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.
Ibogaine treatment has seen a rise in popularity in recent years, specifically when it comes to opioid addiction treatment. There are many claims made regarding the success rates of Ibogaine treatment, which uses a psychoactive compound found in several different plants to facilitate a detox experience for patients addicted to a wide-range of substances. While this treatment seems to show promise, it is important to be aware of the potential risks involved in undergoing this largely unproven and untested form of addiction treatment. Before diving into this treatment method, it’s important to answer the question: is Ibogaine safe?
The Trap of the Magic Pill Mindset
In the battle to overcome addiction, it can be tempting to believe that a simple magic pill or treatment will be the answer to the problem. Unfortunately, addiction is often the result of many factors in one’s life. Whether it be trauma, a genetic predisposition to certain substances, social influences, or other co-occurring disorders, addiction can stem from many root causes, something which a simple treatment modality such as Ibogaine will not fully address.
To quote from Harvard Medical School professor Dr. Bertha Madras: “People think there is going to be a magic pill that’s going to erase addiction, and that’s just not reality. What they should not be desperate for is a quick fix.” While certain treatment methods can be useful in the process of overcoming addiction, a holistic, multi-faceted approach is the recommended way to address an addiction, as it will incorporate each issue which is contributing to the dependence.
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The Dangers of Ibogaine Treatment
Ibogaine has been promoted recently as an alternative therapy to traditional methods, specifically as an option for opioid addiction treatment. Some medical professionals believe that Ibogaine inhibits the reuptake of serotonin, and that it can not only prevent a person from experiencing dangerous withdrawals, but that it can also reduce a person’s desire to use the substance again.
It is claimed that the spiritual aspects of this substance induce a sense of introspection which also leads to relief from addictive cravings, as a person will have an increased degree of perspective after their Ibogaine experience. This is the result of the fact that Ibogaine is an intense, hallucinogenic drug that can last up to 24 hours. Ibogaine can cause physical responses such as dry mouth, nausea and vomiting, muscle coordination issues, as well as extreme levels of dehydration.
In addition to the physical symptoms a person may experience as a result of taking Ibogaine, the drug can also bring on intense emotional reactions, many of which can be difficult for some individuals to process. If a practitioner is not able to effectively help guide a patient through their experience, Ibogaine can become a terrifying experience, fraught with uncertainty and unclear solutions.
An Uncertain, Unproven Treatment for Addiction
While Ibogaine seems to show promise as a treatment option for addiction, there is simply not enough data to say for sure whether this is a reliable and effective modality. A patient who decides to take the chance and try Ibogaine as a method for curing their addiction must rely on a certain degree of faith, as there is an absence of proven, time-tested evidence to fall back on in terms of how effective this drug is.
Because Ibogaine is listed as a schedule 1 drug in the United States, there are no Ibogaine clinics available stateside where a person can seek treatment. Instead, individuals are forced to go to Mexico and other countries where Ibogaine is allowed, but still not has heavily regulated as it would be in the US. While some clinics may claim to offer a trusted, safe environment for patients to detox within while using Ibogaine, this process is undoubtedly risky and involves a great level of inconvenience for the person who decides to go this route.
In order to answer the question: is Ibogaine safe, we must look at the potential risks inherent in this treatment option. According to a study conducted by the National Institutes of Health, Ibogaine affects the cardiovascular system and there have been alarming reports of life-threatening complications, as well as sudden death cases associated with the administration of Ibogaine. The most likely cause of these sudden death cases was cardiac arrhythmias, showcasing the potential downsides which can impact a patient if they don’t consider all of their current health conditions.
Is Ibogaine Safe?
Ibogaine is an unknown, mostly untested treatment option which has a long way to go before it can be considered a safe option for patients seeking relief from their drug addiction. The most effective treatment options are always those that address the confluence of factors which can make up the reasons for why a person becomes addicted. Magic pills are an intriguing idea to entertain, but the truth is that they are simply not a realistic outcome for people seeking relief from their addiction.
After declaring the US in the midst of a public health emergency in 2017 due to the opioid crisis, The President signed a bill into law that experts believe will help to curb the opioid crisis. The new legislation is called the SUPPORT for Patients and Communities Act.
More Funding for Addiction Treatment
The new law provides funding to federal agencies and states so that they can provide increased access to addiction treatment. It also puts measures in place to help alleviate the crisis, such as:
• Preventing overprescribing • Training law enforcement agencies to intercept drug shipments at US borders
The bill signing was the culmination of a 12-month effort by the legislative and executive branch to react to the opioid crisis. While lawmakers said the bill was a step in the right direction, although many of them said it didn’t go far enough to deal with the epidemic. Rep. Frank Pallone of New Jersey cautioned of ramifications of talk of reducing access to publicly-funded treatment programs.
Congress and the White House entered into discussions for making a plan for confronting the epidemic in October 2017. This was before several congressional hearings by the House and the Senate on the same subject.
Public health experts have spoken out in favor of the bill, since it increases access to treatment. They say this is a critical step to controlling the epidemic. One of the measures in the legislation removes an old measure that didn’t allow clients with substance abuse issues get treatment in mental health facilities with more than 16 beds under Medicaid.
Private Companies on Board with New Initiatives
The White House has also pointed to new initiatives from private companies:
• Amazon has programmed its Alexa voice service to answer consumers’ questions about opioids and addiction. • Blue Cross Blue Shield, the major insurance provider, will establish a national toll-free phone number to help US residents locate drug and alcohol treatment centers. • Biopharmaceutical company Emergent BioSolutions will offer free Narcan nasal sprayers at over 16,500 public libraries and 2,700 YMCAs. Narcan, when administered to someone experiencing an opioid overdose, can help reverse the condition.
Treatment Still the Main Focus
What this new law and other efforts do is to help continue to focus on the need for treatment at all levels. This current drug crisis won’t subside until there are enough people seeking and receiving quality treatment for their substance use disorders. Desert Cove Recovery is proud to be a leader in rehabilitation for people both in Arizona and from all over the country.
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.
Bentley University and Gravity Diagnostics have entered into a partnership to conduct research into whether a person’s DNA can predict susceptibility to opioid addiction. The results of this work could give doctors prescribing pain medication an indication of how likely a patient is to become addicted. It could also predict how well patients who already have an opioid addiction problem will respond to specific treatments.
From Prescription Opioid Use to Addiction
According to the National Institute on Drug Abuse (NIDA), between 21-29 percent of chronic pain patients don’t take their medications properly and more than 115 people lose their lives due to opioid overdose every day. The majority (80 percent) of heroin users began their slide toward this illicit drug by misusing prescription opioid pain relievers.
Researchers will examine individuals’ DNA to discover how susceptible this factor makes them to becoming opioid-dependent. For people who have already become addicted to opioids, the scientists will examine their DNA to determine whether they are likely to respond well to both opioid and non-opioid treatments.
The results of this work could have a significant influence on doctors’ decisions about whether to prescribe opioid to specific patients. When a physician does make the choice to prescribe an opioid pain medication, a patient’s DNA profile may influence how much of the medication he is prescribed. The research results can also influence how doctors treat patients with a history of addiction.
Partnership Includes Multiple Departments at Bentley
The partnership, which will last three years, will include faculty from several departments at Bentley: Natural and Applied Sciences, Sociology and Economics. A public health geneticist will also be on the team to provide assistance with research. Bentley students will enter and process data, and write computer scripts.
Gravity Diagnostics, a Northern Kentucky-based laboratory, is providing a $360,000.00 grant to finance the work. Bentley was selected as a research partner because, “[it is] doing successful research that is relevant to the world today.”
Data Analytics First Phase in Research
In the initial phase of the research, data analytics will be used to pinpoint the genetic features that are the best predictors for addiction and responses to treatment. Once they have been identified, these features and predictions will be tested by comparing them to DNA samples taken from active opioid addicts and those in recovery.
The goal is to discover why some people become addicted to substances quickly, while others can use the same drug and seem to be resistant to physical addiction for some time.
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.
FDA Approves Two Generic Medications for Opioid Dependence Treatment
Mylan Technologies Inc. and Dr. Reddy’s Laboratories SA have received the go-ahead to market buprenorphine and naloxone sublingual film. These products will be made available to patients as generic versions of Suboxone, a medication used to treat opioid dependence.
Buprenorphine is used to reduce the severity of opioid withdrawal symptoms. Naloxone blocks their effects and reverses the same. The two medications can be used as part of an overall treatment program that includes counseling and prescription monitoring.
More Help Available for Opiate Addiction
Generic buprenorphine and naloxone sublingual film will be available in several dosage levels. These medications can only be prescribed by medical professionals certified by the Drug Addiction Treatment Act.
Dr. Scott Gottlieb, the FDA Commissioner, stated that the FDA is taking steps to “advance the development of improved treatments for opioid use disorder” and to ensure that these medications are available to patients who need them. He also said that includes “promoting the development of better drugs, and also facilitating market entry of generic versions of approved drugs to help ensure broader access.”
About Medication-Assisted Treatment
Medication-assisted Treatment (MAT) is a treatment option that uses FDA-approved medications (buprenorphine, methadone or naltrexone) along with counseling and other types of behavioral therapies, to treat opioid addiction. This form of treatment reduces the severity of withdrawal symptoms. The medications used for MAT don’t give participants the “high” or feeling of ecstasy normally associated with opioid abuse, although some of these medications can wind up being abused as well, so they alone are not a permanent solution.
At an appropriate therapeutic dose for a patient, buprenorphine is also supposed to reduce the pleasurable effects he would experience if he took other opioids. This effect would make continued use of opioids less attractive, therefore much less likely.
Patients who are receiving MAT for opioid use disorder benefit from this type of treatment in another way as well: they cut their risk of dying by 50 percent, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
Everyone’s experience of addiction is different. Likewise, everyone’s path toward recovery is unique. When it comes to overcoming an addiction to opiates, seeking outside help is a must. For that help to be effective, a treatment plan that is tailored to suit the needs of the individual patient is essential. Rehab facilities have many tools at their disposal, and one of the best ones for assessing a patient’s opiate withdrawal symptoms and experiences is something called the Clinical Opiate Withdrawal Scale. Read on to learn more about this useful tool and how it is used to help people overcome serious addictions.
Often abbreviated simply as COWS, the Clinical Opiate Withdrawal Scale is an 11-point scale that is used to rate common symptoms and signs of opiate withdrawal. Unlike the Subjective Opiate Withdrawal Scale, or SOWS, which is a self-reporting tool, it is designed to be administered by a clinician. Each of the 11 listed symptoms are given a score on a scale of 0 to 5, with 5 representing the most severe manifestation of the symptom in question. The patient’s score is then tallied and used to determine a tailored opioid withdrawal treatment plan.
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Which Signs and Symptoms are Assessed on the Scale?
Inpatient and outpatient treatment centers alike have numerous tools at their disposal for helping patients to withdraw safely from opiates. In particular, medications like buprenorphine and suboxone are often prescribed to help manage the most severe and uncomfortable symptoms. In turn, patients are less likely to relapse due to severe discomfort. However, to be effective, these medications must be administered at strategic points in the withdrawal process. The COWS scale is the primary tool that clinicians use to determine not only which medications should be used but when they should be administered.
The 11 signs and symptoms that are assessed on the COWS scale are:
1. Resting pulse rate – The patient’s pulse is monitored regularly. A resting pulse of 80 or below is given a score of zero while a resting pulse of 120 or higher is given a score of five.
2. Gastrointestinal upset – Symptoms may range from none to multiple episodes of vomiting and diarrhea.
3. Sweating – This symptom may not be present at all. On the other end, sweat may be streaming from the face or body.
4. Tremors – Tremors may not be present, or they may be severe enough to interfere with a patient’s ability to speak or move.
5. Restlessness – On the COWS scale, this symptom may not be present at all. In the worst case, the patient may be unable to sit still for more than a few seconds at a time.
6. Yawning – No yawning may be happening at all, or it may be happening as frequently as several times per minute.
7. Pupil size – Pupils may be pin-sized when exposed to light, or they may be extremely dilated on the more severe end of the scale.
8. Irritability and anxiety – Someone experiencing opioid withdrawals may show no sign of anxiety or irritability at all, or they may be so anxious or irritable that they struggle to participate in the assessment.
9. Bone and joint aches – This symptom can range from very mild to so severe that the patient is constantly rubbing their joints and unable to sit still.
10. Gooseflesh skin – Skin may be smooth on one end of the scale or look like gooseflesh on the other.
11. Teary eyes and runny nose – These symptoms may be missing entirely, or the eyes and nose may run constantly on the more severe end of the scale.
Benefits of the COWS Scale
After assessing the patient for each of the 11 symptoms, their score is tallied to determine how severe their withdrawal is. A score of 5 to 12 represents mild withdrawal while a score of 36 or higher represents severe withdrawal. Clinicians may use other scales in conjunction with COWS to gain an even clearer understanding of a patient’s current state; the Buprenorphine Administration Scale, for example, is often used in conjunction with COWS to determine effective doses of that medication as well as when to administer it. With many medications, introducing them too early can have the opposite effect, which can lead to a longer and more difficult withdrawal period.
Are You Looking for Opiate Addiction Treatment?
If you are coping with an addiction to opiates and are ready to regain your freedom from substance abuse, it’s important to understand that help is absolutely vital—and it is readily available. Detoxing from the drug is the first step, and the right inpatient or outpatient treatment program will use the COWS scale or other proven tools to determine the best individualized plan for you. Once detoxing is over, you will be free to begin the real work of addiction recovery and to take the first steps toward a lifetime of sober living.
The current opioid crisis is responsible for producing a new epidemic among teens and young adults. It’s a potentially-fatal bacterial heart infection called endocarditis.
This condition is most commonly seen in older adults. Now doctors are seeing it in much younger patients more often due to opioid drug use.
What is Endocarditis and How is is Related to Opioid Abuse?
Endocarditis is a bacterial infection of the inner lining of the heart chamber and its valves. The condition occurs when bacteria are enter the body, then are spread through the bloodstream until they attach themselves to damaged parts of the heart. It is spreading through the use of shared needles by IV drug drug users.
The clump of bacteria grows over time, and the infection can be life-threatening if it isn’t treated, according to Dr. Sarah Wakeman, the Medical Director of the Substance Use Disorder Initiative and the Addiction Consult Team at Massachusetts General Hospital.
How Infection is Spread
In a doctor’s office, clinic or hospital setting, a health care worker will swab a patient’s skin with a disinfectant to kill bacteria before administering an injection. The purpose of this step is to avoid pushing bacteria from the skin into the body with the needle. Opioid drug users who are using needles may not be taking this step, which has led to the increase in endocarditis cases.
Endocarditis Treatment Not Enough for Opioid Use Disorder Patients
Endocarditis can be treated using intravenous antibiotics over a long time. If the damage to the heart valves is severe, surgery may be recommended to replace them.
If the patient is also injecting opioids, such as heroin, treating the infection is only treating half of the problem. The opioid use disorder is still present, and the patient will go right back to using once if he doesn’t get appropriate help for the addiction.
According to a 2016 Tufts University study, hospital admissions for endocarditis due to injectable drug use increased from 3,578 in 2000 to 8,530 in 2013. The study also found that a large number of these cases involved young people aged 15-24.