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Category Archives: Trends
Increasing numbers of Americans are being prescribed powerful opiate painkillers during emergency room visits, a new study has found. Between 2001 and 2010, emergency departments in the United States showed a 49 percent increase in prescriptions for narcotic painkillers despite the fact that there was only a small increase in the percentage of visits for painful conditions.
The study, published in the journal Academic Emergency Medicine, found that in 2010, 31 percent of ER visits involved a narcotic painkiller prescription, up from about 21 percent in 2001.
These increases were seen for conditions including abdominal pain, back pain, headache, joint and muscle pain, and toothaches.
In addition, the study found that hydromorphone and oxycodone had the greatest increase in ER administration between 2005 and 2010, while oxycodone and hydrocodone had the greatest increases in discharge prescriptions.
About 12 million Americans abused prescription painkillers in 2010, while roughly 15,000 Americans die annually from overdosing on such drugs, according to the U.S. Centers for Disease Control and Prevention.
A New Jersey task force on heroin and opiate abuse is calling for a number of measures to address the state’s growing prescription drug and heroin epidemic. In a new report, the Governor’s Council on Alcoholism and Drug Abuse said the number of drug-related deaths in the state is skyrocketing, rising 53 percent from 2010 to 2012, with more than two-thirds of those fatalities involving prescription drug abuse, according to this article. The report proposes major changes to New Jersey’s prescription pill monitoring laws, improvements to an insurance system that stacks the deck against drug addicts, and expanded use of recovery communities for students battling opioid addiction, the article says.
Like many other states, New Jersey has seen a rise in heroin abuse in light of the prescription drug addiction epidemic. Heroin is cheaper than pills, and in many cases easier to obtain. In the report, the task force chairman wrote:
“This is hardly the traditional path to heroin abuse, and that is one of the things that make the present situation so troubling. Because readily-available prescription pills have become a gateway drug, heroin is finding its way into the world of people who never imagined that they would ever confront this terrible substance.”
Rhode Island authorities are taking emergency steps to address an overdose crisis by making the overdose antidote naloxone more widely available, including to law enforcement agencies. According to this article, the state’s health department says Rhode Island is in the midst of “a severe prescription and street-drug overdose crisis” and that expanded access to naloxone — otherwise known as Narcan — has become “immediately necessary to save lives.”
The emergency regulations allow for naloxone to be prescribed not only to a person experiencing an overdose or at risk of one, but to family members and friends in a position to assist, while police departments would also be able to obtain and administer Narcan under a standing order from a prescriber, according to the article.
Rhode Island reported 55 accidental overdose deaths this year through March 4, about twice the normal number, the article says.
Fifteen states and Washington, D.C. currently have some type of Narcan distribution program, including some where family and friends of addicts receive kits in case of emergency.
There is evidence that Ohio’s efforts to curb prescription drug addiction among teens is working. Fewer than 12.8 percent of ninth through 12th graders reported using prescription painkillers without a doctor’s orders at least once during their life, according to the 2013 Ohio Youth Risk Behavior Survey. The number marks a 40 percent drop from the previous study, in 2011, when 21.3 percent of students said they had used painkillers without a prescription, according to this article.
But the state’s fight is far from over: many painkiller addicts are turning to heroin when their prescriptions run out or they can no longer afford to get the painkillers from dealers, leading to a surge in overdose deaths in the Greater Cincinnati area, the article notes.
From 2000 to 2011, Ohio’s death rate due to unintentional drug poisonings increased more than 350 percent, and the increase in deaths has been driven largely by prescription drug overdoses, according to the Ohio Department of Health.
In Kentucky, where prescription drug and heroin addiction are rife, hospitalizations for babies born dependent on drugs because of their mothers’ addictions are continuing to increase even as drug overdose deaths level off. In 2012, there were 824 hospitalizations for infants with neonatal abstinence syndrome, up from 678 in 2011 and 28 in 2000, according to this article, which cites a new report by the Kentucky Injury Prevention and Research Center. In addition, the report found that even though drug overdose deaths overall have leveled off and adult drug overdose hospitalizations have gone down, heroin-overdose deaths rose 207 percent between 2011 and 2012, the article says.
According to the article:
Along with the rise in infant hospitalizations has come a similar increase in the charges for these hospital stays in Kentucky, which reached $40.2 million in 2012, up from $200,000 in 2000. Researchers found that 694 of the 824 hospitalizations in 2012 were expected to be paid by government-funded Medicaid, for a total of $34.9 million.
Kentucky currently only has one-tenth of the substance abuse treatment beds it needs, according to data from the Substance Abuse and Mental Health Services Administration.
The rise in heroin addiction across the nation, fueled by the prescription drug addiction epidemic, has caused an uptick in the number of people 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. The increase in demand for treatment has left many addicts to wait weeks in some cases for care because of denial from their insurance companies, according to this article. Before insurance companies agree to cover inpatient services they want evidence that an addict has tried one or more outpatient programs, has little or no outside support network, and has a health condition that makes treatment a medical necessity, the article says.
Previously, a typical inpatient program lasted a month and the average detox program ran seven to 10 days; these days, as a result of insurance companies scaling back their coverage and increasing their deductibles, inpatient services generally run 10 days and detoxes three to five days — and most insurers will only pay for up to 10 days, the article says.
Pharmacy officials in Georgia are reporting that robberies are occurring with greater frequency in light of the state’s recent crackdown on pill mills. According to this article, Georgia became a pill mill magnet after neighboring states, including Florida, passed tougher laws regulating pain clinics.
Georgia lawmakers passed similar legislation last year requiring pain clinics to be licensed by the state medical board and owned by physicians, and the state also launched a prescription drug monitoring program, the article says. As the pill mills have dwindled, pharmacy officials say people who have addictions are being forced to seek drugs elsewhere, leading to the spike in robberies, the article says.
In 2010 alone, the Georgia Bureau of Investigation Medical Examiner’s Office reported there were 560 prescription drug-related deaths in the 152 of 159 counties for which it performs autopsies — at least a 10 percent increase since 2009.
Florida’s efforts to combat painkiller abuse resulted in the number of pill mills in that state dropping from 854 to 580 between March 2011 and March 2012, according to this article. In that same time period, the number of inappropriate prescribers of OxyContin in Florida dropped from 98 to 11; Florida previously had the most prescribers of OxyContin in the nation, the article says.
In Wisconsin, where heroin killed nearly 200 people in 2012, legislators are considering legislation that would provide immunity to anyone who helps a person who has overdosed on drugs, and would also provide immunity for possessing and administering the overdose antidote Narcan, according to this article.
They are also considering a separate bill that would target the abuse of opiate painkillers like Vicodin and OxyContin by allowing more medicine collection sites to accept them for disposal. A third measure would create regional treatment centers, the article says.
Heroin overdose deaths surpassed cocaine deaths in Milwaukee County for the first time in 2012, and heroin was present in 32% of fatal overdoses from mixed drug cocktails, according to this article. Narcan is increasingly being used to address the problem: statewide, emergency medical services have seen an increase in naloxone in the last three years, from 2,915 uses in 2010 to 3,247 in 2011 and 3,730 in 2012, the article says.
Overdose hospitalizations accounted for approximately two of every 10,000 hospital visits in 2012, and opiate-related deaths have grown from 2.19 per 100,000 deaths in 2000 to 8.08 in 2011, a report by the State Council on Alcohol and Other Drug Abuse found.
What started as an OxyContin and prescription drug addiction problem in Vermont has now grown into a full-blown heroin crisis, with heroin overdose deaths doubling last year from the year before, according to Gov. Peter Shumlin. There has been more than a 250% increase in people receiving heroin treatment in Vermont since 2000, with the greatest percentage increase, nearly 40%, in just the past year, the governor said in his state of the state address. Since 2000, treatment for all opiates increased by more than 770% increase; in 2013, there were twice as many federal indictments against heroin dealers than in the prior two years, and over five times as many as had been obtained in 2010, Shumlin added.
In addition, more than $2 million of heroin and other opiates are being trafficked into Vermont every week, the governor said. Due to the state’s proximity to Boston, New York, Philadelphia, and other cities where heroin is cheap, dealers can make a lot of money from addicts in Vermont: a $6 bag of heroin in New York City can go for up to $30, Shumlin said.
In Ohio, prescription drug addiction is increasingly putting young, educated suburbanites on the path to heroin addiction. According to this article, these addicts are flooding detox centers, rehab facilities and jails — and are also ending up in the morgue in record numbers. Statewide, nearly 500 people died of heroin overdoses in 2013 alone, and the number of heroin-related deaths has more than doubled in the past three years in a majority of Ohio counties, from 292 in 2010 to 606 in 2012, the article says.