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Category Archives: Trends
U.S. Attorney General Eric Holder is urging federal law enforcement agencies to identify, train and equip personnel who may interact with a victim of a heroin overdose with the drug naloxone. The potentially life-saving drug — which effectively restores breathing to a victim in the midst of a heroin or opioid overdose — is already carried by officers in some state and local law enforcement groups while on patrol.
The U.S. Department of Justice wants federal law enforcement agencies, as well as their state and local partners, to review their policies and procedures to determine whether personnel should be equipped and trained to recognize and respond to opioid overdose by various methods, including the use of naloxone, otherwise known as Narcan. Seventeen states and the District of Columbia have amended their laws to increase access to naloxone, resulting in over 10,000 overdose reversals since 2001.
According to Holder:
The shocking increase in overdose deaths illustrates that addiction to heroin and other opioids, including some prescription painkillers, represents nothing less than a public health crisis. I am confident that expanding the availability of naloxone has the potential to save the lives, families and futures of countless people across the nation.
In Pennsylvania — which ranks among the top 10 states in per capita heroin and opioid deaths— more than 3,000 residents have died from heroin and multi-drug overdoses since 2009, according to this article.
Heroin has recently been dramatically rising in popularity in Pennsylvania: four years ago, 20% of those newly admitted for drug treatment cited heroin as their primary substance of abuse, but the rate has since increased to 23.5%, and the state has about 40,000 heroin users.
Nationwide, the number of people using heroin nearly doubled from 2007 to 2012 to some 669,000 people. Painkiller addicts across the U.S. are turning to the hardcore street drug when pills become too expensive or scarce, according to a letter published in 2012 in the New England Journal of Medicine. Three researchers examined the effect of the abuse-deterrent formulation on the abuse of OxyContin and other opioids, surveying 2,566 people seeking treatment for abuse of or dependence on opioid drugs. Although 24% found a way to defeat the tamper-resistant properties of the abuse-deterrent formulation, 66% indicated a switch to another opioid, with heroin the most common response.
An older form of the powerful prescription painkiller OxyContin that has been banned in the United States is still showing up in some areas of the country, possibly making the journey from Canada, where it is still legal, according to this article. In 2013, the FDA banned generic versions of OxyContin, which could easily be crushed, in favor of a tamper-resistant version produced exclusively by Oxy maker Purdue Pharma under a new patent. The Canadian government has so far continued to approve generic, crushable forms of oxycodone that are highly prone to abuse — though it has recently indicated it may soon force all opioid manufacturers to render their products tamper-resistant.
The news came as a study into skyrocketing opioid deaths in Canada found that painkillers are responsible for one in eight deaths among young adults in Ontario, according to this article. Opioid overdoses killed nearly 6,000 people in Ontario between 1991 and 2010, half of them under the age of 42, the study found.
Canada is the world’s second largest per capita consumer of prescription opioids after the United States.
Heroin use skyrocketed by more than 80% nationwide from 2007 to 2012, with the number of heroin users rising from about 373,000 to 669,000 in 2012, according to this article, which cites data from the federal Substance Abuse and Mental Health Services Administration presented at the U.S. Conference of Mayors in Dallas.
Physicians in the U.S. prescribe enough painkillers to medicate everyone in the country 24 hours a day for a month, and most heroin users start with prescription drugs, the article says.
Meanwhile, new data from the CDC the number of drug poisoning deaths related to heroin jumped by 45% from 2010 to 2011. But the number of people who are dying from overdosing on prescription drugs hasn’t dropped — about half of the 41,340 people who died of drug poisoning in 2011 took prescription opiates, according to this article.
Delaware has put into place emergency prescribing regulations regarding Zohydro, a powerful new painkiller many critics fear may fuel the epidemic of painkiller abuse. Late last year, Zohydro gained FDA approval despite the fact that after its own advisory committee had voted 11-2 against allowing the drug on the market. Since then, 29 state attorneys general have urged the agency to reconsider its decision, and Massachusetts Gov. Deval Patrick even attempted to ban the drug (a federal judge later blocked that order). Delaware Secretary of State Jeffrey Bullock said the regulations were necessary “to address the imminent peril to the public health, safety and welfare of all Delawareans” caused by Zohydro. According to his statement:
The use of this new and dangerous narcotic painkiller known as Zohydro must be monitored closely because the abuse of it can be deadly. It carries even higher risks of abuse than other short-acting formulations.
Zogenix, the maker of Zohydro, recently reported that about 9,000 prescriptions were filled through June 13 since the drug hit the market in March. The company plans to target about 20,000 prescribers it describes as “high decile [extended-release/long-acting] opioid prescribers” who account for 60% of the market, and envisions Zohydro along the lines of the multibillion-dollar market for OxyContin, according to this article.
Georgia is the latest state to see an spike in heroin abuse following the rise of prescription painkiller addiction, with heroin submissions to the Georgia Bureau of Investigation’s crime lab increasing by more than 300% since 2011. The current fiscal year has seen a 20% increase in heroin submissions, while all other drugs during that period have decreased by 22%, according to this article. Many users claim they started off taking prescription painkillers like OxyContin; when the drug started to have less effect, they began melting and shooting up the painkillers before eventually moving on to heroin, the article says.
According to the Georgia Bureau of Investigation, in 2012 prescription drugs played a role in 592 deaths in the 152 of 159 counties in Georgia for which it performs autopsies. Meanwhile, several major metro Atlanta counties recently reported a spike in heroin-related deaths: in DeKalb County, heroin deaths doubled, increasing from 5 to 10 between 2012 and 2013; in Gwinnett County, deaths rose from 2 in 2012 to 7 in 2013; and Cobb County saw heroin-related deaths surge from 9 in 2011 to 16 in 2012, according to this article.
New Jersey Gov. Chris Christie is urging physicians to be more careful about their prescribing habits when it comes to potentially addictive painkillers, and is encouraging their participation in the state’s voluntary drug monitoring program. The comments came at a doctors’ conference where the governor described how deeply affected he has been by the recent death of a close friend due to pain medication, according to this article.
Only about 20 to 25 percent of doctors in the state voluntarily use the program, the article says. Meanwhile, treatment centers in the state reported 7,238 admissions for painkiller addictions in 2010, 12 times more than in 2000, the article adds, citing data from the Substance Abuse and Mental Health Services Administration.
Christie had previously come under fire for rejecting an early version of the state’s Good Samaritan bill, which he claimed was too narrowly focused on encouraging more reporting of drug overdoses, rather than other aspects such as drug abuse deterrence, violence prevention and public safety. In May 2013, he signed an updated version of the bill into law, but partially vetoed a separate bill that would make the overdose antidote naloxone available to spouses, parents and guardians of people addicted to opioids. This March, the Christie administration issued a waiver allowing emergency medical technicians to administer naloxone after completing a training course.
The number of West Virginians who have died from heroin-related overdoses has tripled over the past five years, jumping from 22 in 2007 to 67 in 2012, according to this article. Meanwhile, fatalities caused by prescription pain pills have declined for the first time since 2009, the article says, citing the latest available figures from the West Virginia Health Statistics Center.
Berkeley County had the highest number of heroin overdose deaths, with 36 residents dying between 2007 and 2012; Cabell County had the second-highest number of heroin-related overdose deaths, with 26, followed by Monongalia County, with 15 over the past five years; and Kanawha County ranked fourth with 13, according to the article.
West Virginia has the highest drug overdose rate in the country. Between 1999 and 2004, there was a 550% increase in drug overdose deaths in the state, and drug overdose is the leading cause of death for West Virginians under 45 years old.
Despite increased media coverage and efforts to crack down on abuse, overdose deaths due to prescription drugs and heroin continue to happen at alarming rates in many states.
In Massachusetts, Gov. Deval Patrick recently declared a public health emergency due to the sharp increase in heroin overdoses and opioid addiction, with many addicts shifting from more expensive and harder-to-get pills to heroin, which is cheaper and widely available. Massachusetts state police say 185 people died from suspected heroin overdoses between November and February, a figure that does not include overdose deaths in the state’s three largest cities; the number of all opioid-related deaths increased from 363 in 2000 to 642 in 2011.
In Oklahoma, unintentional prescription drug overdoses claimed the lives of 534 residents in 2012; state health authorities say about half of them had taken drugs prescribed by their own doctors, according to this article.
In Iowa, the number of heroin overdose deaths rose 700 percent from 2003 to 2012, from one death to eight, according to this article.
The rise in heroin addiction across the nation, fueled by the prescription drug addiction epidemic, means that increasing numbers of people are in need of inpatient treatment services — but many who need help are contending with a shortage of services and constraints placed on care by insurance companies, according to this article.
Unlike withdrawal from dependencies on alcohol or benzodiazepines, heroin withdrawal isn’t life-threatening – but it is so horrific that many addicts are drawn back to the drug and overdose, the article notes. Because withdrawal is not directly deadly, most insurance companies won’t pay for inpatient rehab, either claiming that the addict does not meet the “criteria for medical necessity” — that inpatient care would be an inappropriate treatment — or requiring that the user first try outpatient rehab, the article says.
Of the 23.1 million Americans who needed treatment for drugs or alcohol in 2012, only 2.5 million people received care at a specialty facility, the article says, citing data from the Substance Abuse and Mental Health Services Administration.
The number of people reporting heroin use in the previous year increased between 2007 and 2012, from 373,000 to 669,000, while nearly 80 percent of people who had used heroin in 2011 had also previously abused prescription painkillers classified as opioids.