Tag Archives: addiction

Suboxone Being Sold On the Black Market and May be Stopping Drug Overdoses

When you think of “street drugs,” more than likely the first thing that comes to mind is illegal ones such as heroin. These aren’t the only types of drugs being sold by dealers. Prescription drugs are making their way from medicine cabinets to the street, where they are being sold to users who never had a prescription for them initially. This is not an uncommon practice; however, it has now expanded to include medications normally prescribed to treat drug addiction itself.

Buprenorphine on the Streets

Suboxone is a brand name for one of the addiction treatment medicines used to treat patients for opioid abuse. Another brand name is buprenorphine. Both of these medications contain opioids. They are normally given under a doctor’s orders as part of a medication-assisted treatment program (MAT) that includes counseling with a licensed alcohol and drug counselor or a therapist with experience in this area of practice.

Instead, they are being sold along with drugs designed to give users a “high.” Many people are looking for Suboxone through these channels to try to protect themselves from an opioid overdose. They may also be wanting to get off opioids and are looking for Suboxone to make the withdrawal process easier. Some users try to put together enough of the medication so that they can try to treat their substance abuse issue on their own, which is never a good idea.

One of the Worst Opioid Crisis Cities in US

In Philadelphia alone, more than 1,000 people are dying from drug overdoses annually. This figure pushed the City of Brotherly Love into the dubious category of being the large city with the worst opioid crisis in the US.

In response, city and state officials have taken measures to get more people into drug treatment programs. Along with eliminating the requirements for having insurance company pre-authorizations and having identification, they have set up mobile treatment centers where doctors are issuing prescriptions for Suboxone to patients on the street.

Treatment is still an expensive proposition for those who don’t have Medicaid or private health insurance coverage. People who have lost their health insurance due to a job loss may find themselves at a disadvantage. Some of them bought Suboxone on the street to get off heroin on their own. This is a less expensive option than paying to see a doctor and seeking professional help.





New Laws to Get Addicted and Mentally Ill Into Treatment Are Not Being Enforced

Last year, San Francisco decided to expand its ability to force people who are severely mentally ill and those who are addicted to drugs into treatment. The idea behind introducing court-ordered treatment was to stop the cycle of the most severe cases — “the sickest of the sick” — continually moving and out of the city’s Emergency rooms.

San Francisco’s Homeless Population Tops 8,000

There is no question that San Francisco already has a significant problem with homelessness. The city is finding it difficult to provide services for its current homeless population. Most of its homeless are already living with mental health issues and drug addiction.

Legislation Meant to Apply to Few SF Residents

The legislation was expected to apply only to a small segment of the Golden Gate City’s population. Along with the types of patients mentioned above, another 50-100 people representing a small number among the city’s most vulnerable population, were expected to meet the criteria for court-ordered treatment.

The law has been in effect for a year. To date, no one has been considered for the program. Several public agencies are pointing fingers at each other for the delay in implementing it. The coronavirus pandemic has not helped the situation, either.

Public health officials have said they have the names of approximately 10 people who may qualify for conservatorship (court-ordered treatment). They can’t take any further action because the City Attorney’s Office and the Superior Court must agree on the procedure to file a petition under the new legislation. The Department of Health has said it will support those people under other services in the meantime.

Court Says it is Prepared to Accept Petitions for Treatment

Ken Garcia, speaking on behalf of the court, has said it is ready to accept petitions. None have been filed. Mr. Garcia said that the court is ready to process petitions when they are brought to the court office. He explained that it is not the court’s function to start petitions and that it is unable to do anything until a case is brought before it.

The City Attorney’s Office, for its part, said that it is waiting for the court to approve the process. It stated that this effort has been delayed due to the pandemic.

John Coté, the City Attorney’s spokesperson, explained that his office is working with the court to finalize the procedure. He stated that the City Attorney’s office hopes to have it in place “soon.”

New Law Expands Conservatorship Definition

The new laws expand the definition of “conservatorship” to include people who are addicted to drugs. It also includes those who are severely mentally ill. People in the latter category must have been taken to a 5150 hold (emergency crisis hold) a minimum of eight times. Approximately 630 people are currently in this situation in San Francisco. This figure includes those being treated in residential and outpatient treatment programs.

The program’s critics say that the bar for someone to receive court-ordered treatment is still too high. They point out that there are still more people who are too sick to seek help on their own. The critics also point out that the program’s guarantee that participants will receive housing after completing their treatment is inappropriate in a city like San Francisco which already has an issue with limited housing resources.

Source: https://www.sfchronicle.com/politics/article/Why-SF-s-new-laws-to-force-more-mentally-ill-15318574.php

Opioid Crisis Took a $631B Toll Out of US Economy in Only Four Years: Study

The results of a study conducted by the Society of Actuaries found that the opioid crisis cost the US economy $631 billion from 2015-2018. The largest portion of this cost was attributed to the potential lifetime earnings of people who died due to drugs, with healthcare costs coming in second place.

Governments Suing Drug Companies

More than 2,000 local and state governments have taken drug manufacturers to court over their role in the opioid crisis. They are seeking to recover damages for the cost of first responder services, public health services and more. The results from the report found that the private sector and individuals bear most of the financial cost (more than two-thirds) as opposed to the government (less than one-third).

Financial Costs of Opioid Crisis Difficult to Track

The federal government has been keeping statistics on the number of deaths attributed to opioid abuse. The number has reached 400,000 American lives lost since 2000. Getting a clear figure of the financial cost has been more difficult.

According to a report released by the Centers for Disease Control and Prevention, the cost was $79 billion (2013). This figure is less than half the cost published in the latest report for more recent years. The opioid crisis has also intensified since 2013; fentanyl and carfentanil have contributed to a higher death toll. Opioid-related deaths grew throughout 2017 and stabilized in 2018 at approximately 47,000 lost lives.

According to the actuaries’ report, the opioid crisis will cost approximately $171-$214 billion in 2019. Even the most optimistic prediction puts the cost higher than the 2017 numbers.

Child Welfare, Criminal Justice Costs Up due to Opioids

The new study found that child welfare system and criminal justice costs have increased due to the opioid epidemic. Most of the increased health care costs related to opioid addiction and overdoses were absorbed by Medicaid, Medicare and other types of government programs. The crisis was also responsible for $18 billion in commercial insurance costs in 2018 and lost productivity accounted for an additional $27 billion hit to the economy last year.

Ketamine May Help Treat Cocaine Addiction: Study

The results of new research have found that a single ketamine infusion, when combined with mindfulness-based relapse-prevention therapy (MBRP) can be effective in improving abstinence rates in cocaine-addicted adults. This treatment has also been found effective in reducing craving rates.

The results from a randomized control trial conducted by researchers at New York City’s Columbia University Medical Center indicate that abstinence rates were “significantly higher” in patients who received the ketamine infusion and MBRP compared to patients in the control group.

Elias Dakwar, a medical doctor and an associate professor of psychiatry at Columbia University, explained that patients receiving behavioral modification treatment may benefit from certain medications, even if they only receive it one time.

What is Ketamine?

Ketamine is an anesthetic that is used for human and veterinary purposes. It is a dissociative drug, which means its use can cause a distortion of sights, sounds and colors. While under its influence, a person may also misinterpret himself or his environment. Ketamine is used in surgery for general anesthesia and as a pain control drug. Research has shown it may be useful for treating severe depression.

The US Food and Drug Administration (FDA) currently doesn’t approve any medications for treating cocaine use disorder.

Ketamine and Mindfulness Part of Treatment Studied

The researchers pointed out that treating this type of addiction is challenging due to low motivation, high behavioral reactivity and cravings. Ketamine may improve on many of these issues. It may also serve as a stepping stone for mindfulness training for patients.

The researchers assigned 55 participants to two groups in a random manner. All of them were seeking help for cocaine addiction. One group was given a 40-minute ketamine infusion (0.5 mg/kg) or midazolam (an anesthetic used for pre-operative sedation and in surgery) in a five-week trial.

All participants were admitted to a psychiatric research unit for five days. They received an infusion on the second day and MBRP sessions on Days 2-5. After the trial was completed, the participants were referred to follow-up treatment. Six months later, they were interviewed by telephone.

MBRP therapy focused on learning how to be mindful and assimilating this practice into everyday life. It also challenged clients to apply mindfulness when faced with high-risk situations that might trigger a relapse.

Follow-up visits were conducted on a weekly basis starting two weeks after the infusion and ran through the fifth week following the procedure. The participants completed surveys and tests to measure mindfulness, stress sensitivity and cravings.

The researchers found that 92.9 percent of the midazolam group either used cocaine or dropped out, while 57.7 percent of the ketamine group did. At the six-month follow-up interview, none of the participants in the midazolam group had stopped using cocaine. Forty-four percent of the ketamine group were not using cocaine.

The results of the study were published online in the June 24 edition of the American Journal of Psychiatry.


Jails Slow to Help Addicted Inmates with Craving-Reducing Medication

Many jails are slow to help inmates with substance abuse issues. They are just starting to offer medications to help control cravings. Most jails only dispense one of the drugs approved for this purpose.

Medication-assisted treatment (MAT) is considered the standard treatment approach for opioid addiction. Buprenorphine and methadone are prescribed to treat withdrawal symptoms and reduce cravings. Naltrexone blocks the effects of opioids, and can also reduce cravings. This medication can also be used to treat alcoholism.

Approximately 220 of more than 3,000 jails across the US make naltrexone available to inmates. In most instances, the medication is offered to those who are about to be released. Only about 20 jails offer buprenorphine or methadone.

Cost One of the Barriers to Medication Assisted Treatment (MAT)

Experts say barriers to using medications to treat addiction are cost and the long-held belief that total abstinence is the way to attain sobriety. They point out that addiction doesn’t resolve itself because the affected person isn’t using drugs regularly. Many inmates with addiction issues will start using on release if they don’t get appropriate treatment.

A doctor must obtain a special license to distribute buprenorphine and methadone, which may not be easy for a physician working in a jail to acquire. These medications should be continued on a long-term basis to be an effective long-term drug treatment solution.

For inmates transitioning to life outside of jail, the change can be challenging enough without keeping track of medications. Many offenders who have recently been released have little support from family or friends.

MAT Can Help Reduce Relapses, Return to Custody

According to experts, offering opioid addiction treatment to jail inmates could help to address the opioid epidemic, since offenders may be less likely to use drugs after their release. Some research studies have shown MAT is effective at reducing relapses and the likelihood of returning to jail. The results of a small study on MAT with inmates in Rhode Island found that opioid overdose deaths among newly released offenders dropped by 60 percent.

Americans Abusing OTC Meds Along with Opioids: Study

Prescription opioid pain medications aren’t the only drugs being abused by Americans. Over the counter (OTC) preparations are also falling into that category.

The results of a new study conducted by researchers at Boston University School of Health has revealed that close to one in five users of headache remedies like Advil and Aleve doesn’t use the medicine as recommended. They admitted to exceeding the maximum recommended dose during a one-week period.

OTC Medication Use by Consumers Unsafe

People who use too many of these NSAIDs (non-steroidal anti-inflammatory pain relievers) likely won’t be starting on the slippery slope of moving toward heroin use. That doesn’t mean what they are doing is safe.

Dr. David Kaufman, the lead researcher on the study, and a professor of epidemiology at Boston University’s School of Public Health, explained that these drugs can produce serious side effects when taken. Even though they are readily available, it doesn’t mean that consumers can make up their own dose, no matter what the dosing instructions say on the label.

Consumers Don’t Read Medication Packages When Dosing

Consumers’ attitude that they can choose their own dose, no matter what the label states, along with lack of knowledge about dosing limits, is contributing to exceeding the daily limit, according to Dr. Kaufman.

The study was conducted in 2015-2016 by having 1,326 participants keep drug diaries for a week. Participants were, on average, 45 years of age. The majority of them (75 percent) were white, and 60 percent were women.

Most of the study participants (87 percent) took ibuprofen, which is sold OTC under brands like Motrin or Advil. Thirty-seven percent of the participants reported they took other NSAIDs like Aspirin or naproxen, such as Aleve.

Chronic Pain Patients More Likely to Take Higher Doses

The study results showed more than 15 percent of the study participants took too many of the pills at least one day of the week. Participants who live with chronic pain were even more likely to take more than the recommended dose.

When asked whether non-prescription pill abusers were trying to avoid taking opioids, Dr. Kaufman replied he didn’t think that scenario applied in this instance. He said that avoiding opioids may influence prescribing behavior for physicians, but it may not have a similar effect on consumers.

Alternate Method of Treating Injuries May Prevent Opioid Abuse

One of the most common knee injuries is an Anterior Cruciate Ligament (ACL) tear. These injuries are common because they can be caused by any sudden movement like; stopping quickly, landing from a jump or changing direction suddenly. And while this a common injury, it still generally needs to be repaired with surgery and the patient is oftentimes in a lot of pain before and after the procedure. In order to make the patient more comfortable, doctors are likely to prescribe painkillers before the surgery to handle the pain from the ACL tear.

However, new research suggests that consuming painkillers before an ACL surgery could be very dangerous to the patient, as it greatly increases their chances of developing an addiction to painkillers. Researchers at the University of Iowa Hospitals and Clinics released a study stating that patients who receive painkillers before an ACL surgery are ten times more likely to be on painkillers longer than patients who were not given painkillers before their surgery. And when it comes to painkillers, the length of time a patient uses the medication is extremely important. The longer a patient uses painkiller the more likely they are to develop a physical and mental addiction to the dangerous drugs.

The researchers gathered information from, 4,946 ACL repair cases in order to come up with their findings. While most of the patients healed nicely after their surgeries, not requiring painkillers three months after the procedure, seven percent of the patients were still filling painkiller prescriptions. These seven percent had a much higher rate of pre-operation painkiller use. And younger people are more likely to fall victim to this increased painkiller usage than older people, according to the study.

The study could provide doctors insight as to how dependent the body can become on opioids and may prevent further addiction cases.

“With the ever-increasing opioid epidemic our nation is facing, understanding the risk factors for postoperative narcotic use could aid surgeons and healthcare systems in identifying patients who could benefit from a different pain management and counselling regimen than previously identified,” explained Chris Anthony, co-author of the study.

Study Shows High Rate of Addiction Among Women Inmates

Women inmates are sitting in prisons and jails across the country with more instances of addiction than ever before. A new report, released by the government shows that 69% of female state prisoners and 72% of female jail prisoners are addicted to drugs and/or alcohol. These rates are higher than the male population and higher than the average U.S. population as well.

It turns out, according to the study, that women inmates have higher rates of addiction but they also have higher rates of depression and anxiety that their male counterparts, problems that oftentimes lead to drug abuse. And these inmates are not getting the treatment they need while incarcerated. Instead of enrolling drug addicts in treatment programs while they are in jail, many inmates are left to wait out their sentences without any help for their problems. The study noted that only 28% of state inmates and 22% of jail inmates received treatment while incarcerated. These numbers are extremely low when one looks at the volume of addicts housed within the prison walls. But, this statistic also seems to be the most manageable to change at this point. Offering more treatment options, perhaps making treatment mandatory for those that have committed drug-related crimes could help many inmates from reoffending after their sentences have been served.

“In order to reduce crime and save taxpayer dollars, the U.S. Justice system must address addiction and substance abuse as health problems and provide effective intervention and treatment. Incarceration alone cannot prevent or treat a disease,” cautions the National Center on Addiction and Substance Abuse at Columbia University.

Marijuana was the most common drug the inmates were addicted to, followed by cocaine and then heroin and other opioids. Additionally, it appears that white inmates are struggling with addiction more than black and Hispanic inmates.

But, some states are working hard to improve the lives of inmates with addiction problems. Texas has recently added treatment facilities, specifically for drug addicted inmates and have also implemented treatment programs that are required before the inmate can be released back into society.

Study Shows Drug Use Among Medical Students

Despite the knowledge and understanding of the dangers of drug use, a new study shows that many medical students are experimenting with, and misusing drugs. Marijuana, alcohol and prescription drug use seem to be the most prevalent among medical students, although other illicit drugs are also used on campuses throughout the country.

The study includes information gathered from nine medical schools within the state of Florida and provides a comprehensive snapshot at what types of drugs are being abused by future doctors. According to the data collected, nearly 50% of medical students have used marijuana in their lives. Almost 25% of students used marijuana during medical school. 46.9% of medical students surveyed stated that their prescription drug use got worse in medical school, and most of these students admitted that these prescriptions were not their own. Of those that drink alcohol, 6.7% feel that they have a drinking problem.

Additional probing into the drug problem among medical students revealed the reasons behind the misuse. For instance, 16% of the future doctors that are abusing painkillers do so because it helps to relieve stress associated with medical school and work. For those doctors that are abusing ADHD medication, like Adderall, their primary reason (90%) was to help study, the same motivator for many college students throughout the country.

Perhaps what is most alarming about these figures is that these are the professionals that many families hope will prevent, stop, or intervene on their loved one’s drug use may be struggling with the same issue.

It is clear that medical schools need to step in and adjust the academic and social culture of their institutions. And for their part, schools are trying to help their students. Many school have implemented different early screening techniques to catch potential drug problems before they spiral out of control. Some colleges are implementing different relaxation techniques like yoga, wellness days and other personal services.

“I think the take away for medical schools is you have an opportunity and an obligation to help students develop into the healthiest physicians they can be. It’s much easier treating addiction problems or psychiatric issues early as opposed to waiting until they become more severe,” said Dr. Lisa Merlo, a clinical psychologist at the University of Florida and Director of Research for the Professionals Resource Network.