Monthly Archives: September 2013

VA over-prescribing narcotics to vets: report

soldier drugsEasy access to powerful prescription opiates has led to a rise in overdose deaths among war veterans, a new report has found. According to the Center for Investigative Reporting, the Department of Veterans Affairs has issued more than one opiate prescription per patient, on average, for the past two years. Prescriptions for four opiates – hydrocodone, oxycodone, methadone and morphine – have surged by 270% in the past 12 years, CIR found in an analysis of data obtained through a Freedom of Information Act request.

According to CIR:

The agency charged with helping veterans recover from war instead masks their pain with potent drugs, feeding addictions and contributing to a fatal overdose rate among VA patients that is nearly double the national average.

CIR notes that this spike in opiate prescriptions has occurred despite new VA regulations laid out in 2009 requiring clinicians to follow an “integrated approach” to helping veterans in pain, including a stronger focus on treating the root causes of pain rather than using powerful narcotics to reduce symptoms.

Many areas of the nation with military bases and large VA hospitals have seen prescription drug abuse skyrocket among American soldiers in recent years.

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Heroin stepping in for painkillers across the U.S.

pills and syringeLocally and across the nation, law enforcement officials have noted an increased use of heroin, which has become a cheaper alternative to legal opiates like hydrocodone and oxycodone. In Grand Rapids, Mich., heroin has become so strong that it can be snorted, which eliminates a hurdle for needle-phobic users, according to this article. In less than four months, Grand Rapids Police have responded to three heroin-overdose deaths, and another 10 overdoses, the article says. Heroin is also on the rise up and down the West Coast, fueled in part by prescription drug abuse, according to this article. The article notes that prescription painkillers and heroin have the same effect on abusers, but heroin is usually cheaper and easier to get.

A recent survey by the Substance Abuse and Mental Health Services Administration showed the number of heroin users across the country has risen from 373,000 in 2007 to 669,000 last year.

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Maine heroin deaths up 300% since 2011

heroinfoilDriven by the painkiller addiction epidemic, the number of people in Maine who have died from a heroin overdose each year since 2011 has increased by 300%, according to Harper’s Magazine, which cites data from the state’s Department of Health and Human Services. Some experts say that the trend is partly being fueled by recent restrictions on doctors in prescribing painkillers, which has led to a rise in the amount of low-cost heroin in New England states that is increasingly purer and thus more potent and dangerous. According to this recent article in the New York Times, though heroin was once seen as an urban drug, it has been making an alarming comeback in the smaller cities and towns of New England, including in Maine.

Earlier this year, a report found that more than one-third of the prescription drugs stolen from Maine pharmacies are taken by employees. An investigation by the Maine Center for Public Interest Reporting of state disciplinary records revealed that from 2003 to 2013, 16 pharmacists and 41 pharmacy technicians lost their licenses for stealing drugs from pharmacy shelves or from the patients whose prescriptions they filled.

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Opioid prescriptions up, but pain treatment unimproved: study

PILLS.jpgPrescription opioid use has skyrocketed over the last decade, but the identification and treatment of pain has failed to improve – and the use of non-opioid analgesics has plateaued, or even declined, a new study has found.

The study by the Johns Hopkins Bloomberg School of Public Health, published Sept. 13 in the journal Medical Care, analyzed trends from 2000 to 2010 associated with patients seeking medical treatment for non-cancer pain, and found no significant change in the proportion of pain visits – approximately one-half – treated with pain relievers.

During that time period, opioid prescriptions nearly doubled, from 11% in 2000 to 19% in 2010, the study found. In addition, of approximately 164 million pain visits in 2010, roughly half were treated with some kind of pain relieving drug: 20% with an opioid and 27% with a non-opioid pain reliever, according to the study.

The information comes just after the U.S. Food and Drug Administration announced new labeling changes and postmarket study requirements for extended-release and long-acting opioid analgesics. According to the agency, the changes are aimed at combatting “the crisis of misuse, abuse, addiction, overdose, and death from these potent drugs that have harmed too many patients and devastated too many families and communities.”

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Calif. lawmakers OK painkiller legislation

pills and pill bottlesThe California Senate has given the green light to two bills aimed at combatting prescription drug abuse and overdose deaths by helping authorities track painkiller prescriptions and enabling enhanced scrutiny of deaths involving such drugs.

The proposed legislation would require coroners to report prescription overdose deaths to the state’s medical board for review, according to the Los Angeles Times, which earlier reported on the nearly 4,000 accidental deaths involving prescription drugs in Southern California and found that in half the cases, drugs that caused or contributed to a death had been prescribed by that person’s physician.

The legislation would also enhance and provide sustained funding for California’s prescription drug monitoring system, known as CURES, which contains detailed data on prescriptions for painkillers, the LA Times said.

The two bills now head to the desk of Gov. Jerry Brown for approval.

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FDA unveils new labeling rules for opioids

pill bottlesUnder pressure from activists and other critics, the U.S. Food and Drug Administration on Tuesday announced new safety labeling changes for extended-release and long-acting opioid analgesics such as OxyContin.

According to the agency, the changes are aimed at combatting “the crisis of misuse, abuse, addiction, overdose, and death from these potent drugs that have harmed too many patients and devastated too many families and communities.”

The updated labels must state that such medications are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment.

In addition, because of the risk of addiction and abuse “even at recommended doses,” as well as the greater risks of overdose and death, the drugs must be labeled as “reserved for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain,” the agency said.

The FDA’s move was met with skepticism by some activists who were concerned the changes do not go far enough. Pete Jackson, the president of Advocates for the Reform of Prescription Opioids, said the development could be viewed as either a step in the right direction or as “another smokescreen put out by the FDA to make it look like they are doing something.”

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Pharmacy employees contributing to Maine painkiller thefts

pharmacyMore than one-third of the prescription drugs stolen from Maine pharmacies are taken by employees, a new report has found.

According to this article, an investigation by the Maine Center for Public Interest Reporting of state disciplinary records has revealed that from 2003 to 2013, 16 pharmacists and 41 pharmacy technicians lost their licenses for stealing drugs from pharmacy shelves or from the patients whose prescriptions they filled.

There are 1,866 pharmacists and 2,461 pharmacy technicians in Maine, so the percentage of pharmacy employees caught stealing drugs is small – although much of pharmacy drug theft likely goes undiscovered and unreported, the article notes.

The American Pharmacists Association has said that pharmacists’ easy access to powerful painkillers often encourages them to take the drugs.

While Maine is seeing some progress in terms of curbing prescription drug abuse, substance abuse specialists in the state say there has been a sharp uptick in heroin addiction as pill addicts make the switch to the illegal street drug.

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Suburban pill addicts increasingly trying heroin

pills and syringeThe number of first-time heroin users in the U.S. is on the rise, as painkiller addicts turn to the street drug because it’s cheaper and more potent. This trend is particularly affecting suburban areas: in one Ohio county, 93 residents died during the first half of 2013 away after shooting, snorting or smoking heroin; another four fatally overdosed inside county limits, but resided elsewhere. In Tennessee, statewide data show that the number of heroin-incidents has more than doubled since 2010. And in West Virginia, data reported earlier this year showed a 44% increase in fatal heroin overdoses, a trend also noticed in increasing heroin seizures, ambulance runs and hospital admissions tied to the drug.

A study recently released by the Substance Abuse and Mental Health Services Administration found that people who used pain pills non-medically were 19 times more likely to start using heroin.

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