Category Archives: Drug Abuse

Waiting lists grow for medicine to fight opioid addiction

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A self-serve supply of needles and containers for their disposal at a Burlington, Vermont, needle exchange center that distributes more than 2,500 needles every day. As the opioid epidemic mushrooms, the demand for treatment is outpacing capacity.

By Christine Vestal
Stateline

BURLINGTON, Vermont — After more than a decade of getting high on illicit opioid painkillers and heroin every day, Christopher Dezotelle decided to quit. He saw too many people overdose and die. “I couldn’t do that to my mom or my children,” he said.

He also got tired of having to commit crimes to pay for his habit — or at least the consequences of those crimes. At 33, he has spent more than 11 of his last 17 years incarcerated. The oldest of seven children, he started using marijuana and alcohol when he was 12.

It’s been five years since Dezotelle started treatment the first time, and he still hustles for drugs every day. Only now, instead of heroin or OxyContin, he’s trying to score buprenorphine, one of three federally approved opioid-addiction medications. He says heroin is much easier to find, and it’s less than half the price of buprenorphine on the streets and parking lots of this college town.

Vermont Gov. Peter Shumlin, a Democrat, was among the first in the nation to address the opioid epidemic. He devoted his entire State of the State address to the crisis in 2014. Since then, his administration and many of Vermont’s private practice doctors have made treatment more available than it is in most of the country.

But it’s not enough.

In this state of about 626,000, almost 500 addicts are on waiting lists to receive medication for opioid dependence. More than half will wait close to a year.

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Nationwide, a shortage of doctors willing to prescribe buprenorphine, which reduces drug cravings, and a federal limit on the number of patients they can treat, prevents many who could benefit from the addiction medication from getting it.

Less than half of the 2.2 million people who need treatment for opioid addiction are receiving it, U.S. Health and Human Services Secretary Sylvia Burwell said this month, previewing President Barack Obama’s new budget, which was released Tuesday and proposes $1.1 billion to expand the availability of buprenorphine and other opioid-addiction medications.

Where are the Doctors?

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Few doctors willing and able to prescribe anti-addiction drugs

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By Christine Vestal
Stateline

Photo: Jr de Barbosa CC license

Photo: Jr de Barbosa CC license

SAN FRANCISCO — Dr. Kelly Eagen witnesses the ravages of drug abuse every day. As a primary care physician at a public health clinic here in the Tenderloin, she sees many of the city’s most vulnerable residents.

Most are homeless. Many suffer from mental illness or are substance abusers. For those addicted to opioid painkillers or heroin, buprenorphine is a lifesaver, Eagen said.

By eliminating physical withdrawal symptoms and obsessive drug cravings, it allows her patients to pull their lives together and learn how to live without drugs.

Clinical studies show that U.S. Food and Drug Administration-approved opioid addiction medicines like buprenorphine offer a far greater chance of recovery than treatments that don’t involve medication, including 12-step programs and residential stays.

But as the country’s opioid epidemic kills more and more Americans, some of the hardest-hit communities across the country don’t have enough doctors who are able — or willing — to supply those medications to the growing number of addicts who need them.DopamineOpioidsv4

More than 900,000 U.S. physicians can write prescriptions for painkillers such as OxyContin, Percocet and Vicodin. But because of a federal law, fewer than 32,000 doctors are authorized to prescribe buprenorphine to people who become addicted to those and other opioids. Most doctors with a license to prescribe buprenorphine seldom — if ever — use it. Continue reading

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Helping drug-addicted inmates break the cycle

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DEADLY BIAS: Why Medication Isn’t Reaching the Addicts Who Need It, Part II

By Christine Vestal
Stateline

Barnstable_County_Massachusetts_incorporated_and_unincorporated_areas_Buzzards_Bay_highlighted - by Rcsprinter123 via WikipediaBUZZARDS BAY, Mass. — A week before 22-year-old Joe White was slated for release from the Barnstable County Correctional Facility, 26 law enforcement officials and social workers huddled around a table to discuss his prospects on the outside.

For substance abusers like White, they aren’t good.

In the first two weeks after a drug user is released from jail, the risk of a fatal overdose is much higher than at any other time in his addiction.

After months or years in confinement, theoretically without access to illicit drugs, an addict’s tolerance for drugs is low but his craving to get high can be as strong as ever.

Most inmates start using drugs again immediately upon release. If they don’t die of an overdose, they often end up getting arrested again for drug-related crimes.

Without help, very few are able to put their lives back together while battling obsessive drug cravings.

Addiction_v4 Continue reading

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Medicaid to fund more addiction treatment

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By Ben Allen
WITF/KHN/NPR

For decades, if someone on Medicaid wanted to get treatment for drug or alcohol addiction, they almost always had to rely solely on money from state and local sources.

Now, in a dramatic shift, the federal government is considering chipping in, too. The agency that governs Medicaid is proposing to cover 15 days of inpatient rehab per month for anyone enrolled in a Medicaid managed care plan.

But in Pennsylvania, those who work in the addiction field are not happy with that news. While it’s a good start, they say, 15 days of residential care isn’t nearly enough time for many people addicted to heroin, opioids, alcohol or other drugs to get clean and stay that way.

“Where they came up with the 15 days, I don’t know, but it’s not based on research,” said Mike Harle, head of the nonprofit treatment program Gaudenzia, which serves about 20,000 patients a year in Pennsylvania, Maryland and Delaware. In just 15 days, he said, you can’t expect to achieve a positive outcome. Continue reading

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Doctors seek to prevent abuse in midst of opioid epidemic

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The U.S. is in the grips of a prescription drug epidemic, fueled in part by an explosion in opioid prescriptions over the past several decades. Roughly half of those prescriptions are written by primary care doctors. NPR’s Robert Siegel talks with Dr. Wanda Filer, president of the American Academy of Family Physicians, about her experience prescribing opioids and what doctors can do to prevent abuse.

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Drug overdose deaths hit all-time high – CDC

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Tablet Thumb BlueMore persons died from drug overdoses in the United States in 2014 than during any previous year on record, the US Centers for Disease Control and Prevention report in this week’s issue of the MMWR.

Some facts from the report

  • From 2000 to 2014 nearly half a million persons in the United States have died from drug overdoses.
  • In 2014, there were approximately one and a half times more drug overdose deaths in the United States than deaths from motor vehicle crashes.
  • Opioids, primarily prescription pain relievers and heroin, are the main drugs associated with overdose deaths.
  • In 2014, opioids were involved in 28,647 deaths, or 61% of all drug overdose deaths; the rate of opioid overdoses has tripled since 2000.

The 2014 data demonstrate that the United States’ opioid overdose epidemic includes two distinct but interrelated trends: a 15-year increase in overdose deaths involving prescription opioid pain relievers and a recent surge in illicit opioid overdose deaths, driven largely by heroin.

To read the report go here.

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Most Americans say they have a personal tie to prescription drug abuse

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By Lisa Gillespie
KHN

The growing abuse of prescription painkillers now touches home for a majority of Americans, according to a poll released Tuesday.

One in three say either they have been addicted to painkillers or they have known a family member or close friend who was.

More than 56 percent of the public say they have a personal connection to the issue, reports the latest monthly tracking poll of the Kaiser Family Foundation.

That share includes those who say they know someone who died from a painkiller overdose, have been addicted themselves or know someone who has and those who know someone who took painkillers not prescribed to them, the poll’s results show. (KHN is an editorially independent program of the Foundation.)

Details from the poll:

— 16 percent say they know someone who has died and 9 percent say that person was a close friend or family member.

— 27 percent say either they have been addicted to painkillers or they have known a family member or close friend who was.

— 63 percent of whites say they have a personal connection to the abuse of prescription painkillers compared with 44 percent of blacks and 37 percent of Hispanics.

Half of those surveyed rank prescription painkiller and heroin abuse as a top priority for their governor and legislature, behind improving public education and making health care more accessible and affordable, which drew 76 percent and 68 percent shares, respectively.

Sixty-two percent of those polled said the drug Naloxone, which can reverse an overdose and is handed out in some states without a prescription and for little or no cost, should only be available via prescription.

Efforts to reduce painkiller abuse would be at least somewhat effective, many Americans say. Providing treatment for addicts is cited by 85 percent, monitoring doctors’ prescribing habits by 82 percent and encouraging people to dispose of leftover medication by 69 percent.

Kaiser’s tracking poll was conducted Nov. 10 to 17 among 1,352 adults.The margin of error for the full sample is +/- 3 percentage points.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

khn_logo_lightKaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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10 percent of US adults have drug use disorder at some point in their lives

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75 percent report not receiving any form of treatment.

From the National Institutes of Health

Three red and white capsulesA survey of American adults revealed that drug use disorder is common, co-occurs with a range of mental health disorders and often goes untreated.

The study, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, found that about 4 percent of Americans met the criteria for drug use disorder in the past year and about 10 percent have had drug use disorder at some time in their lives.

“Based on these findings, more than 23 million adults in the United States have struggled with problematic drug use,” said George F. Koob, Ph.D., NIAAA director. “Given these numbers, and other recent findings about the prevalence and under-treatment of alcohol use disorder in the U.S., it is vitally important that we continue our efforts to understand the underlying causes of drug and alcohol addiction, their relationship to other psychiatric conditions and the most effective forms of treatment.”

“Based on these findings, more than 23 million adults in the United States have struggled with problematic drug use.” —George F. Koob, Ph.D.

NIAAA directorA diagnosis of drug use disorder is based on a list of symptoms including craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. Continue reading

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Opioid epidemic continues in Washington

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Tablet Thumb BlueFrom the Washington State Department of Health

New Washington health data shows a significant drop in deaths from prescription narcotics in recent years.

Tragically, the decline is offset by a doubling of the number of heroin deaths in our state during the same time.

Both heroin and prescription narcotics are types of drugs known as opioids.

Progress in preventing deaths from prescription narcotics compromised by rising heroin fatalities

Data from 2014 state vital statistics records show the number of deaths from prescription narcotics has steadily dropped from a peak of 512 deaths in 2008 to 319 in 2014.

At the same time, heroin killed 293 people in Washington last year, about twice as many as in 2008. Overall, the number of deaths from opioid overdose in Washington remains at about 600 a year. Continue reading

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How heroin is hitting the foster care system

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320px-HeroinBy Sophie Quinton
Stateline

Timothy Dick’s office receives all kinds of reports of child abuse and neglect. Perhaps a child has a broken bone, or is underfed, or has been left home alone for too long.

But when caseworkers drive to the child’s home to investigate, they often discover the same root cause. “What we’re finding more and more is that the parents are addicted to opiates. And more often than not, it’s heroin,” said Dick, assistant director of child protective services in Clermont County, Ohio.

In Ohio and other states ravaged by the latest drug epidemic, officials say substance abuse by parents is a major reason for the growing number of children in foster care. In Clermont County, east of Cincinnati, more than half the children placed in foster care this year have parents who are addicted to opiates, Dick said. Continue reading

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Q&A: Vermont Gov. Peter Shumlin on attacking the drug epidemic

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VermontBy Elaine S. Povich
Stateline

In January 2014, Vermont Gov. Peter Shumlin devoted his entire State of the State address to the opiate drug scourge ravaging his state. While Vermont is not the only state to experience the growing addiction problem, it arguably has been the most aggressive in tackling one aspect of it — offering treatment to residents who agree to participate.

Gov. Shumlin

Gov. Shumlin

Within six months of his speech, Shumlin, a Democrat, signed bills and executive orders that included $6.7 million for a “hub and spoke” treatment program of central facilities and small treatment outposts, a medication-assisted addiction therapy program, tougher sentences for drug traffickers and new regulations for prescribing and monitoring prescription drugs. One of biggest changes is giving people who are picked up by police the choice of treatment instead of criminal prosecution.

In January 2015, the state reported that medically assisted drug treatment had increased by 40 percent. Of those who completed treatment plans, 75 percent showed improved functioning. But the report also said more treatment opportunities are needed, citing the difficulty in hiring and retaining clinicians and other health care providers as a major obstacle.

A year and a half after his groundbreaking speech, Stateline checked in with Shumlin to talk about his progress and what remains to be done. Continue reading

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