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Thursday, January 31, 2013

Buprenorphine Related Emergency Room Visits


Released in 2002, Buprenorphine was considered a miracle drug when it came to addicts recovering from opiate addiction. As with most swords there are two edges to the blade, with a number of people ending up in the emergency room as a result of the drug.

Emergency departments reported a significant rise in the number of incidents related to the opioid addiction medication between 2005 and 2010, according to a new government report. Buprenorphine-related visits rose from 3,161 in 2005, to 30,135 in 2010, according to Medical News Today. The report was conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The FDA approved buprenorphine as a treatment for opioid addiction, for its ability to prevent opioid misuse without any withdrawal effects. However, buprenorphine use has greatly increased in the past few years; in 2005, it went from 5,656 physicians prescribing the drug to 100,000 patients. By 2010, more than 18,500 doctors prescribed the medication to over 800,000 patients.

While the risk of overdose potential is much lower than drugs like methadone, buprenorphine can cause serious harmful effects, particularly if it is taken improperly, or for non-medical uses - according to a SAMHSA news release.

Half of buprenorphine-related emergency department visits in 2010 involved the non-medical use of the drug. Of the reported visits, 59 percent also involved the use of other drugs such as benzodiazepines, pain relievers and illicit drugs.
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Monday, January 28, 2013

Parents Have Little Concern About Child Prescription Drug Misuse

The United States is in a grip of a prescription drug epidemic and unfortunately it seems like parents are not as concerned as they should be. Just one-third are very concerned about the misuse of prescribed narcotic pain medicine by children and teens in their community a new survey found, according to HealthDay. Only one-fifth are very concerned about the misuse of these drugs in their own families.

University of Michigan Mott Children’s Hospital conducted the national survey of more than 1,300 parents with children ages 15 to 17. According to the findings, 38 percent of black parents, 26 percent of Hispanic parents, and 13 percent of white parents are very concerned about the misuse of narcotic painkillers in their own families. Prescription drug misuse has been shown to be three times higher among white teens than black or Hispanic teens, according to the researchers.

66 percent of respondents strongly support requiring parents to show identification when they pick up narcotic painkillers for their children, and 57 percent strongly support policies that would ban obtaining prescriptions for the medicines from more than one doctor, according to the survey.

They found 41 percent of parents favor a policy that would require a doctor’s visit to obtain refills on these medications, with about half saying they do not support a requirement that unused pain medicines be returned to a doctor or pharmacy.

“Recent estimates are that one in four high school seniors have ever used a narcotic pain medicine. However, parents may downplay the risks of narcotic pain medicine because they are prescribed by a doctor,” Sarah Clark, Associate Director of the Child Health Evaluation and Research Unit at the University of Michigan, said in a news release. “However, people who misuse narcotic pain medicine are often using drugs prescribed to themselves, a friend or a relative. That ‘safe’ prescription may serve as a readily accessible supply of potentially lethal drugs for children or teens.”
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Friday, January 25, 2013

DEA Wants New Vicodin Restrictions

Pain management is very difficult to monitor effectively, as a result an epidemic has developed in this country beyond what anyone could have ever imagined. One of the key factors leading to the epidemic is that doctors are unable to deny patients adequate pain relief, even if there are no clear indicators that a patient is actually in pain. Doctors prescribe more Vicodin (containing the ingredient hydrocodone) than any other narcotic on the market which has brought the drug to the attention of the Drug Enforcement Agency.

The Drug Enforcement Administration (DEA) has put forth a proposal to more tightly control prescriptions of drugs containing the ingredient hydrocodone which has started a fiery debate among doctors, according to NPR.

Since the year 2000, hydrocodone related incidents have sent people to the emergency room at staggering rates. Unlike many other opiate narcotics, Vicodin contains acetaminophen, which makes the drug subject to fewer regulations than pure hydrocodone.

The DEA has called for stricter regulation of Vicodin, in order to reduce abuse of the drug for almost an entire decade. The DEA hopes to change the way drugs like Vicodin which combine hydrocodone with other products are classified, requiring patients to have more interaction with doctors in order to obtain prescriptions for them.

One of the leaders for Physicians for Responsible Opioid Prescribing, Andrew Kolodney, wants opioids to be used only for patients who absolutely need them, like cancer patients. “This epidemic has been fueled by overprescribing of opioids, particularly for chronic noncancer pain, whether it’s low back pain, headaches,” he told NPR. “I think that’s really created a public health crisis.”

Physicians for Responsible Opioid Prescribing would like the Food and Drug Administration to rewrite labels on opioids to state that physicians should write prescriptions only for severe pain and at much lower doses. The group wants prescriptions for the drugs to be written for a maximum of 90 days at a time. “The way to begin to turn the epidemic around is by getting doctors to prescribe more cautiously,” Kolodney said.  

A committee of the FDA will meet January 24 and 25 to consider the DEA’s request.

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Wednesday, January 23, 2013

Judges Deny Marijuana Reclassification

Marijuana advocates across the country took another blow by the federal government with the U.S. Appeals Court refusing to overrule the Drug Enforcement Administration’s (DEA) classification of marijuana as a dangerous drug with no accepted medical uses this week, the Los Angeles Times reports.

In retaliation the marijuana advocacy group, Americans for Safe Access, had sued the government, claiming the DEA had a duty to reexamine the medical evidence, and to reclassify marijuana as a drug with medical benefits for those suffering and in pain, the article notes.

The judges on the court deferred to the judgment of federal health experts, stating they required more evidence before they could reclassify the drug, a typical response on the matter.

“To establish accepted medical use, the effectiveness of a drug must be established in well-controlled, well-designed, well-conducted and well-documented scientific studies [with] a large number of patients. To date, such studies have not been performed,” according to a DEA document that was quoted in the court decision.

Judge Harry Edwards wrote the judges did not dispute that “marijuana could have some medical benefits,” but added they were not willing to overrule the DEA because they had not seen large “well-controlled studies” that proved the medical benefits of marijuana.

“To deny that sufficient evidence is lacking on the medical efficacy of marijuana is to ignore a mountain of well-documented studies that conclude otherwise,” Joe Elford, Chief Counsel with Americans for Safe Access, said in a news release. “The Court has unfortunately agreed with the Obama Administration’s unreasonably raised bar on what qualifies as an ‘adequate and well-controlled’ study, thereby continuing their game of ‘Gotcha.’”  

The group has said it will appeal to the Supreme Court.

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Thursday, January 17, 2013

Doctors Need to Screen for Problem Drinking

Physicians are the first line of defense when it comes to addiction, but, unfortunately it seems that they are overlooking key signs that their patients are suffering. In most cases, doctors are simply asking the wrong questions or none at all. A new study found that almost three-fourths of patients drinking problems are missed by doctors because they don’t conduct alcohol screening questions. Instead, doctors are relying on gut feelings about whether a patient is engaging in problem drinking.

A doctor can spot alcohol problems by asking a few simple questions about drinking habits, which could help patients cut back on drinking, experts told CNN. Almost 1,700 adults were asked to complete questionnaires, created by researchers, at the end of a primary care doctor’s visit.

Questions Like:

  • Drinking Habits
  • How often they drank.
  • How many drinks they usually had per day.
  • Has their drinking ever put them at risk of being hurt or cause an accident.
After the visit, doctors were asked whether they thought the patient had problems with alcohol.

The doctors who relied on gut instinct about their patients drinking, instead of conducting a screening, missed almost three-fourths of patients who screened positive for alcohol problems

“I hope that by papers like this, it’s going to be a nudge to a physician to say … ‘Maybe I should start screening.’ It’s not that hard to do,” said study author Dr. Daniel Vinson of the University of Missouri School of Medicine.

The study appears in the Annals of Family Medicine.
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Wednesday, January 16, 2013

Prescription Drug Tracking Devices

The New York Police Department has announced it will put decoy pill bottles with tracking devices on pharmacy shelves, in an effort to track stolen painkillers. The fake bottles will appear to contain oxycodone, The New York Times reports.

The bottles will not actually contain painkillers, but will have a GPS device. “We would anticipate the burglar and robber will take numerous bottles, and among them will be the bait bottle,” said the department’s chief spokesman, Paul J. Browne.

The fake bottles rattle when they are shaken, as if they contained pills. They sit on a special base. When the bottle is lifted from the base, it starts to send out a tracking signal. The department hopes to have the program in place by March, and is asking all of the city’s 1,800 pharmacies to participate.

Purdue Pharma, which makes OxyContin, developed the bottles. They are already being used in some pharmacies around the country.

Around the nation, pharmacies have been robbed by armed criminals looking for narcotics, anti-anxiety drugs and other controlled medications. Some are addicted to the drugs themselves, while others sell the pills.
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Wednesday, January 9, 2013

Racial Disparities In Treatment

It would be nice to think when it comes to drug and alcohol treatment that everyone gets a fair shake. Perhaps that is true when it comes to private treatment facilities, but when it comes to public programs a new study has found that is not always the case. Black and Hispanic patients are less likely to complete publicly funded alcohol and drug treatment programs, compared with white patients, the study found.

The reason for the disparity is likely related to higher unemployment rates and housing instability for Black and Hispanic patients, researchers suggest.

More than a million discharged patients from substance abuse treatment programs were analyzed by researchers during the study. The findings showed that about half of all Black and Hispanic patients who entered publicly funded alcohol treatment programs were unable to complete treatment; however, when it came to white patients about 62 percent were able to finish.

Funding for integrated services and more Medicaid coverage under the Affordable Care Act might help improve minorities’ access to treatment, researchers wrote in Health Affairs.

“Our findings show troubling racial disparities in the completion of alcohol and drug abuse programs, and they point specifically to socioeconomic barriers that make it difficult for minority groups to access and sustain treatment,” researcher Brendan Saloner, PhD, of the University of Pennsylvania, said in a news release. “For example, in both alcohol and drug treatment groups, black and Hispanic patients were more likely than white patients to be homeless. But, disparities among the groups were found to be lower in residential treatment settings, indicating that access to residential treatment could be particularly valuable for these patients.”
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Monday, January 7, 2013

New Study Could Change Opiate Addiction Treatment

Opiate addiction is extremely challenging to recover from for a number of reasons; although, there are many tools available today to help with the process. There happen to be several modes of thinking by addiction specialists when it comes to a successful recovery, but according to a new study, how opioid dependence is viewed and treated could change.

Buprenorphine is commonly prescribed for treating opioid dependence and has been proven to be quite successful. People who are dependent on opioids and are being treated with buprenorphine do not receive additional benefit from cognitive behavioral therapy, the new study found. Cognitive behavioral therapy is used to treat many psychiatric conditions and substance use disorders.

The researchers from Yale University studied 141 people with opioid dependence. They were divided into two groups. One group received buprenorphine treatment alone, and the second group received the drug treatment plus cognitive behavioral therapy.

Patients in both groups had a significant reduction in self-reported frequency of opioid use. Those receiving cognitive behavioral therapy did not have a greater reduction in use than those receiving buprenorphine treatment alone.

“This study demonstrates that some patients can do very well with buprenorphine and minimal physician support,” lead author Dr. David A. Fiellin noted in a news release. “This treatment represents an important tool to help reduce the adverse impact of addiction, HIV, and overdose due to heroin and prescription opioids.”

The findings appear in the American Journal of Medicine.
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Wednesday, January 2, 2013

Blocking Generic Painkillers

The battle against prescription drug abuse in the U.S. is painstaking and tireless; while much progress has been made over the last several years there is still many more moves that could be made to curb this ever growing issue. Pharmaceutical producers have long been scrutinized that the drugs they produce can be easily tampered with; by crushing to snort or melting the drugs down for injection users make them faster acting and more effective. Such practices increase the chance of overdose deaths by tenfold.

Manufacturers of the painkillers OxyContin and Opana are attempting to block generic drug makers from producing cheaper versions of the drugs, stating that doing this would save lives. Their argument is that these newer drugs will not have the tamper-resistant designs used in making the brand-name pills, according to The New York Times.

It is no secret that generic forms of certain drugs are typically much less expensive than brand name versions. One reason for the reduced price tag is the fact that such drugs are cheaper to produce since they lack prohibitors keeping people from misusing the drugs.

Purdue Pharma, makers of OxyContin and Endo Pharmaceuticals, the makers of Opana, have made their painkillers much more resistant to melting or crushing, which they believe saves lives making them more difficult to abuse. However, some may view this attempt to block the production of generic versions an attempt to increase their companies' revenue by pushing out the competition.

In December, a federal judge threw out a lawsuit by Endo, which attempted to have the FDA block production of generic versions of Opana. The article quotes court papers filed in response to Endo's lawsuit, the FDA called the company’s action a "thinly veiled attempt to maintain its market share and block generic competition."
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