Archive for April, 2017

Anti-Drug Vaccines Could Be a Game-Changer for People Battling Addiction

Posted on: April 25th, 2017 by sobrietyresources

The toll of addiction is staggering. Approximately one in seven people who try addictive substances will get hooked, and the abuse of illicit drugs costs the economy $193 billion each year in healthcare, crime prevention, and loss of productivity, according to the National Institute on Drug Abuse. Around 22,000 people each year die after overdosing on illicit drugs.

Those in recovery walk a fine line. Any slip-up could potentially send them back down the path to addiction. But now, there could be a new tool to help addicts fight back. Researchers are working on vaccines that block drugs from reaching the brain, preventing addicts from getting high. These vaccines could help people in recovery stay clean, but they’re not likely to become part of the standard childhood immunizations lineup.

Some drugs already exist to help people get off a substance, but most must be taken daily and can have side effects including joint pain, anxiety, and impotence. Addiction vaccines, on the other hand, could work for months — or even years — though they would require multiple boosters.

The latest efforts in the field focus on prescription opioids like fentanyl, but work on addiction vaccines also includes shots for nicotine, cocaine, heroin, and methamphetamines. Chilean researchers are even working on an addiction vaccine for alcohol. With nearly two decades of research already invested, these efforts may soon pay off for people in recovery.

Vaccines are like a training course for the immune system — they give the body an opportunity to fight attackers like viruses or bacteria. Or in this case, drugs of abuse.

“The concept of addiction vaccines is if you can prevent the addictive molecule from reaching the brain, you won’t get the high and you’ll stop using,” explains Ron Crystal, a researcher at Weill Cornell Medical College who has developed a vaccine against cocaine that will soon go into clinical trials.

Making the Small Seem Large

The aim is for the immune system is to develop enough antibodies to attack the drug. Crystal describes the process: “If you snort some cocaine, it takes about 6 to 8 seconds to travel to the receptors in your brain, where it will induce an effect of getting high,” he says. “The antibodies have to be sufficient — like little Pac-Men floating around in your blood — to prevent the drug from reaching the brain.”

Viruses are incredibly tiny — after all, they require a special microscope to be seen. But compared with chemicals from addictive drugs, viruses are huge, which is why human immune systems don’t recognize the drugs as invaders. “That’s the reason why, even with million of smokers in the world who have nicotine floating around in their blood, nobody develops antibodies to it,” Crystal says.

To get around this problem, Crystal’s vaccine uses bits of viruses, like the cold virus, and a particle that mimics the structure of cocaine. When injected, the vaccine stimulates the immune system to mount a response to the cold virus — and the cocaine structure that’s hitching a ride.

In primate studies, only 20 percent of a cocaine dose was able to cross into the brains of immunized animals. The system requires a monthly booster to keep the level of antibodies up — something that would likely be required in people, too.

Heroin Treatment — in a Needle

Among the anti-heroin vaccines being tested, one coaxes the immune system to attack heroin and helps eliminate it from the body so effectively that it can neutralize lethal levels of the drug in animals.

A second anti­-heroin vaccine, developed at the Walter Reed Army Institute of Research in Silver Springs, Maryland, goes after two closely linked problems: It keeps heroin from reaching the brain while also preventing HIV infection.

“One of the common things is the threat of HIV due to substance abuse in injection drugs, and sharing needles,” says Gary Matyas, a biochemist who is leading the research at Walter Reed. “One of our goals is to develop vaccines for HIV, even something that partially works against HIV.”

The dual-purpose vaccine uses a protein carrier to create high levels of antibodies that bind to heroin and stop it from reaching the brain. The researchers plan to combine the vaccine with a novel therapy that reduces the risk of HIV. This vaccine protected about one-third of participants against HIV when it was tested in Thailand in 2009 — a modest result, but the first time any vaccine has worked in a human trial.

Merging the HIV vaccine with the heroin vaccine could be a game-changer for the two epidemics, which are intricately linked: Around a quarter of AIDS cases stem from intravenous drug use. Matyas says the combination anti-heroin-HIV vaccine is ready to enter clinical trials.

There are still challenges, though. When a person receives a vaccination against heroin, he or she also will lose the pain relief from morphine, since the two substances are closely linked. “So you lose those drugs as therapy for pain,” says Matyas, who points out there are other painkillers that don’t have the same chemical makeup and would still work.

That might be a small price to pay for getting rid of addiction, though the process involves more than just a vaccine. The researchers say vaccines are just one part of a system of changing behavior — but they could offer an important respite for people who are trying their best to make a change. It’s common for people to relapse, or to require more than one type of treatment, before finding a course of recovery that suits them.

“Basically I view any of these vaccines as a therapy for someone who wants to quit,” Matyas says. “It’s a tool for someone who wants to quit. They give a window where someone would have the opportunity to overcome their addiction.”

By KATHARINE GAMMON – April 24th, 2017

Her heroin party guests paid a cover to get in. Some had to be resuscitated to leave, cops say

Posted on: April 21st, 2017 by sobrietyresources


[email protected]

A Florida woman is accused of running a heroin party house — and collecting a cover charge before customers could go inside to get high.

The 37-year-old Sarasota woman, Danielle Baggett, was arrested April 11 on a charge of a nuisance dwelling, where deputies responded to seven overdoses, including her own.

The Sarasota County Sheriff’s Office Special Investigations Section was looking into the surge of suspected heroin and fentanyl overdoses, in particular at a home in the 4500 block of South Lockwood Ridge Road starting in August 2016. Deputies had been to the house, called by some as a “drug flop house,” 33 times since the start of the investigation for non-overdose related calls.

Detectives interviewed Baggett and she assured them that she was trying to “clean up” illegal activities at the house, according to the probable cause affidavit.

But over a period of seven months, victims would use heroin — sometimes cut with methamphetamine, sometimes with fentanyl — and then overdose.

Three of the overdoses happened one day after the next. Baggett was at the house each time deputies would respond and resuscitate them. One of the victims said he was dragged from the house and left in the front yard as he was overdosing.

According to the affidavit, the victims told detectives that Baggett created an environment at her house “for everyone to get high.” It was so exclusive, Baggett required a sort of cover fee of drugs before anyone could go inside, according to the affidavit.

The sheriff’s office said her prior record included arrests for marijuana possession, drug paraphernalia possession, dealing in stolen property and contributing to the delinquency of a minor.

Baggett was held at the Sarasota County jail on a $1,500 bond and was released April 12, but the investigation is ongoing and more charges are expected, according to the sheriff’s office.






Documents highlight Prince’s struggle with opioid addiction

Posted on: April 19th, 2017 by sobrietyresources

AP, Monday, 17 Apr 2017 | 8:28 PM ET

Before his death, Prince abused opioid pain pills, suffered withdrawal symptoms and received at least one opioid prescription under his bodyguard’s name, according to search warrants and affidavits unsealed Monday.

Prince was 57 when he was found alone and unresponsive in an elevator at Paisley Park on April 21. Nearly a year after his accidental overdose death at his suburban Minneapolis studio and estate, investigators still don’t know how he got the fentanyl that killed him. The newly unsealed documents give the clearest picture yet of Prince’s struggle with opioid painkillers.

What do authorities say happened?

Investigators heard plenty from the people at Paisley Park when Prince’s body was discovered. They told investigators that Prince was recently “going through withdrawals, which are believed to be the result of the abuse of prescription medication.”

When authorities later checked a database set up to monitor who’s getting prescriptions for controlled substances, they found nothing for Prince. But there was a prescription for the opioid painkiller oxycodone written for Kirk Johnson, Prince’s bodyguard.

The prescription was dated April 14, 2016, the same day Prince was revived with an anti-overdose drug after falling ill on a plane. Dr. Michael Schulenberg, who wrote the prescription, told authorities he put the prescription in Johnson’s name to protect Prince’s privacy, according to a detective’s affidavit. Schulenberg’s attorney, Amy Conners, said in a statement that Schulenberg never prescribed opioids to Prince directly nor to another person with the intent of giving them to the singer.

Johnson’s attorney, Clayton Tyler, said Johnson “did not secure nor supply the drugs which caused Prince’s death.” An autopsy showed Prince died of an overdose of fentanyl, another drug in the opioid family.

What are potential charges?

Writing a prescription under another person’s name violates state and federal law, said Ruth Martinez, executive director of the Minnesota Board of Medical Practice.

Martinez said she could not comment on whether the board is investigating Schulenberg’s treatment of Prince. The agency’s website on Monday listed no disciplinary or corrective actions taken against the doctor.

The board doesn’t launch investigations unless someone makes a complaint. Complaints typically take 90 to 120 days to resolve, she said.

A person convicted under the law could be stripped of the ability to prescribe controlled substances by the U.S. Drug Enforcement Administration and face other discipline from the state medical board.

Why no charges yet?

A year might seem like a long time without charges, but criminal justice experts say the fact that no one’s been charged doesn’t mean no one ever will. They say it’s a complex thing to track illegally obtained pills, and investigators and prosecutors want to build strong cases before interviewing witnesses who might provide useful information.

Although they can resort to subpoenas, the targets can exercise their right against self-incrimination — and the only way to get them to talk after that is by offering immunity. And, experts say, prosecutors and investigators don’t want to lose a high-profile case such as Prince’s — likely increasing their caution.

How often do prescribers use false names?

Martinez of the Minnesota medical board said it’s “quite infrequent” for a doctor to write out a prescription for someone in another person’s name.

Two Los Angeles attorneys say it happens all the time in Hollywood. Celebrities frequently use aliases in hospitals and doctor’s offices.

Laws against prescribing with a false name are not usually enforced when a doctor intends to protect a celebrity’s privacy, said Los Angeles attorney Ellyn Garofalo.

She represented a doctor who was acquitted of all charges, including false name allegations, in the death of Anna Nicole Smith, the Playboy model and reality TV star who died of an accidental overdose in 2007.

“They would be indicting every pharmacist in Beverly Hills if this were strictly enforced,” Garofalo said Monday.

Los Angeles criminal defense attorney Harland Braun said there are good reasons for doctors to want to protect privacy with the insatiable appetite for celebrity gossip.

“Say you have a major male actor who has a prescription for Viagra, do you want that out on TMZ?” Braun said.



Love or Drugs? The Science Behind an Addict’s Choice

Posted on: April 18th, 2017 by sobrietyresources

Drug addiction is increasingly becoming one of America’s most widespread epidemics. So much so, the Center for Disease Control reports that 91 Americans die every day from opioid overdoses.

When you combine that with overdoses from all other substances as well, that number almost doubles.

What’s more, these numbers are only rising (exponentially, in fact).

Shocking, right?

It seems clear, then, that something in the addiction treatment field just isn’t working.

One of the biggest problems today is the notion that addicts can simply choose to sober up—that they can just pick love over drugs.

Sadly, it’s a bit more complex than that.

Love and Drugs: Similarities and Differences

When you boil it down to the chemical fundamentals, love and drugs produce a pretty similar effect in the brain: they both release dopamine. This powerful and important neurotransmitter is the primary reason we seek out certain substances and experiences. In essence, it’s one of the driving forces behind all motivation.

When you look at basically any type of reward, whether it be reading a good book, eating a rich piece of chocolate cake, or finally getting that long-deserved promotion, the warm and fuzzy feelings you get are all the result of dopamine production.

And when it comes to love, that feeling of absolute euphoria, weightlessness, and pure joy is due almost entirely to a flooding of dopamine in the brain.

How does this type of reaction compare to drug use? It’s actually surprisingly similar and several studies have likened feelings of being in love to the effects of using cocaine and alcohol.

When it comes to drugs, though, an addict may experience significantly higher levels of dopamine when using compared to natural rewards—2 to 10 times higher according to the National Institute on Drug Abuse.

In addition to the unnaturally intense pleasure caused by such high levels of dopamine, this neurotransmitter also has an important role in working memory, an integral part of reasoning and decision making. In most cases, the greater the dopamine produced from an experience, the more likely we are to unconsciously commit that experience to memory.

Given the amount of dopamine produced by abusing certain substances, it’s no wonder that an addict’s cravings can be so much more intense than a normal memory.

The result of such extensive drug use is a brain that’s been physically altered to seek out experiences which yield unnaturally high levels of dopamine, a demand that can only be met by more and more substance abuse.

Chemically speaking, it’s not surprising that love alone doesn’t stand much of a chance against addiction.

The Present State of Addiction Treatment

So, the question is, “Why is this distinction important?”

One of the biggest problems facing addiction rehab today is having a treatment program that relies only on 12-step programs like Alcoholics Anonymous and Narcotics Anonymous. While some of the behavioral guidelines are helpful, their focus on addiction as a spiritual or moral flaw detracts from the fact that addiction is actually a brain disease.

Which is why treatment centers are turning their attention towards evidence-based therapy options like Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and Medication-Assisted Treatment (MAT). Such therapies not only treat addiction like the medical disorder it really is, they utilize science and behavioral approaches that have clinically proven results which are backed up by the numbers.

And when combined with the professional administering of treatments such as these, love can indeed stand a chance against addiction.

Akikur Mohammad, M.D., Contributor 04/18/2017 01:15 pm ET

Drug addiction more like learning disorder than disease, says best-selling author

Posted on: April 14th, 2017 by sobrietyresources

Bob Young The Seattle Times, April 12th, 2017, 10:59 a.m.

Maia Szalavitz first tried cocaine at 17, in Jerry Garcia’s hotel room, then became addicted to cocaine and heroin in her late teens and early 20s. She stopped using unprescribed drugs in 1988.

For nearly 30 years, she has made a career reporting on neuroscience, drugs and addiction. Her work has appeared in Time, Vice and The New York Times. Her latest book, “Unbroken Brain,” has attracted attention for arguing that addiction is more like a learning disorder than a disease or sin and that treatment approaches haven’t caught up with research.

As opioid-related deaths rise, we talked with Szalavitz before she spoke at the annual conference of the National Council for Behavioral Health in Seattle last week.

Q: Why do you say addiction is more like a learning or developmental disorder than a moral failing?

A: Learning disorders have a couple characteristics; one is they obviously involve learning. And addiction is defined as compulsive behavior despite negative consequences. Negative consequences is synonymous with punishment. It basically means you’re failing to learn from punishment. So that is a problem with learning. The other thing that happens in learning disorders, they’re usually restricted to a specific sort of brain circuit.

Q: Why are young people more vulnerable to addiction?

A: Developmental disorders characteristically appear at a certain time in life. Schizophrenia tends to come on in early adulthood and late adolescence. Addiction, similarly adolescence and early adulthood. This tells us something about what circuitry is being affected.

In this instance, it’s the circuitry that motivates us to survive and reproduce. Basically, addiction is love gone awry. You fall in love with a drug or activity rather than a person. That is the basis of why I think it’s a learning disorder. It happens because 90 percent of addiction starts in adolescence or your early 20s.

When you fall in love, it completely changes your priorities and you might do some irrational and not well-advised things to make sure you’ll be with that partner.

What happens in addiction is that reprioritization is now aimed at a drug rather than getting a person in your life.

Q: You’ve suggested the developing brain in young people is like a strong engine with weak brakes.

A: That’s probably Nora Volkow’s analogy. (Volkow heads the National Institute on Drug Abuse.) The brain develops from the inside out. The inner areas are the things that keep you alive like breathing and digestion and all these involuntary functions. Then you get the highest areas which are involved in decision-making and self-control. This is why your 2-year-old has very little self-control. The brain develops outwardly like that, until age 25 pretty much. So basically what you’re getting is development of an area that gives you strong desires to find a partner or impress your peers before you have a voice that says, “That is actually a stupid idea, don’t do that.”

Q: Why isn’t tough love, whether it’s stigmatizing, arresting, forcing treatment, the best approach to addictions?

A: There are two things here. We just said they have no brakes, so punishing them for having no brakes isn’t going to create brakes. Second, we’ve just said addiction is defined as compulsive behavior despite negative consequences. So if negative consequences were going to fix it, it wouldn’t exist in the first place.

It’s also cruel and inhumane. The horrifying thing about our addiction-treatment system is we stigmatize and do tough love and put all this pressure on people with addiction who are trying to change and who often want to stop. But then we tell them the way to stop is to go to this center where people are going to scream at you and take away the only thing that gives you any comfort and try to humiliate you. Well, I think I’m going to avoid that and take drugs, thank you very much. Then we blame people with addiction for not wanting to get help.

One of the reasons we need to decriminalize all possession and we need to get the criminal justice system out of forcing people into treatment is because treatment won’t improve until it has to attract its customers. When the customer is the criminal justice system, it makes it really easy for providers to get away with lousy treatment because the patient is always blamed. They didn’t work the program. They didn’t do the right thing. They’re the ones going to jail.

Q: Doesn’t evidence support other approaches?

A: There are two medications that are known to cut the death rate by at least 50 percent. These are methadone and buprenorphine, the brand name is Suboxone. And these medications only work if you take them long term. And that means years, not months, and it could be for life.

Basically, these medications give you a steady state in your opioid system. Your natural endogenous opioids in your brain are there to make you feel connected and safe and loved. When you are normally attached to people, you will feel endorphins when you are hugging them.

What happens when these medications work and you’ve got a person at a regular stable dose is they can drive, they can love and they can do anything that anybody else can do. But the problem is people confuse addiction with physical dependence and think that because you still need this medication to function you are still addicted.

This is not true. If that were true, I am a Prozac addict at this moment. I need antidepressants to function comfortably in this world. I don’t think this makes me a worse person than anybody else in this world, and if you want to think that, that’s your problem. That would make people with diabetes insulin addicts.

Q: Where does a safe injection facility, which has been proposed in Seattle, fit in treatment?

A: Harm reduction is basically the idea that I don’t care if you’re using drugs. We should care that somebody somewhere is at risk of harming themselves or others seriously. That is where government and society should have a role.

Safe injection is a great example of harm reduction.

Needle-exchange programs were America’s introduction to the concept of harm reduction. For the most part, no one wants to share needles because it’s gross, you could get disease, and because if you have a new needle, it’s going to be sharper, which means it’s more likely to get the vein, which means you’re more likely to get high.

So what turns out to happen is that if you do provide needles, people do change their behavior and New York went from over 50 percent IV drug users infected (with HIV) to 3 percent, and the state calls needle exchange the gold standard of HIV prevention.

The other thing about needle exchange that is 100 percent applicable to safe injection facilities is that when you walk in to a needle exchange and you’re an IV drug user, this is a place for you. You don’t have to promise you’re going to be abstinent at some point in the future. You don’t have to pray for anything. You just have to show up and people say, “We believe you’re a valuable person who deserves to live.” And that is the most powerful medicine for virtually any psychological or learning problem because people can learn and change when they feel safe and accepted.

You have to get creative around this because people are always going to want to change their consciousness, and you can either accept that and try to reduce the harms that could be associated with that, or we can continue banging our heads against the wall and harming people in the process, which is what we’re doing now.

Doctors once treated alcoholism with heroin. Now, they want to treat heroin addiction with marijuana.

Posted on: April 12th, 2017 by sobrietyresources

By Keith Humphreys April 11

A new drug treatment program says it has a cure for heroin addiction: marijuana.

The claim has attracted national attention, but the history of analogous miracle cures is as long as it is discouraging.

In the late 19th and early 20th centuries, some American physicians were persuaded that the best treatment for what was then called “alcoholism” or “inebriety” was morphine, an opiate. Even as late as the 1960s, researchers documented that a number of then-living morphine-addicted patients had been introduced to the drug by physicians as a treatment for their problem drinking.

At the turn of the 20th century, Bayer Corp., best known today for aspirin, rolled out what it marketed as a “safe, nonaddictive” alternative to morphine: heroin. Initially proposed as a pain killer and cough suppressant, it briefly gained a following among doctors who thought it a cure for morphine addiction and alcoholism. William White, a historian of the addiction field, notes that a well-meaning philanthropic organization known as the Saint James Society actually “started a campaign to provide free samples of heroin to any morphine addict who wanted to take the cure.”

Meanwhile, other physicians — most famously Sigmund Freud — touted yet another new wonder drug that would supposedly cure addiction to morphine, alcohol, heroin and tobacco, too.  It was cocaine, which claimed new victims of addiction, including William Halsted, a medical doctor, the founder of modern surgical practice.

In each case, initial enthusiasm for the “miracle treatment” waned when the new drug more often compounded than relieved the problems of addicted patients. Like an invasive species introduced intentionally into an environment to combat other invasive species, each new cure eventually became a problem in itself.

What accounts for these cycles of enthusiasm and disappointment? Historian David Courtwright of the University of North Florida emphasizes that medicine is surprisingly prone to fads. “Physicians like new drugs. When one becomes available it often gets overused. In the 1970s, for example, physicians prescribed Valium for a wide range of conditions, from anxiety to insomnia to muscle spasms. Quite a few patients became dependent.” Not incidentally, Valium was a benzodiazepine, a class of drugs that had been marketed as safer alternatives to barbiturates, a previous wonder drug that also proved to be addictive and dangerous.

The experience of patients also plays a role in persuading people that a drug is a miracle cure. Because using addictive drugs feels good in the short term (that’s why they are addictive), it can seem to patients with an enormous range of illnesses that addictive drugs are making their illness better. In some cases this is true: A certain extract of marijuana appears to reduce epileptic seizures, for example (prior Wonkblog coverage here). But in other cases the underlying condition is as bad as ever and the positive feelings that the patient is interpreting as successful treatment are really just the psychoactive reinforcement of the addictive drug.

Fortunately for people facing the potentially deadly disorder of heroin addiction, there is no need to rely on marijuana or any other unproven treatment. Multiple, well-researched FDA-approved medications are available, as are psychological therapies and mutual support groups that can produce additional benefits for heroin-addicted patients. The federal government operates a 24-hour-a-day helpline that can help addicted individuals access these lifesaving services.

Keith Humphreys is a professor of psychiatry at Stanford University




Workers comp programs fight addiction among injured workers

Posted on: April 10th, 2017 by sobrietyresources


Meet a victim of the nation’s opioid addiction scourge: the American worker.

A number of U.S. states are taking steps through their workers compensation systems to stem the overprescribing of the powerful painkillers to workers injured on the job, while helping those who became hooked to avoid potentially deadly consequences.

Injured workers, like so many others dealing with pain, are often prescribed opioids like OxyContin and Vicodin.

“I was eating them up like they were candy,” said Jimmy Duran, of Boston, who was prescribed opioids for years after hurting his neck and fracturing vertebrae in a workplace accident in 2004. A commercial mover, Duran was hit and thrown 30 feet by a moving truck.

“OxyContin, Percocet, morphine. … It ruined my life,” he said. “It brought me to my knees.”

Unable to work, broke and desperate to feed his habit, Duran said he eventually began dealing cocaine to bring in cash, a mistake that landed him in jail for two years. Free of addiction now, he has become a licensed counselor at a substance use prevention and treatment program.

In all, about 2.8 million private industry workers and 752,000 public sector employees suffered nonfatal workplace injuries in 2015, more than half resulting in time away from work, according to the most recent figures from the federal Bureau of Labor Statistics.

According to a survey by CompPharma, an industry group that seeks to control workers compensation spending, more than $1.5 billion was spent on opioids by workers compensation insurers in 2015, with prescriptions for injured workers accounting for 13 percent of total opioid pharmacy costs in the U.S. that year. Survey respondents cited opioids and addiction as their most pressing concern.

A separate study of 337,000 workers compensation claims in 25 states published last year by the independent Workers Compensation Research Institute found that 55 to 85 percent of injured workers who missed seven days or more of work received at least one opioid prescription.

Rates of longer-term opioid use varied widely among states, the study found, including 1 in 6 injured workers in Louisiana, and 1 in 10 in California, New York and Pennsylvania, but only 1 in 30 in New Jersey and Missouri.

States oversee workers compensation insurance systems that employers pay into, and that provide medical care and help offset wage losses from on-the-job injuries.

Omar Hernandez, an administrative judge who resolves workers compensation disputes for the Massachusetts Division of Industrial Accidents, said injured workers belie a common misconception of addicts as people shooting up in back alleys.

“These are people from all walks of life that didn’t ask to get injured,” he said. “These are hard-working people who unfortunately suffered a work-related injury … and are now hooked on these drugs.”

After he and other judges became alarmed by overdoses and deaths among people in the state’s workers compensation system, Hernandez spearheaded a voluntary program for people who had settled claims but were still being treated with opioids. It offers an expedited hearing process to resolve medication disputes with insurers and assigns care coordinators to help guide workers toward alternative treatments for pain.

Other states are changing policies, as well.

Calling opioid abuse a public health crisis that “deeply affects” injured workers in New York, the workers compensation board there announced in October it would allow insurers to request hearings to determine whether a claimant should be weaned off opioids.

Under new rules issued by the Ohio Bureau of Workers Compensation, reimbursement for opioid prescriptions can be denied if it’s believed physicians are overprescribing or otherwise failing to follow “best medical practices” in treating injured workers.

The rules also allow the bureau to provide treatment for opioid dependence to workers who got hooked on painkillers after getting hurt.

Those and previous steps taken by Ohio to combat opioid abuse have resulted in 44 percent fewer injured workers receiving opioids in the past five years, saving $46 million in drug costs, said Melissa Vince, a spokeswoman for the bureau.

Duran’s advice to other injured workers is to use painkillers sparingly and get off of them as quickly as possible.

“Once you’re on these pills, you forget you’re hurt,” he said. “You’re just about getting that high.”





Boy, 13, Dies of Suspected Heroin Overdose After Allegedly Getting Into Dad's Drugs: Reports

Posted on: April 7th, 2017 by sobrietyresources

Inside Edition, April 4, 2017

A 13-year-old Ohio boy died of a suspected heroin overdose after getting into a stash of drugs that allegedly belonged to his father, who has been jailed in a previous drug-related case, authorities said.

Nathan Wylie was left with no brain activity and on life support after his dad and a co-worker discovered him unconscious on March 28 at a mechanic’s lot in Dayton, relatives and officials said.

The pair managed to carry the teen to a fire station next door and allegedly indicated that Nathan had gotten into his father’s drugs, WHIO-TV reported.

Medics reportedly administered four milligrams of Narcan to no avail, and Nathan was rushed to a nearby hospital because he was not breathing.

He died Saturday at the hospital.

“His life has been tragically cut short,” a woman who identified herself as Nathan’s aunt wrote on a GoFundMe page created to raise money for his burial. “The family was not prepared for such a tragedy and one thing that we can give Nathan is a resting place for his family to visit him.”

Police said that they were interviewing witnesses and waiting on the coroner’s toxicology report to determine what drugs the boy accessed and how.

It could take up to eight weeks for the toxicology report to be completed, officials said.

The boy’s father, 40-year-old Robert Wylie, was arrested on suspicion of child endangerment.

Though he was technically released on March 30 in connection to the overdose case, he remained in custody at the Montgomery County Jail for a December drug possession arrest, officials said.

Police in December said they found Wylie with a needle, syringe, heroin and crack cocaine during a traffic stop of his girlfriend, according to a report.

He had been charged with possession of heroin, possession of cocaine and advertising and possessing in that case, online records show. That case is pending in court.

Cops had previously found drug paraphernalia in the boy’s home, when another minor who then lived there sent a picture of a bag of white power and a razor blade on a plate to a relative, according to WHIO-TV.

That photo made its way to the police.

Officers later found two crack pipes and a capped needle in the home, the TV station reported.

At the time, Wylie and his girlfriend reportedly were arrested for child endangerment, possession of drug paraphernalia and drug abuse instruments.






State of the State: Kasich wants $20 million to fight addiction

Posted on: April 5th, 2017 by sobrietyresources

By Randy Ludlow , The Columbus Dispatch

By Jim Siegel , The Columbus Dispatch

SANDUSKY — Declaring drug addiction “a common enemy,” Ohio Gov. John Kasich announced in his State of the State address Tuesday night that he is requesting up to $20 million in funding to help develop promising treatments and technologies to tackle the state’s opioid crisis.

The second-term Republican used his annual taking-it-on-the-road speech to reveal that the Third Frontier Commission, which handles bond money approved by Ohio voters, will help nudge promising drug-treatment ideas into reality.

The idea is to solicit proposals from researchers and centers that need a funding boost to quickly finish their drug-addiction breakthroughs to curb abuse and addiction, moving them from “the laboratory to the front line,” the administration said.

The proposal was the biggest Kasich advanced as he talked for 70 minutes and unveiled few other new initiatives before a crowd of about 1,400 people, including a joint session of the House and Senate, in the Sandusky State Theatre.

Cheri Walter, chief executive officer of the Ohio Association of County Behavioral Authorities, called Kasich’s Third Frontier funding plan “a new way of thinking about things.”

“It sounds to me like he is looking at new ways to address pain other than using prescription drugs,” Walter said. “He also may be talking about treatment. We do need to try to do new things.”

But, Walter said, more money still is needed for prevention and ongoing treatment.

Kasich talked at length on drugs. “We love our children and care about our neighbors, so we’ve got to deliver this message to them: ‘Don’t do drugs or you will destroy your life and you will destroy the purpose for which the good Lord created you,’” the governor said.

Ohio’s torrent of deaths, principally from opioids such as heroin and fentanyl, reached 3,050 in 2015, the highest in the nation. Preliminary numbers and some experts suggest that total may have exceeded 4,000 last year.

“The governor hit it right on the head, that we’re ensuring we’re doing everything we can to ensure that communities have the tools to address all the needs they have with this opioid crisis,” said Speaker Cliff Rosenberger, R-Clarksville. “We’re in a tight budget. I’m not sure what we’re going to be able to do or not do.”

Minority Democrats and treatment providers have complained that the state is not doing enough to battle the crisis, and local communities have faced significant state funding cuts over the past six years. Kasich has countered that the state now spends nearly $1 billion a year in state and federal funds — largely for drug-addiction treatment for Medicaid patients — to counter the epidemic, though most of that is federal and local money.

Senate Minority Leader Joe Schiavoni, D-Boardman, noted that two counties have had to rent refrigerator trucks to handle the glut of bodies from overdose deaths.

“You can’t just talk about drugs. You have to take action. You have to make investments in educating kids and giving police to deal with the problem and making sure we have rehabilitation for these folks,” he said.

“To say we’ve cut $5 billion in taxes, and have $2 billion sitting in a rainy-day fund, and then in the next sentence talk about how we are trying to help folks in the shadows — we do not have the programs in place to do that.”

The governor also used his next-to-last State of the State address to call for Ohio to prepare itself to attract and handle the high-tech jobs of the future.

He announced he is appointing a task force of business, industrial and higher-education “thinkers” to “look into the future and anticipate what we might lose and what we might gain.”

Ohio’s schools, universities and workforce must be prepared to evolve and handle a coming sea change of new jobs tied to technology such as autonomous vehicles, drone technology and data analytics, Kasich said. His budget seeks investments, including a state chief information officer, to promote research into new products and jobs.

While the state’s job growth continues to trail national averages, Kasich observed that the state is becoming more attractive to businesses such as Amazon and others and the state is welcoming a wave of innovative jobs. “The world’s job creators know that we here in Ohio makes things. That’s why they’re turning to us for their future success,” he said.

The governor defended his “tight” state budget proposal, observing, “If we do not hold the line on spending, I will tell you this: We will get crushed economically.”

The Republican-controlled General Assembly appears to have largely balked at Kasich’s proposal to increase the sales tax by one-half percent to further cut income taxes. But, the governor said a failure to further reduce and eventually eliminate the income tax would make Ohio less competitive for jobs.

Kasich presented three “Governor’s Courage Awards,” with one going to Franklin County Municipal Judge Paul M. Herbert for helping human-trafficking victims, including prostitutes. Herbert has helped about 200 women through the court’s CATCH (Changing Actions to Change Habits), a two-year program that treats prostitutes as victims instead of jailing them as criminals, the governor said.

While Kasich’s speech was interrupted by applause about three dozen times, not all who listened were pleased. A knot of about 50 protesters gathered in a park about two blocks from the theater to denounce problems ranging from algae blooms threatening Lake Erie to Kasich’s education policies to equal pay for women on what was billed as “Equal Pay Day.”

“Wage equality is not a women’s issue,” said the Rev. Rob Patton, a United Church of Christ pastor who now works with animal “assistants” for children. “It’s an issue because it’s the right thing,” said Patton, of Vermilion.

Waking up: As state response lags, communities step up to fight addiction

Posted on: April 4th, 2017 by sobrietyresources

Police departments, churches, health care institutions and municipalities recognize the need to invest in a remedy to the opioid crisis. Slowly, even the government is coming around.

 BY JOE LAWLOR STAFF WRITER April 4th, 2017, Posted 4:00 AM Updated at 6:52 AM

In town halls, police departments, churches, county jails and hospitals across Maine, the talk is what to do about heroin.

From folding chairs in Down East community centers to pews in southern Maine churches, community leaders and activists are working to address a public health crisis that state government was slow to recognize and address.

Grass-roots efforts have aimed to fill the void left by state policies that made it more difficult for addicts to get treatment despite the rising overdose deaths, 378 in 2016, or about one death per day.

“I didn’t need a revelation. It’s happening all around us,” said the Rev. Todd Bell, pastor of Calvary Baptist Church in Sanford, which is starting a faith-based treatment program this spring.

But is Maine’s approach working?

Since December, state government has begun to devote more money and resources to the opioid epidemic, including $5.4 million for the uninsured, and to reduce MaineCare wait lists for treatment. A tough new state prescribing law passed last year intends to curb the flow of prescription opioids – blamed for fueling the crisis – and prevent people from getting addicted in the first place.

To understand the state of Maine’s often conflicting views of the crisis, a recent radio interview with Gov. Paul LePage offers insight.

Speaking on WVOM in Bangor last month, LePage asserted that opioid treatment was readily available and free for the uninsured.

Not true.

Addiction specialists, hospitals and doctors’ groups report that access to treatment is nearly impossible for the uninsured. And they account for about 40 percent of those who are seeking help, according to treatment centers. Maine – because of LePage’s vetoes – has also refused to expand Medicaid, which would open up drug treatment to thousands who are now uninsured.

Rob Gay knows personally how hard it is to find treatment with no insurance. After a suicide attempt in August and years of opioid abuse, Gay tried for six months before he finally got into a long-term residential treatment program operated by Milestone Foundation in Old Orchard Beach. The foundation has three beds for the uninsured.

“I definitely lucked out,” said Gay, 34, of Gardiner. “The wait was nerve-racking, and I lost hope sometimes. It’s so hard to get in anywhere.”

Gay said he easily could have been one of the hundreds who died of a drug overdose over the past few years.

More than twice as many people in Maine died from drug overdoses – 378 – than from vehicle accidents in 2016.

Will the varied efforts – by the state, communities, police, churches, the health care industry and treatment providers – be enough to reverse the tide of overdose deaths?

Some are skeptical Maine is doing enough – and that the mixed messages are weakening the response.

Health care experts contend that the LePage administration – despite recent attention to treatment – has not devised a comprehensive response to the problem, even as the overdose rate accelerated over the past three years.

Steve Cotreau, program manager for Portland Community Recovery Center and a coordinator for Operation Hope, a Scarborough Police Department program that helps connect addicts with recovery, said inaction by the state led to Operation Hope starting in 2015. Most of the program’s placements are out-of-state because of the lack of treatment resources in Maine.

Cotreau said he suspects the vacuum caused by the state’s tepid response led to the launch of other local and regional efforts.

“If the state had done more, there wouldn’t have been this great need,” Cotreau said. “People wanted to do something. But these are just Band-Aids trying to cover a gaping wound. We need huge interventions, and they’re not happening yet.”

Gordon Smith, executive vice president of the Maine Medical Association, which represents doctors before the Legislature, said while it’s difficult to predict overdose trends, he believes deaths could continue to climb over the next few years. He said the response has improved but is not yet robust enough.

“I’m not confident that there’s going to be improvement anytime soon in overdose deaths,” said Smith, who has worked for more than a year on new prescribing standards and trying to persuade more doctors to treat addiction.

Even in Vermont – hailed by national addiction experts as a model on how to address the opioid crisis – overdose deaths are still climbing. Vermont had 155 deaths from heroin or other opioids in 2016, up from 94 the previous year. Since 2014, Vermont has devoted resources and committed to a model to deliver treatment to its residents.

Meanwhile, grass-roots efforts in various parts of Maine are cropping up, from Sanford to Portland, Lewiston, Bangor, Augusta and other cities and towns. Many of the efforts are to expand medication-assisted treatment – including Suboxone and methadone – which curbs cravings and is widely considered the most effective treatment for opioid addictions.


One of the most vexing problems is connecting the uninsured to treatment, because opioid addicts often lose their jobs and their insurance while grappling with addiction. LePage has vetoed several attempts to expand MaineCare, the state’s version of Medicaid, which would open up treatment options for thousands by allowing more low-income Mainers to qualify for insurance. The administration instead has promised to spend an additional $5.4 million to help the uninsured and those receiving MaineCare, providing medication-assisted treatment to an estimated 750 more people.

Experts call it a start but say much more needs to be done.

For instance, Medicaid expansion would provide insurance to 80,000 Mainers, although it’s unknown how many of the newly insured would take advantage of substance use treatment services. Medicaid expansion will go before voters in a November referendum.

About 25,000 to 30,000 Mainers with addiction can’t get the help they need, according to the Substance Abuse and Mental Health Services Administration. About 15,500 people received treatment for opioid addictions in 2015, according to state statistics. The total number of people with opioid addictions is unknown.

Other steps have also constricted treatment options in Maine.

Since 2012, the administration has cut methadone reimbursement rates, limited eligibility for methadone treatment to no more than two years without prior authorization and removed thousands of adults from MaineCare. Leaders of methadone clinics say Maine’s $60 weekly reimbursement rate for methadone is too low and was a major reason that a Sanford methadone clinic closed two years ago. New requirements imposed upon methadone clinics in late 2016 are also limiting access, said Jim Cohen, an attorney who represents the clinics. About 4,000 Mainers receive methadone treatment.

LePage also vetoed bills to expand access to naloxone, a life-saving antidote to overdoses.

The Legislature finally overrode one of those vetoes to make naloxone available to family members and friends of drug users.

Meanwhile, a bill sponsored by Rep. Karen Vachon, R-Scarborough, would pump $6.7 million into medication-assisted treatment, giving access to about 1,000 Mainers and adding more muscle to the administration’s proposals to expand treatment.

Vachon said the crisis is so acute that it’s time for a more aggressive response.

“The proper treatment requires a lot of big cost,” she said. “It’s a tough disease to tackle.”


The medical community has also been slow to react, a point that has been made by the Maine Medical Association and several doctors who are addiction specialists.

“With one death daily, it’s a disgrace that only 5 percent of Maine primary care physicians have obtained the DEA waiver to treat addiction. We can do better by our patients,” the association said in a recent Facebook post.

Maine is far from alone on that count, said Dr. Norman Wettereau, chairman of the American Society of Addiction Medicine’s family practice work group. Wettereau said in most states, the response to the opioid crisis was weak.

“I am infuriated with the medical profession,” said Wettereau, an addiction specialist in Rochester, New York. “They were a major cause of the problem, and they didn’t want to do anything about it.”

He said Vermont, New York, Massachusetts and Rhode Island are among the states that are doing a better job of providing treatment and reducing the prevalence of opioid prescriptions.

A “hub and spoke” system launched in Vermont two years ago is being used as a model for Maine. The idea is to have a central location – a clinic, usually – for the most acute patients with substance use disorder. Those who stabilize are transferred to other programs, usually primary care practices.

The system will require more doctors who are trained and willing to prescribe Suboxone, a difficult problem to solve but one where progress is being made, Smith said. This year nurse practitioners and physician assistants acquired the authority to prescribe, which should help alleviate the shortage, Smith said.

Gay, who recently made it into the Milestone treatment program, said Suboxone has helped him, although his goal is to eventually taper off of the medication. Like many heroin users, he started on prescription painkillers. Although he had taken other drugs in high school, he said his opioid addiction started when he injured his shoulder playing hockey and his doctor prescribed him Vicodin.

Gay said shortly before his suicide attempt, he was arrested for stealing and pawning guns so he would have money for drugs.

“I knew I liked the feeling it gave me,” he said. “I felt like Superman.”


Local and regional efforts to combat opioids are springing up all over the state, including in Portland, Augusta, Bangor and other places.

Many times, the new programs encounter barriers caused by Maine’s lack of treatment resources.

At Nasson Health Care in Sanford, the clinic is expanding Suboxone treatment, but the current financial model makes it difficult to do so to a great degree. The uninsured must pay out-of-pocket, and Suboxone costs several thousand dollars per year. If 40 percent of the patients treated were uninsured, the cost would be unsustainable, said Nasson executive director Mary Sabol, because the clinic would have to foot the bill.

“If we (Nasson) tried to pay for that many uninsured, it would break our bank,” Sabol said.

Nonetheless, health systems are rolling out new programs despite the obstacles.

MaineHealth, the largest health care network in the state and the parent company of Maine Medical Center, is establishing a hub and spoke model in health networks across the state.

In Augusta, Alane O’Connor, a Waterville nurse practitioner, is launching a program with MaineGeneral Medical Center in which several doctors staff a clinic for a few hours each month, seeing patients and writing Suboxone prescriptions. Once the patients are stabilized, they are transferred to primary care practices.

The Maine Health Access Foundation is spending $800,000 over the next two years on $75,000 grants that will help communities across the state launch medication-assisted treatment.

In the Bangor area, a new program in Old Town operated by the Penobscot Community Health Center this spring will start serving about 200 patients. Bangor is also opening a detox center, the second in the state after Portland’s Milestone Foundation.

Grace Street Services, a medication assisted treatment provider, is working with several partners to open a facility in Sanford.

Portland has formed a coalition seeking funding through a federal program, while Buxton, Gorham, Windham and Westbrook are collaborating on a program that connects people with treatment programs. The Cumberland County Jail is starting an opioid treatment program for inmates, and York County is working on opening a long-term, residential treatment program.

Eric Haram, an independent consultant who formerly ran a treatment program at Mid-Coast Hospital in Brunswick, said he now travels the state, explaining how to start Suboxone programs, and he’s seeing a lot more interest in recent months.

“There’s been a seismic change, a cascading effect,” Haram said. “People are starting to get it, and are saying, ‘Yeah, let’s do this.’”

Smith, at the Maine Medical Association, said the state’s recent decision to fund more treatment represented “a huge turnaround in the administration’s philosophy” and would help address the mounting toll of addiction. But he also said he’s not convinced that Maine has found a way yet to make a significant impact on the heroin epidemic.

“I’m afraid there’s a lot of people in trouble,” he said, “and we still haven’t yet devoted enough resources to this.”




Copyright 2017. All Rights Reserved.