How Will the Opioids Crisis Response Act Fight Addiction?

Opioids Crisis Response Act into law

Much to the excitement of addiction recovery advocates and after a time stalled in Congress, lawmakers are finally close to passing a hefty bill to combat opioid abuse. The measure would combine law enforcement and public health measures, and includes initiatives and funding to help make addiction recovery services more accessible to people with opioid use disorder. If passed, the law will be the most comprehensive action to date to deal with the opioid epidemic.

The bill is a rare bipartisan effort in a time where many initiatives have stalled entirely due to the deep political divides in both the House and the Senate. The bill itself stalled in the House of Representatives earlier because Democrats objected to a part of the law that would benefit a group tied to the pharmaceutical industry that helped create the epidemic of addiction that our country faces today.

Finally, a compromise was reached in the Senate this week removing the provision, and the bill was modified to focus on a variety of other efforts, including:

  • Attacking illegally imported drugs by creating a new type of cooperation between the federal Food and Drug Administration and Customs and Border Protection.
  • Providing the Postal Service with tools and equipment to detect and stop illegal shipments of synthetic compounds like fentanyl from coming into the country.
  • Providing money to increase boost research on non-opioid pain treatments
  • Make substance-abuse therapy more accessible to Medicare via telemedicine services.
  • Create a pilot program of Medicare coverage for opioid addiction treatment.
  • Give more access to medication-assisted treatment by lifting a cap on the number of patients (from 100 to 275) that a qualified doctor can prescribe drugs like Suboxone, a drug that helps limit opioid cravings and ease the physical pain of withdrawal.
  • Authorize $500 million per year through 2021 for new grants to help states fight opioid addiction.
  • Create new grants to be used by the Department of Health and Human Services to develop to help support addicts in recovery in their transition to independent living. It would also help create job programs for them.
  • Launch a pilot program that would provide temporary sober housing for people in recovery.

Although addiction recovery advocates say that the bill still doesn’t provide the states with enough money, it’s a good step towards combating the opioid addiction epidemic. Some of the funds may be matched in the states to help round out the costs.

The Senate expects to vote on the legislation next week.

 

 

 

 

Single-Step Naloxone Most Effective in Reversing Overdoses

Naloxone Narcan

Addiction professionals and first responders cope with a lot of variables when responding to an overdose, but nothing has changed the outcomes of emergency calls like Naloxone (also known as Narcan), an opioid antagonist drug that has the power to reverse overdoses. There are several versions of Naloxone delivery available. However, research has revealed that the single-step nasal inhaler seems to be most effective at reversing overdoses, according to new research led by faculty at Binghamton University, State University at New York.

In the past few years, expanded access to naloxone has saved thousands of lives by reversing fatal overdoses in people with opioid use disorder. While many people who overdose are not ready for help yet, others identify the moment their overdose occurred as a pivotal point in their life that helped them choose to get into recovery. Law enforcement and other first responders carry the drug on them all the time, especially in places like Ohio where overdoses take place in parking lots and other public spaces.

There is more than one way to administer Naloxone. Injections can be difficult for the untrained person to deliver, but there is often help available for people who choose to carry the drug. Sometimes injections are required multiple times for serious overdoses, and the skill of the person injecting the drug may come into play when it comes to reversing the drug.

William Eggleston, the clinical assistant professor at the School of Pharmacy and Pharmaceutical Sciences at Binghamton University, wanted to know if everyday people can successfully administer naloxone after basic video training. His research found that for ordinary people who aren’t first responders, the single-step nasal spray was used most successfully with minimal problems.

Eggleston conducted a study to estimate and compare the rate of successful administration and the time to successful administration by community members for single-step nasal spray, multi-step atomized nasal spray, and intramuscular simulated naloxone.

For the study, and over the course of several days, 138 adults with no prior naloxone training were asked to watch a two-minute video teaching them how to administer the drug. For each type of administration, they were asked to the adminster the reversal drug on a dummy.

After the video training, participants were able to administer the single-step nasal spray naloxone with a higher rate of success than the other types. This information is important for community naloxone programs across the United States.

“With training, nasal sprays, in general, had a higher degree of success than the shot,” Eggleston said. “Even if it seemed to us it was a no-brainer that we should be using nasal sprays, we had no data before, so now we have some to support that.”

Many people don’t realize it, but Naloxone has also been used to help people who have overdosed on other drugs such as synthetic marijuana and benzodiazepines.

The cost of the single-step Narcan spray is about $140, making it more cost prohibitive than the injection, which is about $40.

Image courtesy and copyright Adapt Pharma.

Fentanyl-Cocaine Combo Causing Deaths in MD

Image shows an empty hospital bed.

In Maryland, the government has been doing its best to fight the addiction crisis, but they’re not yet winning: in 2017, the number of fatal overdoses increased 9%. Most of these overdoses (90%) were considered to be opioid-induced, with Fentanyl overdoses increased by 42 percent last year, rising from 1,119 in 2016 to 1,594. Fentanyl is a drug that is 50 times stronger than heroin and is typically used in a medical setting. When added to other street drugs, it can be deadly, especially if novice opioid users are taking the drug. In Maryland, they have discovered that a fentanyl-cocaine combination of drugs is causing deaths. Between 2015 and 2016, cocaine deaths doubled because of this lethal combination.

The Maryland Department of Health Secretary Rober R. Neall called the increase in fentanyl-related deaths “staggering.” Officials think that the overdose deaths of cocaine containing fentanyl were accidental; the user may have had no clue that the two drugs were combined. Over 71% of cocaine deaths in 2017 was due to the fatal combination.

These deaths did not seem to have anything in common other than they were accidental. State officials say that the increase in cocaine deaths took place across demographics, affecting all age groups and both genders almost equally.

Heroin overdose deaths have also been decreased in the last year. In 2016, they had amounted to 58% of overdose deaths in the state.

In 2017, the amount of drug fatalities hit an all-time high in Maryland, although the actual increase in drug deaths was just 9%. This number compares to a 66% increase from 2016 to 2017. So it’s possible that efforts to combat fatal overdoses are working. One way the state is helping prevent these overdoses is via Narcan, an opioid antagonist that can help reverse overdoses. They are available both to first responders as well as over-the-counter for residents that have taken the training online.

 

 

Synthetic Cannabinoid Drugs Cause Bleeding, Injury Nationwide

Synthetic cannabinoid drugs like K2, Spice and other similar formulations of what is often called “fake marijuana” have now caused bleeding in several states across the US, in what officials say is a growing trend of additives that contain rat poison.

According to the American Association of Poison Control Centers (AAPCC), the CDC and several health departments in many states are actively investigating cases of severe bleeding among people who have used synthetic cannabinoid products –which are both sold on the street and sometimes as shady gas stations in certain cities. It’s believed that this bad batch of products is tainted with Warfarin or a similar drug used to kill rats – essentially a blood thinner that causes internal bleeding and bruising. People have been hospitalized in Ohio and North Carolina for bleeding eyes, ears, and other internal severe damage.

In fact, since March, 0ver 200 people in Illinois and other states have suffered from bleeding disorders. If you or anyone you know has purchased any synthetic cannabinoid product (e.g., K2, Spice, Synthetic Marijuana, Fake Weed, etc.) since March 1, 2018, it is recommended that you dispose of it immediately. It is unknown which specific drugs are tainted, and it’s better to be safe than sorry. Signs of poisoning include bleeding gums or orifices and vomiting blood. Overdose on products contaminated with the rat poison can easily kill drug users, especially those who already suffer from other health conditions. If you use ANY drug and begin to experience severe unexplained bleeding or bruising, please call 911.

While synthetic cannabinoids are often called “fake marijuana,” they affect different receptors in the brain than marijuana. Use of drugs like K2 can easily cause an overdose, and people have been known to suffer seizures and hallucinations that result in injury.

If you or somebody you love is using synthetic cannabinoids and you’re not sure you can stop on your own, please call a treatment hotline to find out what your options are. You deserve to live a healthy, drug-free life free of the pain of active addiction.

 

 

 

 

Opioid Manufacturers Spent 3 1/2 Times As Much Money on Drs in Canada

A 2016 report shows that pharmaceutical manufacturers spent 3 ½ times as much money pushing opioids to doctors in Canada. The 2016 report is the only one where numbers are currently available for more than one country.

According to The Star, Purdue Canada, the company that manufactures Oxycontin gave just over $2 million to Canadian health-care professionals in 2016. In the report, the money is flagged as spending for doctors to provide consulting services and deliver speeches on medical topics. In America, it was found that the addresses that the doctors were supposed to have made were sometimes around a dinner table in a fancy restaurant, or in a hotel with a small audience of other doctors.

Purdue Canada gave Canadian doctors a large amount of money. The Star investigation shows that every 1,000 residents, Purdue spent $58 on Canadian doctors compared to $17 in the U.S.

The records do not indicate how many individual Canadian doctors were the recipients of such payments. Some of the payments may have been related to drugs other than Oxycontin. They also manufacture drugs that include an antinausea medication and a stimulant used to treat attention deficit hyperactivity disorder.

In 2012, Purdue pulled OxyContin from the Canadian market in 2012 and replaced it with OxyNeo, a tamper-resistant drug that has been known to cause overdoses due to its release formula.

Purdue is the subjects of dozens of lawsuits in the United States and has pleaded guilty to some accusations of misleading doctors and patients about Oxycontin’s addiction profile and its ability to be abused. In that case, in 2007, three executives paid $634 million to settle the charges.

There have not been any government actions regarding Purdue or similar drug companies in Canada. However, a $20-million settlement to a Canadian class action lawsuit against Purdue was put on hold last March. A Saskatchewan judge refused to approve the agreement and said that the compensation was not fair and reasonable to the patients who got addicted to the prescription drug. Purdue is already appealing that case.

 

Medicaid Recipients Have Better Access to Treatment Than Others

Medicaid Recipients

Poor adults seeking help for their opioid use disorder can get more help using Medicaid than other people, including those who may have no insurance or private insurance, according to a report by the Kaiser Foundation.

Medicaid has been instrumental to combatting the opioid epidemic, and in areas where the Affordable Care Act expanded Medicaid, the most vulnerable populations are given a lifeline. Not only do they get help with any long-lasting medical effects of drug addiction, but they also are often able to attend an inpatient or outpatient treatment program.

Republicans have often spoken about retracting the expansions of Medicaid or forcing participants to participate in work programs to “earn” their health insurance. Although many people with substance abuse disorders experience extreme poverty as a barrier to treatment, no new funds have been made available on a federal level to increase access to drug treatment.

According to the Kaiser Foundation, 43% percent of nonelderly adults with opioid addiction who were covered by Medicaid received inpatient and outpatient opioid addiction treatment services in 2016. In comparison, only 21% of those with private insurance and 23% of the uninsured were able to get the addiction treatment services they needed.

About 1.9 million adults experienced opioid addiction in 2016. Of those who were able to attend a treatment program, Medicaid covered 38%. Health experts credit the Medicaid expansion in 33 states, which has extended access to a range of treatment services. People who are covered by Medicaid can get access to life-changing addiction treatment services. Medicaid typically covers medication-assisted treatment such as Suboxone alongside counseling and other support services.

People with an opioid abuse disorder and the right kind of medical coverage usually have access to treatment in either inpatient or outpatient settings. There are some ways that addiction treatment can be administered, from a private doctor’s office or clinic setting to a fully-scheduled and monitored inpatient treatment program. Having access to a variety of options allow individuals the flexibility they need according to their lifestyles and needs.

If you are looking for information on which states have expanded Medicaid, click here.

Kratom Recall Due to Salmonella Expands Nationwide

kratom recall

Recently, the Centers for Disease Control notified the public that a salmonella outbreak caused by Kratom had prompted a recall of the product. Kratom products sold under brand names including Botany Bay, Enhance Your Life and Divinity by Divinity Products Distribution are all part of the voluntary recall. Kratom is often touted as an opioid substitute that can help people with a variety of issues, from addiction and chronic pain to anxiety and inflammation. The supplement, which is currently legal, is a plant native to southeast Asia that has become more popular in recent years due to its easy availability on the internet.

The Oregon Health Authority asked people to stop using kratom last week when testing found salmonella bacteria in several product samples. Four people in Oregon have already gotten sick from the bad batches they consumed.

The Food and Drug Administration issued a “voluntary destruction and recall” for the kratom supplements distributed nationwide under the brands mentioned earlier. If you own products included in the kratom recall, it is most appropriate to throw them away or even use them as compost, according to the FDA.

“There are currently no FDA-approved therapeutic uses of kratom, and importantly, the FDA has evidence to show that there are significant safety issues associated with its use,” federal regulators told the media in a news release. The DEA recently announced that kratom works similarly to prescription opioids, and has caused deaths in the US due to heart issues, anaphylaxis, and other complications. Kratom is often referred to as a type of “snake oil” supplement, with vendors and users claiming it can cure everything from the pain of arthritis to mental health issues and even addiction itself.

While used to help opioid users detox from heroin and other deadly opioids, Kratom has few studies to show its effectiveness, and there have been no studies to determine whether it is addictive or not. Users who take the drug often say there are no ill effects, although there are dozens of anecdotes online of people who have trouble ceasing Kratom after using it for a few months or more. Headaches are one of the most common complaints of people who are attempting Kratom cessation.

If you or somebody you love is taking Kratom as a supplement, and you don’t think you can stop on your own, there is help available. Addiction treatment can help you cease to use in a therapeutic, calm environment where you can work on reclaiming your own life. Medication-assisted treatment may be helpful, but this is something that you and your treatment center will need to weigh based on your health conditions and patterns of use.

Dozens Overdose on Synthetic Drugs At/Near Homeless Shelter

person on stretcher

Last week, dozens of homeless people overdosed at (and around) a homeless shelter in Indianapolis, Indiana. The site of the crisis was Wheeler Mission, a Christian nonprofit which describes itself as a temporary emergency shelter to homeless and disadvantaged men. Wheeler Mission’s Chief Development Officer Steve Kerr told the media that most of the people overdosed inside or nearby. “We’ve experienced overdoses in the facility before but never ever to this degree.”

The shelter, which also operates a drug treatment center in Indianapolis, believes that somebody distributed synthetic drugs (Spice, K2, or bath salts), possibly laced with PCP to guests at the shelter. A person in a security video smoking the substance dropped to the ground immediately and went into convulsions. One man tried to bite another man in another video the police viewed.

Police arrested 63-year-old Melvin Cannon and 59-year-old Nathaniel Davis of “possession of and dealing in a synthetic drug or synthetic drug lookalike substance.”

Synthetic Overdoses are a Medical Emergency

While staff on-site attempted to administer Narcan to help the overdose victims, police and other first responders were tasked with keeping others within a two block radius alive. Police said they handled 25 overdose calls, and the effects of the toxic concoction lasted up to 48 hours. People who were hospitalized had overdose symptoms consistent with the results of Spice.

Synthetic drugs, however, are almost never the same formulation twice. Created to give a “cheap high” and usually marketed on the street to vulnerable populations such as the homeless, synthetic drugs are unfortunately a trend that is unlikely to end soon.

A week ago, four people overdosed on Spice in New Haven, Connecticut in 24 hours, the first event of its kind. “Every time a synthetic drug enters the market, just like many street drugs, there’s always a bit of a different formulation. There is always a chance that the drug may is laced with something even more toxic. We’re seeing a lot of these drugs being laced with other drugs, PCP, Carfentanil, things to boost the dosage,” New Haven Fire Chief John Alston told WTOL News.

Overdose symptoms of synthetic drugs can range from seizures, a racing heart, unconsciousness, and other immediate feelings of illness or sickness.

Office of National Drug Control Policy Needs New Drug Czar

The Trump Administration recently employed 24-year-old Taylor Weyeneth to be the deputy chief of staff (also known as the drug czar) of the Office of National Drug Control Policy or ONDCP. While many addiction advocates were hoping the Administration would be filled by an experienced professional, the appointment of Mr. Weyeneth proved to be profoundly flawed.

Before Mr. Weyeneth’s work for the Trump administration, there were only two jobs from which he gleaned experience the only position he’d held since graduating from college in 2016. One of these tasks was working on President Donald Trump’s presidential campaign, the Washington Post reported earlier this month. Aside from his young age, and lack of experience in the field of mental health or addiction, this young man’s lack of knowledge also spilled into the jobs he listed on his resume. Included in the resume was a post he held at a law firm, where the attorneys terminated him for being a “no show” just seven months into the position.

Like many young people first entering the world of employment, he had three versions of his resume. However, each resume had discrepancies that at best, were inaccurate. At worst, they were meant to deceive and claim that he had more experience than he did, even as the experience listed was meager. For example, on all three resumes, Weyeneth asserted he had a master’s degree from Fordham University. The Washington Post spoke with a university spokesman who told them that Weyeneth had not completed his coursework and did not earn the degree.

How did such an inexperienced person get appointed to the commission? The question remains unanswered. Weyeneth graduated from college in May 2016 and was quickly named a White House liaison to the drug office the following March. By July, he was promoted to deputy chief of staff in July. His resume noted no experience in the field of health and human services, mental health or addiction.

Although Mr. Weyeneth has announced his plans to step down by the end of the month, his appointment is a cause for alarm in a department meant to set policy and recommend funding and programs for states, cities, and counties struggling with an epidemic with no end in sight.

ONDCP Needs an Experienced Drug Czar to Tackle Addiction

In the addiction field, honesty is paramount, and policy needs to be set by experienced mental health professionals, medical professionals, and people experienced in the area of addiction and recovery. It is unclear who is in charge in the interim once Mr. Weyenth’s post is vacant; however, the ONDCP website lists Richard Baum as Acting Director. Mr. Baum has a wealth of experience in the drug policy field as an academic and serves as an Adjunct Professor at Georgetown University’s McCourt Graduate School of Public Policy where he teaches students about American drug policy.

Every year, ONDCP works on and plans a National Drug Control Strategy, which outlines the presidential Administration’s efforts to reduce drug use, manufacturing and trafficking. The policy also focuses on lowering drug-related crimes, overdoses, and other health consequences. In 2017, the agency was still acting on former President Obama’s plan.

Using Marijuana for Morning Sickness is Dangerous

A new study shows that more women than ever are turning to marijuana for morning sickness, although there is no medical evidence to show that this is safe. In fact, experts are warning that using marijuana while with child is dangerous for the unborn.

The study, which followed trends in pregnant women in California, is a cause for alarm for many reasons. For one thing, the marijuana use referenced in the study was self-reported, which means that study participants likely under-reported their use of cannabis. An earlier study by the same organization also found marijuana use among pregnant women rose from 2.37% in 2002 to 3.85% in 2014.

The numbers may sound small, but the worries of medical providers are not. Nora D. Volkow, director of the National Institute on Drug Abuse, published an editorial explaining the many dangers. Few things are known about the effects of marijuana use on fetal development. However, with reports that women should avoid sugar, caffeine, and even specific candies such as licorice to help with normal fetal growth, it seems that marijuana use would be an automatic “no” for pregnant women. Most of the women in these studies were younger, typically ages 18-24, and may not be aware of the dangers.

Many people are suspicious of prescriptions and worry the dangers of “big pharma” drugs are more pronounced than the dangers of marijuana. Marijuana is touted as a natural, safe alternative to other medications, and more women seem to think it’s less dangerous than medical treatments for morning sickness and other ailments. It is also possible that many of these pregnant young women are addicted to marijuana, and have trouble quitting usage on their own.

Marijuana is a drug. It has mostly been viewed as a recreational drug in the past 10 years, and few medical studies can back up the medicinal usage for pregnant women.

marijuana for morning sickness

What the Research on Using Marijuana During Pregnancy Says

No research or recommendations, even from medicinal marijuana providers, suggest that marijuana usage during pregnancy is a good idea.

In fact, research from the Centers for Disease and Control shows pregnant women who use marijuana put their child at risk of low birth weight and developmental problems. According to the National Institute of Drug Abuses, animal studies have linked marijuana use to miscarriages, but no human evidence currently shows how large this risk is. However, research shows that women who use marijuana while pregnant are 2.3 times as likely to have a stillborn child.

Using drugs while pregnant is more dangerous than drinking coffee or soda while pregnant, and it is not a solution to your medical needs. Whatever you put in your body, you are putting in a vulnerable, not-fully-developed body that hasn’t even taken its first breath. If you are having severe morning sickness, talk to your obstetrician or primary care doctor. The American College of Obstetricians and Gynecologists recommends that women avoid marijuana while trying to get pregnant, during pregnancy, and while they are still breastfeeding. Using marijuana for morning sickness can be dangerous to your baby’s health.

If you are pregnant and having trouble ceasing drug or alcohol use, there is help available. You’re not alone, and you’re not a bad person. Addiction is a disease and it can be treated with the right support network in place. Please call a treatment center on this page or your local Narcotics Anonymous or Alcoholics Anonymous hotline. You don’t have to use if you don’t want to, and you don’t have to make the journey alone.