Cardinal settles with DEA over painkiller distribution

Cardinal Health has reached a deal with the Drug Enforcement Administration that will block one of its Florida facilities from distributing controlled substances for two years. The company also said it will take steps to improve anti-diversion procedures designed to prevent prescription drugs from being abused.

Earlier this year, the DEA suspended Cardinal’s license after finding that the company – which is one of the nation’s largest distributors of pharmaceuticals – sold excessive amounts of oxycodone to four Florida pharmacies. (The suspension related only to the company’s license to distribute controlled substances from its Lakeland, Fla. facility, which the DEA claims shipped 50 times as much oxycodone to its top four customers than it has shipped to its other Florida retail customers.)

Cardinal challenged the suspension in federal court, and both the company and the DEA filed documents that gave an inside look into how prescription painkillers have flooded the black market.

Cardinal was initially granted a temporary restraining order blocking the suspension after convincing a judge that the move would disrupt drug shipments to more than 2,500 pharmacy customers in Florida, Georgia and South Carolina. The company said it has “robust controls and performs careful due diligence,” noting that in the past four years, it has stopped shipping controlled medicines to more than 350 pharmacies it determined posed an unreasonable risk of diversion, including 160 in Florida alone.

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Pain advocacy group shuts doors amid Senate probe

A U.S. Senate investigation into financial ties between producers of prescription painkillers and organizations that champion such drugs was announced Tuesday, just after the American Pain Foundation, the nation’s largest organization for pain patients, said it would shut down. The group said in a statement on its website that its closure was due to “irreparable economic circumstances.”

APF – which received 90 percent of its $5 million in funding in 2010 from the drug and medical-device industry – came under fire in December over its ties to pharmaceutical companies.

The Senate investigation was launched amid concerns that doctors and consumers aren’t getting accurate information about the risks of powerful opiate painkillers. According to the New York Times, pharmaceutical companies that received notice of the probe include OxyContin maker Purdue Pharma; Endo Pharmaceuticals, which makes Percocet; and Johnson & Johnson, which markets Duragesic.

APF – which was also sent a letter – claims on its website that “misguided state and federal policies are impeding access to appropriate and reasonable medical care for people struggling with pain, and deterring even the most compassionate medical providers from treating anyone with pain conditions.”

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Painkiller addiction in Knoxville, Tenn.

This is Part Two of an ongoing series by Cityview concerning the opiate addiction epidemic in Knoxville, Tenn. that explores where the painkillers that are flooding East Tennessee are coming from. The article points out that any licensed doctor can open and run a pain management clinic, even those without training in pain management – and doctors who prescribe opiates can make as much as $7,000 to $10,000 per day by billing insurance or getting cash from patients.

Read Part One of Cityview’s series, “The Faces of Addiction,” here.

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One in four U.S. high schoolers exposed to pills: report

Nearly 1 in every 4 high school seniors in the United States has ever had some exposure to prescription opioids either medically or nonmedically, according to new research published in the Archives of Pediatrics & Adolescent Medicine.

One in eight older U.S. teenagers has abused opioid painkillers without prescriptions, with many of them starting to misuse the pills at age 16 or 17, the research found, while an estimated 80 percent of abusers had previously been prescribed to them for a medical condition.

Nearly 40 Americans die per day from overdoses of prescription painkillers like OxyContin and Vicodin, according to a recent CDC report. Every day, 2,500 youth between the ages of 12 and 17 abuse a prescription pain reliever for the very first time.

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Ohio sets new rules for opioids in the ER

Ohio’s governor has unveiled new guidelines for the prescription of opioids in emergency rooms and urgent care centers in a state where overdoses of such drugs are now the leading cause of accidental death. Gov. John Kasich said the rules establish an emergency department limit of a three-day supply of opiates and encourage emergency room doctors to make use of available state databases to identify abusers.

Emergency rooms are a major source of the nation’s opiate prescriptions, with 39 percent of all opioids prescribed, administered or continued in the U.S. Opioid prescribing for pain-related ER visits rose from 23 percent in 1993 to 37 percent in 2005.

Read more about prescription drug abuse in Ohio here.

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OxyContin Activists: Natalie Costa

Orange County, Calif. may seem like the perfect place to live, but it has a dirty little secret: it’s number two in the country for deaths by prescription drug overdoses. In May 2010, Laguna Niguel resident Natalie Costa was thrust full force into the epidemic when her daughter Brianne called her from her high school, frantic: her good friend, 17-year-old Mark Melkonian, had passed away after overdosing on the painkiller Opana. Costa, who owns a performing arts school, teamed up with director Brent Huff to produce “Behind the Orange Curtain,” a full-length feature documentary that delves into the tragic trend afflicting the affluent area, which has more rehab centers per capita than any other county in the nation. The film premieres at this year’s Newport Beach Film Festival on May 2, and has been chosen by the Film Fund out of 400 films representing 50 countries as one of “five films to see.” Oxy Watchdog caught up with Costa ahead of the premiere for more details on the making of the documentary and the extent of the pill addiction epidemic in Orange County.

Watchdog: Tell us more about why you decided to make this documentary.

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Opiate abuse on the rise among U.S. soldiers

Abuse of prescription drugs and heroin is becoming more common among U.S. troops, with eight American soldiers dying of overdoses during deployments in Afghanistan in 2010 and 2011, according to U.S. Army investigative reports recently released to CNN. The number of soldiers testing positive for heroin has grown from 10 instances in fiscal year 2002 to 116 in fiscal year 2010, the article says.

Read more about prescription drug addiction among American troops here.

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FDA considers broadening access to opioid overdose treatment

The Food and Drug Administration held a public hearing Thursday to discuss making the life-saving opioid overdose reverser naloxone available over the counter. Although opiate overdoses are on the rise, many people still don’t know about naloxone, which literally reverses the dangerous effects of taking too much OxyContin or heroin by counteracting the depression of the central nervous system and respiratory system.

The Drug Policy Alliance, a group that seeks to advance policies that reduce the harms of both drug use and drug prohibition, said in a policy brief that naloxone’s status as a prescription drug is one of the key barriers to broader access. And due to its status as a generic medication, producing it does not yield substantial profits, so many pharmaceutical companies are unwilling to manufacture it, the organization noted.

A recent report by the Centers for Disease Control and Prevention found that naloxone has successfully saved the lives of more than 10,000 overdose victims since 1996. However, only 15 states and the District of Columbia currently have naloxone distribution programs. This, despite the fact that nearly 40 Americans die per day from overdoses of prescription painkillers like OxyContin and Vicodin, according to a recent CDC report.

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Wash. painkiller prescription rules spark debate

Over the last decade, opioid prescriptions have increased nearly four-fold – even though little is known about the risks associated with their long-term use. In Washington state, worries about over-prescription have prompted new guidelines requiring doctors to refer patients taking painkiller dosages above a certain level for evaluation by a pain specialist if they aren’t showing signs of improving. The move has caused waves in the pain management community, with some doctors and patient advocates fearing that it will deprive legitimate pain sufferers of necessary medications. Others have praised the rules, but worry that patients who are suddenly taken off powerful painkillers will experience severe withdrawal.

The death toll from overdoses of narcotic pain relievers such as OxyContin and Opana has more than tripled in the past decade, with more than 40 people dying every day, according to the Centers for Disease Control and Prevention.

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New company offers pill comparison shopping – but at what price?

A former Facebook engineer has founded a new startup company that aims to help consumers find cheaper prescription drugs in their area. Good RX allows users to enter a drug and a location, and then gives the price rundown at both nearby pharmacies as well as national mail order companies. It also alerts users to manufacturer co-pay cards, pharmacy discounts, and state discount programs, and provides other “tips” from a real, live on-staff pharmacist on how to slash drug prices.

GoodRX, which says it has compiled more than one million drug prices for more than 6,000 drugs, notes that it doesn’t sell drugs, and only “offers prices and unbiased coupon and discount information for legitimate, licensed U.S. pharmacies that you already visit regularly.”

GoodRx also hopes to profit from data provided by users of its “My Prescriptions” service, which will target users with specific ads and offers based on information provided about medical conditions and prescriptions.

A search for Opana – a popularly abused opioid painkiller – in San Francisco revealed the addresses and phone numbers of more than two dozen pharmacies within a five-mile radius that stock the drug, compared prices, and even offered discount coupons to be presented to pharmacists.

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