Category Archives: Prescription Drug Abuse

Monthly Injection Treatment for Opioid Addiction Approved by FDA

The FDA (US Food and Drug Administration) has approved a monthly treatment for addiction that is the first of its kind. The new option can be used for those struggling with substance abuse issues stemming from an addiction to narcotics such as prescription painkillers or heroin.

Sublocade, from Indivior Plc, is buprenorphine given by injection. The drug reduces the sensations of withdrawal symptoms in addiction patients. Administering the drug monthly could help patients comply to the treatment schedule, compared to other versions currently available such as daily oral doses in the form of pills or dissolving strips.

Effort to Reduce Stigmas Around Drugs

Approving the new drug treatment product is part of the Administration’s plan to reduce stigmas surrounding this class of medications. Buprenorphine is a synthetic opioid, and critics have expressed their opposition to medication assisted treatment (MAT). Instead, they favor changing users’ behavior to combat the current opioid crisis.

The FDA and other federal agencies are supporting MAT, which involves administering drugs and providing counseling to those affected. The White House referred to the situation as a “public health emergency” in October.

The FDA commissioner, Scott Gottlieb, released a statement recently that said the FDA is “committed to expanding access to treatments that can help people pursue lives of sobriety.”

New Medication Available Early in 2018

According to reports, Sublocade will be made available to patients early in 2018, according to Indivior. The National Institute on Drug Abuse reports that in 2016, drug overdoses were responsible for taking the lives of more than 64,000 Americans. This figure includes overdoses caused by prescription drugs, such as fentanyl and OxyContin, and illicit ones like heroin. Clients who receive medication assisted treatment for drug addiction reduce their risk of death from all causes in half, according to the FDA, making this option a valuable one.

Mr Gottlieb stated that the FDA is currently working on guidelines that will get further treatment options for treating opioid addiction into the market more rapidly.

Should Hospitals be Accountable for Post-Surgical Painkiller Addiction?

Patients checking into a hospital for surgery is a very common occurrence. After their procedure, they want and expect to be given enough pain medication to be kept comfortable while they recover.

Often, the pain medication given by the surgeon and other medical providers is an opioid. They are prescribed for severe pain and are considered effective at providing temporary relief. The problem is that a number of doctors are prescribing these powerful painkillers without understanding how quickly patients can develop a dependency and thus start to experience withdrawal symptoms. When patients ask about how to taper off the medication when they are recovered from their surgery, they are often not getting enough information or accurate instructions.

Post-Surgical Opioid Dependency

Some doctors and hospital administrators are now asking the question, If some patients are becoming addicted to opioids starting with a stay in a hospital for surgery or another procedure, should the hospital be held responsible? Is the addiction a medical error in the same category as an infection acquired in hospital?

At least three physician/executives with the Hospital Corporation of America have argued that the answer should be, “Yes.” Drs. Michael Schlosser, Ravi Chari and Jonathan Perlin have stated that since this type of addiction arises during a hospital stay and is a “high-cost and high-volume condition,” and that it can often be avoided by implementing and applying new guidelines for patient care.

The doctors say that although it would be difficult for hospitals to monitor all the patients being given opioid pain medications in the weeks and months after their release, hospitals should have a system in place to try. The issue of long-term opioid use as a hospital-acquired condition opens the door for standards of care to be put in place to help patients manage their pain and protect them from coming to future harm.

Holding Hospitals Responsible May Have Financial Impact

Compensation and bonus structures at many hospitals are tied to patient satisfaction surveys, and that has been cited as one reason for doctors to continue over-prescribing drugs in an effort to keep patients happier. Less painkillers initially may mean that more patients experience some additional discomfort, and even though they may be saving lives from potential addiction, the doctors could wind up getting lower reviews and thus less pay.

Majority of Surgical Patients Have Drugs Left Over

Studies have revealed that the majority of patients (between 67-92 percent) have painkillers left over after surgery. Approximately 10 percent of patients need what is described as “intense pain management,” but it is difficult for physicians to identify which patients need this level of pain relief.

There are no set guidelines for what types of opioids should be prescribed after surgery, the typical dose that should be prescribe or how long patients should take them. In 2016, the Centers for Disease Control (CDC) released prescribing guidelines for opioids for chronic pain patients, but they only addressed acute pain briefly.

A new study published in September found that the optimal time for opioid use after surgery is between four and nine days.

FDA Approves Nerve Stimulator for Opioid Withdrawal

The Food and Drug Administration (FDA) has given its approval for a specialized tool that will be used to help US patients addicted to prescription pain medications and get them off opioids.

The newly-approved device delivers electric pulses to the area behind the patient’s ear. This electric pulse triggers a current which travels to the person’s occipital nerves (the ones reaching from the spinal cord to the back of the neck) and cranial nerves. It functions as a PNFS (Percutaneous Nerve Field Stimulator) device system and stimulates the patient’s brain to mask opioid withdrawal symptoms.

This medical device has been named the NSS-2 Bridge (NSS stands for “Neurostimulation System”.) Research shows that when used over a five-day treatment period, the process can be effective. The device is used during the period when an opiate-dependent person is likely to experience the most intense pain, as well as body tremors and sweating, during withdrawal.

Seventy-three patients were involved in the trials to determine the device’s effectiveness. Close to one-third (31 percent) of the participants noticed a reduction in symptoms within half an hour of getting the device. The trial found that 64 of the patients got relief and were ready to move forward to medication-assisted therapy after using the device. This represented a success rate of 88 percent after the five-day trial. However, other applications may include permanent abstinence rather than switching to a maintenance drug.

The FDA has decided to approve the device, even though the results of the study are limited. Further trials will be undertaken to evaluate its effectiveness in various settings.

FDA Commissioner Scott Gottlieb stated in his reasons for approving the new device that there is a need for finding new ways of helping people who are addicted so that they can achieve sobriety with “medically assisted treatment.” He went on to say that while research is continuing to find better medicines to treat opioid use disorder, medicine also needs to look to devices to help as well.

Finding alternative methods of treating opioid dependency is a major topic of discussion regarding dealing the epidemic our nation faces. In addition to helping people get off these drugs, it is imperative to find more ways to reduce or avoid using these highly addictive substances.

Compound May Offer Pain Relief Without Fear of Addiction

New research from Indiana University-Bloomington may give doctors and their patients living with pain a non-opioid option for treating severe pain.

Researchers conducted a pre-clinical study involving mice. They discovered that compounds known as PAMs (Positive Allosteric Modulators) heighten the effect of natural pain relievers the body produces internally when injured or exposed to stress. PAMs were first discussed with attendees at the 2016 Conference for the Society for Neuroscience, held in San Diego, California.

About PAM

The researchers chose a PAM that would intensify endocannabinoids. These two brain compounds (anandamide and 2-arachidonoylglycerol) specifically act on the CB1 receptor that responds to the presence of THC, the main psychoactive ingredient in marijuana. The PAM used in the study was GAT211, a molecule that coauthor Ganesh Thakur at Northeastern University created that had effects that concentrated on the brain.

The PAM increased the effects of the endocannabinoids without creating the undesired side effects associated with marijuana use. These include lowering of body temperature and clumsiness.

The pain relief achieved from PAM was more effective and lasted longer than when drugs were used that work by breaking down then metabolizing the brain’s cannabis-type compounds. Using PAM on its own means natural painkillers target the correct part of the brain as needed. The alternative is take drugs that bind to receptor sites throughout the body.

Increases the Body’s Natural Ability to Relieve Pain

Study leader Andrea G. Hohmann, a professor and chair of neuroscience at the University’s Department of Psychology and Brain Sciences, stated that the study revealed a PAM increases the body’s pain relieving ability without decreasing effectiveness over time. This is a key component of addiction; a person finds that they need to consume more of their drug of choice to experience the desired effect.

Professor Hohmann went on to say that she sees the research her team is doing as “an important step forward” in the goal to find new, non-addictive pain relievers.

The results of the study were published in the journal Biological Psychiatry.

Non-Addictive Painkillers Help Save Lives from Opioid Overdose

Continuing to find ways of providing pain relief for patients that don’t involve drugs with a high potential for abuse is of utmost importance in the battle against opioid addiction. Tens of thousands of lives are now lost each year due to overdoses and millions of people are abusing these drugs.

If you have a loved one who needs treatment help for a substance abuse problem, contact Desert Cove today for more information about our program.

Research Indicates Link Between High Sugar Diet and Opioid Addiction

New research from the laboratory of behavioral neuroscience at the University of Guelph has suggested a possible link between diet and risk of opioid addiction. Specifically, children and adults may be more vulnerable to opioid addiction when high amounts of refined sugars are consumed.

There has been a lot of press recently about the current opioid crisis — and for good reason. The Centers for Disease Control and Prevention (CDC) reports that provisional counts for the number of deaths has increased by 21 percent in the period 2015-2016. Drug overdoses are now claiming lives at double the rate of motor vehicle accidents and firearms combined.

Sugar Activates Reward Centers in Brain

Research studies have revealed that refined sugar activates the reward centers in the brain in the same manner as addictive drugs. Opioid abuse has also been linked to poor diet, including a preference for foods that are high in sugar. Based on this link, researchers had questions about whether there was a connection between a diet with an excessive amount of refined sugar and an increased susceptibility to opioid addiction.

How Research Was Conducted

The research team looked at whether an unlimited level of access to high fructose corn syrup changed laboratory rats’ behavior and responses to oxycodone, a semi-synthetic opioid. High fructose corn syrup, a commonly used food additive in North American processed foods and soft drinks, was selected for this study.

In one study conducted by doctoral student Meenu Minhas, the rats were given unrestricted access to drinking water sweetened with high fructose corn syrup. The sweetened water was removed after about a month. After a few days where the rats didn’t have access to any sweetened water, researchers evaluated the rats’ response to oxycodone.

The researchers found that when the rats consumed high levels of corn syrup, they may experience less rewards from the oxycodone. As a result, the rats may be looking to take higher amounts of the drug.

High Sugar Diet May Contribute to Opioid Addiction

The results indicate that a diet high in sugar may dampen the pleasure that someone may get from taking drugs such as Percocet, Percodan, and OxyContin at lower doses. Since these sedative drugs normally make a user feel more relaxed shortly after being ingested, someone who isn’t getting these results is likely to take a larger dose to get the desired results.

Higher doses of sedatives and painkillers can be dangerous. At high levels, they can interfere with central nervous functioning and slow down breathing, leading to coma or respiratory arrest. When combined with alcohol, their effects multiply since alcohol is also a depressant drug.

This research is another good reason to eat a balanced diet, including lean meats, fruits and vegetables, whole grains and low-fat dairy products. There is a place for sweets, but in moderation.

How Well Do Diversion Programs Work for DUI Offenders?

Tiger Woods entered a guilty plea in court on Friday to a charge of reckless driving, a less severe offense than Driving Under the Influence (DUI). According to reports, part of his plea agreement includes the golfer entering a diversion program for intoxicated drivers.

DUI diversion programs exist in a number of other states, such as Texas, Pennsylvania, Oregon, Louisiana, Kansas, Indiana and Georgia. Rules vary, depending on the program. Some states, such as Florida, allow local officials to decide whether to offer the program.

High Success Rates Observed

In the past four years this program has graduated close to 2,500 first-time offenders in Palm Beach County, FL. According to Deputy State Attorney Richard Clausi, the official who oversees misdemeanor prosecutions, stated recently that less than one percent of diversion program participants have reoffended.

Mr. Clausi went on to say that the key to this high success rate is having the participants take responsibility for their actions. The diversion program accomplishes this goal without requiring the participants to go to trial. Instead, they must complete the diversion programs.

How the Diversion Program Works

Woods will spend one year on probation. He will also be ordered to pay a $250.00 fine plus court costs. Woods must also meet the following requirements:

• Attend DUI school
• Perform 20 hours of community service
• Attend a workshop where he will learn how victims of impaired drivers’ lives have changed

Woods will also undergo regular drug tests, since prescription drugs and marijuana were found in his system when he was arrested.

Once he completes the program, Woods can request that the court expunge his reckless driving conviction. If he is ever charged again, Woods is not eligible for the diversion program a second time. As a repeat offender, he would be facing stiffer penalties, including a possible jail sentence, a more expensive fine and a license suspension (mandatory).

One of the greatest golfers in history is attempting to make yet another comeback, as he just announced a tournament he’ll play in this November. Hopefully the diversion and rehabilitation program as well as his surgery will help to have him on track to avoid the self-medicating trap of addiction he was stuck in.

Study Identifies Three Ways to Reduce Risk of Opioid Overdose in Addition to Treatment

reduce risk of opioid overdoseThere are three new helpful recommendations for doctors to follow in order to reduce deaths associated with prescription painkiller overdoses. While some of it is common sense, other parts are simple measures that can save lives. Researchers at the RAND Corporation have found that not prescribing opioids or anti-anxiety medication to patients with opioid dependence problems, ensuring that patients received psychosocial counseling and keeping up with quarterly doctor visits greatly reduced the chances of opioid-related deaths.

Researchers were able to come to these conclusions after observing the care that over 30,000 Veterans received through the VA health system. This at-risk population often sees a large amount of opioid abuse, and researchers were anxious to see what was effective within this vulnerable group. This is also the first study that has looked at developing quality measures to assure against potential opioid overdose deaths. This was important because another group of researchers have recently released data that shows the number of people dying from opioid overdoses is likely not going to reduce for several years unless some drastic changes are enacted.

These changes would be different from, or in addition to changing other prescribing habits, physician education programs about opioid abuse and prescription drug monitoring programs. It also presents another set of guidelines that can be easily checked.

“This is a very large drop in mortality and we need to conduct more research to see if these findings hold up in other patient care settings. But our initial findings suggest that these quality measures could go a long way toward improving patient outcomes among those who suffer from opioid addiction,” commented Dr. Katherine Watkins, lead author of the study.

These three recommendations have been published in the journal Drug and Alcohol Dependence, but researchers are hopeful that the information is more broadly dispensed because of the potential life-saving information to physicians everywhere.

CDC: Number of Opioid Prescriptions Falling

opioid prescriptionsAccording to the Centers for Disease Control and Prevention (CDC), the number of opioid prescriptions in the United States fell 18% between its peak in 2010 and 2015. However, it is still three times higher than it was in just 1999.

The reduction in prescriptions is partially due to the revised prescribing practices that have been recommended for physicians, as well as the general awareness campaigns brought on by the overdose epidemic. For more than a decade our nation has lost many thousands of lives each year to drugs like OxyContin, Vicodin, Percocet, Opana and many others. Unfortunately, those horrible losses are still occurring today.

While there are still some counties around the nation that have shown increased activity in this regard, there are also additional good news reports, such as the number of prescriptions with high doses dropping by 41% since 2010.

It is still unclear what kind of impact this reduction will have on current and future opioid abusers. While there will still be thousands of people who die each year, hopefully that number continues to go down as well.

“We do know that when you start people on prescription opioids, the risk of unintended consequences and illicit use goes up. But our staff has done intensive analyses to see whether changing policies for prescription drugs shifts people into illicit use, and the answer is no,” explained Dr. Anne Schuchat, acting director of CDC, in response to the suggestion that limiting the number of pills being prescribed will drive abusers to seek out street drugs like heroin.

The painkiller epidemic is one area where it seems that cutting down the supply will have an effect on the demand, eventually. This is encouraging news for the continued efforts to help save lives from prescription drug addiction of all kinds, not just opioids. These and other forms of interventions are often necessary when it comes to

Study Cites Benzo Use as Cause for Brain Changes

benzo useA new research study has shown that benzodiazepines, such as Xanax, Valium, Ativan and Klonopin, actually change the structure of the brain. This discovery could lead to further research regarding benzodiazepine addiction that can be explained by altered brain chemistry.

The study, which will be published in the August edition of Psychiatry Neuroimaging, shows that long term use of benzodiazepines can change the caudate in the brain. The caudate is responsible for the reward system, a function of the brain that is often linked to addiction.

The study, which was conducted in Finland, gathered data from MRI scans of 38 people diagnosed with schizophrenia. The MRIs were taken when the subjects were 34-years-old and then again when they were 43-years-old. Comparing the MRIs showed distinct changes in the brains of those that were using benzodiazepines. In order for a study to be valid, researchers have to take into account age, illness, and medication dose, yet even with these adjustments, benzodiazepines still seem to have a major effect on the brain.

Because this is the first study that has analyzed the potential of benzodiazepines to change the structure of the brain, researchers are anxious to further their understanding of this new development.

“There is a need for understanding the mechanisms behind antipsychotic – and benzodiazepine – related structural and functional changes in the brain. Further studies should also focus on how medication-related structural alterations correspond to cognition and functioning,” explained the authors of the study. They also understand that there will need to be a more large-scale population to gather enough data to back up their initial findings more thoroughly.

However, the study is interesting because it may answer questions about the potential for benzodiazepine addiction. Medications like Xanax or Valium are highly addictive and oftentimes abused by people who do not have their own prescription for the drug. Traditionally prescribed to those that suffer from anxiety disorders, these drugs are oftentimes sold on the street to people looking for the high that benzodiazepines can provide.

It can also garner further insight into how to treat benzo addictions in terms of helping to rehabilitate the brain and repair lost function from the drugs.

Anti-Seizure Medications Linked to Opioid Overdose Deaths

Anti-Seizure Medications Opioid OverdoseNew research indicates that one of the factors in the increase in the opiate-related deaths includes another class of prescription drugs. It was found that a recent rise in the number of prescriptions for the nerve medications pregabalin (Lyrica) and gabapentin (Neurontin) has directly correlated to the rise in opiate overdose deaths in some areas. Further investigation has shown that, in addition to opiates, users are also abusing the anti-seizure medication, causing an increase in accidental overdoses.

Drug users have discovered the calming effects of anti-seizure medication and are incorporating these drugs into their daily use. This particular study focused on parts of England, where the numbers show that there were about a million prescription for the two drugs in 2004, but that number soared in 2015, with a total of 10.5 million prescriptions written for pregabalin and gabapentin.

This discovery, which appears in the latest issue of the journal Addiction, illustrates two things. One is that addicts will continue to seek out drugs that they feel enhance the euphoria brought about by their drugs of choice, and that the medical community needs to evolve with the trends. This means that drugs that previously weren’t considered as having a high potential for abuse now need to be policed more thoroughly, and prescriptions for these types of drugs need to remain checked in order to prevent abuse or misuse.

“Poly-drug use is very common amongst drug users. We need more multi-disciplinary studies like ours which seek to combine evidence from laboratory experiments on how drug act, with accounts of what users experience and information on the pattern of drug use and drug harms – in order to make health care workers and drug users aware of the dangers of combining specific drugs,” asserted Graeme Henderson, Professor of Pharmacology and Neuroscience of the University of Bristol.

One possible solution to avoiding the combining of opiates and anti-seizure medication is that medical professionals increase their screening for abuse and prescribe non-addictive alternatives to patients that are in need of anti-seizure medication. This could help prevent future abuse and help save the life of someone who might be showing signs of mixing the two drugs.