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Thursday, July 24, 2014

FDA Approves Opioid Mixed With Naloxone

What if there were a painkiller that was effective at pain relief, but did not have euphoric traits? A drug like that would have little appeal to opioid abusers and would have great appeal to physicians. On Wednesday, the U.S. Food and Drug Administration (FDA) approved a drug that combines oxycodone and naloxone, according to the Los Angeles Times.

In the wake of the FDA's controversial approval of Zohydro ER it would seem that approving such a drug would be a step in the right direction, but that may not be the case. Purdue Pharma has created a drug called Targiniq ER, combining the highly addictive drug oxycodone with naloxone, a drug which blocks the euphoric effects of opioids. The drug was designed so that if someone crushes the pills, then naloxone will become active, denying the user a high.

“Targiniq ER can still be abused, including when taken orally (by mouth), which is currently the most common way oxycodone is abused,” according to a statement by the FDA. Targiniq is not a total deterrent against abuse but will detract some abusers.

“The FDA is committed to combating the misuse and abuse of all opioids,” Sharon Hertz, Deputy Director of the FDA’s Division of Anesthesia, Analgesia and Addiction Products, said in the statement. “The development of opioids that are harder to abuse is needed in order to help address the public health crisis of prescription drug abuse in the U.S.”

Not everyone in the field thinks that Targiniq is the answer to opioid abuse; some believe that it will give doctors a false sense of safety when prescribing opioid drugs. The President of Physicians for Responsible Opioid Prescribing, Dr. Andrew Kolodny, shared his concerns with the newspaper. “If we really want to turn this epidemic around, the most important thing is to stop creating new cases of addiction,” he said. “Coming up with new gimmicks isn’t going to help.”

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Tuesday, July 22, 2014

Drug Sentencing Guidelines Reduced For Current Prisoners

Unless Congress stops a proposed plan by the U.S. Sentencing Commission, more than 46,000 low-level drug offenders will be eligible for early release from prison, according to NPR. The commission unanimously voted to reduce sentence terms for low-level drug traffickers already incarcerated.

“This amendment received unanimous support from Commissioners because it is a measured approach,” Judge Patti B. Saris, Chair of the Commission, said in a news release. “It reduces prison costs and populations and responds to statutory and guidelines changes since the drug guidelines were initially developed, while safeguarding public safety.”

Congress has until November 1st to put a stop to the plan which could reduce sentences by an average of more than two years, according to the article. Federal judges will consider each offender’s petition separately and no prisoner will be released before November 1, 2015.

“This modest reduction in drug penalties is an important step toward reducing the problem of prison overcrowding at the federal level in a proportionate and fair manner,” said Saris in a news release in April. “Reducing the federal prison population has become urgent, with that population almost three times where it was in 1991.”

The Justice Department says reducing mandatory minimum sentences will save the American taxpayers billions of dollars.

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Wednesday, July 16, 2014

Telecare Approach Lowers Risk of Painkiller Addiction

New research suggests that counseling over the telephone could reduce dependence on prescription narcotics for dealing with chronic pain. A study of veterans who suffer from chronic pain showed that veterans who received tele-counseling reported a 30 percent improvement, according to HealthDay.

The study included 250 veterans with chronic pain, with half of the veterans being given traditional pain care from their primary physician and the other half receiving counseling from nurses over the telephone and internet, reports NBC Los Angeles.

Participants in the study who received telecare first met with a nurse in person one time and then received phone pain management counseling over the phone. Patients also received automated symptom monitoring to gauge pain levels. They also were given interactive voice-recorded phone calls and/or online messages which inquired about the patient's level of pain, reactions to the medications they were prescribed and whether they wanted to speak with a nurse.

“Nearly twice as many that had the telecare intervention got better in terms of their pain over the course of the year,” said study co-author Dr. Kurt Kroenke of the Roudebush VA Medical Center in Indianapolis. “On the other hand, twice as many people in the control, usual care group got worse during the course of the year.”

About one-quarter of the control group, those receiving usual care from a doctor, showed an improvement and only half of the control group was happy with the medication they were taking.

The findings were published in the Journal of the American Medical Association.

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Monday, July 14, 2014

Text Messages Can Reduce Binge Drinking

Researchers have found that following up with patients who have dangerous drinking patterns via text message can reduce a patient’s binge drinking by more than 50 percent.

"Each day in the U.S., more than 50,000 adults ages 18 to 24 visit ERs and up to half have hazardous alcohol use patterns," said Brian Suffoletto, MD, of the University of Pittsburgh School of Medicine in Pittsburgh, Pa. "More than a third of them report alcohol abuse or dependence. The emergency department provides a unique setting to screen young adults for drinking problems and to engage with them via their preferred mode of communication to reduce future use."

The study data comes from 765 young adults whose screening showed a history of hazardous drinking patterns. Over the 12 week study period, one-third were texted prompts to respond to drinking-related queries, as well as feedback on their answers. Another third received only text message queries about their drinking and one-third received no text messages at all.

Those study participants who received both questions and feedback reported that they decreased their binge drinking days by 51 percent and lowered the number of drinks per day by 31 percent. The other two study groups reported an increase in binge drinking days.

"Illicit drugs and opiates grab all the headlines, but alcohol remains the fourth leading cause of preventable death in the U.S.," said Dr. Suffoletto. "If we can intervene in a meaningful way in the health and habits of people when they are young, we could make a real dent in that tragic statistic. Alcohol may bring them to the ER, but we can do our part to keep them from becoming repeat visitors."

The study was published in the Annals of Emergency Medicine.

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Thursday, July 10, 2014

Long Term Effects of Stimulant Medication

English: Ritalin (Australian packaging)
Ritalin
With 1 in 9 children (approximately 11 percent of children ages 4 to 17) having been diagnosed with attention-deficit hyperactivity disorder (ADHD), and more than half of which prescribed a stimulant drug, it may come as a surprise that such drugs are not tested for their long term effects by the drug manufactures, according to new research. Drugs like Ritalin and Adderall are heavily tested for efficacy in clinical trials, few tests focus on the long term side effects of children taking these types of medications, according to The Boston Globe.

Investigators at the Boston Children’s Hospital reviewed 32 clinical trials on the 20 ADHD drugs approved by the Food and Drug Administration (FDA). Only five of the 32 clinical trials were geared towards the safety of such medications. On average, 75 patients were given the drugs for testing for about four weeks by the manufacturer before the FDA gave their stamp of approval. 

Despite the FDA requesting six follow-up safety studies, only two long term studies were actually conducted. 

“This is a wake-up call for what’s lacking in the drug approval process and what we want to see in the future,” said study co-author Dr. Kenneth Mandl. “Our findings are particularly troubling since these drugs are so widely used and used for years, not weeks.”

Stimulant drugs have a huge potential for abuse and could have a hand in leading to adolescent addiction. Many parents are unaware that the drugs they are giving their children are amphetamine based and after years of taking prescription stimulants, dependence is just about guaranteed.

The findings can be found in the journal PLOS One.

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Tuesday, July 8, 2014

Floida Curbs Presciption Drug Problem

In the United States, health care providers wrote 259 million prescriptions for opioids in 2012, USA Today reports. Through a series of policy changes, the state of Florida has finally managed to get a hold of their prescription drug problem, according to a new government report. Last year, after closing about 250 pain clinics, known as “pill mills,” the number of high-volume oxycodone dispensing prescribers dropped from 98 in 2010 to none in 2013, the CDC reported.

Florida created new laws for regulating pain clinics and built a new prescription monitoring program. As a result the number of opioid overdose deaths significantly decreased and the report indicates that the numbers are still falling. “These changes might represent the first documented substantial decline in drug overdose mortality in any state during the past 10 years,” the report points out.

“Overdoses from opioid narcotics are a serious problem across the country and we know opioid overdoses tend to be highest where opioids get the highest use,” said CDC Director Tom Frieden. He went on to say that opioid medications “can be an important tool for doctors to use … but they are not the answer every time someone has pain.”

Other states have not had the same success as Florida; Alabama, West Virginia and Tennessee still have high prescription opioid rates, according to the report. More states need to implement prescription drug monitoring systems and link up with systems from other states. This would prevent doctor shopping across state lines and significantly reduce the number of pills prescribed.

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Wednesday, July 2, 2014

First U.S. Drug Czar in Recovery

Drugs Policy: Untangling the Knot
(Photo credit: World Economic Forum)
Many Americans think of the U.S. Drug Czar as the general leading the war on drugs, attacking addiction on two fronts: first the suppliers and then the users. American prisons and jails are overcrowded with non-violent drug offenders, whose only real crime was being an addict. If this country is truly fighting a war on drugs, then the majority of incarcerated Americans could be considered prisoners of war. Ever since Nixon declared war on drugs, law enforcement, led by the drug czar, have systematically targeted individuals who struggle with addiction; only recently has treatment become an option for offenders.

In the past, the position of drug czar was given to an ex-military or former law enforcement person, being the logical choice. Today, the story is little bit different and many might find it interesting to learn that the current drug czar is not only ex-military or former law enforcement, but is actually in recovery himself.

Drug czar, Michael Botticelli, changed his life after a drunk driving accident on the Massachusetts Turnpike more than 25 years ago. Botticelli began drinking regularly when he was a junior in high school, developing into alcoholism through his 20s, and being arrested for drunken driving in 1988.

“There is no shame in this. This is a disease,” Botticelli said in Worcester, addressing a recent conference sponsored by the New England School of Addiction and Prevention Studies.

After a long stent as director of the Massachusetts’s Bureau of Substance Abuse Services, he was selected to be the U.S. Drug Czar. His initiatives and unorthodox methods of treating addiction in his own state caught the eye of many, including former czar Gil Kerlikowske.

After years of arresting everyone who had any connection with drugs, Botticelli believes the best way to fight substance abuse is to reduce demand, and no longer wasting huge amounts of money and manpower into jailing dealers and penalizing users.

Source:
The Boston Globe

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