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Monthly Archives: May 2013
The California Senate has given the stamp of approval to a package of bills aimed at reducing prescription drug abuse and overdose deaths, including a measure that would require coroners to report deaths involving prescription drugs to the Medical Board of California. The Los Angeles Times reports that the Senate also signed off on a bill that would upgrade the state’s prescription drug monitoring program, known as CURES. In addition, lawmakers approved a measure that would make it easier for the medical board to investigate physicians suspected of overprescribing and suspend their prescribing privileges, and a bill that would prohibit pharmacies from advertising commonly abused narcotic medications, such as OxyContin and Vicodin, according to the LA Times.
The package of legislation will now move on to the California Assembly for approval.
The CURES bill faced the strongest opposition from the pharmaceutical and biotech industries, the Times says, even though it had the support of a coalition of law enforcement groups, health insurance companies, and business, labor and consumer organizations. That opposition was dropped after the bill’s sponsors removed a provision that called for a tax on drug makers to pay for teams of investigators to crack down on drug-seeking patients and doctors who recklessly prescribe to them, according to the Times.
As the prescription drug and heroin epidemic in Kentucky has worsened, residents have been taking advantage of a law that allows parents or other concerned people to petition the court to order involuntary drug treatment for an adult, according to this article. The Matthew Casey Wethington Act for Substance Abuse Intervention, enacted in 2004, is named for Casey Wethington of Kenton County, who died of a heroin overdose in August 2002 at age 23, the article says. More than a dozen states have laws dealing with involuntary commitment for addiction treatment, including Florida and Ohio.
Fewer than 10 Casey’s Law petitions were filed in Boone, Campbell and Kenton counties each year from 2004 through 2008, the article notes, but cases for the three counties jumped to a total of 20 in 2009 and in 2010, then shot up to 66 in 2011 and 71 in 2012 as the opiate epidemic progressed.
Heroin use in Kentucky has exploded in the past decade, fed by sophisticated supply networks focused on mostly white suburban and rural users who have become hooked on prescription painkillers, according to an earlier article by the Cincinnati Enquirer.
In Philadelphia and its surrounding suburbs, an increase in opiate use is leading to a spike in heroin use — and that heroin is plentiful, more pure, and more affordable than ever before, according to an investigational series by the Bucks County Courier Times and The Intelligencer. The majority of people arrested for dealing drugs in the suburbs are doing it to supplement their own addiction, the series reveals, while dealers that have historically stayed in the urban venue have made a business decision to instead travel to the outskirts and suburbs of the city to take the product to the user.
Unfortunately, the series notes, efforts to crack down on the illegal diversion of prescription pills in the area have resulted in a new marketplace for heroin. Says one official:
As we do a better job addressing abuse of opioid prescription drugs, users currently hooked on those will most likely turn to heroin as a cheaper, purer, albeit deadlier, alternative.
The series also notes that there is no one-size-fits-all solution to opiate addiction, but points out that some addicts are finding relief through Vivitrol, a monthly injection of naltrexone that blocks the euphoric and pain-relieving effects of heroin and most other opioids.
North Carolina is set to open a new inpatient treatment center specifically to deal with the state’s growing problem with opioid addiction, according to this article. The Walter B. Jones Alcohol and Drug Abuse Treatment Center in Greenville, N.C. has been certified by the federal government to become the state’s only inpatient center, and will be one of 75 nationwide offering full services for opiate addiction.
The program will serve high-risk patients with intake, detoxification and treatment in a hospital setting, and will also offer services to new mothers, who can bring children under age one into treatment with them, the article says.
Last year, about 1,000 people in North Carolina died of prescription drug overdoses, according to the N.C. Attorney General’s Office.
The Minnesota Medical Association is considering requiring doctors to take continuing education courses on pain management and addiction and increasing use of the Minnesota Prescription Monitoring Program in order to deal with the state’s prescription drug abuse issue, according to this article. As of March 2013, only 40% of pharmacists and 30% of doctors in Minnesota were using the monitoring system, according to the article.
Florida has taken a number of measures to combat its prescription drug addiction problem, with the unintended consequence of the resurgence of heroin as a popular substitute for painkillers. From July 2010 to June 2011, there were 45 heroin-related deaths statewide, according to this article, which cites data from the Florida Medical Examiners Commission. That number jumped to 77 heroin-related deaths from July 2011 to June 2012, the article says.
The article also notes that addiction treatment numbers are up in Florida, with treatment centers in Broward County seeing an 87% increase in admissions in 2012 among addicts using heroin as their drug of choice, up from 169 to 316; in Miami-Dade County, such admissions jumped from 227 to 308 in the first half of 2012.
It was reported earlier this year that while the number of oxycodone-related deaths in Florida plunged during the first half of 2012 compared with the same period in 2011, heroin-related deaths were holding steady.
Florida’s crackdown on painkiller abuse has resulted in the number of pill mills in the state dropping from 854 to 580 between March 2011 and March 2012, according to this article.
The U.S. Food and Drug Administration said Friday it will continue to allow sales of the generic version of the painkiller Opana that does not include an abuse-resistant feature.
Opana’s manufacturer, Endo Pharmaceuticals, had submitted a petition to the agency asking it to ban generic forms of the painkiller, which Endo has reformulated as “Opana ER” to make it harder to abuse. That petition was denied by the FDA, which said Endo’s reformulation was not significantly safer than the original version:
While there is an increased ability of the reformulated version of Opana ER to resist crushing relative to the original formulation, study data show that the reformulated version’s extended-release features can be compromised when subjected to other forms of manipulation, such as cutting, grinding, or chewing, followed by swallowing. Reformulated Opana ER can be readily prepared for injection, despite Endo’s claim that these tablets have “resistance to aqueous extraction (i.e., poor syringeability).” It also appears that reformulated Opana ER can be prepared for snorting using commonly available tools and methods.
Endo’s petition came after Purdue Pharma successfully asked the FDA to ban any generic versions of OxyContin based on the powerful painkiller’s original formulation, which does not include anti-abuse features designed to make it more difficult to crush, break, or dissolve.
Scientists are developing a vaccine to treat heroin addiction, and it has proven effective in keeping drug-addicted rats from relapsing in a preclinical trial, according to this article in Popular Science. Researchers from the Scripps Research Institute in California revealed in a study published in Proceedings of the National Academy of Sciences that the vaccine is now ready for human trials.
The vaccine apparently generates antibodies that bind heroin and its metabolites in the bloodstream, preventing them from making their way to the brain. The vaccine “essentially keeps the body from experiencing the fun parts of drug use, like euphoria and pain obstruction,” the article says.
According to the article:
In the study, rats were trained to press a lever three times to receive an injection of heroin. During 12-hour periods of self-administrated access to the drug, the addicted rats began taking heroin compulsively in greater and greater quantities. Then the researchers removed the heroin for 30 days and gave some of the rats the vaccine. After the period of abstention, they were re-exposed to freely accessible heroin. Rats that didn’t receive the treatment resumed taking the drug in increasing quantities, while those that received the treatment didn’t redevelop the compulsion.
In New Jersey, where drug overdoses are the leading cause of accidental death, one county is experiencing a massive uptick in heroin overdoses as prescription painkiller addicts make the switch to the illegal street drug. In two years, heroin has claimed at least 50 lives in Bergen County and has its grasp on hundreds more who became hooked through painkillers such as OxyContin and Opana, according to this article. As compared to pills, heroin, at $5 per bag, is far cheaper, potent, and widely available, the article notes.
The widespread painkiller addiction epidemic has fueled the rise of heroin use nationwide, particularly among suburban youth. Between 2007 and 2011, the number of users went from 373,000 to 620,000, according to federal data, and heroin-dependent young adults more than doubled to 109,000 between 2009 and 2011, according to the article.
Legislators in New Jersey are currently considering implementing a law that would grant immunity to those who dispense and administer naloxone, a medication that counters the effects of overdoses from opiates like OxyContin and heroin. The Opioid Antidote and Overdose Prevention Act would allow medical providers to prescribe naloxone and allow people to administer the drug to overdose victims without fear of being prosecuted. It would also require that prescription recipients get information on how to prevent and recognize overdoses, as well as how to administer the medication and care for the overdose victim. Eight other states have similar laws.
Prescription painkiller sales are set to increase by 15% and hit $8.4 billion by 2017, due in part to the U.S. Food and Drug Administration’s recent decision to ban any generic versions of OxyContin based on the powerful painkiller’s original formulation, which does not include anti-abuse features designed to make the pill harder to abuse. Experts are predicting a race across the pharmaceutical industry to create a market where all opioids have abuse-deterrent properties, according to the Wall Street Journal.
According to the FDA, “because original OxyContin provides the same therapeutic benefits as reformulated OxyContin, but poses an increased potential for certain types of abuse, the FDA has determined that the benefits of original OxyContin no longer outweigh its risks and that original OxyContin was withdrawn from sale for reasons of safety or effectiveness.”
OxyContin’s manufacturer, Purdue Pharma, reformulated the drug in 2010 to make it more difficult to crush, break, or dissolve; the reformulated pill forms a viscous hydrogel and cannot be easily prepared for injection. The FDA noted Tuesday that abuse of OxyContin by these routes, as well as the oral route, is still possible.