OxyContin and Opioid Epidemic Settlement

When discussing the American opioid addiction epidemic, the name OxyContin is synonymous. The brand name of oxycodone, a powerful prescription opioid, is closely associated with our toxic relationship with painkillers in the United States. 

 

Even people who've never been prescribed an opioid are familiar with OxyContin. The drug was prescribed by doctors in large amounts from the mid-nineties onward. The drugmaker – Purdue Pharma – marketed OxyContin as safe for users; the company contended that it carried a low risk of addiction. 

 

Now 25 years later and tens of thousands of overdose deaths, OxyContin is anything but safe when prescribed in high doses for protracted periods. What's more, most of today's heroin users were introduced to opioids via drugs like oxycodone. Around 80 percent of people using heroin started down the path of opioid use disorder with prescription painkillers. 

 

In recent years, the prescription drug industry or "big pharma" has been asked to account for its role in creating the public health crisis we face today. From doctors to drug distributors to the makers of the drugs themselves, many entities are in the hot seat for the more than 450,000 Americans who have died from an overdose since 1999. 

 

While heroin and illicit fentanyl – a drug 100 times more potent than morphine – dominate the headlines today, the epidemic's origin goes back to rampant overprescribing dating back to the 1990s. According to the Centers for Disease Control and Prevention (CDC), many doctors continue to prescribe high doses of oxycodone across the country more than two decades later. 

 

In 2017, there were still almost 58 opioid prescriptions written for every 100 Americans; more than 17% of Americans had at least one opioid medication filled. More than 191 million opioid prescriptions were dispensed to Americans that year. 

 

OxyContin Maker Held Accountable

 

Last month, the U.S Justice Department and Purdue Pharma agreed regarding its role in the opioid epidemic. The pharmaceutical giant agreed to plead guilty to criminal charges and face penalties of around $8.3 billion, The New York Times reports. Members of the Sackler family – the owners of Purdue Pharma – agreed to pay $225 million in civil penalties. 

 

Purdue will plead guilty to felony charges of defrauding federal health agencies and violating anti-kickback laws, according to the article. The company will be ordered to pay $3.54 billion in criminal fines, $2.8 billion in civil penalties for violating the False Claims Act, and $2 billion in criminal forfeiture of profits. 

 

It's worth noting that there are thousands of pending lawsuits against Purdue Pharma. The agreement with the justice department could pave the way to a resolution in many of those cases. Steve Miller, chairman of the company board, said: 

 

"Purdue deeply regrets and accepts responsibility for the misconduct detailed by the Department of Justice in the agreed statement of facts." 

 

While more than $8 billion is a lot of money, there is little indication that the company will pay anything close to that because it filed for bankruptcy court protection when the lawsuits started piling up. What's more, there are some who feel that the agreement does not go far enough even though it did not preclude the filing of criminal charges against Purdue executives or members of the Sackler family. Maura Healey, the Massachusetts attorney general, said: 

 

"The D.O.J. failed. Justice in this case requires exposing the truth and holding the perpetrators accountable, not rushing a settlement to beat an election. I am not done with Purdue and the Sacklers, and I will never sell out the families who have been calling for justice for so long." 

 

Massachusetts is moving forward with depositions against the Sacklers this month. It will be interesting to see how the cases against Purdue Pharma plays out. It could set a precedent; it is not the only company facing lawsuits for impropriety related to prescription opioids. 

 

Opioid Use Disorder Treatment

 

Please reach out to Celebrate Hope if you are struggling with prescription opioid or heroin addiction. We can help you break the cycle of addiction and get on the path toward healing. Opioid use disorder is treatable and recovery is possible

Enough Fentanyl to Kill 26 Million People

Opioid use disorder is a treatable mental illness; those who undergo treatment and commit themselves to working a program of recovery can lead productive lives. While useful forms of treatment are available, many find it difficult to seek help due to the intense cravings typical of opioid addiction. Everything that public health officials can do, must be done, to encourage as many people as possible to seek addiction treatment—the risk of overdose death is notoriously high.

Many of you are probably aware that the likelihood of fentanyl exposure among heroin addicts is exceedingly high. With each year that passes, more and more people succumb to fentanyl exposure, an analgesic that is 100 times more potent than morphine and 50-80 times stronger than average batches of heroin. When people cut heroin with fentanyl, the result is a deadly cocktail. In fact, research shows that fentanyl-related deaths more than tripled between 2010 and 2016.

One of the reasons fentanyl is more prevalent than ever is because cartels in Mexico can synthesize the drug with ease. Drug cartels acquire the necessary precursors from Asia and then chemists south of the border manufacture the hazardous substance. Once in powder form, the drugs is either stamped into pills disguised as highly coveted OxyContin or cut into batches of heroin to boost potency. In either case, opioid users on this side of the border have no way of knowing that the drug they are about to ingest, smoke, snort, or inject contains the presence of fentanyl.

Fentanyl is Everywhere

So just how likely is it that people will come in contact with fentanyl? Highly likely! The drug made the headline once again after a Nebraska State Trooper pulled over a truck hauling 118 pounds of the deadly substance, CNN reports. The U.S. Drug Enforcement Administration (DEA) states that 2 milligrams of fentanyl is a lethal dose; a little math shows that there was enough fentanyl confiscated to kill roughly 26 million people.

"This year is going to be a banner year, a record year in a bad way, in overdose deaths in the United States," said Matthew Barden, an associate special agent with the ‎DEA.

Naloxone is a drug that can reverse the deadly symptoms of an overdose; unfortunately, fentanyl is so potent that it often doesn’t work and people die. When a fentanyl overdose is reversed, first responders often have to give victims multiple doses of the drug. Pharmacies sell naloxone under the name Narcan. Fentanyl is only going to be more prevalent in the coming years. Anyone caught in the destructive cycle of opioid use disorder should seek help immediately and begin working a program of addiction recovery.

 

Southern California Opioid Use Disorder Treatment

Celebrate Hope at Hope By The Sea can assist anyone struggling with an opioid use disorder. We can help you end the cycle of addiction, please contact us today.

Cocaine and Fentanyl Overdose Death Concerns

Cocaine, unlike heroin, is considered a party drug by most people despite the fact that it’s highly addictive and can cause an overdose. Heroin is used mostly in relative secrecy, whereas cocaine is something far more socially acceptable. People are far less likely to feel the need to be discreet; it’s a drug that is regularly passed around at parties.

Two drugs, heroin and cocaine, both addictive and hazardous to one’s health yet one of the drugs is cast in a far darker light. One might argue that the discrepancy is for a good reason; after all, a far more significant number of overdose deaths stem from opioids than stimulants like cocaine. People consider cocaine as being safer than heroin resulting in increased social acceptance. More than a hundred people aren’t dying from cocaine overdoses every day.

While heroin and opioids, in general, are deadlier than cocaine, the latter is used more often—especially for recreation. The potential for cocaine misuse and abuse is significantly higher, and the drug is commonly used in conjunction with other substances as well, mainly alcohol. You may not associate cocaine with overdose, but it was involved in thousands of deaths in past several years across the country.

 

Cocaine with a Side of Fentanyl

Mixing stimulants and opioids occurs on a regular basis among people with opioid use disorder. However, your average social cocaine user flirts with opioids only on rare occasions. If offered a “downer,” most people who use cocaine recreationally will say, “no thanks.” Which is why a new trend has people concerned, the heightened prevalence of cocaine laced with fentanyl. Having an opioid "tolerance" and being exposed to fentanyl is dangerous enough, for those without a tolerance—overdose is almost a guarantee.

In New York, 37 percent of overdose deaths in 2015 involved cocaine and fentanyl; heroin was not part of the equation. Officials see cocaine and fentanyl admixtures outside the Empire State; cocaine samples tested positive for the synthetic opioid in both Nashville and Knoxville, Tennessee, USA Today reports. Anyone who uses or abuses cocaine should understand that the stakes just got higher.

“To be blunt, what you might buy and use [cocaine], thinking it’s a good time, could cost you your life,” warns T.J. Jordan, Assistant Director of the Tennessee Bureau of Investigation: Drug Investigation Division. 

Overdose death can easily happen without the introduction of synthetic opioids. Fentanyl and carfentanil, an even stronger analog, are being mixed with other drugs frequently these days. Naloxone, to make matters worse, is not enough to reverse an overdose in many cases. The only 100 percent effective way to avoid the risk of overdose is addiction treatment and working a program of recovery. Perhaps the most concerning feature of this new trend:

“Those that are using cocaine recreationally, their usage is going to increase because of the physical addictive aspects of opiates are being injected into the cocaine,” said Patrick O’Shea, a former recreational drug user. “It’s shaping up to be a disaster.”

 

Recovery is the Solution

Those caught in the vicious cycle of substance use disorder face great risks today. Fentanyl isn’t going anywhere and is likely to become more prevalent. Seeking addiction treatment and recovery is the only sure way to avoid exposure to fentanyl. Please contact Celebrate Hope at Hope by The Sea to begin the life-saving mission of addiction recovery.

Fentanyl Salesmen Arrested for Kickback to Doctors

An aspect of the prescription opioid epidemic that is often ignored is the role of pharmaceutical salesmen. These are people who are employed by pharmaceutical companies to travel around the country enticing doctors to prescribe their medical product. Now, it stands to reason that a physician's willingness to prescribe a drug should be based off of the drug's effectiveness at treating a specific condition—and in a perfect world that may be the case. However, doctors are often times given huge incentives to prescribe one medication over another, a practice which surely had a hand in the rampant over prescribing of drugs like OxyContin (oxycodone).

In the wake of the beloved pop star Prince’s death, attention has been redirected back to the powerful opioid analgesic fentanyl. Many Americans may have never heard of fentanyl as the drug is not commonly used outside of hospital settings. Those who had heard of the drug before may have been unaware that fentanyl is 100 time more potent than morphine. Fentanyl, while fast acting and highly effective, can cause severe respiratory depression that can be fatal; this is why it should be scarcely used except under the close supervision of doctors and nurses.

In an attempt to stem the tide of irresponsible prescribing practices, law enforcement has begun to set their sights on pharmaceutical salesmen. Recently, two former pharmaceutical salesmen were arrested from charges stemming from paying doctors to prescribe a form of fentanyl, USA Today reports. The two salesmen, who worked for Insys Therapeutics, allegedly paid two doctors in the New York-area $259,000 in kickbacks to prescribe Subsys.

Most fentanyl prescribed for take home use comes in the form a transdermal patch. The patches are adhered to one’s skin—slowly releasing the drug throughout the course of the day. Subsys, on the other hand, is sprayed under the tongue, according to the article. The spray version of fentanyl works quickly, relieving pain in just five minutes.

"You have this hyper-powerful drug marketed intensely, aggressively and shamelessly without any sense of the addictive and lethal power of what is being sold," said Arthur Caplan, the director of medical ethics at NYU Langone Medical Center in New York.

We will continue to follow the fentanyl story. Stay tuned. 

Coroner's Report: Fentanyl Caused the Death of Prince

This past April, millions of people around the United States and across the globe were shocked to learn that Prince Rogers Nelson, more widely known as Prince, died at the relatively young age of 57. While it was unclear as to the cause of the pop singer's death, many were convinced that the superstar passed away from drug related issues. It probably comes as little surprise that Prince suffered from pain after decades of high energy performances, and it was widely known that he endured a hip injury that required pain medication.

Prince had been known to lead a clean life, refraining from mind altering substances over the years, which made it hard for many to believe that his death could be the result of a drug overdose. Now, two months later, the coroner's report has come out, and the cause of his death was an overdose of the powerful opioid analgesic fentanyl, CNN reports. It is likely that you have heard news reports about the drug in recent years, as fentanyl is commonly mixed with heroin to increase potency—resulting in a wave of overdoses across the united states.

Just to put the drug into perspective, fentanyl is around 80 to 100 times stronger than morphine and roughly 40 to 50 times more potent than pharmaceutical grade (100% pure) heroin. The drug is known to cause severe respiratory depression even in small doses—rife for the potential of overdose. Heroin users, more often than not, have no idea that the “dope” they are about to snort or inject is laced with fentanyl; being unaware of the presence of the powerful analgesic, users will dose themselves out as they normally would—ignorance that can prove deadly.

Authorities are still trying to determine where Prince acquired the fentanyl that led to his death, according to the article. To be sure, it could have come from only one of two places. Either a physician wrote him a prescription for fentanyl to treat his pain, or he acquired the drug through illegal channels. Fentanyl is being produced in clandestine labs, typically overseas in countries such as China where it is easy for chemists to acquire the requisite precursors. The drug is then shipped out of China, finding its way to Mexico where it is then moved north of the border.

Without a doubt it is important authorities find Prince’s source; however, where the drug came from will not bring the beloved artist back—as is the case with the thousands of Americans who lose their life in this country from prescription opioid and heroin overdoses. What’s more, Prince’s death, much like Michael Jackson's and a number of other stars' deaths in recent years, drives home the point that everyone is eligible for addiction—and all who use opioids are at risk of overdose. Every day in the United States alone, over 70 people succumb to opioid overdose deaths.

Is W-18 Too Powerful for Naloxone?

Over the last few years there have been a number of deadly cases of heroin laced with fentanyl overdoses. Fentanyl is a powerful opioid analgesic, typically used in a hospital setting for either surgery or the most severe pain. The drug is roughly 80 to 100 times more powerful than morphine and around 40 to 50 times more potent than pharmaceutical grade heroin, according to the Centers for Disease Control and Prevention (CDC). With potency like this, it is easy to see that mixing fentanyl and heroin together is a sure recipe for disaster.

Fentanyl is now being produced in clandestine labs in China, shipped to Mexico and mixed with inferior grades of heroin to increase potency. Heroin users in the United States are often times unaware of the deadly admixture when they use, so they do not adjust their dosage accordingly—overdose often ensues. You might find yourself wondering if there could be a more deadly amalgamation. The answer to that question, unfortunately, is yes.

A drug that could be as many as 10,000 times more potent than morphine is possibly being mixed with heroin in the Philadelphia area, The Philadelphia Inquirer reports. The drug, known as W-18, may be too powerful for the opioid overdose drug naloxone to reverse. The Drug Enforcement Administration (DEA) has released a bulletin warning of the dangers associated with mixing W-18 with other drugs, such as heroin. The agency pointed out that a microscopic dose of W-18 could be fatal.

Recently, anesthesiologist Anita Gupta, who works as a pharmacist and pain specialist at Drexel University College of Medicine, began seeing cases of overdose where patients didn’t have the typical response when naloxone was administered. Gupta’s suspicion for the atypical response was the presence of W-18.

“The symptoms were worse than we were used to seeing,” said Gupta. “We were getting patients with symptoms of near-death, and often required multiple doses of the antidote naloxone.”