Category Archives: Prescription Drug Abuse

New Research Examines at Link Between DNA and Opioid Addiction

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.

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.

For more information on opioid addiction treatment, and to find out if you have insurance coverage for addiction treatment, give us a call today.

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).

FDA Approves Non-Opioid Drug to Treat Opioid Withdrawal Symptoms

The US Food and Drug Administration (FDA) has approved Lucemyra (lofexidine hydrochloride) to treat opioid withdrawal symptoms in adults. This drug may lessen the severity of withdrawal symptoms; however, it may not prevent them.

Lucemyra is only approved for a treatment period of up to 14 days. The medication is not meant to be used as a treatment for opioid use disorder (OUD). It’s one part of a long-term treatment plan for patients with OUD.

Opioid Withdrawal Symptoms

When someone has been taking opioids over a period of time, he will develop a physical dependence on the drugs. This is to be expected, and doesn’t necessarily mean that a patient has become addicted to the medication. Withdrawal symptoms can occur in patients who have been using opioid pain medications as directed by their doctor and people with OUD.

These withdrawal symptoms include the following:

• Anxiety
• Cravings
• Diarrhea
• Difficulty sleeping
• Muscle aches
• Nausea
• Runny nose
• Sweating
• Vomiting

How Opioid Withdrawal is Typically Managed

For patients taking opioid pain medications as directed by a doctor, opioid withdrawal is typically managed by slowly tapering off the drug. This strategy is used to lessen the effects of withdrawal symptoms. Some patients are able to avoid experiencing withdrawal symptoms entirely.

In a patient with OUD, withdrawal is typically treated by substituting another opioid medication. In time, the dose is gradually reduced or the patient is switched to a maintenance therapy program. These medication-assisted therapy (MAT) treatments may use drugs like methadone, buprenorphine or naltrexone. Medications may be prescribed to treat specific symptoms, such as aches and pains or stomach upsets.

About Lucemyra

Lucemyra is taken orally and works by reducing the release of the brain chemical norepinephrine. Its actions are believed to play a role in several opioid withdrawal symptoms.

DEA Suspends Louisiana Pharmacy Distributor Over Suspicious Orders

The Drug Enforcement Administration (DEA) announced that it has issued and served a Suspension Order on Morris & Dickson Company. The wholesale pharmaceutical distributor is situated in Shreveport, Louisiana.

The DEA alleges that the distributor failed to identify “large suspicious orders for controlled substances.” These substances were sold to independent pharmacies that the DEA says had questionable need for the drugs.

Hydrocodone and Oxycodone Purchases

The investigation centered on purchases of hydrocodone and oxycodone. It revealed that in some instances, the pharmacies were allowed to buy six times as much as a normal order. Regulations are in place requiring distributors to identify orders which are out of the norm; the DEA is alleging that Morris & Dickson Company failed to identify these large orders. As a result, millions of hydrocodone and oxycodone pills were distributed, in violation of existing law.

DEA Acting Administrator Robert W. Patterson stated that pharmaceutical distributors have an obligation to make sure that all controlled substances being ordered are for legitimate purposes. Distributors have a duty to “identify, recognize and report” any suspicious orders to the DEA.

Company Failed to File Suspicious Order Reports

The DEA became aware of the high-volume orders involved in this investigation in October, 2017. The Agency’s records revealed that the company hadn’t filed any suspicious order reports on any of the pharmacies placing the large orders. On review, the purchases made weren’t in line with the pharmaceutical market:

• Independent retail pharmacies were buying more of the drugs than the largest chain pharmacies in the state.
• The pharmacies were buying more narcotics than several of the largest pharmacies in a single zip code.

The DEA states that more than four million people in the US are addicted to prescription pain medications. This figure includes 250,000 adolescents. Drug overdoses are the leading cause of death in the United States, surpassing deaths from motor vehicles accidents or deaths due to firearms.

Length of Opioid Prescriptions and Opioid Addiction

Every day, people who were only seeking a little pain relief unwittingly become addicted to opioids.

Most get prescriptions from their doctors following surgery or an injury. Many seek relief for ongoing back pain. Some borrow pills from friends just to take the edge off after a stressful day at work. None ever plan on getting hooked.

In 2016, 66% of all fatal drug overdoses in the U.S. involved an opioid. What was only an area of concern in the late ‘90s is now a full-blown crisis.

If you’re worried about your opioid habit, you may have reached out to us just in time. Keep reading to find out how your lawmakers and the professional caregivers at Desert Cove Recovery can help you.

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Limiting the Length of Opioid Prescription

In an effort to stop this epidemic, mental health experts and politicians want to limit the number of doses that patients can get at one time. Several states have passed laws on prescription lengths. The CVS pharmacy chain recently announced that it will only dispense seven days’ worth of opioids at a time.

The idea behind shorter prescriptions is to take unnecessary pills out of circulation. Limiting doses will result in less potential for abuse. Even people who use painkillers responsibly fail to properly dispose of the extras; stockpiles in home medicine cabinets are tempting.

Finding the magic number is no easy task. In the Centers for Disease Control and Prevention guidelines, the recommended length of opioid prescription is three to seven days. Some experts challenge those numbers, pointing out that they are far too conservative for major surgeries like hysterectomies. They also argue that unreasonably short prescriptions will only prompt patients to get refills.

There’s no easy fix, but the opioid addiction crisis has everyone’s attention. That’s a good thing.

Understanding Opioid Addiction

Prescription opioids are closely related to morphine, codeine and heroin. Commonly used opioids include methadone, hydrocodone and fentanyl. One of the most frequently prescribed remedies, oxycodone, is twice as powerful as morphine.

Synthetic opioids attach to receptors in the brain so that your perception of pain is altered. If you have a legitimate need for them on a short-term basis, they’re a godsend. However, they have great potential for becoming addictive.

Synthetic Opioids are Addictive

Dopamine is a natural feel-good chemical that gives you a warm sense of pleasure and reward when you’re enjoying yourself. In mentally healthy people, it’s always at just the right dose.

In addition to relieving pain, opioids signal your brain to increase production of dopamine. The excess might result in a rush of intense euphoria. There’s a severe letdown when the sensation wears off.

People become addicted to opioids when they try to duplicate that initial high by increasing the dose or combining pills with other drugs like alcohol. The body quickly builds tolerance, and the vicious cycle of addiction begins.

That’s why lawmakers are so concerned about doctors over-prescribing painkillers. The practice results in millions of loose pills being abused or falling into the wrong hands.

Are You Addicted?

You may have an opioid addiction if you’ve experienced even one of these symptoms:

Taking opioids after your pain has subsided
Taking higher doses than prescribed
Taking opioids that aren’t prescribed to you
Trying without success to stop
Using opioids recreationally
Combining opioids with other substances
Craving opioids when you’re not using them
Lying about opioid use
Becoming defensive when friends or family members express concern
Sleeping during waking hours
Experiencing irritability, mood swings or depression

Your chances of becoming addicted are significantly higher if you have a mental problem such as depression, anxiety or eating disorder. You’re also at greater risk if anyone in your family struggles with substance abuse. Traumatic events in your past, like divorce, domestic violence or rape, will also make you more susceptible to opioid addiction.

Getting Help for Addiction

Substance abuse can start with one bad decision, but after that, the painkillers take over. Like other drugs, they teach your brain to crave them.

Drug addiction is a chronic disease with no cure, but it can be managed just like asthma or diabetes can. Just as people become addicted every day, people start to recover every day.

Choosing Desert Cove Recovery for Help With Opioid Addiction

Our caregivers at Desert Cove Recovery have years of experience with people just like you. Our comprehensive treatment plans utilize time-tested approaches that help recovering addicts stay clean for good:

The 12-step model
Cognitive behavioral therapy
Individual and family counseling
Group meetings
Holistic approaches such as prayer, meditation, yoga, art, music or massage
Exercise classes and outdoor activities
Nutritional instruction

With professional help, you can break free from the grip of opiate addiction. Call Desert Cove Recovery today to speak with a caring counselor. We’ll tailor a unique treatment plan that’s just right for you.

Med Conference: Buprenorphine Effective for Addiction Treatment

Attendees at a presentation during Hospital Medicine 2018 learned that the drug buprenorphine is appropriate to prescribe for hospitalized patients with opioid use disorders. The same medication is also effective for treating the acute pain experienced by patients being treated using buprenorphine.

Significant Increase in Drug Overdose Deaths

Dr. Anika Alvanzo, from John Hopkins Medicine, made a presentation at the conference. She referred to the significant increase in drug overdose deaths over the past 20 years. The number of fatalities jumped from three percent per year between 2006-2014 and 18 percent per year in the years 2014-2016. Dr. Alvanzo said that a large number of these deaths can be linked to increased use of synthetic opioids.

Types of Prescription Pain Medications

While some people refer to opioids to describe all types of prescription pain medications, they differ in the way they are made.

• Opiates are natural pain medications that are derived from opium. The opium is extracted from the opium poppy and is used to make medications such as morphine and codeine.
• Synthetic opioids are manufactured by humans and include methadone and fentanyl.
• Semi-synthetic opioids are a hybrid made from making chemical modifications to opiates. Drugs in this category include oxycodone, hydromorphone and buprenorphine.

Buprenorphine Availability a Bridge to Treatment for Opioid Use Disorders

Dr. Alvanzo stated during her presentation that there are currently three medications approved by the Food and Drug Administration (FDA) for treating opioid use disorder: buprenorphine, naltrexone and methadone. She went on to say that when buprenorphine is prescribed to patients on discharge from hospital, it “significantly increases” the likelihood that the patient will seek professional treatment. Approximately 75 percent of patients were in treatment one month after discharge.

The doctor urged her colleagues attending Hospital Medicine 2018 to consider getting their buprenorphine certification so that they can order the drug within the hospital and at discharge for patients. She referred to buprenorphine availability as a “bridge to treatment” for opioid use disorders patients.

Bacterial Infection Hidden Epidemic, Taking Lives in Opioid Crisis

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.

Dentist Group Announces Policy to Cut Opioid Painkiller Prescriptions

The American Dental Association its members to reduce the number of opioid painkillers they are prescribing. The Association announced a new policy stating that members should “essentially eliminate” opioids from the list of remedies they have at their disposal, “if at all possible.”

Weekly Limits for Narcotics

The Association also wants to have a time limit put in place on prescriptions of no more than one week at a time. Under the new policy, dentists would be required to complete a mandatory education program that encourages use of other pain relievers.

Dentists Prescribe Most Opioids to US Teens

Dental practitioners are the leading source of opioid prescriptions for US teens, even though they write less than seven percent of opioid prescriptions in the US. During the period from 2010-2015, the most notable increase in dental prescriptions was for patients aged 11-18. The rate jumped from close to 100 per 1,000 patients to 165 per 1,000 patients. Among all age groups, the rate increased from 131 per 1,000 patients to 147 per 1,000 patients.

Other Options Shown to be Just as Effective

The number of opioid prescriptions written by dentists continues to rise even though evidence has shown that ibuprofen and acetaminophen control most dental pain effectively, according to an analysis conducted on five studies. The results were published in the Journal of the American Dental Association. These over-the-counter medications are less risky than opioids, which are addictive.

When dentists prescribe opioids, they tend to prescribe Vicodin or Percocet to relieve the short-term pain from procedures such as wisdom teeth extractions, dental implants and root canal work.

Dr. Paul Moore, Professor at the University of Pittsburgh’s School of Dentistry and the co-author of the analysis, said that the fact dentists are still prescribing opioids when other options are just as effective most of the time is “a little disturbing.”

The Association’s new policy supports requiring dentists to complete continuing education courses on limiting opioid use to retain their license. A number of states have already adopted this policy.

Hospitals Reduce Opioid Dispensing in Response to Epidemic

More hospitals are changing their policies about dispensing opioids to emergency room and surgical patients. Drugs like OxyContin, Vicodin and fentanyl, which are prescribed to temporarily provide relief for moderate to severe pain, have also caused irreparable damage. It’s difficult to determine how many people who currently have an addiction to opioids were first exposed to the drugs at a hospital, but it is often where people first encounter them.

Hospital patients aren’t the only ones who were at risk of becoming addicted to painkillers. People who were prescribed large amounts of this class of drugs would often end up with leftover pills. More than 50 percent of Americans who misuse opioids get them from friends or family members, according to the National Survey on Drug Use and Health.

Now there is an increasing number of hospitals and other medical practices that are reducing the number of pills being prescribed for pain. Doctors are saying that opioids are not the only choice for treating acute pain and that less potent options are often just as effective. In the past six months, Rush University Medical Center has given patients recovering from surgery ibuprofen, acetaminophen and gabapentin, which is used to treat nerve pain. A mild opioid medication is used to treat sharper spikes of pain and more acute pain.

Dr. Asokumar Buvanendran, a pain specialist at Rush University Medical Center, said that patients were “more satisfied” with the new protocol. It represents a trend that is hopefully leading more people away from these deadly drugs.

According to experts, opioid use skyrocketed in the 1990s when doctors started prescribing them to patients much more often. During this time, physicians were influenced in their choice to provide medicines in this class to patients by aggressive pharmaceutical company marketing tactics.

Rethinking Approach to Treating Pain

Most of the opioids were given to chronic pain patients. They were also the first choice for post-surgical pain or for patients visiting emergency rooms complaining of pain.

Doctors had the idea that drugs didn’t cause addiction; abusers were solely responsible for their own plight if they became addicted. Research has now shown that the properties of the drugs themselves change brain chemistry in users to cause the addiction.

New Opioid Prescribing Guidelines Help Doctors Make Better Decisions

Northwestern Medicine now talks to patients about the dangers of opioids before surgery. Patients are asked to bring any unused medication to follow-up appointments with their surgeon, so that the drugs can be disposed of safely.

All doctors in the state are required to enroll in a database to monitor painkillers and prescriptions that are commonly abused, a measure to seek out those who may be “doctor shopping” to get drugs. Some hospitals have similar in-house systems.

The Centers for Disease Control and Prevention has called for doctors to prescribe a maximum of seven days’ worth of opioids for patients to take home for acute pain. Many emergency departments today are only giving out 24 – 72 hours’ worth of pills.

While some chronic and severe pain patients may feel these tougher prescribing practices are prohibitive to their care, hopefully there is some comfort knowing that their inconvenience could be contributing to saving lives.

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