Opioid Overdose Deaths Among Latinos

"I'm a serious addict," Julio Cesar Santiago (44), tells NPR. "I still have dreams where I'm about to use drugs, and I have to wake up and get on my knees and pray, 'let God take this away from me,' because I don't want to go back. I know that if I go back out there, I'm done."

The above quote is likely to resonate with anyone who lives with alcohol or substance use disorder and finds addiction recovery. In early recovery, most people kneel and pray regularly throughout the day; the gravitational pull of drugs and alcohol is a force to be reckoned with requiring eternal vigilance to prevent relapse. While all mind-altering substances carry inherent risks of injury and premature death, one could argue that opioids exist in a separate class with exponentially higher stakes.

The American opioid addiction epidemic remains as one of the chief public health concerns. Many of you are aware that roughly a hundred people perish from an overdose each day usually stemming from prescription opioids, heroin, or fentanyl (a synthetic opioid approximately a hundred times stronger than morphine). Almost 3 million American battle opioid use disorder, an estimate that some experts feel is probably conservative. One of the ways researchers develop stats on how many people are struggling with a condition is by the number of individuals that receive treatment. Given that the vast majority of people living with addiction never access care, it is hard to develop an accurate picture of the problem. Even still, we can confidently assert that more than 2 million people are bound to OUD in this country.

Opioid Use Disorder, Overdose, and Latinos

Most of the news about the epidemic focuses on the disproportionate number of non-Hispanic whites suffering from opioid use disorder and dying of an overdose. As a result, the media and many experts overlook specific demographics struggling with opioids, especially Latinos. In fact, research shows that opioid overdose deaths among Latinos is on the rise nationwide, and in Massachusetts, ODs are increasing at twice the rate of whites and blacks, according to NPR. The Centers for Disease Control and Prevention(CDC) reports that Latino overdose deaths rose 52.5 percent between 2014 and 2016, as compared to 45.8 percent for whites.

"What we thought initially, that this was a problem among non-Hispanic whites, is not quite accurate," says Robert Anderson, mortality statistics branch chief at the CDC's National Center for Health Statistics. "If you go back into the data, you can see the increases over time in all of these groups, but we tended to focus on the non-Hispanic whites because the rates were so much higher."

It is challenging to extrapolate what's behind the surge in opioid overdose deaths among Blacks and Hispanics. After conducting scores of interviews with addicts, physicians, and treatment providers a more precise picture emerged; a lack of bilingual treatment options, cultural barriers, and possible deportation fears likely have a hand in the growing death toll. What’s more, NPR points out that the Substance Abuse and Mental Health Services Administration (SAMHSA) website is only available in English; however, they do offer a toll free number "for free and confidential information in English and Spanish for individuals and family members facing substance abuse and mental health issues." Mind you, that it's SAMHSA's responsibility to improve the quality and availability of treatment and rehabilitative services.

Opioid Use Disorder Treatment

If you are suffering from addiction and a co-occurring mental health disorder, please contact Celebrate Hope at Hope by The Sea. We can help you end the cycle of addiction and provide you with the tools and skills necessary for achieving lasting recovery.

1 Million Heroin Users in America

Grim news was printed this week, courtesy of The New York Times. And, once again opioids are at the center of the discussion. Preliminary data compiled by the newspaper indicates that drug overdose deaths in America probably exceeded 59,000 last year. Unless something drastic is done soon, this is a trend that will likely continue in the coming years.

People are dying. Opioid use disorder, or opioid addiction is the root of the problem. Yet, in 2017, nearly twenty years into the 21st Century, millions of Americans still struggle to access addiction treatment services. Even when they want help. In rural America, the closest addiction treatment center is sometimes hundreds of miles away. Given that fact that many opioid addicts are at the lower end of the socioeconomic scale, the likelihood of traveling such distances for help is slim to none.

In addition to a lack of treatment options, many addicts still have hard time getting naloxone, the opioid overdose reversal drug that has saved thousands of American lives, and will continue to do so. But, getting the drug without a prescription is still not possible in certain places. Even if one can acquire it, affording the medicine is a whole different story. Perhaps you've heard the news about ever-increasing naloxone prices. Wherever you find demand, you find greed.

 

An Epidemic That Costs Billions

Prescription opioids are still a problem, to be sure. Yet, heroin use has steadily increased in recent years. What’s more, the mixing of heroin and fentanyl has become a common occurrence. Users who don’t know their heroin was mixed with the deadly painkiller are at great risk of overdose death. There are an estimated 1 million people actively using heroin in America today, according to a University of Illinois at Chicago press release. All told, heroin use in the United States costs society $51 billion in 2015. The costs are tied to:

• Addiction Treatment
• Heroin-related Crime
• Imprisonment
• Treating Chronic Infectious Diseases
• Treating Newborns with Neonatal Abstinence Syndrome (NAS)
• Overdose Deaths
• Lost Job Productivity

“The downstream effects of heroin use, such as the spread of infectious diseases and increased incarceration due to actions associated with heroin use, compounded by their associated costs, would continue to increase the societal burden of heroin use disorder,” said UIC pharmacoeconomists, Simon Pickard.

 

The Greatest Cost Is Life

Loss of productivity pales in comparison to the staggering death toll that could be reduced by increasing access to addiction treatment services. The longer one goes without treatment, the greater the chance of an overdose. If you are struggling with addiction to any form of opioids, please contact Celebrate Hope at Hope By The Sea today.

Our highly-trained staff specializes in the treatment of opioid use disorder. The opioid addiction epidemic is the most serious drug crisis the world has ever seen, and putting an end to it starts with treatment.

Reversing Overdose Has A Heavy Price

In a perfect world, opioid addicts would have free-access to the lifesaving drug naloxone. The drug can reverse the deadly effects of an opioid overdose, and one could argue that doctors should co-prescribe naloxone when they write an opioid prescription and community outreach programs should handout naloxone free to heroin addicts who cannot afford to buy it from a pharmacy. Sadly, that is not the world we live in, but some lawmakers in the United States have been fighting to expand access to the miracle drug, which has proved difficult because of price.

If one were looking to buy naloxone, they can expect to pay upwards of $150 for two doses. Certainly, you cannot put a price tag on life, but if you can’t afford the naloxone kit you may lose yours. Lawmakers have received a lot of pressure from addiction experts to reign in the ever-increasing price of the lifesaving drug. This week, experts called on the government to act in The New England Journal of Medicine, according to HealthDay. The experts write:

“Naloxone’s price increase is part of an overall trend of increasing prescription-drug prices for both new brand-name drugs and old, off-patent generics. Public frustration with rising drug prices has led to a number of recent policy proposals, including Vermont’s new legislation requiring companies to justify price increases, California’s attempt to constrain drug payments, and the recently proposed and bipartisan-supported Fair Accountability and Innovative Research Drug Pricing Act. None of the federal or state initiatives expanding naloxone’s availability, however, address the drug’s rising cost.” 

Part of the issue is that there are limited options. An increase in demand for the drug has the expected effect of drug makers seeing an opportunity to increase profit, regardless of the deadly consequence of people being unable to afford the drug. Here are the numbers:

• Hospira (a Pfizer Inc. company) charges $142 for a 10-pack of naloxone —a 129 percent increase since 2012.
• Amphastar's 1 milligram version of naloxone costs around $40—a 95 percent increase since September 2014.
• A two-dose package of Evzio (naloxone) costs $4,500, a more than 500 percent increase over two years.

“The challenge is as the price goes up for naloxone, it becomes less accessible for patients,” said study lead author, Ravi Gupta, a fourth-year Yale medical student. "Taking action now is essential to ensuring that this lifesaving drug is available to patients and communities."

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.”