across the country, the Broadway Center offers not only methadone, but the two other federally approved addiction medications, buprenorphine and naltrexone, and a full complement of mandatory addiction counseling and group classes.

“If you went to a doctor for any other disease, you’d expect to be offered all available treatment options,” said Dr. David Gastfriend, scientific adviser at the Philadelphia-based Treatment Research Institute, which studies substance abuse treatment. “Addiction treatment should be no different.”  Continue reading

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Opioid epidemic spurs rethink on medication and addiction

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Tablet Thumb BlueBy Anna Gorman
Kaiser Health News

Drug treatment providers in California and elsewhere have relied for decades on abstinence and therapy to treat addicts. In recent years, they’ve turned to medication.

Faced with a worsening opiate epidemic and rising numbers of overdose deaths, policymakers are ramping up medication-assisted treatment.

Faced with a worsening opiate epidemic and rising numbers of overdose deaths, policymakers are ramping up medication-assisted treatment.

President Barack Obama last week said he’d allocate more money for states to expand access to the medications. He also proposed that physicians be able to prescribe one of the most effective anti-addiction drugs, buprenorphine, to more patients. Continue reading

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As fentanyl deaths spike, states and CDC respond

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DeafentanylBy Christine Vestal
Stateline

ATLANTA — When Ohio tallied what many already knew was an alarming surge in overdose deaths from an opioid known as fentanyl, the state asked the U.S. Centers for Disease Control and Prevention to investigate.

The rash of fatal overdoses in Ohio — a more than fivefold increase in 2014 — was not an isolated outbreak. Fentanyl is killing more people than heroin in many parts of the country. And the death toll will likely keep growing, said CDC investigators Matt Gladden and John Halpin at the fifth annual Rx Drug Abuse and Heroin Summit here.

At least 28,000 people died of opioid overdoses in 2014, the highest number of deaths in U.S. history. Of those, fentanyl was involved in 5,554 fatalities.

Fentanyl, used in its legal pharmaceutical form to treat severe pain, represents the latest evolution of an epidemic of opioid addiction that began with prescription painkillers and moved to heroin, as users demanded cheaper drugs and greater highs.

At least 28,000 people died of opioid overdoses in 2014, the highest number of deaths in U.S. history. Of those, fentanyl was involved in 5,554 fatalities, a 79 percent increase over 2013, according to a December CDC report.

Unpublished data for the first half of 2015 indicate an even steeper spike in fentanyl deaths, Gladden said.

Cheap and Lethal

Continue reading

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Fantasy sports fueling rise in gambling addiction

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Data GlobeBy Ana B. Ibarra
Kaiser Health News

Poison comes in many forms for addicts: Alcohol and drugs usually come first to mind, but gambling — often overlooked — is of increasing concern to state officials and rehab centers.

The number of problem gamblers has grown in recent years with an explosion of betting opportunities available at the touch of a smartphone screen.

That is particularly true during this month’s annual “March Madness” college basketball tournament.

The state’s Office of Problem Gambling, part of the Department of Public Health, recorded 36,000 calls to its hotline last year — the highest number since it began public awareness efforts in 2003, said Terri Sue Canale-Dalman, who heads the agency. The number of problem gamblers in California is estimated to have reached 1 million.

The average gambler loses about $38,000 a year and is $20,000 in debt, Canale-Dalman said. And the damage is not only monetary: Relationships are often lost and some gamblers suffer a decline in mental and physical health. Continue reading

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Debate arises over HHS plans for privacy rules on addiction treatment

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computer laptop and stethoscopeBy Michelle Andrews
Kaiser Health News

What’s more harmful to patients being treated for drug or alcohol abuse: risking their health by keeping other medical providers in the dark about their substance abuse treatment?

Or risking their jobs, homes and child custody arrangements by allowing potentially damaging treatment details to be electronically shared among an array of medical providers?

Advocates have painted the possible patient outcomes in starkly different terms as they consider the federal government’s recently proposed update to guidelines that govern the release of patient records for alcohol and drug abuse treatment. Continue reading

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Building a ground army to fight heroin deaths

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sln_overdoseReversalLine
By Christine Vestal
Stateline

BALTIMORE — A crowd quickly gathers here on one of West Baltimore’s many drug-infested street corners. But it isn’t heroin they’re seeking. It’s a heroin antidote known as naloxone, or Narcan.

Two city health department workers are holding up slim salmon-colored boxes and explaining that the medication inside can be used to stop someone from dying of a heroin overdose. Most onlookers nod solemnly in recognition. They’ve heard about the drug. They want to know more.

Nationwide, more than 150,000 people received naloxone kits from community outreach programs like Baltimore’s between 1996 and 2014, and more than 26,000 overdoses were reversed using those kits, according to a recent survey funded by the U.S. Centers for Disease Control and Prevention.

In addition, police, emergency medical technicians and emergency room physicians have used the drug to save tens of thousands of lives. Baltimore police officers started carrying the kits last year.

But as the opioid epidemic seeps into nearly every small town and suburb across the country, state, local and federal officials are trying to make the life-saving prescription drug available everywhere, particularly at local pharmacies. Continue reading

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Are state-sanctioned heroin shooting galleries a good idea?

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320px-HeroinBy Sarah Breitenbach
Stateline

A bustling economy. Record-low unemployment. A ballooning heroin problem.

That’s how Mayor Svante Myrick describes Ithaca, New York, where he hopes to open the nation’s first safe injection facility — a place where heroin users could shoot their illegal drugs under medical supervision and without fear of arrest.

His proposal, part of a plan to address drug abuse in the 31,000-person college town in central New York, is not a novel idea. Safe injection sites, which also connect clients to treatment programs and offer emergency care to reverse overdoses, exist in 27 citiesin other parts of the world. Some have been around for decades.

But no safe havens for injecting illegal drugs exist in the United States, which is experiencing an epidemic of opioid addiction and a rising tide of overdose deaths. Some lawmakers in California and Maryland want to change that and make legal what addiction specialists say is already going on at many clinics or needle-exchange programs across the country.

Proponents of the sites say they reduce the risk of dying from heroin use because addicts are drawn out from alleys, public restrooms and run-down buildings and into supervised settings where they can be quickly treated for overdose symptoms.

Once there, access to clean needles reduces an addict’s exposure to infections, as well as diseases like hepatitis C and AIDS. And, supporters say, drug users are more likely to pursue addiction treatment once they develop trusting relationships with clinic staffers.

Other lawmakers, however, warn that supervised heroin shooting galleries run contrary to state and federal drug laws and would encourage illegal drug abuse.  Continue reading

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States, CDC seek limits on painkiller prescribing

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Tablet Thumb BlueBy Christine Vestal
Stateline

Overdoses from OxyContin and other opioid pain relievers killed nearly 20,000 Americans in 2014. States and the federal government want to stop liberal prescribing practices seen as causing the epidemic.

As medical director for the Washington state workers’ compensation program in 2001, Dr. Gary Franklin made a chilling discovery: Otherwise healthy workers who took painkillers for minor injuries were ending up dead a few years later.

“It isn’t drug dealers that are on our South American border that are our biggest challenge. It is our drug dealers who are FDA-approved selling the stuff in every pharmacy in America.”

“It was shocking,” Franklin said. “Workers are on the job, they report a back sprain, and then they are dead.” In dozens of cases, patients had been prescribed opioid painkillers for chronic pain. Most had taken drugs like OxyContin consistently for months or years.

Doctors were prescribing high doses of opioid painkillers in most other states too. Doctors and their patients had been assured the pills were safe, and yet thousands of people were dying. “They would take one more pill before going to bed and never wake up,” Franklin said.

Now, in the throes of the deadliest drug epidemic in U.S. history, governors, presidential candidates and major health care organizations — from insurance companies to physician associations — are calling for limits on the number and strength of opioid pills prescribed.

The U.S. Centers for Disease Control and Prevention is close to taking the unprecedented step of issuing national guidelines to curb liberal opioid prescribing practices widely blamed as the cause of the epidemic.

“It isn’t drug dealers that are on our South American border that are our biggest challenge,” Democratic Vermont Gov. Peter Shumlin said last month at a meeting of the National Governors Association. “It is our drug dealers who are FDA-approved selling the stuff in every pharmacy in America.” sln_mapOPIOIDPRESCRIBING Continue reading

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My road to long-term recovery from opioid abuse

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By Jordan Coughlen Wheeling, West Virginia
From the HHS blog

I grew up in an average home. I went to decent schools. I was raised by good parents. Yet here I am, a person in long-term recovery from opioid abuse.

My substance use disorder took effect the day I traded two CD’s for six prescription painkillers. I didn’t even know what opioids were until I heard the “cool” kids at high school talking about them.

When I heard a friend had broken his toe and had some prescription drugs that he wasn’t using, my curiosity took over.

jordan-coughlen

President Barack Obama talks with introducer Jordan Coughlen backstage prior to a community forum on the prescription drug abuse and heroin epidemic, at the East End Family Resource Center in Charleston, W.Va., Oct. 21, 2015. (Official White House Photo by Pete Souza)

For many years, the road to recovery seemed out of reach, and a life of substance misuse seemed my only route. Opioids were my lover, my teacher, and my best friend. They overshadowed all that was important to me and distorted the faces of those I loved. Continue reading

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