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.

Raising Awareness About Overdose Deaths

As things stand right now, experts believe that there will be more overdose deaths in 2017 than last year. Before this year comes to an end, over 50,000 more Americans will likely succumb to an overdose. Just to give you an idea of the staggering death toll, 64,000 people died of an overdose in 2016. That is 11, 596 more Americans than the year before (52,404). We probably do not have to mention that the cause of these terrible incidents was opioid narcotics. Such as prescription opioids, heroin and synthetics like fentanyl (100 times stronger than morphine).

With ever-mounting opioid-related morbidity rates, it’s fair to say that this problem demands the attention of every American. And that all of Us, can have a hand in raising awareness about opioid addiction and treatment. Particularly regarding the fact that treatment works and addiction recovery is possible. Believe it or not, many of the afflicted do not think that they can break the cycle of addiction. It is a belief that is often fortified by individuals' attempts to abstain from opioids on their own. That is, not having the aid of medical detox and addiction treatment professionals. Without assistance, relapse is almost always a given. Being more a question of “when,” rather than “if.”

Even if someone manages to get past the acute withdrawal stage on their own, which is possible (believe it or not), the likelihood of achieving long-term recovery is slim. The pull of opioids is extremely strong, and without a Program and a “higher power” to rely on, relapse is usually a foregone conclusion. Which is why lawmakers, health experts and local clergymen to double their efforts to encourage people with opioid use disorders to seek assistance.

 

#2069 Opioid Overdose Deaths

In the wake of last year's overdoses, Rev. Ron Tibbetts of the Trinity Episcopal Church in Wrentham, MA, decided to launch a novel campaign. In 2016, the state of Massachusetts lost 2,069 of its citizens to opioid-related overdoses, The Boston Globe reports. Upon learning of the startling figure, Rev. Tibbetts started the #2069 sign campaign to raise awareness.

Here’s how it works; the church has made simple lawn signs that people in Mass can order to place in their yard. The signs have a white background with “#2069” on them, intended to be stark and bleak, according to the Reverend. Signs can be purchased by making a $12 donation which will go towards an awareness rally the church is holding on Oct. 28, 2017, The Globe reports. Called No Shame 2017. The event is meant to raise opioid awareness and recognize first responders who have been assisting overdose victims. By the end of August, some 277 signs had been ordered from the Trinity Episcopal Church.

“It’s empowered us to become a lot more aware of the world around us,” said Tibbetts.

 

Addiction Recovery

The work of Trinity Episcopal Church is just one example of houses of faith doing their part to address the epidemic. Across the country, churches have been opening their doors to addicts with nowhere else to turn. At Celebrate Hope we commend the good works happening in Mass, and would like to help spread the message that addiction recovery is possible with the help of Christ. If you are struggling with opioids please contact our faith-based residential addiction treatment center. We can help you break the cycle of addiction and help you re-establish contact with your higher power.

Methamphetamine Induced Stroke Among Young People

Verily, there isn’t a narcotic without inherent risks. Each of us knows this to be true. Even if you have never been touched by addiction, you know someone whose life was turned upside down by substance misuse. Untreated substance abuse will ultimately end with institutions and premature death. That does not need to be the case though. There is treatment available to those who would seek it, but most will never get the chance. However, if you are reading this it means that you still can find recovery.

These days we seem to give almost exclusive attention to prescription opioids, heroin and synthetics like fentanyl or carfentanil. And for good reason, the epidemic we have been confronting for nearly two decades is like nothing we have ever faced before. Over a hundred Americans lose their lives every day from overdose. The government has declared a state of emergency, with lawmakers and health experts being confounded over what to do about it. But, the essential solution (which has been under-utilized) is providing greater access to treatment. Better educating doctors and patients about the dangers of opioids to prevent future use disorders and potential overdoses. Because at the end of the day, ours is a problem of addiction. Preventing it, and treating the disease will save lives.

When focusing on the opioid addiction epidemic we must not take our eye off some of the other narcotics both ruining and taking lives. In many ways, like the somnolence typified by opioid use, the epidemic has put us in a state of sleepiness regarding other substances. You know, not too long ago all the talk was about methamphetamine. Once called the most deadly and pernicious substance being abused by Americans. But a combination of numerous factors caused many Americans to think that the tide of the meth epidemic had been stemmed. Which makes sense, after all everyone was talking about meth — then they weren’t. So, meth must not be a problem anymore, right?

 

Meth Hasn’t Gone Anywhere, We Stopped Talking About It

Not for nothing, addiction has been around forever. But when it takes people’s lives in overwhelming numbers at young ages, people seem to give it more credence. Such was the case with opioids. As the death toll continued to mount with each year that passed, we were all forced to confront the opioid epidemic. Especially when people from nearly every demographic are dying every day. Unfortunately, while we were all focusing on opioids, cocaine and methamphetamine use continued and increased with few taking notice. Perhaps some new research will cause people to divert their attention from opioids for a moment.

A review of research, published online in the Journal of Neurology Neurosurgery & Psychiatry, indicates a heightened risk of stroke among young people who use meth, BMJ reports. This is concerning considering that methamphetamine use is on the rise, especially in North America. Methamphetamine can be swallowed, inhaled, or injected. Swallowing and injecting meth was associated with Haemorrhagic strokes (bleed into the brain) risks. Whereas, inhalation was linked to ischaemic stroke (caused by a clot).

“With the use of methamphetamine increasing, particularly more potent forms, there is a growing burden of methamphetamine related disease and harms, particularly among young people, in whom the majority of methamphetamine use occurs,” the researchers wrote. “Indeed, it is likely that methamphetamine abuse is making a disproportionate contribution to the increased incidence of stroke among young people observed over recent years.”

 

Methamphetamine Treatment

Meth addiction, as you can see, can lead to premature death. It may not be as common as opioid overdose, but worth everyone's focus. This is not just a drug that makes people “hyper” and rots out one’s teeth. The caustic effect it has on the human body can be fatal. If you are addicted to methamphetamine, please contact Celebrate Hope at Hope by The Sea to discuss treatment options. Recovery will save your life.

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.

Ocean Holds Opioid Alternatives

In the United States, we are in desperate need of opioid alternatives when it comes to the treatment of pain. It is fair to say that the problems we face with opioid addiction today, would not be so severe if opioid painkillers were not so effective. Calls to look for alternative forms of pain management have been loud in recent years, yet physicians may be scratching their heads about what to prescribe instead. Unfortunately, many pain sufferers do not respond to meditation and acupuncture. And frankly, severe pain can require the use of powerful opioids.

Those tasked with developing opioid alternatives for pain relief are researchers at any one of a number of colleges/universities around the country. But effective research requires large teams working thousands of hours. The point being, finding opioid alternatives could take years to accomplish—when we need solutions now. Nevertheless, researchers trudge sedulously to find such alternatives, sometimes looking for answers in the strangest of places.

A number of medications currently used today have their origins in the tropical rain forests of the world. But when it comes to pain management, new options may be residing in the deep blue sea. Meet Conus regius, a species of sea snail that is both predatory and venomous.

Conus regius (Credit: Zsnapper)

Researchers at the University of Utah have isolated a compound from the snail's venom that acts on a pain pathway different from the pathway targeted by opioid painkillers, GEN reports. The compound, RgIA4, was successful at blocking alpha9alpha10 nicotinic acetylcholine receptors (nAChR) pain pathway receptors in rodent models. The research was published online in the Proceedings of the National Academy of Science.

"RgIA4 works by an entirely new pathway, which opens the door for new opportunities to treat pain," said J. Michael McIntosh, M.D., professor of psychiatry at the University of Utah Health Sciences. "We feel that drugs that work by this pathway may reduce the burden of opioid use." 

The Conus regius sea snail could be vital for the development of new painkillers that do not carry the same risks as opioids. What’s more, while RgIA4 works its way through the body in only 4 hours, the pain-relieving effects of the compound were still working 72 hours after the injection, according to the article. Dr. McIntosh points out that the majority of painkillers used today are not sufficient in addressing chronic pain. Better alternatives may be found in the ocean. Really exciting stuff.

“Nature has evolved molecules that are extremely sophisticated and can have unexpected applications," says Baldomera Olivera, Ph.D., professor in biology at the University of Utah. "We were interested in using venoms to understand different pathways in the nervous system."

Cocaine, Heroin and Overdose

For an addict, there is such a thing as “more high.” Even if tolerance says otherwise. With some drugs, such as marijuana, a continued effort to increase one’s euphoria may not be that dangerous. But for drugs like prescription opioids or heroin, riding the line between intoxication and overdose is never in one's best interest—but highly sought after. What is considered to be a good high, can quickly turn into a deadly overdose.

The death toll related to drug abuse is almost always focused on opioid narcotics these days. While such drugs do not need any help with regard to being dangerous, addicts will commonly mix opioids with other narcotics, sometimes “uppers” and sometimes with more “downers.” It is quite common for people who mix opioids with benzodiazepines to experience a fatal overdose. However, there is another trend that has the power to take one’s life, commonly referred to as “speedballing.” That is mixing opioids and cocaine together, to be injected simultaneously. You may be aware that a number of celebrities have lost their life to the admixture, including:

• John Belushi
• Chris Farley
• Philip Seymour Hoffman

The general public almost never hears about cocaine anymore, being overshadowed by drugs like heroin and fentanyl. If you did hear about cocaine, it is likely that it was because somebody famous died using the drug recently. But make no mistake, cocaine abuse is still a very real problem affecting many Americans. And for those with an opioid use disorder, who are finding that their tolerance is making it difficult to experience euphoria, cocaine might be the solution they consider. Anyone who has ever done a speedball will tell you that there is no other high quite like it, or as dangerous.

While cocaine use rates have been down in recent years, the U.S. Drug Enforcement Agency's (DEA) 2016 National Drug Threat Assessment has shown a significant increase in cocaine-related overdose deaths in recent years, according to the U.S. News & World Report. Cocaine can be deadly on its own; but when mixed with opioids the drug becomes exponentially more fatal.

“When there are no opioids involved in cocaine-overdose deaths you see an overall decline in recent years,” says Christopher M. Jones, an acting associate deputy assistant secretary with the Department of Health and Human Services. “But when you look at cocaine and opioids together, we see a more than doubling in the number of overdoses since 2010, with heroin and synthetic opioids increasingly involved in these deaths."

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."

The Naloxone Yo-Yo Effect

It could easily be argued that naloxone, the lifesaving overdose reversal drug sold under the brand name Narcan, is one of the most important drugs ever produced. If it's administered in a timely manner, the life of an opioid addict can be spared from what would have otherwise resulted in an overdose death.

In the United States, practically every first-responder has been trained to administer the drug, in response to the staggering overdose death rates linked to the epidemic plaguing America. Additionally, a number of states have taken certain actions, making it much easier for addicts and their families to acquire the ever important drug—in many cases a prescription is not required for obtaining the miracle drug.

While the United States has the highest overdose death rates in the world, after decades of over prescribing painkillers and a burgeoning heroin market, our neighbors from the North have hardly been spared. In fact, between November 17-23, there were nearly 500 overdoses that required paramedics in the greater British Columbia (B.C.) area, CTV reports. Situations that would usually be considered routine, involving naloxone treatment. However, it turns out that addicts have begun mixing naloxone with their heroin in an attempt to protect oneself from an overdose.

Obviously, the method is far from the right course of action. The act of using an opioid, followed by naloxone, is being called “yo-yoing” or the “yo-yo” effect, according to the article. Heroin causes feelings of euphoria; naloxone reverses those effects by essentially starting a process of drug withdrawal—a real up and down experience. One that is far from pain-free.

In B.C. paramedics are arriving at the scene of overdoses and seeing empty vials of the overdose reversal drug, the article reports. Addicts are getting a false sense of safety from yo-yoing, but Paramedic Sophia Parkinson says that a person who uses naloxone needs to be followed up with by medical personnel, as the effects of the antidote can be fleeting.

Please take a moment to watch a short video on the Yo-Yo Effect:


If you are having trouble watching, please click here.

Treating Cocaine Addiction

Despite the fact that the main focus regarding addiction these days is centered upon opioid use disorder, a form of addiction involving prescription painkillers and heroin, many Americans continue to regularly abuse cocaine. It is often the case that both opioids and cocaine are used in conjunction, as addicts attempt to maintain a delicate balance between the downing effects of opioids and the upper effects of cocaine. A practice commonly referred to as “speedballing.” You may be aware of the fact that a number of notable celebrities have lost their lives due to speedballs, such as John Belushi.

When cocaine is used on its own, the chances of an overdose are significantly less than that of opioids. Drugs in the opioid family cause severe respiratory depression which can easily lead to death. Part the reason that opioid addiction has garnered the attention of mainstream media to the degree that it has is the result of how deadly that form of drug can be. But rest assured, cocaine addiction can severely impact the course of one’s life, and without treatment it can be extremely difficult to find recovery.

Unlike opioid addiction, there are currently no accepted drugs to help people get off, and stay off, of cocaine. There isn’t a Food and Drug Administration (FDA) drug to treat cocaine addiction. However, new research suggests that blocking certain brain-cell receptors, specifically a receptor referred to as the TrkB, could reverse signs of cocaine dependency, ScienceDaily reports. The findings were published in the Journal of Neuroscience.

"I think this study could help revive the idea of targeting TrkB signaling to treat addiction," said The Scripps Research Institute (TSRI) biologist Candice Contet, senior author of the study. 

While blocking the TrkB has not been tested on humans, the technique showed great promise in rat models, according to the article. The researchers found that rats that learned to self-administer cocaine infusions, reduced their use of cocaine markedly when the TrkB blocker was given to them—exhibiting decreased signs of dependence. The findings are extremely important, especially when you consider that over 2 million Americans abuse cocaine.

People struggling with addiction may not be able to admit their need for help. If your cocaine problem is affecting your marriage, parenting, employment, friendships, finances, and spirituality, it’s time to call Celebrate Hope’s Christian addiction treatment center.

The Pain of Opioid Withdrawal

It is easy to blame the American opioid epidemic on doctors, pharmaceutical companies and our over reliance on prescription drugs. While all of those played a huge role in the issue becoming a full blown national crisis, the fact remains that opioid narcotics are extremely difficult to stop using for many people—especially those who experience legitimate chronic pain. Those of you in recovery for an opioid use disorder, whether prescription painkillers or heroin, know all too well just how difficult it was to break the cycle of opioid addiction.

It often takes people suffering from opioid addiction a number of attempts at abstinence to finally succeed. And those who do manage to find recovery from such drugs typically need assistance via medical detox, inpatient treatment and regular attendance at 12-Step recovery meetings.

Those who have known alcoholics who managed to sober up using Alcoholics Anonymous, may find themselves asking why opioid addicts are unable to do the same? The answer to that question usually lies in the nature of opioid withdrawal. The early days of abstinence from opioids is by all accounts an extremely painful, uncomfortable experience. Typically characterized by:

• Anxiety
• Depression
• Diarrhea
• Cramping
• Insomnia
• Irritability
• Nausea
• Pain
• Restlessness

While it is true that opioid withdrawal is painful, those who actually have a chronic pain condition which led to the use of opioids in the first place, are met with even more pain as the drugs leave their system. What’s more, it can take some time for the brain to start producing painkilling endorphins after being idle for extended periods of time. Those who cannot tolerate the pain experienced during that interim period are at great risk of relapse, HealthDay reports. Kelly Dunn, an addiction specialist who researches opioids at Johns Hopkins University School of Medicine, in Baltimore, points out that:

"When you stop taking opioids it takes time for your body to regenerate its own 'painkiller' system," she explained. "Generally, four to five days. The severity varies per patient, and it's not predictable who will react how -- but withdrawal is real." 

It for the reasons mentioned above that many prescription opioid addicts require inpatient treatment. Being in a monitored environment, closed off from the medicine cabinet at home and aided by addiction withdrawal medicines are vital to the success of recovery.

Naloxone Without a Prescription

In the United States, we face a grave and serious situation with regard to both prescription opioids and heroin use. For far too long an unprecedented number of Americans have been able to access prescription opioids, even in situations where an alternative treatment could be utilized. In the wake of widespread over prescribing, an old drug reemerged on the scene—heroin.

Historically, heroin was thought to be a drug found only in heavily populated urban environments—used primarily among the poor and those of ethnic descent. While there may have been some truth to that idea in the past, it is far from reality today; Americans affected the most by illicit heroin and prescription opioid abuse reside in rural parts of the country—the Appalachian region strongly considered to be the epicenter of the American opioid epidemic.

If you have been following the media reports on this subject, it is likely that you have read about the efforts being made to mitigate the crisis. Efforts include:

• Expanding Access to Addiction Treatment
• Offering Treatment Instead of Jail Time
• Utilizing Prescription Drug Monitoring Programs
• Making It Easier to Acquire Naloxone

By and large, there has been widespread support on both sides of the political spectrum for expanding access to the lifesaving opioid overdose reversal drug naloxone—sold under the brand name Narcan. Thousands of American lives have been saved by the miracle drug, prompting lawmakers, health experts and those who work in the field of addiction to call for legislation which would make it easier for the friends and families of addicts to acquire naloxone.

If you think about it, it makes perfect sense. Time is of the utmost importance when it comes to an opioid overdose. Friends and family are, more often than not, the ones who are present—having naloxone on hand can better ensure a positive outcome. The good news is that states are jumping on board, and now practically every state has some form of legislation allowing people to buy naloxone without a prescription, Fox News reports.

"This saves lives, doesn't seem to have any negative impact that we can identify, therefore it should be available," said Dr. Corey Waller of the American Society of Addiction Medicine.

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.”

Alternatives to Opioids (ALTO)

If you experience an injury that requires a trip to the local emergency room, there is a good chance that you will be prescribed an opioid narcotic for the pain and will be told to follow up with your primary care physician. If you are still experiencing pain when you see your family doctor, there is an even greater chance that you will be prescribed more painkillers. In fact, nearly half of all opioid prescriptions written in the United States come from primary care physicians. One does not have to take opioids for too long before dependence develops, a slippery slope towards addiction which began back at the emergency room. So, what would happen if emergency room doctors only prescribe opioids as a last resort?

At one emergency room in New Jersey, the chairman of emergency medicine has decided to answer that question. At St. Joseph's Regional Medical Center in Paterson, NJ, doctors have begun using opioid alternatives to treat pain, keeping opioids off to the side for last ditch treatment efforts only, the Associated Press reports. The program, Alternatives to Opiates (ALTO), has been used since January, and in the first two months 75 percent of the emergency rooms 300 patients did not receive prescription opioids.

This month, the Centers for Disease Control and Prevention (CDC) released new prescribing guidelines, calling on primary care physicians to only use prescription opioids when every other alternative proves ineffective. While the guidelines are not something the CDC is normally responsible for creating, due to the dire nature of this epidemic every health agency needs to work together to put a stop to prescribing opioids when they are unnecessary.

Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing points out that emergency rooms are the front lines of the opioid crisis we face, according to the article. He supports the doctors at St. Joseph's, utilizing alternative forms of pain management.

"In many cases, we're exposing people to opioids when we don't need to be," said Kolodny.

Draconian Drug-Induced Homicide Laws

Last week we wrote about caution to heroin dealers from prosecutors. If you sell heroin to someone which results in a fatal overdose you may be looking at a over 20 years in prison. It turns out that you may not have to be a heroin dealer to receive a life sentence after all. A man in Louisiana was given a life sentence for injecting his girlfriend with heroin that resulted in an overdose death, Fox19 reports. The stiff sentence raises a lot of questions about culpability.

The case of Jarret McCasland, 27, is not simple. While the man has a history of selling drugs, he did not sell the heroin that resulted in the death of his girlfriend Flavia Cardenas, 19. Nevertheless, 19th Judicial District Judge Don Johnson gave McCasland the maximum sentence possible for a second degree murder charge.

"There are two consenting adults who were using drugs,” said McCasland's attorney, J. Rodney Messina. “this thing could have flip-flopped. He could have been the one that's six feet under, and then they would be prosecuting Miss Cardenas." 

We know for act that treating addiction with jails and prison is not effective in deterring drug use, and it certainly does not cure addiction. In recent years, in the wake of the American opioid epidemic, we have seen a dramatic change in how lawmakers look at addiction. Many of which now believe that treatment is the most effective weapon for fighting addiction. Apparently, lawmakers in some parts of the country did not receive the memo. A drug policy reformist at Roosevelt University, Kathie Kane-Willis, contends that draconian drug-induced homicide laws need to be changed, according to The Fix.

 “It may seem like a kinder gentler war on drugs and perhaps for folks in urban areas that is the case,” said Kane-Willis. “In the Midwest and the South that is not the case at all, in fact we are seeing really disturbing trends in the ways that these cases are being handled.”

Keep in mind, If you or a loved one is battling opioid addiction, please contact Celebrate Hope at Hope by The Sea. We can help you learn how to live free from addiction and begin your journey of recovery.

Over The Counter Naloxone

It cannot be stressed enough; there is need for greater access to the life saving opioid overdose reversal drug naloxone in the United States, especially when you consider that the Center for Disease Control and Prevention (CDC) reports that 44 people die every day from an overdose. In recent years, there has been call from both addiction experts and lawmakers for expanded access to naloxone, sold under the brand name Narcan. The drug was recently approved by the Food and Drug Administration (FDA) to be used in nasal spray form, which makes it easier for people without any medical knowledge to administer the miracle drug.

The World Health Organization (WHO) has stated that expanded naloxone access could save more than 20,000 lives per year in the United States. It is estimated that the drug saved 10,000 lives between 2006 and 2010.

In a number of states and cities across the country, naloxone can now be acquired without a prescription. This means that both opioid users and their families can purchase the drug with little effort, and more lives will be saved. CVS pharmacies in 13 states are preparing to offer naloxone over the counter, EMS 1 reports. With the rise in heroin use across the country, a byproduct of the prescription opioid epidemic, the likelihood of overdose rates increasing is great.

"Over 44,000 people die from accidental drug overdoses every year in the United States and most of those deaths are from opioids, including controlled substance pain medication and illegal drugs such as heroin." said Tom Davis, vice president of pharmacy professional practices at CVS/pharmacy. "Naloxone is a safe and effective antidote to opioid overdoses and by providing access to this medication in our pharmacies without a prescription in more states, we can help save lives." 

The states where naloxone will be offered over the counter include:

• Arkansas
• California
• Minnesota
• Mississippi
• Montana
• New Jersey
• North Dakota
• Ohio
• Pennsylvania
• South Carolina
• Tennessee
• Utah
• Wisconsin

Please take a moment to watch a short video on the subject below:


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If you or a loved one is battling opioid addiction, please contact Celebrate Hope at Hope by The Sea. We can help you learn how to live free from addiction and begin your journey of recovery.