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Monthly Archives: March 2013
In a sign that some of the measures Florida has taken to combat its prescription drug addiction problem are working, state authorities are reporting that the number of oxycodone-related deaths plunged during the first half of 2012 compared with the same period in 2011. From January 2012 to June 2012, there were 759 oxycodone-related deaths, down from 1,058 during the same period in 2011, according to this article.
In that time period, there were 42 oxycodone-related deaths in Orange and Osceola counties — fewer than half the number of those deaths during the same period of the previous year — while heroin-related deaths remained the same, the article says. Meanwhile, in Seminole County, the number of oxycodone-related deaths during the 2011 and 2012 periods remained the same, 19, and there were increases in deaths associated with cocaine, methadone and morphine, according to the article.
While these numbers are encouraging, the Miami Herald recently called into question how effective the state’s crackdown on pills has really been. Although many of Florida’s so-called “pill mills” seem to have shifted to the more permissive regulatory environment in nearby Georgia, some operators have switched to weight-loss or anti-aging clinics, where they continue to sell profitable pharmaceuticals right on the premises, the article noted.
More disturbing statistics are emerging from Ohio, which has been hit hard by the prescription drug addiction epidemic — and where there has been an uptick in heroin use, resulting in devastating effects on the children’s population. As this article reports, in Warren County — a primarily white, upscale area — only 6% of the children’s protective services cases in 2008 referred for ongoing services were related to heroin abuse; by 2011, that figure had jumped to 73%, including 106 cases involving 170 children.
In addition, the article says, 33% of Clermont County kids being removed from their parents are because of opiate abuse, while 90% of opiate abuse is heroin; half of the cases Hamilton County Children Services sees are heroin-related; and the number of children being removed from their homes in Butler County because of heroin abuse has doubled since 2010.
And more infants in the area are being born already addicted to opiates: in 2009, 11 of every 1,000 births were drug-exposed; that figure more that tripled by Sept. 30, 2012, when 36 of every 1,000 infants born were drug-exposed, the article notes.
New York Sen. Charles Schumer is calling for added safety features to be imposed on generic forms of the prescription painkiller OxyContin that are set to hit the market in April. The lawmaker says he fears that these copycat versions, which do not include anti-abuse protections that cause them to turn into gels or chunks when crushed, could enable abusers, according to this article.
Many popularly abused prescription painkillers, including OxyContin, have been reformulated in recent years to allegedly make them abuse-resistant. But generic manufacturers are bringing their own versions of such drugs to market that don’t include tamper-proof properties.
Oxycodone prescriptions in Staten Island — which ranks third in oxycodone prescriptions per capita in the state — have remained relatively steady, with 141,022 written last year, compared to 142,059 in 2011, according to the article.
Overdose is now the leading cause of accidental death in New York, where almost 22.5 million prescriptions for all types of narcotic painkillers were written in in 2010, according to a recent report issued by the state’s attorney general.
Tighter controls on the popularly abused painkiller OxyContin in Canada have had positive results, but experts say the country’s massive pill addiction problem is still spiraling out of control: in 2010, for the first time, Canada surpassed the United States to become the highest opioid-consuming country, per capita, in the world, according to this article.
Moreover, in 2011, twice as many Ontarians were killed by opioid overdoses as drivers killed in car accidents, and addiction treatment programs are overflowing with people addicted to publicly funded drugs, the article adds.
As you may remember, OxyContin manufacturer Purdue Pharma replaced the painkiller last March in Canada with OxyNEO, an alternative billed as “tamper-resistant” because it is harder to crush. Today, Ontario’s OxyNEO prescriptions are about 60% what OxyContin prescriptions were a year ago; in Newfoundland, they’re 22%; in B.C., 67%, according to the article.
But other long-acting opioids such as fentanyl and hydromorphone — including Hydromorph Contin, also made by Purdue — are now among the fastest-growing causes of Ontario’s opioid overdose deaths, the article says.
Although opiate overdoses are skyrocketing in the U.S., 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. (This always amazes me, but I myself didn’t know about naloxone until well after my brother’s heroin overdose death in 2009. It took less than 10 minutes for me to get trained in Narcan use by the wonderful folks at the D.O.P.E. Project, a nonprofit whose mission is to reduce fatal overdose deaths by providing overdose prevention education and naloxone to drug users and their loved ones — and if you live in the Bay Area, I highly suggest contacting them to get trained.)
In Canada — which is second only to the U.S. in per-capita consumption of prescription opiates — naloxone costs less than $12, but isn’t widely distributed or acknowledged, according to the Waterloo Region Crime Prevention Council. In a powerful new short film, the WRCPC explains how naloxone can help save lives and highlights the need for expanding overdose prevention.
Distributing the life-saving opioid overdose reverser naloxone can save one life for every 227 naloxone kits distributed, a study found earlier this year.
Iowa has taken an interesting approach towards stopping the practice of seeking out multiple doctors for painkiller prescriptions with a program that “locks” Medicaid recipients into using one doctor, one pharmacy and one hospital. And according to this article, the program appears to be having some positive results: by locking in more patients, the state saved $14.8 million from July 2010 through September 2012 in the cost of drugs and doctors’ visits.
The number of “locked-in” Iowa Medicaid recipients has increased sevenfold from 200 in 2010 to 1,430 in January, the article says, a jump that came after Iowa Medicaid started screening patients not for just doctor-filled prescriptions, but for non-emergency visits to hospital emergency rooms.
The state’s prescription drug monitoring program was launched in March 2009, but only one-quarter of Iowa doctors and prescribers are registered to use the database, which includes more than 4.2 million prescriptions annually, the article says.
Prescription painkillers caused 62 deaths in Iowa in 2011, up from just four deaths in 2000, while prescription abuse treatment admissions more than quadrupled from 187 in 1999 to 878 in 2009, according to the Iowa Department of Public Health.
Like many states, North Carolina has implemented a prescription drug monitoring database to identify people who abuse and misuse powerful painkillers. Now, a new study at the University of North Carolina at Chapel Hill shows that the system – which is voluntary – is only used by about one-third of the 34,000 physicians who are registered with the Drug Enforcement Agency to prescribe controlled substances – and fewer than half of those registered actually used it in the last six months of 2011.
However, at the same time, the number of patients with the most severe drug-seeking behaviors – those who used 10 prescribers and 10 pharmacists within six months – decreased substantially from 217 in 2008 to 115 in 2012, the study found.
Prescription drug overdose kills an average of three people per day in North Carolina.
Nearly all states have operational prescription drug monitoring programs, with the exception of Montana, Nebraska, Arkansas, Wisconsin, Georgia, Maryland, New Hampshire, and the District of Columbia, according to the latest research from the Alliance of States with Prescription Monitoring Programs.
The Toledo Blade has a new story on Ohio’s recent spike in heroin-related overdose deaths following the prevalence of prescription painkiller abuse throughout the state. As we are seeing elsewhere in the nation, the trend has resulted in a shocking uptick in heroin deaths: in 2010, the paper reports, 14 such deaths occurred in the region, increasing to 31 in 2011, and to 55 last year. As of early February, 14 heroin-related deaths had already been tracked this year by the Lucas County coroner’s office, the paper adds.
Furthermore, the paper reports that the overdose deaths can be connected to an influx of “China white” heroin, which is more potent than the brown kind traditionally more prevalent in the region. Toledo police seized about 1,454 grams of heroin in 2011, but only 5.3 grams were the white type; last year, however, of the 3,371 total grams seized, about 68% was white, and so far this year, white heroin accounts for about 80% of the heroin seized, according to the paper.
Statewide, heroin overdose deaths rose from an average of 100 per year between 2000 and 2005 to about 224 per year between 2006 and 2010, the latter accounting for 15% of all overdose deaths, the paper says.
The numbers are staggering: in the United States, the number of overdose deaths from prescription opioids has more than tripled in the past decade, resulting in nearly 15,000 fatalities in 2008 alone and now accounting for more than 40 deaths every single day – not to mention the fact that estimated annual health care costs from this epidemic are as high as $72.5 billion.
How did we get here?
In the latest issue of Emergency Medicine News, Dr. Leon Gussow, a physician and editor of The Poison Review blog, examines how opioid analgesics – once feared as dangerous medications with high risk for addiction and overdose – became the drug class most frequently prescribed in the U.S., with four million patients a year receiving scripts for these powerful medications.
Parents whose children died of drug overdoses urged California’s medical board on Monday to utilize a tracking database of prescriptions to help identify doctors who over-prescribe powerful narcotics amid the state’s growing addiction epidemic. The testimony came from members of advocacy organizations, including the National Coalition Against Prescription Drug Abuse, and other individuals and experts who said the board’s failure to investigate complaints of physician misconduct in a timely manner has often had deadly results.
By the time parents were allowed to start their testimony, several of the board’s members had wandered out of the hearing, leaving only five active listeners (the board currently has 15 members.) When one of the parent speakers – a registered nurse whose son was addicted to pills and died of a heroin overdose last year – asked when the full board would be available, one of the members replied “soon” and added that everyone’s testimony would be transcribed.
Not very reassuring.
Among the powerful speakers were Bradley DeHaven, whose son was previously addicted to OxyContin; April Rovero, the founder of NCAPDA after her son died of a prescription drug overdose; and Jodi Barber, producer of the short film Overtaken who lost her son to an Opana overdose.