Category Archives: Prescription Drug Abuse

Number of Pregnant Opioid Addicts Surged Over Last 15 Years

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.

Xanax Abuse Rates Rising

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.

Dentists Offer Option to Opioids for Pain Relief and Fighting 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.

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.

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