Richmond Tests “First Responders for Recovery” Program

In recognition of International Overdose Awareness Day, Richmond Virginia launched a new program meant to save the lives of people struggling with addiction. The Richmond Ambulance Authority (RAA) and Richmond City Health District (RCHD) announced the new initiative, dubbed “First Responders for Recovery”.

The program, modeled as an evidence-based program, helps people struggling with substance use by connecting them to local recovery resources. The program uses a Peer Recovery Specialist named Courtney Nunnally. Courtney herself is a person in recovery. She’s been inspired to help others who struggle and offer them some hope.  “This program is a way for me to give others hope and a path to recovery and I really believe it will save lives.”

What Do “First Responders for Recovery” Do?

As a Peer Recovery Specialist, Courtney offers a unique perspective to EMTs and paramedics and EMTs. When a person overdoses, they are often feeling vulnerable and need guidance. They may be receptive to trying to get clean and sober, but overwhelmed or without the resources to do so. Offering them a way to get help can make all the difference.

Courtney helps paramedics and EMTs encourage patients to sign a “First Responders for Recovery” release form, where they agree to speak with a RCHD’s Peer Recovery Specialist within the next 48 hours.

Peer Recovery Specialists then connect with the patient to try and get them into a path to drug and alcohol treament. They may even be able to secure a spot in treatment the same day. If a person is hesitant, the specialist will then give them a resource packets filled with recovery options in the Metro Richmond.

Planting a Seed

Giving a person who feels trapped in addiction a way out is important. While not everyone who overdoses will try to get help right away, they at least know the options are there. Saving lives through recovery resources is possible.

Richmond has a high rate of opioid overdoses, and this program is only one step to solving the problem. Like many states, Viriginia has limited funds for new treatment centers.

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What We’ve Learned From Johnson and Johnson’s Opioid Trial So Far

In Oklahoma, a battle is being waged between state attorneys and the pharmaceutical giant.  State attorneys state in their lawsuit that Johnson & Johnson has played a large role in the opioid epidemic in the state, accusing sales representatives of deceptively promoting opioids to doctors.

Johnson & Johnson Trial Heats Up

The state says that  company representatives made 140,000 sales calls to Oklahoma doctors over a period of years, among other aggressive marketing tactics. This allegedly led to overprescription, addiction, and ultimately death for those unfortunate enough to overdose.

Brad Beckworth, a lawyer for the state, went to the stand last week to ask Kimberly Deem-Eshleman, the company’s corporate representative, about those calls and other tactics used by sales reps.

Last Week, Dr. Russell Portenoy, a leading pain expert testified that Johnson & Johnson understated the risk of abusing opioids or the risl of addiction. In a taped testimony, the doctor stated that Big Pharma “overstated the benefits of chronic-opioid therapy’’ and “understated the risk of abuse, addiction and overdose.”

Due to this deception, state attorneys say Johnson & Johnson caused a “public nuisance’’ that led, ultimately to a deadly opioid epidemic in Oklahoma and across the United States.

Increased Opioid Sales via ‘Cynical Brainwashing’

Johnson & Johnson is accused of operating “a cynical, deceitful multimillion-dollar brainwashing campaign” to drive up sales of its opioids Oklahoma’s attorney general, Mike Hunter, told the civil when it opened last month.  Through their deceptive marketing activities, the state claims the company of taking leading role in “the worst manmade health crisis in the history of the country and the state”.

The Oklahoma case against Johnson & Johnson is a strong one. In fact, there were once several other parties named in the lawsuit. They made the decision to settled out of court, paying over 100 million dollars as settlement of the case.

Johnson and Johnson is accused of pushing opioids on patients that didn’t necessarily merit the high strength. The company, motivated by “greed”, began pushing their fentanyl patch, Duragesic, routinely for chronic pain. They applied more aggressive marketing tactics as they watched their rival Purdue Pharma grow rich from OxyContin.

Later on, the company started growing its own opioid poppies overseas, and became a supplier to narcotic pharmaceutical manufacturers. They even supplied the ingredients to Purdue Pharma, the maker of Oxycontin.

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U.S. Justice Department Joins Suboxone Lawsuit

Suboxone lawsuit

The U.S. Justice Department has joined a lawsuit alongside several whistleblowers that alleges that the companies marketed off-label and higher dosages than approved, as well as other deception. Several ex-workers are in the process of suing on behalf of the government, as whistleblower laws allow. It appears the government is now up to speed on the wrongs listed in lawsuits against Indivior Plc. and Reckitt Benckiser Group PLC, both involved in marketing the opioid addiction treatment Suboxone.

What is the Lawsuit About?

One of the complaints unsealed on Aug. 2 was filed by former Reckitt employee Ann Marie Williams, claiming that the companies marketed unapproved dosages and uses of Suboxone and Subutex. Williams Reckitt made misleading claims to the U.S. Food and Drug Administration to obtain approval for a dissolvable film version of Suboxone.

The lawsuits were filed under the False Claims Act, a law that allows whistleblowers to sue companies on the government’s behalf. Now it seems the government is willing to intervene in the cases as well, adding more power to the claims.

The Justice Department filed their cases in federal court in Abingdon, Virginia, saying they are ready and willingly are intervening in four separate whistleblower lawsuits related to the companies’ marketing of Suboxone and the related drug Subutex.

Indivior, an offshoot of Reckitt, claimed last month it was in “advanced discussions” with the Justice Department to resolve an investigation dating back to 2013 related to its marketing practices. It appears that the lawsuit is one way the Justice Department can force their hand.

What Part Was Illegal?

The lawsuit says that just as the patent to make Suboxine pills exclusively was finishing up, allowing competition and generic versions to potentially enter the market, Reckitt sought U.S. approval of a new patent-protected dissolvable strip version of the drug. The manufacturer said the film version would be safer and less susceptible to abuse.

However, the lawsuit alleges that this was not the case. The film version was inferior to the tablets and posed more of a chance of misuse. It also had other hazards, such as an increased risk to children who could be overdosed if they got ahold of the film and put it in their mouths.

Despite these issues, the companies marketed the Suboxone film as “safer” for patients and children than tablets, the lawsuit said. This also implied that the pill form of Suboxone was less safe, which could have caused some doctors to prescribe the film rather than the more-effective pill.

Losing the Lawsuits will be Costly

Indivior has set aside $438 million to cover lawsuits right now, while Reckitt has set aside $390 million in connection with the investigation. It doesn’t appear that either company believes they will win these cases.

“We have been cooperating with the DOJ in its investigation for several years, and we remain in advanced discussions about a possible resolution that would render any suit by the department unnecessary,” Indivior said in a statement.

Reckitt spokeswoman Patty O’Hayer said on Wednesday that the company “will be presenting our case to the DOJ in the appropriate channels to defend the actions that we believe that we have taken.”

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Many Addiction Centers Won’t Use Medication-Assisted Treatment

therapist listening to her patient

According to US News, the majority of drug and alcohol treatment centers in the United States don’t offer three standard Medication-Assisted Treatment (MAT) services, even though the U.S. Food and Drug Administration recommends and encourages them for people with opioid use disorder.

Only six percent of treatment centers in the United States offered all three medications, while about thirty-six percent of treatment centers offer one MAT drug for opioid users.

MAT drugs help users curb their desire to use, or help with other side-effects and withdrawal symptoms. Buprenorphine, naltrexone, and methadone are the only drugs approved by the FDA for long-term treatment of opioid use disorder. The drugs are viewed as safe and effective by regulators and researchers, but often there is a stigma attached to the medications. Many treatment centers prefer to use traditional therapy and 12-step meetings rather than provide clinical services.

Dr. Ramin Mojtabai, a professor of mental health at the Johns Hopkins School of Public Health in Baltimore and lead study author, and his team analyzed 10,000 surveys from people who attended outpatient centers conducted by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) between 2007 and 2016.

The government is hoping to change the way that treatment centers help their clients.

“The Trump Administration is pursuing every opportunity to address our country’s opioid epidemic and support patients struggling with opioid use disorder. This work at HHS includes placing a special priority on ensuring access to a full range of safe and effective options for medication-assisted treatment,” said HHS Secretary Alex Azar last August, when recommending MAT as a new standard of drug and alcohol treatment. “The evidence is clear: medication-assisted treatment works, and it is a key piece of defeating the drug crisis facing our country. The FDA’s new guidelines have the potential to bring new medications to market that are more closely tailored to patient needs and help give Americans facing addiction a better chance at recovery.”

However, progress is still being made as the treatment profession changes and adapts to the new climate that combines science with traditional treatment, such as talk therapy and 12-step programs. Addition federal funding for research and training for people currently in the industry would probably speed the process.

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Dark Web Drug Dealers Say They’ve Banned Fentanyl

Image of a man in a hoodie with sunglasses typing on a laptop with gloves

Owners of websites on the dark web say that they’ve decided to voluntarily ban fentanyl, according to the National Crime Agency based in the UK. The “open air” online drug outlets have done this in a bid to avoid additional scrutiny as reports from the US, and the UK show that fentanyl is now causing the most overdose deaths each year.

In the UK alone, 180 deaths in 18 months were attributed to fentanyl, while in the US, fentanyl overdoses doubled in 2016 to outpace heroin and Oxycontin.

Several large drug-dealing websites have also quietly“de-listed” fentanyl because they don’t want to be investigated when there is an overdose death, according to Vince O’Brien, an investigator at the UK National Crime Agency.

So-called dark web markets have popped up in recent years and have become a reliable source for drug dealers to get their supply. Users place an order using bitcoins, which allow some anonymity when both are buying and selling the products. Many opioids are sold in powder form and shipped to the US where somebody then mixes them and uses a pill press to shape them into pills. In many cases, this is when the fentanyl is incorporated into the product. However, some people have ended up with tainted pills without knowing it. Drug dealers, who may not even use the drug, are potentially exposed to fentanyl if they order it online. For people who don’t use any opioids, it can be dangerous or even deadly to come into contact with the amount that could fit on the tip of a pen or pencil.

While US Customs and Border Control seize thousands of pounds of heroin every year, there are no statistics currently available on the website specifying the attempted importation of drugs.

Fentanyl is 50-100 times stronger than morphine, which is why it leaves some people in peril when they use it. It’s recommended that anyone who takes or uses opioids carry Naloxone, and opioid-antagonist drug, in case of overdose.

Treatment is always available for anyone with a fentanyl or other drug problem. Please look through our directory and get help if you need. Recovery is a path for anyone who wants it!

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Despite Addiction Worries, FDA Panel Quietly Approves a Stronger Opioid

Image of a rubber stamp that says "FDA Approved"

An FDA panel gave preliminary approval to a new kind of opioid drug meant to treat severe pain such as the kind people experience during surgery. The drug, sufentanil, which will be marketed under the brand name Dsuvia, is actually five to 10 times stronger than fentanyl.

Surprisingly, the drug advisory committee voted 10-3, approving the drug. While this doesn’t set approval in stone, the FDA usually follows the advisory committee’s instruction. While the FDA has been pushing for more restrictions on opioids, there was no mention of fears of addiction or overdose in the discussions.

There was one dissenting opinion, however; Raeford E. Brown Jr., MD, who chairs the committee. Dr. Brown doesn’t like the idea of allowing another potent and lethal opioid into the drug market, where fentanyl rules the day when it comes to accidental overdoses. He worries that some doctors won’t pay attention to dosing, which could also be dangerous.

With the approval, the pharmaceutical company itself is pretty thrilled to reveal a new product. “We are pleased with the advisory committee’s recommendation to approve Dsuvia as a treatment in medically supervised settings for adults experiencing moderate-to-severe acute pain,” said Pamela Palmer, chief medical officer and co-founder of manufacturer AcelRx.

“We believe Dsuvia represents an important noninvasive acute pain management option with potential to significantly improve the current standard of care.”

Sufentanil is a synthetic opioid that is supposed to be used for IV and epidural anesthesia. It is ingested as a pill that dissolves under the tongue. This new formulation of sufentanil was designed for rapid pain relief and takes effect in about 15 minutes. The drug itself lasts about three hours, making it ideal for surgeries.

The FDA had earlier mentioned two safety concerns to the manufacturer. They were worried about possible adverse effects in patients who require the maximum proposed dosing. They also worried that due to the small size, misplaced pills could be lethal who come across them or misuse them. The small size could have been deceptive to young people who experiment with drugs.

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Pharm Companies Search for Safer Pain Relief Solutions

The addiction epidemic in America is still raging, with a record 72,000 overdose deaths according to estimates from the Centers for Disease Control for 2017. The pharmaceutical industry has been slow to respond to the numbers. However, the increased scrutiny has made the industry do a double-take regarding profitability. With lawsuits stemming from nearly every state in the US, profits for opioids seem to be on a steady decline. And with the decrease in prescribing, doctors have worried that legitimate chronic pain patients will be left without treatment. New research is now in progress to find new pain drugs that prevent chronically ill people from being neglected or left behind due to opioid unavailability.researchers for pain relief

Multiple research groups have been tasked with the creation of less dangerous and less addictive opioid development. While they also are focusing on changing the opioids to make them less harmful, they are also looking at opioid alternatives. This is important to note because historically, Big Pharma has downplayed the addictive nature of opioids, and there is little trust in the medical community when it comes to “safer opioids” at this point. Pharmaceutical companies have appeared to defend addictive drugs at every turn, from lobbying to paying doctors to dole them out like candy. Many experts in the addiction industry would say that there’s no trusting the industry to police itself. However, pain is a real problem for many diseases, and for some people, currently, only opioids can help. Researchers are attempting to create an opiate that can offer pain relief with far less risk of addiction or overdose, which is caused by decreased respiration.

The substances tested have only entered the basic stages of research, where they are tested on animals, not humans. But researchers are hopeful.”It’s encouraging,” says Laura Bohn, a biochemist at Scripps Research in Jupiter, Florida. “There has been a really big push to develop nonopioid pain relievers. But it has been really hard.”

Let’s hope the focus on non-opioid pain relief is successful.

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South Carolina Announces Emergency Response Plan for Opioids

opioids south carolina

Last Wednesday, South Carolina Gov. Henry McMaster announced that he had created a state emergency response plan to tackle the chronic and ongoing opioid epidemic.

The plan was created with the input of more than 24 organizations and outlines strategies to support state and local efforts. In December 2017, Gov. McMaster first began formulating a plan to combat opioids by issuing a public health emergency.

The governor’s emergency declaration brought together state officials, private partners, and law enforcement to utilize the emergency management infrastructure to combat the growing epidemic or opioid deaths, addiction, and abuse.

The new plan calls for better record-keeping in the medical community and addiction-related opioid training. Physicians will be expected to have opioid-informed conversations with their patients and understanding other pain treatment options. This should help raise awareness of the dangers of opioid use, and help physicians prevent and respond to opioid use disorder.

The plan also involves adding treatment and recovery options, increasing resources to combat illicit opioid supply chains, and other actions that help to reduce fatal opioid overdoses and divert addicted person to treatment instead of incarceration for drug-related offenses. The State Law Enforcement Division and the state Department of Alcohol and Other Drug Abuse Services will help direct these new efforts to combat opioid addiction in South Carolina.

“This plan is a living, breathing document that we will add to and amend as we encounter new issues and achieve successes,” McMaster said. “We will combat the opioid crisis the only way our state knows how: as one team collaborating and sharing talents and resources to help the people of South Carolina.”

According to the South Carolina Department of Health and Environmental Control, opioid-related deaths have been climbing in the state in the past several years. The most recent statistic shows that in 2016, 550 deaths occurred in South Carolina from a drug overdose with prescription opioid drugs listed on the death certificate. These numbers were up 7% in 2015 and up 18% from 464 in 2014. The deaths outpace the number of homicides throughout the state.

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Today is National Drug Take-Back Day: Take Action!

pills for drug take-back day

Today is National Drug Take-Back Day, a day where anyone, anywhere in the US can go to a location and safely dispose of prescription drugs. If you have any painkillers, opioids/opiates, sedatives or anti-anxiety drugs that have been sitting in your cabinet, do the right thing and find a location to dispose of your unused medications safely. You might safe a life! You can also get rid of conventional drugs such as antibiotics by visiting one of the locations.

Why Dispose of Drugs on National Take-Back Day?

During most of the year, it’s nearly impossible to dispose to dispose of any addictive drugs safely. Pharmacies don’t want the liability when dealing with opioids and other dangerous drugs, so they won’t let you return them. Flushing them or throwing them away can contribute to tainting the water, soil, and environment. Don’t do it! Future generations certainly don’t need the added worry of addictive substances in the water. There is also the worry that if you throw the drugs in the trash, somebody could sift through it and use or resell any pills. Please don’t take the chance – take the time to dispose of your drugs safely and properly.

Find a Take-Back Location

Use Google’s tool to find a take-back location. If you can’t do it today, check the DEA website for any sites that operate year-round, and learn how to dispose of drugs safely. If you live near a Walgreens, they have disposal pouches to offer year-round, and many other pharmacies have similar options. Ask your pharmacist for information on disposing of drugs safely.

What Drugs Can I Return on Take-Back Day?

On Take-Back Day, you can take the opportunity to return pretty much any prescription drug, but please be careful if you are returning any hardcore opioid such as fentanyl. Most of these drugs are usually recommended to flush down the toilet if a disposal site isn’t available. The long-term damages caused by flushing are grim — this is why many of our fish have large doses of lithium in their system, for example.

On take-back day, you can dispose of ANY drug.

However, it’s a great time to dispose of the following dangerous drugs safely, too:

  • Benzhydrocodone/Acetaminophen
  • Apadaz
  • Buprenorphine
  • Belbuca
  • Bunavail
  • Butrans
  • Suboxone
  • Subutex
  • Zubsolv
  • Fentanyl
  • Abstral
  • Actiq
  • Duragesic
  • Fentora
  • Onsolis
  • Klonopin
  • Adderall
  • Diazepam
  • Diastat/Diastat AcuDial rectal gel
  • Hydrocodone
  • Anexsia
  • Hysingla ER
  • Lortab
  • Norco
  • Reprexain
  • Vicodin
  • Vicoprofen
  • Zohydro ER
  • Hydromorphone
  • Dilaudid, Exalgo
  • Meperidine
  • Demerol
  • Methadone
  • Dolophine
  • Methadose
  • Methylphenidate
  • Daytrana transdermal patch system
  • Morphine
  • Arymo ER, Embeda, Kadian, Morphabond ER, MS Contin, Avinza
  • Oxycodone
  • Combunox, Oxaydo (formerly Oxecta), OxyContin, Percocet, Percodan, Roxicet, Roxicodone, Targiniq ER, Xartemis XR, Xtampza ER, Roxybond
  • Oxymorphone
  • Opana, Opana ER
  • Tramadol
  • Tapentadol
  • Nucynta, Nucynta ER
  • Sodium Oxybate
  • Xyrem oral solution

and any other drug you aren’t using and don’t plan to use, especially those that can be abused.

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Purdue Pharma Says It Will Cease Marketing OxyContin

empty Oxycontin package

Purdue Pharma, one of the largest manufacturers of Oxycontin in America, has vowed to stop marketing the opioid to doctors. Oxycontin is an opioid medication that has been on the market for over 20 years and is viewed by many addiction and law enforcement professionals to be the catalyst for America’s current opioid addiction crisis. It’s a common drug of abuse and is often responsible for overdoses.

Purdue released a statement saying that it would no longer send sales representatives to market the opioid painkiller at doctor’s offices and that the Medical Affairs office will now handle all Oxycontin orders and queries.

Many people involved in the addiction industry, the medical community and other public heatlh experts say it’s too little, too late.

Purdue has long marketed Oxycontin as effective and safe for use, dropping off samples at the offices of practitioners and telling physicians that it was ideal for treating chronic pain. While these statements weren’t proven, medical marketing is an industry that often finds the loopholes.

Purdue has also done much more than market Oxycontin to doctors. They have also lobbied for the use of opioids under the guise of advocacy groups, according to a report released by Sen. Claire McCaskill. And in states where the opioid epidemic has been raging, the company seemed to look the other way when millions of pills ended up in the street of a comparatively tiny town.

Oxycontin is a dangerous and powerful drug. Purdue has made millions of dollars from the opioid crisis, ceasing to market Oxycontin isn’t a step closer to making amends for the years of damage the drug has caused through deceptive marketing. Over a dozen states are suing Purdue for what they call false marketing practices that cost local lives. West Virginia was one of the first to sue. They settled years ago, but Purdue never admitted wrongdoing.

Purdue says that with the changes in marketing, they laid off half of their sales positions, leaving the remaining 200 sales employees to focus on marketing other medications. That’s a lot of sales reps that were once actively marketing a drug well-known for its addiction properties. But where is the promise they won’t do the same thing with another dangerous drug?

 

 

 

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