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Tag Archives: doctors
Pennsylvania — which ranks 14th in the nation in prescription overdose deaths — has unveiled new emergency room opioid prescribing guidelines in an attempt to stem the tide of prescription drug abuse.
The new guidelines state that emergency room doctors should limit prescriptions for short-acting opioid painkillers to a week’s supply, and should not prescribe OxyContin, methadone or extended-release morphine without coordinating with the patient’s primary care physician.
According to the guidelines:
Opioid analgesics may be necessary for the relief of pain, but improper use of opioids poses a threat to the individual and to society. Providers have a responsibility to diagnose and treat pain using sound clinical judgment, and such treatment may include the prescribing of opioids. Providers also have a responsibility to minimize the potential for the abuse and diversion of opioids. Therefore, providers should use proper safeguards to minimize the potential for abuse and diversion of opioids.
Health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every adult in the U.S. to have a bottle of pills, according to the U.S. Centers for Disease Control and Prevention.
FedEx Corp. is facing charges that it delivered prescription painkillers and other controlled substances for illegal Internet pharmacies.
The charges include 15 counts of conspiracy to distribute controlled substances and misbranded drugs and drug trafficking. Prosecutors claim FedEx delivered drugs to Internet pharmacies that supplied pills to customers who filled out online questionnaires without undergoing doctors’ examinations, in violation of federal and state drug laws.
According to the indictment, FedEx knew as early as 2004 that it was delivering drugs to dealers and addicts:
FedEx’s couriers in Kentucky, Tennessee, and Virginia expressed safety concerns that were circulated to FedEx Senior management, including that FedEx trucks were stopped on the road by online pharmacy customers demanding packages of pills, that the delivery address was a parking lot, school, or vacant home where several car loads of people were waiting for the FedEx driver to arrive with their drugs, that customers were jumping on the FedEx trucks and demanding online pharmacy packages, and that FedEx drivers were threatened if they insisted on delivering packages to the addresses instead of giving the packages to customers who demanded them. In response to these concerns, FedEx adopted a procedure whereby Internet pharmacy packages from problematic shippers were held for pick up at specific stations, rather than delivered to the recipient’s address.
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.
Two California counties have launched a lawsuit accusing five major pharmaceutical companies of obscuring the addictive effects of OxyContin, Percocet and other powerful opioid painkillers while reaping billions of dollars in profits from the drugs. The companies deceived tens of millions of doctors and patients about the “significant dangers and questionable benefits of prescription opioids” for the treatment of long-term non-cancer pain, according to a complaint filed today in California state court. The five opioid manufacturers — Purdue Pharma, Cephalon, Janssen Pharmaceuticals, Endo Health Solutions, and Actavis — concealed the dangerously addictive nature of the medicines while touting benefits that had no scientific support, in order to expand the market for the drugs and boost profits, the lawsuit alleges.
The complaint charges that the pharmaceutical companies marketed opioids as “rarely” addictive, misrepresented the evidence of their efficacy for treating chronic non-cancer pain, trivialized their serious side effects and falsely assured doctors and consumers that opioids were safer than over-the-counter drugs.
According to the suit:
These pharmaceutical companies have a long history of aggressively marketing these dangerous drugs through sophisticated campaigns. These campaigns employ industry-funded professional associations, patient advocacy groups, and physicians to deceive consumers and their doctors about the harms and purported benefits of opioids for treating chronic pain.
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.
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.
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.
A major doctors’ organization is urging its members to practice greater caution and restraint when prescribing prescription painkillers in light of the abuse epidemic. The American College of Physicians said in a policy letter published in the Annals of Internal Medicine that prescription drug abuse is a “serious public health problem” and that physicians and other health professionals with prescribing privileges play an important role in helping to ensure safe and effective use of drugs like OxyContin and Vicodin.
According to the group, evidence-based, nonbinding guidelines should be established regarding recommended maximum dosage and duration of therapy that a patient taking controlled substance medications may receive.
In addition, the ACP called for the establishment of a national prescription drug monitoring program to help doctors detect and prevent prescription drug abuse by identifying individuals who seek to obtain prescriptions for addictive medications from multiple physicians for themselves or to sell. Former President George W. Bush launched an initiative in 2005 authorizing federal grants for states to establish or enhance PDMPs, the group said, but funding was initially delayed and has been inconsistent.
There are many reasons why teenagers get hooked on prescription drugs, but new research conducted at the University of Michigan has found that those who are prescribed pain relievers are at “notable risk” for abusing opioid drugs.
A University of Michigan researcher found that teens may develop an increased tolerance to the medication, which can lead to continued use of the drug after the initial prescription is finished.
According to the researcher:
“Once an adolescent has been medically exposed to a potentially addictive medication, adolescents are more likely to engage in nonmedical use and diversion, including buying, selling and giving away pills.”
Earlier this year, a separate study found that one in four teens has misused or abused a prescription drug at least once in their lifetime – a 33% increase over the past five years – up from 18% in 2008.
Of those kids who said they abused prescription medications, one in five (20%) had done so before age 14, that survey found.
Easy 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.