The results of a survey conducted by The Hartford, a leading property and casualty insurance company, have found the current opioid epidemic is having a “tangible and growing impact” on employers across the US. The survey also found that a majority of Human Resources (HR) professionals and workers feel they don’t have the knowledge or resources necessary to deal with addiction.
Companies of All Sizes Participated in Opioid Survey
Two thousand workers and 500 HR leaders participated in the national survey, which collected responses from companies of all sizes.
• Two-thirds of HR professionals (67 percent) said their company is being impacted by opioid use today, or will be in the future. • Just under two-thirds of the HR professionals (65 percent) revealed that opioid addiction is impacting their company financially.
Employees, HR Staff Feel Unprepared for Substance Use Problems
The Hartford survey is an opportunity for employers to provide addiction education materials to workers, as well as develop and implement consistent policies and procedures regarding drug misuse.
• Many employees (76 percent), as well as HR professionals (64 percent), don’t feel they are well trained when it comes to helping co-workers who have an opioid addiction issue. • When asked if they could spot the signs of an opioid addiction, 24 percent of HR professionals and 18 percent of employees felt extremely or very confident they could. • Nineteen percent of HR professionals and employees feel they are extremely or very knowledgeable about how to reduce the risk of opioid addiction.
The Opioids in the Workplace survey was conducted with an online research panel on August 9-15, 2018. A representative sample of 2,500 US adults from across the nation was divided into two groups. Two thousand full and part-time workers and 500 participants with an HR role answered questions.
The margin of error for the first group is +/-2.2 percent at the 95 percent confidence level. For the second group, the margin of error is +/-4.4 percent at the 95 percent confidence level.
Reports about the opioid crisis and drugs fentanyl, carfentanil and heroin have dominated recent headlines. During the years 200-2016, the number of lives lost to opioids has more than quadrupled. Though opioids have taken up a lot of our collective attention during the first part of the twenty-first century, it would be a mistake to ignore another addictive substances that have had a negative impact on people’s lives: alcohol.
A new report released from the California Health Care Foundation looked at substance use disorders in California. It examined the impact of alcohol, opioid and other substance use over time. Although this particular report was specific to California, the figures are a fair representation for situations in Arizona and nationwide as well.
Key Findings from Substance Abuse Report
The report, entitled “Substance Use in California: A Look at Addiction and Treatment,” has several key findings, including:
• Alcohol use disorder was the most common type of substance use disorder among California residents. Approximately six percent of Californians met the criteria for alcohol dependence. Three percent of state residents met the criteria for dependence on illicit drugs.
• Experimenting with drugs and alcohol is likely to start during the adolescent years. By the time they reach Grade 11, over half of students in California have tried alcohol and close to 40 percent have tried marijuana.
• Young adults (aged 18-25) were most likely to develop substance use disorders, with the likelihood close to twice the state average.
• The number of Emergency Department visits related to heroin in California has tripled during the years between 2006-2017.
• Alcohol was responsible for more nonfatal Emergency Department visits in California than all other drug diagnoses combined.
Substance Abuse Disorders Treatable
Substance use disorders, including alcohol use disorder, can be treated and managed. Like other chronic illnesses, the risk of relapse is a real and ongoing one. Behavioral therapy helps people with substance use disorders change unhealthy coping mechanisms for new ways of dealing with destructive behaviors. Medications can be used to control cravings for opioids and alcohol and reduce the physical reward a user experiences when they are ingested.
Naltrexone is among the most common medications, which is used in many different forms. Vivitrol is an monthly injectable version of naltrexone that is often used to help fight cravings.
The results from a new report released from the Centers for Disease Control and Prevention (CDC) published in the CDC’s Morbidity and Mortality Weekly Report shed light on the continued effects of the opioid epidemic on a specific portion of the population: pregnant women. The researchers found that the number of women living with opioid use disorder at the time they went into labor and delivered their babies “more than quadrupled” during the 15-year period between 1999-2014.
Opioid Addiction Leads to Other Health Issues
Opioid addiction is responsible for a number of health problems. It can take a toll on a user’s physical and mental health, as well as her personal relationships. According to statistics collected by the CDC, opioids (which include prescription pain medications and illicit drugs such as heroin) were responsible for taking the lives of more than 42,000 people in 2016, a record level for fatalities.
Opioid use at addiction levels during pregnancy has been linked to several negative health consequences for mothers and babies. The drug use can lead to preterm birth, stillbirth and neonatal abstinence syndrome (NAS), a term describing a group of conditions caused when a fetus goes through withdrawal from certain drugs before birth.
National Database Analyzed
Researchers analyzed a national database collected on women from 28 states and discovered the rate of opioid use disorder jumped from 1.5/1000 delivery hospitalizations in 1999 to 6.5/1000 delivery hospitalizations in 2014. The rate increased by 0.39 cases per 1,000 during each year of the study.
Some geographical differences were noted during the study. The average annual increases were highest in West Virginia, Vermont, New Mexico and Maine. They were lowest in Hawaii and California.
Wanda Barfield, MD, Rear Admiral, US Public Health Service (USPHS), and the Director of the Division of Reproductive Health, explained that even in states with the smallest increases year over year, more pregnant women with opioid use disorder are being seen in labor and delivery.
Strategies for Dealing with Opioid Addiction in Pregnancy
The report included strategies for states to take on the issue of opioid addiction in pregnancy.
• Ensure opioid prescribing is in line with the CDC’s current guidelines • Intensify prescription drug monitoring programs. • Institute a policy of substance use screening at the first prenatal visit. • Make certain that pregnant women with opioid use disorder have access to MAT (medication assisted therapy) and other addiction treatment services. • Provide mothers with opioid use disorder with postpartum care that includes substance abuse treatment, mental health treatment, relapse prevention and family planning services.
With all eyes on the opioid problem in America, many people are missing the fact that millions of people are also abusing other prescriptions, such as Xanax. These anti-anxiety drugs have a very high potential for abuse and addiction and there is evidence that it is becoming even more prevalent.
Xanax Seen as Safer than Other Drugs
Addiction specialists are expecting a continued increase in the number of teens and young adults addicted to Xanax and other sedatives belonging to a class of anti-anxiety drugs called benzodiazepines (“benzos”). A number of young people feel that Xanax is safer and more readily available than other drugs, but it is certainly just as dangerous. The drug is abused by itself and also commonly taken with other substances, such as painkillers or alcohol.
Like most other substances, people can develop a tolerance over time, requiring more of it to achieve the same effect. This can lead people who have legitimate prescriptions for the drug to eventually become dependent and sometimes even farther down the path toward addiction.
Often, teens are finding the pills in their parents’ or grandparents’ medicine cabinets, not realizing they can be just as dangerous as opioids or illicit drugs. The risk to health and life increases when Xanax is taken with other drugs and/or alcohol.
Risk of Addiction Higher with Younger Start
When Xanax use starts early in life, the risk of addiction increases. A recent US Surgeon General’s report on drugs and indicated that close to 70 percent of young people who experiment with an illicit drug before the age of 13 will become addicted within the next seven years. Waiting to try illicit drugs until after the age of 17 lowers the risk of addiction to 27 percent.
Addiction professionals are seeing a significant increase in the number of teens and young adults who are addicted to Xanax. Many of them are taking high doses of the drug on a daily basis, sometimes in combination with opioids and alcohol.
Sharon Levy, the director of adolescent addiction treatment at Boston Children’s Hospital, explained that hospitals see trends first. She stated that benzo use among adolescents has “skyrocketed” and that more young people are being admitted to hospitals for withdrawals due to the possibility of dangerous seizures. At the same time, fewer teens are seeking help for prescription opioid addiction.
The opioid epidemic continues to rage through North America, and experts in East Tennessee are looking into the source of the problem. Many of them have determined that it can start with a trip to the dentist’s office.
Dr. Turner Emery, an oral surgeon on Knoxville, explained that doctors have been blamed for a lot of patients getting started on opioids. However, dentists also prescribe this class of medications to their patients, who are also put at risk for addiction.
Exparel Given at Time of Surgery
Dr. Emery is using a medication in his practice called Exparel to reduce risk of opioid addiction. It numbs the area around teeth that have been extracted for up to four days after oral surgery has been performed. When Exparel is used, a dental surgery patient may not need prescription pain medication at all.
The peak time for a dental patient to experience pain following wisdom teeth removal is on the second and third day following surgery, Dr. Emery explains. He has had a couple of patients who have had to take one or two doses of a narcotic, but most patients have been able to relieve their pain wth over the counter (OTC) medicines.
The medication is given by injection in each molar. Patients report that it reduces the need for narcotic pain medication and doesn’t make them feel drowsy during the first few days following their procedure.
First Exposure to Narcotics After Dental Surgery
A number of adolescents are first exposed to opioids following dental surgery. They may also be prescribed these strong pain medications following a sport injury. If a young person is prescribed more medicine than they need for the initial health condition, there is a concern that the opioid pain reliever may end up in someone else’s hands. The young person may continue taking the narcotic after the initial need for the strong pain medication has ended.
Medication Effective for Pain Relief
Exparel isn’t covered by all health insurance companies. The medication costs approximately $200.00, which can be a prohibitive factor for some patients and their families. Dr. Emery states that the medication works “really, really well” and that he has had good results with it.
The opioid epidemic is characterized by an increase in the number of people who misuse narcotics, including prescription painkillers and heroin. The National Institute on Drug Abuse reports that more than 115 people experience a fatal overdose from these substances every day in the U.S. Many who survive are facing a new challenge: hepatitis C infection. According to a study published in the American Journal of Public Health, hepatitis C and opioid use are linked.
What is Hepatitis C?
Hepatitis C is a disease that damages the liver. It’s spread through the blood and can cause liver failure or cancer. Doctors believed they were on their way to eradicating the disease through the use of certain medications, however, the rise of the opioid epidemic changed those expectations. The number of people with hepatitis C tripled from 2010 to 2015, according to CNN. Currently, approximately 3.5 million Americans have hepatitis C.
The decade from 2004 to 2014 saw a 400 percent increase in acute hepatitis C as well as an 817 percent increase in admissions of people ages 18 through 29 who injected prescription opioids. Most people who had hepatitis C before the 1990s were part of the baby-boomer generation. People born between 1945 and 1965 were more likely to have contracted the disease from unsafe medical procedures or blood transfusions. The increase of hepatitis C in the younger generation points to a link between the disease and opioid injections.
Hepatitis C is Spreading Through Injected Drug Use
Twenty-eight percent of people who inject drugs are infected with hepatitis C every year. Reusing the equipment that’s used to administer opioids intravenously can quickly cause an outbreak.
Jon E. Zibbell PhD was in charge of the study that looked at the connection between hepatitis C and the opioid epidemic from 2004 to 2014. He found statistically significant increases in the rates of hepatitis C among opioid users who injected the drugs.
Continued after image:
Many people start taking prescription painkillers orally. Over time, they transition to injecting heroin because it is cheaper and delivers a quicker high. New infections occur most often among these opioid users, many of whom are younger than 40.
In some states, the number of people infected with hepatitis C is double the natural average. Once many people within a community are infected, the disease spreads more rapidly because they share equipment.
Women in rural counties are three times more likely to have hepatitis C than women in urban counties, according to a CDC study. The study did not intend to compare opioid abuse rates with hepatitis C rates, however, Dr. Stephen W. Patrick, the study’s author, said that 5 times more infants were born with opioid withdrawal symptoms in rural areas than urban ones. One concern that experts have is that babies born with hepatitis C may not be treated because their mothers are unaware that they’re infected.
Catching Hepatitis C Before It’s Spread Further
Because many people don’t have symptoms or seek treatment, the actual number of people who inject drugs and have the disease is probably much higher than researchers have found.
It takes time for symptoms of hepatitis C to show up, therefore, many people don’t know that they’re infected until it’s too late. Plus, most people with drug abuse disorders don’t seek treatment for their addiction. Oftentimes, many people don’t know that they have hepatitis C until they receive a blood screening for a blood donation or routine exam.
By that time, liver damage may have set in. People who do have symptoms right away are more likely to get treatment that prevents the disease from progressing.
The FDA has approved several treatment regimens that can cure the disease. The problem is that many people who suffer from hepatitis C and opioid abuse disorder don’t get help. People who suffer from addiction may be compelled to take part in risky behaviors, such as sharing needles, even though they know about the dangers.
Jonathan Mermin of the CDC says that testing people who are at risk of developing the disease, which includes anyone who has injected opioids intravenously, can increase the effectiveness of treatment for those who test positive.
Free needle exchange programs have cut down on the number of people who use dirty needles. However, the stigma of drug addiction prevents many people from taking advantage of these programs or going further to attend rehab. Access to treatment is another obstacle that people with hepatitis C face.
Treating Hepatitis C in Addiction Treatment AZ Setting
Many rehab centers are staffed by medical professionals who can provide treatment for hepatitis C alongside therapy for addiction. At rehab, patients can be monitored to make sure that they administer their hepatitis C medication correctly, which is crucial for curing the disease. Because some hepatitis C treatments cause side effects such as depression, getting help at a comprehensive rehab center, such as our addiction treatment AZ, is important for managing psychological and emotional issues as well as physical ailments.
If you have hepatitis C and suffer from opioid addiction, call our addiction treatment AZ to learn how we can help you manage your substance abuse disorder as well as other physical and medical conditions. Treating the mind, body and spirit can help you succeed on your path to recovery.
Methamphetamine addiction is on the rise again in many areas. Meth use by pregnant women resulted in a number of negative neonatal outcomes, according to results from a systemic review and meta-analysis published in the Journal of Addiction Medicine. The review indicated meth use during results in a measurable decrease in the following:
• Infant birth weight • Head circumference • Body length • Gestational age at birth
The review also found that expectant mothers who were exposed to methamphetamine didn’t experience “excessive pregnancy complications” due to their illicit drug use.
Pregnant Women “Vulnerable Population” for Meth Use
Dr. Dimitrios-Rafail Kalaitzopoulos, from the Reproductive Endocrinology Unit, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece, wrote that pregnant women are one of the “vulnerable populations” that use methamphetamine. Dr. Kalaitzopoulos stated that data about the effects of meth use during pregnancy is limited, since existing studies have involved only small samples and have not accounted for the participants using other drugs as well as methamphetamine.
The investigators examined several types of materials while conducting their review, including an orderly review of clinical literature and a deep dive analysis of case-control studies. They included studies which compared women who were exposed to methamphetamine during their pregnancy with a control group who didn’t use meth.
Multiple Studies Examined by Researchers
Eight studies involving a total of 626 participants who used methamphetamine during pregnancy and 2,626 women who didn’t use the drug during pregnancy (the control group) were examined and analyzed. The results showed no difference (statistically) between women who used meth during pregnancy and the control group on preeclampsia (high blood pressure during pregnancy) rates.
Dr. Kalaitzopoulos pointed out there was a limitation to this type of meta-analysis due to the methods used to identify pregnant women who used meth. The ones who were recruited into the methamphetamine users group were placed there through a combination of self-reporting and toxicological reports, such as maternal urine tests, meconium tests performed on the infant’s first bowel movement or neonatal urine toxicology. In some instances, self-reporting only was used or taking a urine sample from the infant only was used.
None of these methods is considered ideal. To determine the extent of maternal drug use, all these methods should be used together, according to Dr. Kalaitzopoulos.
UCLA researchers have made two discoveries that provide new information on chemical messengers in the brain regulating addiction and sleep. One of the new findings involves the brain of people living with a heroin addiction and the other involves the brain of drowsy mice.
In 2000, scientists at the University of California Los Angeles found that narcolepsy (a sleep disorder whose symptoms include excessive sleepiness, sleep attacks, hallucinations and loss of muscle control) is caused by loss of approximately 90 percent of the brain cells that contain the neurotransmitter hypocretin. This chemical messenger is normally present in 80,000 brain cells.
Narcolepsy and Heroin Addiction
Narcolepsy is not a common disorder, affecting about one in 2,000-3,000 people. It can go undiagnosed for a number of years, with the patient usually starting to experience symptoms in childhood or adolescence.
The results of a new study have revealed that heroin addicts have 54 percent more hypocretin-secreting neurons that non-addicts, on average. Tests performed on mice have confirmed that opiate use is responsible for this increase. The jump in hypocretin cells lasted for up to four weeks after morphine treatment stopped, which is well after the morphine would have left the mice’s bodies.
The researchers thought morphine, which is the active ingredient in heroin, may restore the hypocretin-producing neurons which are missing in narcolepsy patients. To put this idea to the test, they gave narcoleptic mice morphine. The researchers found that morphine increased the number of hypocretin-producing cells, and the symptoms of narcolepsy disappeared.
Brain Neurotransmitter May Contribute to Opioid Cravings
The mice continued to produce hypocretin after they were taken off morphine. To the researchers, this observation led to a theory that humans may continue producing hypocretin after going through heroin detox (detoxification). The researchers thought the increase in hypocretin levels may be linked to opiate cravings and that bringing them close to “normal” levels might potentially reverse narcolepsy symptoms in humans.
More work will be needed with mice before this treatment approach can be recommended for human patients. Researchers would like to discover whether reducing the number of “excess” hypocretin cells could have a role in relieving withdrawal symptoms for long-term opiate users and preventing relapse once they are clean.
Increase Insurance Coverage for Addiction to Lower Risk of Opioid Deaths
Patients who are living with an opioid addiction and want to get help shouldn’t be denied access to treatment by their health insurance providers. This statement was one of the new policy recommendations co-authored by Professor Claudio Nigg, from the Office of Public Health Studies, University of Hawaii at Mānoa.
Lack of Full Coverage for Addiction Treatment a Barrier
The most likely reason people who want, but don’t get, addiction treatment is that government and private insurance policies don’t cover the cost of getting help, according to a statement posted June 27, 2018, on the Society of Behavioral Medicine’s website.
Professor Nigg explained, “To fight the opioid addiction epidemic that is ravaging the US today, policymakers need to increase Medicaid funding for addiction treatment and declare the opioid epidemic to be a national emergency, and not just a public health emergency.”
On a typical day in the United States, 3,900 people start taking a prescription opioid medication for non-medical reasons. Dozens of people die each day from an opioid overdose. In 2016, 77 people died from an opioid overdose in Hawaii, according to the National Institute on Drug Abuse.
Medication-Based Treatment for Opioid Addiction
Research has shown that medication-based treatment (MAT) is one approach for clients living with opioid addiction. It includes two components.
First, clients take medication to decrease cravings for drugs (such as oxycodone, morphine and heroin). They also attend behavioral modification therapy (“talk therapy”), which helps them change their thinking and actions.
Funding for Counseling Needed Along with Medications
Professor Nigg points out that while many insurance programs will pay for the medication, getting funding for counseling is much more difficult. He points out that people need the talk therapy, not just the medications to be treated properly for their addiction.
Nigg is an expert in the behavioral health science field. He has studied theories of behavioral change throughout his career and has conducted research on the motivations for people to take part in healthier living strategies.
When patients with substance abuse disorder visit their doctor’s office or the local emergency room seeking help, finding appropriate treatment for them is challenging in many instances. Physicians and treatment center administrators shared their thoughts about the obstacles and delays to getting help in the Journal of Addiction Medicine.
Several issues contribute to gaps in patients getting into treatment programs, according to the study conducted by researchers at Brown University and Butler Hospital. The opioid crisis has underlined the gap between the high need for substance abuse treatment and lack of availability to programs in the US.
SAMHSA Report Reveals Shortfall in Substance Abuse Treatment
A report released by the Substance Abuse and Mental Health Services Administration (SAMHSA) states that 21.7 million people living in the US need substance abuse treatment. Only 2.35 million of them receive the help they need at a facility specializing in providing this type of care. There hasn’t been much information gathered at the organizational level about the barriers to treatment for people seeking help for substance abuse disorders.
Major Obstacles and Delays in Getting Help for Substance Abuse
Researchers interviewed 59 people they referred to as “stakeholders in the treatment referral process”. These included emergency room doctors, addiction specialists, drug and alcohol treatment center staff and administrators. When the interviews were analyzed, four major ideas stood out:
1. Healthcare providers may not be fully aware of scope of treatment options.
Providers may not have the knowledge required to determine the best type of treatment for a patient. If a healthcare provider does determine the right treatment level for a patient, he must find a program that is a good match for the patient’s needs.
2. Healthcare providers have difficulty determining patient eligibility.
Each treatment center sets its own eligibility requirements, which may prevent a particular patient from receiving needed care.
3. Providers unable to find out whether treatment centers have space available.
Once a healthcare provider determines a patient needs treatment, it is challenging for the provider to find out whether the chosen center has a bed available.
4. Communication challenges make referrals from emergency room directly to a treatment bed difficult.
Often, there is a delay in starting treatment. Direct referrals, where the patient can be taken directly to the drug and alcohol treatment center, are the best approach, especially for patients needing help for opioid use disorders.