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Friday, September 25, 2015

The Treatment of Addiction Involving Opioid Use

America's opioid crisis has resulted in an exponential increase in those who require substance use disorder treatment. This means the need for effective, evidence based treatment modalities has never been greater. In recent years, with recommendations from a number of health agencies, many treatment programs have adopted medication assisted treatment (MAT) approaches when treating opioid addiction. The use of medications, along with in psychosocial therapies, has shown the most promise.

The American Society of Addiction Medicine (ASAM) officially released its National Practice Guidelines for the Use of Medications in the Treatment of Addiction Involving Opioid Use and related products, ScienceDaily reports. The new guidelines should aid treatment programs in providing more effective therapies.

"Suboptimal treatment has likely contributed to expansion of the epidemic as well as concerns for unethical practices," writes Drs. Kyle Kampman of the University of Pennsylvania School of Medicine and Margaret Jarvis of Marworth Alcohol and Chemical Dependency Treatment Center.

"At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it." The skill and time needed for effective use of medications for opioid use disorders "are not generally available to primary care doctors."

The guidelines include:
  • Alter Prescribing Patterns for Pain Medication
  • Expand Access to Naloxone
  • Expand and Standardizing Medication-Assisted Treatment (MAT)
"This Practice Guideline was developed to assist in the evaluation and treatment of opioid use, and in the hope that, using this tool, more physicians will be able to provide effective treatment," writes Kampman and Jarvis.

The new evidence-based recommendations are published in the Journal of Addiction Medicine.

Friday, September 18, 2015

Officials Take Down A Major Synthetic Drug Ring

The eastern coast of the United States has become the front line in the fight against synthetic drugs, primarily South Florida and New York. The bulk of synthetic drugs is being manufactured in China, and then shipped to the U.S. to be distributed. Both lawmakers and law enforcement are attempting to stem the flow of these insidious drugs which have been known to lead to unpredictable side effects.

On Wednesday, law officials delivered a huge blow to a major synthetic drug ring in New York, TIME reports. It is alleged that the ring unlawfully imported 100 kilograms of synthetic compounds used to make synthetic marijuana. There was enough material to produce about 260,000 drug packets which would retail for about $30 million.

Altogether, five synthetic drug processing facilities and warehouses were raided, along with more than 80 stores and bodegas around New York City, according to the article. Using commercial delivery routes, the compounds synthesized in China were shipped to a processing facility in the Bronx. The chemicals, along with other solvents, are sprayed onto tea leaves.

“Despite sometimes being called synthetic marijuana, this is not marijuana – it can have unpredictably severe and even lethal effects,” Preet Bharara, U.S. Attorney for the Southern District of New York, said in a statement. “What is more, use of these drugs aggravates all manner of other societal ills: it is entering prisons; preying on the homeless; burdening our hospitals and emergency rooms; fueling addiction; exacerbating mental health problems; and increasing risks to cops who must deal with people high on this poison. Synthetic cannabinoids are a deadly serious problem that demands an equally serious response.”

Friday, September 11, 2015

Fentanyl Makes Heroin Deadlier

If you have ever undergone surgery, then there is a good chance that you were given a powerful opioid analgesic called fentanyl. The drug is highly effective at combating severe pain, and is reported to be 100 times stronger than morphine. Fentanyl is primarily used in hospital settings, but it is also available in transdermal patches for home use. Naturally, the drugs potency makes it an ideal drug for opioid addicts, but it comes with a heightened risk of overdose.

As opioid overdose rates continue to climb all over the country, the result of prescription painkiller and heroin abuse, it is hard to imagine that heroin dealers have been lacing heroin with fentanyl. The mixing of the two drugs is amplifying the overdose crisis, NPR reports.

Dealers are lacing heroin with fentanyl because diluted batches of heroin often lack the potency that users require. Fentanyl exponentially increases the potency of heroin. If an IV heroin user is unaware that fentanyl is present, they are at an increased risk of overdose and potential death.

Between late 2013 through 2014, federal officials report that there were at least 700 fentanyl-related deaths, according to the article. It is likely that the death toll will continue to rise because a form of fentanyl, known as acetyl fentanyl, can be synthesized relatively easily by Mexican cartels. Federal agents report that the cartels have increased production and are smuggling the powerful drug across the border along with heroin.

“Heroin is bad enough, but when you lace it with fentanyl, it’s like dropping a nuclear bomb on the situation,” Mary Lou Leary, a deputy director in the White House’s Office of National Drug Control Policy, told NPR. “It’s so, so much more dangerous.”

Friday, September 4, 2015

Judge Halts Lawsuit Against Big Pharma

For over a decade pharmaceutical companies have profited from people’s addiction to opioids. While it is a little bit harder today, it is still quite easy to get written a prescription for a highly addictive opioid for a minor ailment. The nation has seen firsthand the damage caused by opioid misuse and addiction, leading to thousands of overdoses and a rise in heroin use. The number of people requiring substance use disorder treatment for opioids has skyrocketed in recent years, a cost which mostly falls on state budgets. Some are of the opinion that “big pharma” should cover the cost of the damage their drugs have cost.

Last year, two California counties filed a lawsuit against five (5) major pharmaceutical companies, calling on them to pay for the damages resulting from the prescription opioid epidemic. Sadly, both Orange and Santa Clara counties received a blow last week, when a judge halted the lawsuit, The Los Angeles Times reports. The halt was due to a pending FDA inquiry into the safety and efficacy of painkillers.

"The FDA is not going to help us with this," said Orange County Dist. Atty. Tony Rackauckas. "This is a plague on our society. The suffering goes on day in and day out." 

The pharmaceutical companies in question asked Court Judge Robert J. Moss to dismiss the suit based on the grounds that the FDA had exclusive jurisdiction over the matter, according to the article. Purdue Pharma lawyer Lisa Gilford pointed out that if the case continued forward it would only serve to duplicate FDA efforts, and a decision could be rendered that was at odds with the FDA. Purdue stated:

"We are pleased Judge Moss agreed that complex scientific issues regarding the treatment of chronic pain are best decided by the FDA, the agency with relevant expertise."
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