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Thursday, February 25, 2016

Providing On Demand Addiction Treatment

In a perfect world, if a person needed treatment for a substance use disorder, they would receive help immediately. Sadly, the growing demand for beds at such facilities can sometimes be a challenge, in the wake of the opioid epidemic affecting people from all walks of life. A lot of news about this subject deals with the lack of treatment services in rural parts of the country, but urban America is struggling to provide substance use disorder services, too.

Baltimore, Maryland, has a long history with opioid addiction, with inner-city heroin use spiking in the 1990’s. While the city has been working for decades to provide effective addiction treatment services, Baltimore Health Commissioner Leana Wen has been battling to provide on demand treatment of late, NPR reports. Making the choice to seek help for addiction is often a split second decision, those who are told they will have to wait for help are at risk of changing their mind, or worse, a potentially fatal overdose. Wen would like help to be available the second an addict makes the choice to seek recovery.

In the late ‘90s, George Soros gave the city of Baltimore $25 million for the design of innovative plans for dealing with addiction, such as treatment on demand. It's been almost two-decades now, and there are an estimated 20,000 people using heroin in Baltimore, and 65,000 struggling with some kind of addiction, according to the article. Wen points out that the city is far from the mark when it comes to providing on demand addiction treatment, a goal which may not be possible to achieve.

“We can progress, because we’re so far off from it,” said Wen. “We’re so far off.” 

There is a team, lead by Wen, currently designing a database that would help addiction outreach programs determine how many treatment beds are available at any given time in Baltimore, according to the article. She is also concerned that, despite widespread agreement among those who work in the field of addiction, there is still a stigma surrounding medication assisted treatment (MAT).

“There is the misguided belief out there that methadone, buprenorphine treatment is replacing one addiction with another,” Wen said. “That is not true. Methadone and buprenorphine are proven, evidenced-based treatments endorsed by every medical organization.”

Tuesday, February 23, 2016

Black Box Warning for Opioids and Benzodiazepines

One of the most common mixtures of prescription medications is opioid with benzodiazepines, such as OxyContin ® (oxycodone) and Xanax ® (alprazolam). Both types of medications are highly addictive and carry the potential for overdose, especially when mixed together. A number of health officials called upon the Food and Drug Administration to add what are known as "black box" warnings to both types of medications, The Washington Post reports. The call to action came from 41 officials from municipal health departments across the country, and from universities, too.

The black box warnings would inform people prescribed such medications that mixing the two can carry with it fatal consequences. It is no secret that the country is in the midst of opioid epidemic which the Centers for Disease Control and Prevention (CDC) reports is evident by the fact that 44 people die from opioid overdoses every day. What’s more, last week a study was published that found that overdoses involving benzodiazepines have quadrupled since 1996.

"The science clearly demonstrates that this is a potentially fatal combination, when opioids and benzodiazepines are prescribed together," said Nicole Alexander-Scott, director of Rhode Island's Department of Health. "These kinds of black box warnings work. We know they do." 

When such medications are taken together they can depress the respiratory system to the point where patients will cease breathing, according to the article. Doctors may not be warning their patients of the potentials dangers associated with mixing anti-anxiety drugs with painkillers. The black box warning would provide an extra level of protection.

On Monday, the FDA released a statement, which wrote that the agency “is committed to working with the health care community and our federal, state and local partners to help reduce opioid and benzodiazepine misuse and abuse. We will continue to monitor the combined use of these products and take necessary actions to ensure prescribers and the public are informed of the risks involved with the use of these medications."

Thursday, February 18, 2016

A Vaccine for Fentanyl

In recent years there has been growing trend of mixing the opioid narcotic fentanyl with heroin, an admixture that has resulted in a large number of overdoses throughout the country. Most drug users aren’t even aware of the presence of fentanyl in their heroin, which means they do not alter the amount of their dose - an error that can prove to be tragic.

Perhaps you may be wondering why heroin dealers would lace their product with another opioid. Heroin passes through many hands before it reaches the hands of an addict. As the drug travels among the various hands the purity diminishes along the way, due to a process known as “stomping” - the act of adding benign ingredients to a drug to increase the amount that can be sold, thus increasing profits. By the time the drug arrives on the street, the purity can be extremely weak and that is where fentanyl comes into the picture.

Fentanyl is 80 to 100 times stronger than morphine, and is used by physicians to treat severe pain. What’s more, fentanyl is approximately 40 to 50 times more potent than pharmaceutical grade heroin, and hundreds of times more potent than street heroin. While mixing fentanyl to heroin makes it stronger, it also makes heroin much more deadly because fentanyl in high doses can cause life-threatening respiratory distress when used with other drugs. Fentanyl is being made with relative ease in clandestine laboratories, and there is high likelihood that we will see more fentanyl/heroin overdose deaths.

In the near future there may be a vaccine available that will block the effects of fentanyl in the human body. Researchers have been working on vaccine that actually destroys fentanyl in the blood stream before it crosses the blood-brain barrier, Popular Science reports. A research team at The Scripps Research Institute (TSRI) injected mice with modified fentanyl molecules three times over the course of six weeks. Amazingly, mice that were given the vaccine were unable to get high on the drug and most of the vaccinated mice survived a lethal dose of fentanyl a month later.

The vaccine is not ready for human trials and it is important to keep in mind that the vaccine will only target fentanyl; it will have no effect on other opioid narcotics, according to the article. However, down the road the researchers would like to experiment with a vaccine that targets both fentanyl and heroin.

“We want to stay one step ahead of these clandestine laboratories making illegal opioids for black market demand,” said Kim Janda in a news release, the Ely R. Callaway Jr. Professor of Chemistry and member of the Skaggs Institute for Chemical Biology at TSRI. “The importance of this new vaccine is that it can block the toxic effects of this drug, a first in the field.” 

The research was published yesterday in the journal Angewandte Chemie.

Tuesday, February 16, 2016

Middle-Aged Women Are Not Immune to Eating Disorders

Most people who work in the field of addiction and mental health will probably agree that eating disorders are extremely difficult to treat and are under diagnosed. When we talk about eating disorders, conditions such as anorexia nervosa and bulimia typically come to mind first. What’s more, such disorders are most often associated with adolescent girls, and there are many who might find it surprising to learn that older women are susceptible as well.

It may seem like as people age they become less concerned about body image, shape and weight. However, new research suggests that a large number of middle-age women are seeking help for eating disorders, The Daily Beast reports. The study on perimenopausal eating disorders was conducted by researchers from the University of North Carolina (UNC) was published in the journal Maturitas.

The research highlights the fact that eating disorders can affect people over the course of one’s life, and that there is belief among many physicians that middle-aged women are not susceptible to unhealthy eating conditions, according the article. In fact, some older women who have sought help for eating disorders have been brushed off by their doctors.

“Physicians and the general public have had this long-term belief that midlife women are somehow immune to eating disorders, and that’s just not true,” said study co-author Jessica Baker at UNC. 

Part of the reason that many doctors are unwilling to diagnose older women with eating disorders is rooted in stereotypes that have long surrounded such conditions. People often think of eating disorders as something that traditionally only affects one demographic, the article writes. Stereotypically, eating disorders affect females that are:
  • Young
  • White
  • Thin
  • Wealthy
The CEO of the National Eating Disorders Association, Claire Mysko, points out that eating disorders impact people of all:
  • Body Weights
  • Races
  • Ethnicities
  • Genders
  • Age Groups
“Dieting and weight loss are painted as solutions to everything in our culture, and it’s easy to grab onto that and have it spiral into an eating disorder,” Mysko said.

Wednesday, February 10, 2016

Walgreens Will Offer Naloxone Kiosks

It seems clear that the majority of states have come to terms with the need for greater access to the life saving drug naloxone, a miracle medication that can reverse the effects of an opioid overdose. More and more states are allowing for the drug to be acquired without a prescription, and with the Food and Drug Administration’s (FDA) recent approval of naloxone in a nasal spray form, the drug can be administered with relative ease by friends and family members of opioid addicts.

With the recent surge in heroin overdose deaths throughout the nation, the need for prescription-free naloxone access is dire. Walgreens has announced that they will install naloxone dispensing kiosks in over half of its U.S. locations, more than 500 pharmacies in 39 states, UPI reports. The kiosks will primarily be in Walgreens' 24-hour locations.

CVS pharmacies have also started offering the same service in states where it is legal to dispense the life saving drug without a prescription, according to the article. Between the nation’s two largest drug stores, naloxone will reach thousands of addicts who previously were unable to acquire the drug.

"Walgreens pharmacists play an important role in counseling patients on the safe use of their medications, and now we are leading the way in retail pharmacy's fight against prescription drug abuse," Richard Ashworth, Walgreens president of pharmacy and retail operations, said in a statement. "We understand the challenges our communities face, and we stand ready to help our patients and customers lead healthier lives. When the stakes are this high, the solutions must be comprehensive." 

The World Health Organization (WHO) has estimated that naloxone could prevent 20,000 opioid overdose deaths in the U.S., the article reports. The Centers for Disease Control and Prevention (CDC) reports that 44 people die from an overdose every day in America. Naloxone should be one of the weapons used to save lives; overdose survivors will often seek addiction treatment.

If you are struggling with opioid addiction, help is available at Hope By The Sea. It does not have to come to an overdose to be convinced that help is required. Please contact us to begin the journey of recovery.

Tuesday, February 9, 2016

Super Bowl Ad May Contribute to Opioid Epidemic

We hope that everyone had a safe and sober Super Bowl Sunday; it can be a difficult day for many in recovery who have memories of drinking and watching the game with friends and family. Not everyone who watches the Super Bowl has an interest in American football, a number of people actually care more about the television advertisements aired throughout the game. It could easily be argued that the best commercials shown all year are first seen on Super Bowl Sunday, but this year one ad caught the attention of government officials.

On Sunday, you may have seen a commercial for a drug that treats opioid-induced constipation, which a top White House official believes the ad may actually contribute to the American opioid epidemic, USA Today reports. White House Chief of Staff Denis McDonough criticized AstraZeneca and Daiichi Sankyo, the two pharmaceutical companies who market a drug called Movantik.

“Next year, how about fewer ads that fuel opioid addiction and more on access to treatment," said McDonough. 

Earlier in the week, the Obama Administration announced that they would ask Congress for $1.1 billion to increase access to substance use disorder treatment facilities, according to the article. The prescription opioid and heroin crisis in America has been out of hand for a long time, a problem whose origin can be linked to the over prescribing of painkillers. As both lawmakers and addiction experts fight to get the problem under control, it would be helpful if the pharmaceutical industry would get on board.

"Now you have these ads coming out normalizing long-term use of opioids for a chronic pain problem," said Kolodny, a senior scientist at Brandeis University's Heller School for Social Policy and Management. "There's no question that their ads make this very dangerous and questionable medical practice seem normal." 

The two pharmaceutical companies claim that the ad was intended to raise awareness about a condition that affects millions of Americans, the article reports. Dave Fredrickson, AstraZeneca's vice president of specialty care said that talking and informing people about the condition may lead to more discussion about opioid addiction.

Wednesday, February 3, 2016

WHO Calls For Adult Ratings On Movies That Feature Smoking

While smoking rates continue to drop across the country, it is probably fair to say that more often than not the first mind altering substance that people try are cigarettes. Smoking continues to be one of the leading causes of preventable disease in developed nations, yet people continue to smoke regardless of the potential consequences. In the United States, there are a number of restrictions on tobacco advertising in an attempt to limit young people’s exposure to products that contain nicotine. However, there are still a number of areas where we could do better with regard to education, prevention and potential media exposure which casts the addictive products in a glamorous light.

The World Health Organization (WHO) is calling on the Motion Picture Association of America (MPAA) to give adult ratings to movies that feature smoking, CNBC reports. The WHO report “Smoke-Free Movies: From Evidence to Action,” points out that 44 percent of all Hollywood films in 2014 showed smoking, and 36 percent of films that featured smoking were rated for people under the age of 18.

"Because smoking on screen is uniquely vivid and because young people see so many films so often, its effect in promoting smoking initiation is striking," the report said. "The most vulnerable age group, adolescents, should not continue to be exposed to the most powerful promotional channel for smoking imagery available in today's globalized economy." 

WHO would also like anti-smoking ads to be aired before any film that features smoking, according to the article. On top of that, the United Nations (UN) agency believes that films should no longer exhibit actual tobacco brands. Studies indicate that in the U.S., exposure to tobacco in films accounts for 37 percent of all new teenage smokers.

“With even tighter restrictions on tobacco advertising, film remains one of the last channels exposing millions of adolescents to smoking imagery without restrictions,” said Dr. Douglas Bettcher, the Director of WHO’s Department of Prevention of Noncommunicable Diseases, in a news release.

Tuesday, February 2, 2016

Senate Judiciary Committee On Opioid Epidemic

The impact of the prescription opioid and heroin epidemic has been severe, affecting thousands of American families each year and costing government agencies billions of dollars. There is no question as whether more needs to be done in the way of curbing the decade plus old crisis. Last week, both lawmakers and law enforcement called for more funding and stronger measures for combating the opioid epidemic at a hearing of the Senate Judiciary Committee, The Wall St. Journal reports. What’s more, the governors, senators and law enforcement officials called for greater access to substance use disorder treatment and stricter prescription opioid prescribing practices.

“I have never seen anything like this, in terms of the epidemic we are facing,” said New Hampshire Senator Kelly Ayotte at the hearing. 

Across the country, public addiction treatment facilities have become bogged down, and in some states addicts can wait up to a month for access to a bed. Science driven treatments are one of the greatest weapons at hand in the fight to save lives, having to wait long periods for help can result in a potential overdose and/or death. On top of that, some addicts who make the decision to ask for help may change their mind by the time a bed is finally made available.

At the hearing, speakers pointed out that about 20 percent of opioid addicts receive treatment for their addiction, according to the article. What’s more, the Centers for Disease Control and Prevention (CDC) reports that every day in the United States as many as 44 people die of an opioid overdose death. Naturally, greater funding will allow for the treatment of more addicts and save thousands of lives.

“We are facing a treatment gap of unacceptable proportions. As a nation, we will not stem the rising tide of this public health crisis if only two out of 10 people with an opioid use disorder get the treatment they need,” said Kana Enomoto, acting administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA).

Enomoto notes that there is:
  • A Lack of Clinics in Rural Areas
  • A Lack of Health Care Providers Licensed to Prescribe Opioid Addiction Medication
  • Low Insurance Reimbursement for Addiction Treatment

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