Archive for October, 2017

Recovery advocate Anita Devlin says President Trump ‘in denial’

Posted on: October 27th, 2017 by sobrietyresources No Comments

 

By David Heitz

 

Although First Lady Melania Trump may have stolen the show, President Trump declared the opioid epidemic “a public health emergency” on Thursday.

But will it really be enough to turn the tide and stop overdose deaths?

Here’s an even bigger question.

If resources weren’t an issue, what’s the single biggest thing we could do, as a country, and as individuals, to deal deadly opioids a decisive blow and liberate its victims once and for all?

The answer probably has less to do with financial resources and more to do with intestinal fortitude.

For starters, everyone needs to speak up.

“My son became addicted to opioids when prescribed pain pills for a football injury.”

“My mom overdosed while taking my little sister to soccer practice last week.”

“My uncle went to prison for prescribing pain pills to people who didn’t need them.”

Just ask Anita Devlin, author of S.O.B.E.R., the no-words-minced story of a proud Greek family’s journey from addiction (and stigma) to recovery.

 

Why the delay, President Trump?

 

On Thursday, in an exclusive interview with SobrietyResources.org, she stated “people are ignorant” and the president is “in complete denial” over the opioid epidemic.

Devlin echoed the same sentiment as the tens of thousands of others who have lost loved ones to opioids: Why did it take 76 days for President Trump to follow through on a promise to declare an emergency?

In that amount of time, Devlin noted, more than 10,000 people in the U.S. died of opioid overdose. That’s using a widely held statistic of about 175 deaths per day, a statistic President Trump quoted Thursday.

“These are not addicts who are dying,” she said. “These are our sons and daughters who are dying.

“Addiction is an octopus. Anyone who is in denial and ignorant about the situation tearing through our country, killing our children, all they do, with their ignorance and denial, is feed and nurture this ugly octopus.

“Fearing what they don’t understand.

“Denial equals death, and it’s our children who are dying.”

The pillar of that denial for many of us is that we live in a nation where powerful corporations are able to break laws in ways that hurt us.

And just as the Department of Justice boldly moved at long last in 1999 to hold Big Tobacco accountable for the deaths of millions of Americans, as well as staggering healthcare costs, it probably will need to do so again with Big Pharma.

And in his speech on Thursday, President Trump hinted that may be coming.

The DOJ largely failed in its pursuit of the makers of the deadly tobacco plant, but individual states and private attorneys saw great success.

 

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Lawyer who took on Big Tobacco now aiming legal artillery at Big Pharma

 

Clearly, there is such a thing as divine justice.

The name Mark Moore may sound familiar to you. He scored a credit in the movie “The Insider,” a movie about – you guessed it – whistleblowers in the tobacco insider.

Moore played himself in the movie. Moore is the lawyer, Mississippi’s attorney general at the time, who negotiated “the largest corporate legal settlement in U.S. history: a 50-state, $246 billion agreement that funds smoking cessation and prevention programs to this day,” to quote Bloomberg Businessweek. (1)

Moore is in the news again because now he’s taking on the opioid industry. It sure is bad luck for them that Moore found his nephew overdosed from opioids seven years ago, slouched down from overdose, wet vomit on his shirt.

But it was good luck for the nephew, who was saved by Moore, who is a father figure to the man.

In July, Moore met with a dozen top lawyers from around the country at the same Washington hotel where the quarter-of-a-trillion class-action lawsuit against Big Tobacco was born.

Reported Fortune late last month:

 

“Aided by the lawyers in the room (and others, including high-profile and high-profiting alumni of the tobacco wars, such as Joe Rice and Steve Berman), 10 states and dozens of cities and counties have sued companies including Purdue Pharma, Endo, and Johnson & Johnson’s Janssen Pharmaceuticals—beginning in 2014 but mostly in the past few months.

 

(Forty state AGs have launched preliminary investigations as a way to gauge the viability of litigation.) The suits allege that the companies triggered the opioid epidemic by minimizing the addiction and overdose risk of painkillers such as OxyContin, Percocet, and Duragesic. Opioids don’t just cause problems when they’re misused, the suits argue: They do so when used as directed, too.” (2)

 

Many municipalities already have taken aim at Pharma and its tentacle industries.

In a tiny town in West Virginia in June, mega-healthcare giant Cardinal Health, fingered in the 60 Minutes probe as being one of the most audacious violators of law, flew in top brass to “educate the (Mingo) County Commission.”

Fortune quoted attorney Ken Feinberg, who believes Pharma doesn’t have too much to worry about. Check out this incredibly rich prose:

“Even if the litigation is successful, what will you do with this money?” Feinberg asked.

He says giving it to surviving victims may be problematic, given their addictions.

As for paying for the nation’s crisis, well, the bill is just too big. Says Feinberg:

“I don’t think there’s enough money to cover it.”

 

How America won the tobacco war

 

But going back to the tobacco war, it may have taken half a century but it is being won.

Why has the war against cigarettes been successful? Every ugly aspect of smoking has thoroughly been exploited, and the educational campaign was paid for by Big Tobacco.

Along those lines, Devlin has a great idea. She is on the Board of Directors of a Foundation that will educate young people and communities about opioid addiction through music. She said musical artists are lining up to participate in a campaign to host sober concerts all over America.

The Foundation is called, “Above the Noise.”

You can bet that anything Anita Devlin is involved with likely won’t be sterile in its messaging. Her book, S.O.B.E.R., stands for “Son of a Bitch, Everything is Real,” after all.

Meanwhile, even Melania Trump is saying it: Stop the stigma.

“I have learned so much from those brave enough to talk about this epidemic, and I know there are so many more stories to tell,” Melania Trump explained in a lengthy introduction of her husband Thursday, which included a passionate description of her advocacy work for opioid-addicted children.

In the end, Trump’s order was not the “national emergency” type of declaration used for hurricanes and earthquakes, which would have made a lot of money available very quickly. But it will make money more quickly available in some ways, including getting telemedicine treatment to rural areas where clinicians are scarce.

 

You can check out USA Today’s exclusive report and live footage of the president’s speech by clicking here.

 

There never will be an “end” to opioid abuse even if overdoses were slashed by 90 percent. Once a genie is out of a bottle, the genie can fool the unsuspecting.

Is this really what an “emergency” designation is for, then? How can we recover from an ongoing crisis?

And is now really any time to be using natural disaster funds for things other than natural disasters?

The declaration may have been moot anyway in the long run. Facing stigma and addiction takes every person in every city in every town. Nobody can be forced to acknowledge this problem until they are dead or at a funeral.

But as the president’s approval ratings sink to a new low (38 percent) per Fox News on Thursday, he must face the people who elected him: The so-called ‘Opioid Belt,’ so desperate for hope that a populist message convinced them to vote for him. (3)

And he has let them down in a very big way, even if only in appearances.

 

Bibliography

 

  1. Deprez, E. et al. (2017, Sept. 28). The lawyer who beat Big Tobacco takes on the opioid industry. Bloomberg Business Week. Retrieved Oct. 26, 2017, from https://www.bloomberg.com/news/features/2017-10-05/the-lawyer-who-beat-big-tobacco-takes-on-the-opioid-industry

 

  1. Fry, E. (20176, Sept. 27). Big Pharma is getting hit with a huge wave of opioid suits. Fortune. Retrieved Oct. 26, 2017, from http://fortune.com/2017/09/27/big-pharma-opioid-lawsuits/

 

  1. Fox News. (2017, Oct. 26). Storms erode Trump poll numbers. Retrieved Oct. 26, 2017, from http://www.foxnews.com/politics/2017/10/25/fox-news-poll-storms-erode-trumps-ratings.html

 

 

Heroin withdrawals are awful, but you and your loved one can get through it

Posted on: October 20th, 2017 by sobrietyresources No Comments

 

By David Heitz

 

Heroin withdrawals can be dangerous and fatal, particularly to a heroin addict who already may be in poor health due to prolonged drug use.

For even a healthy pregnant woman, however, heroin withdrawals can result in loss of the fetus.

 

Symptoms include:

Vomiting.

Restless legs.

Cold sweats.

Anxiety.

Irritability.

 

Withdrawal symptoms peak about a day or two after a person last uses heroin. A week later, they usually subside.

“Heroin withdrawal is never fatal to otherwise healthy adults, but it can cause death to the fetus of a pregnant addict,” the renowned Cleveland Clinic reports. (1)

 

According to the Cleveland Clinic:

 

“Physical dependence and the emergence of withdrawal symptoms were once believed to be the key features of heroin addiction. We now know this may not be the case entirely, since craving and relapse can occur weeks and months after withdrawal symptoms are long gone.

“We also know that patients with chronic pain who need opiates to function (sometimes over extended periods) have few if any problems leaving opiates after their pain is resolved by other means. This may be because the patient in pain is simply seeking relief of pain and not the rush sought by the addict.”

 

What it’s like to go through heroin withdrawals: In the words of an addict

 

The non-profit, non-partisan journalism website MinnPost.com has a compelling story that includes first-person accounts of heroin withdrawal.

Writes Ian McLoone, a University of Minnesota graduate student when the piece was written in 2014:

 

“In the moment, when you are experiencing the first few stages of withdrawal, even though you know that the worst that’s going to happen is that you will feel like you have the flu, there’s a psychological piece that is so terrifying and so disconcerting.

“You know that there’s a cure, and you know that it’s out there, and that’s why people will go to such lengths to quell those withdrawal symptoms. Even though it’s ridiculous and it’s weak and it’s pitiful, in the moment, it really seems like it’s the worst thing that can ever possibly happen. Isn’t that weird?” (2)

 

Why some people detox and get past heroin more easily than others

 

Many, if not most, people who suffer from any kind of addition do so because they have a co-occurring mental disorder. To back up and destigmatize: A mental disorder can result from being a victim. For example, PTSD is a common mental disorder that often results in the victim trying to medicate anxiety, anger and angst.

 

Many turn to booze; some turn to opioids.

Those who turn to both often don’t come out alive.

Scientists have known about the effects of opioids on the brain for about 15 years now. In one 2002 study, the authors explained it this way.

 

“The abnormalities that produce dependence, well understood by science, appear to resolve after detoxification, within days or weeks after opioid use stops. The abnormalities that produce addiction, however, are more wide-ranging, complex, and long-lasting.

“They may involve an interaction of environmental effects—for example, stress, the social context of initial opiate use, and psychological conditioning—and a genetic predisposition in the form of brain pathways that were abnormal even before the first dose of opioid was taken. Such abnormalities can produce craving that leads to relapse months or years after the individual is no longer opioid dependent. (3)”

 

It’s important that treatment also address the underlying psychological problems causing most patients to use. A good treatment center also helps people addicted to drugs or alcohol find fun, new habits that will replace those that brought them to treatment in the first place.

 

Besides withdrawals, which can be fatal in already unhealthy people (as most long-term heroin addicts reach the point of injecting), heroin use has many other dangerous consequences, according to Cleveland Clinic.

“Many of the additives in street heroin may include substances that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. Immune reactions to these or other contaminants can cause arthritis or other rheumatologic problems.”

How to manage heroin withdrawals

 

Over-the counter medications for diarrhea, motion sickness and allergies (Benadryl) can help manage opioid withdrawals at home, Healthline.com reports. Chinese medicine such as acupuncture also can be helpful.

Still, quitting a drug “cold turkey’ should be done under the supervision of a doctor, even if you try to do it at home. Tell your doctor of your intent to stop using and make sure they are available to help you if you need it. (4)

 

Managing withdrawals with medication

While nobody looking to get sober likes taking medication that is a derivative of what they’re addicted to, it does make withdrawals easier and safer for the short term.

Many treatments known as “opioid maintenance therapy” are available, including:

Methadone. With the advent of buprenorphine, methadone isn’t used as often as it once was, at least in terms of which medication to choose when it comes to opioid maintenance therapy.

Reports Medscape:

“Methadone, a long-acting synthetic opioid agonist, can be dosed once daily and replaces the necessity for multiple daily heroin doses. As such, it stabilizes the drug-abusing lifestyle, reducing criminal behaviors, and also reducing needle sharing and promiscuous behaviors leading to transmission of HIV and other diseases.

 

“Methadone is a highly regulated Schedule II medication, only available at specialized methadone maintenance clinics. It is estimated that established methadone clinics can accommodate only 15 to 20 percent of U.S. heroin addicts.

“Methadone clinics often generate controversy in communities fearful of addicts in various stages of recovery. In addition, some patients are unable to travel to clinics, and others will not enter methadone maintenance therapy because of fear of stigmatization. Clearly other options would be beneficial for treatment of chronic opioid abuse.”(5)

Buprenorphine. Buprenorphine is usually considered a better choice than methadone because it’s formulated differently. Buprenorphine will not produce the euphoria that comes along with methadone, yet it still will help quell the symptoms of withdrawals. (6)

Today, there even is a long-lasting buprenorphine implants. Studies have shown it has been helpful in some people in terms of easing withdrawals when opioid maintenance therapy also stops.

Naltrexone. According to SAMSHA:

 

“Naltrexone blocks the euphoric and sedative effects of drugs such as heroin, morphine, and codeine. It works differently in the body than buprenorphine and methadone, which activate opioid receptors in the body that suppress cravings. Naltrexone binds and blocks opioid receptors, and is reported to reduce opioid cravings. There is no abuse and diversion potential with naltrexone.” (7)

While heroin withdrawals are extremely uncomfortable and can be dangerous, horror stories make it sounds worse than it actually is – even as bad as it is.

Treatment in a comfortable environment with a supportive treatment team makes heroin withdrawals and even lasting recovery very manageable.

The addicted owe it to themselves to reclaim their lives, and those who love them should support them every step of the way.

Bibliography

  1. Heroin: Abuse and Addiction. Undated. Cleveland Clinic. Retrieved Sept. 24, 2017, from http://www.clevelandclinic.org/health/health-info/docs/0900/0915.asp
  2. Williams, S. (2014, Feb. 14). What’s it really like to withdrawal from heroin and painkillers? MinnPost. Retrieved Sept. 24, 2017, from https://www.minnpost.com/mental-health-addiction/2014/02/whats-it-really-withdraw-heroin-and-painkillers
  3. Kosten, T. et al. (2002, July). The Neurobiology of Opioid Dependence: Implications for Treatment. Addiction Science Clinical Practice. Retrieved Sept. 24, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/
  4. Home remedies to ease opioid withdrawal symptoms. Undated. Healthline. Retrieved Sept. 24, 2017, from https://www.healthline.com/health/home-remedies-opiate-withdrawal#support5
  5. Opioid Abuse: Treatment and management. (2017, July 13). Medscape. Retrieved Sept. 24, 2017, from http://emedicine.medscape.com/article/287790-treatment
  6. Whelan, P. et al. (2012, Jan-April). Buprenorphine v. methadone treatment: A review of evidence in both developing and developed world. Journal of Neuroscience Rural Practice. Retrieved Sept. 24, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271614/
  7. (2016, Sept. 12). Substance Abuse and Mental Health Services Administration (SAMSHA). Retrieved Sept. 24, 2017, from https://www.samhsa.gov/medication-assisted-treatment/treatment/naltrexone

 

D.C. opioid scandal: Will moms, dads, sons and daughters soon be marching on Capitol Hill?

Posted on: October 18th, 2017 by sobrietyresources No Comments

 

By David Heitz

 

A bombshell “60 Minutes” and Washington Post investigation into the opioid epidemic has reverberated from sea to shining sea in just a few days.

The shocking expose broadcast Sunday on CBS showed how Pharma’s auxiliary machinery funneled millions and millions of pain pills – illegally — into communities where the most people were dying of overdose.

But it only proved to be the tip of the iceberg.

They got by with it because the Pharma lobby, spending a quarter of a billion dollars last year to massage our elected representatives in Washington, distracted both parties of both houses.

Even if, perhaps, not directly, or even knowingly on the part of lawmakers.

But if they didn’t know, they sure should have. Most Americans expect diligence from their elected officials, particularly on matters as serious as the opioid epidemic.

We knew it, say people both actively addicted to opioids as well as those in recovery, along with the thousands of Americans who have lost loved ones to overdose.

And their swift demands for change on social media already have toppled one official who was standing outside the door of the president’s inner circle, about to be allowed inside.

As the nation’s drug czar.

 

Founder of NOPE Task Force: ‘What is going on with the DEA?’

 

In a statement to SobrietyResources.org, Karen Perry, founder of NOPE Task Force, described her reaction as she saw whistleblower Joe Rannazzisi tell CBS News correspondent Bill Whitaker the disturbing details.

“Joe spoke at the National RX conference hosted by operation Unite several years when it first began. He was a very informative great speaker (explaining how) the DEA controlled how many pills the manufacturers could produce each year.

“Not knowing the reason Joe left, this past year I was thinking what is going on with the DEA? Why are they allowing for so many pills to be produced? Now, I know. 

“It is truly horrific those (all involved) we trusted with our safety have betrayed us. Too many families struggle with addiction and far too many families are saddened with loss. 

“I am grateful that Joe spoke up. His voice will surely help to change the atmosphere of the DEA and hopefully help to save lives.”

As if the story could not possibly be more horrific, the high-ranking Rannazzisi – indeed, he ran the DEA’s Office of Diversion Control, charged with monitoring Pharma and its support service tentacles – wound up being investigated for “intimidating the U.S. Congress” and later lost his job.

This, after he testified before Congress to the aforementioned hazards in an effort to fix it. He also was intimidated during the hearings by smug lawmakers who refused to take personal responsibility.

 

Lawmakers silence Rannazzisi, make it easy for companies to break law

 

Meanwhile, ex-DEA staffers jumped to the other side and worked in conjunction with Fortune 500 pill distributors and the Department of Justice to slam the brakes on enforcement of laws aimed at shutting rogue distributors down.

They succeeded, managing to send the most inappropriate legislation imaginable through the hallowed halls of Washington as easily as a child sails a paper airplane onto the teacher’s desk.

President Obama swiftly signed the bill, which had bi-partisan support, the support of the DEA and not one vote against it in either house. The bill’s name?

The “Ensuring Patient Access and Effective Drug Enforcement Act.”

If it sounds too politically correct to be true, it probably is.

And now, the government can’t prosecute the mammoth companies such as Cardinal Health, which are responsible for funneling the pills to the places that don’t need them.

In one jaw-dropping piece of footage, a tiny pharmacy in a tiny West Virginia town is seen with business booming. Customers flood in and out as though only an hour is left to buy a chance at a billion-dollar lottery ticket from a store already known for delivering the goods. (1)

Who sponsored this rogue legislation? None other than the man tapped to be President Trump’s drug czar, Sen. Tom Marino.

Marino withdrew from the nomination in disgrace Tuesday, and Trump wasted little time vowing to declare the opioid crisis a “National Emergency.” Such designation makes funding more readily available to fight the crisis.

 

States devastated by epidemic largely went to Trump

 

How the president handles the fallout of the scandal will be critical to his success or failure as a politician. Trump won the so-called “Opioid Belt,” where thousands of people addicted to opioids are dying.

These include states like West Virginia and others in Appalachia, such as Kentucky and Tennessee.

And yet, Congresswoman Marsha Blackburn of Tennessee, one of the sponsors of the bill stripping the DEA of its powers, seemed to delight in her condescending remarks to Rannazzisi when he testified before Congress prior to his ouster.

Her constituents are railing her for it. (2)

Even more shocking is that several national behavioral health companies that treat opioid addiction are headquartered in Tennessee.

One wonders just how Pharma greed possibly could get any worse when, already, most people addicted to opioids have to get off opioids using “opioid maintenance therapy” – none other than more opioids made by Pharma. Quitting opioids cold turkey can be dangerous and deadly, although many succeed under medical supervision.

Some people who enter recovery refuse opioid maintenance therapy out of a desire to truly beat the drug and have a lasting chance of recovery.

A Missouri Congresswoman on Tuesday vowed to undo the damage caused by the bill by introducing her own legislation.
Recovery community demands change

 

While Sunday’s report was both shocking and infuriating to anyone struggling with addiction and those who care about them, history likely will define it as a pivotal moment.

Some have stopped just short of comparing the magnitude of the 60 Minutes/Washington Post story to Watergate.

Recovery groups on Facebook and Twitter mobilized Monday after the story broke. They posted online petitions, phone numbers of elected representatives and the White House, and urged their followers to actively demand change.

Specifically, they demanded Marino be removed from consideration for the job of drug czar.

They not only won, but in short order.

Mendell, founder of Shatterproof, told Fox News that the president declaring a national emergency is exactly what the country needs.

“People are talking about this more and more, but if the president were to declare this a national emergency, it creates recognition around the country and awareness around the country that this epidemic needs right now,” he said. (3)

Mendell founded Shatterproof, a non-profit seeking to be the go-to for drug abuse prevention information for young people. Mendell’s son battled addiction and mental illness until he hung himself.

 

As America laughed at Nancy Reagan, Pharma told us we deserve to be pain-free

 

As Nancy Reagan was telling children to “Just Say No,” a campaign that has been mocked ever since for oversimplifying addiction, the medical establishment was rolling out the “Smiley Face Pain Scale.”

The medical establishment at that time argued that pain was the “fifth vital sign” and that nobody should have to suffer needlessly. They argued opioid pain pills were not addictive.

Now, everyone from public officials to grandmothers of teens who overdosed say they’re tired of all the lies.

Just last night, Erie County, Pennsylvania’s board voted to hire three lawyers, according to GoErie.com, to “investigate, litigate or negotiate for settlement claims ‘related to the marketing, prescribing, distribution or sale of opioids’ against drugmakers and distributors.” (4)

Washington is going to have its hands full with angry Americans for a long time, thanks to “60 Minutes” and the Washington Post.

 

Bibliography

 

  1. Ex-DEA agent: Opioid crisis fueled by drug industry and Congress. 60 Minutes and Washington Post. Retrieved Oct. 18, 2017, from https://www.cbsnews.com/news/ex-dea-agent-opioid-crisis-fueled-by-drug-industry-and-congress/

 

  1. Ebert, J. (2017, Oct. 16).  Marsha Blackburn: Drug law had ‘unintended consequences,’ should be revisited ‘immediately.’ The Tennessean. Retrieved Oct. 18, 2017, from http://www.tennessean.com/story/news/politics/2017/10/16/60-minutes-opioid-tennessee-marsha-blackburn-tom-marino-congress/767510001/

 

  1. Schallhorn, K. (2017, Oct. 17). Trump to declare opioid epidemic national emergency. Here’s what that means. Fox News. Retrieved Oct. 18, 2017, from http://www.foxnews.com/politics/2017/10/17/trump-to-declare-opioid-epidemic-national-emergency-here-s-what-that-means.html
  2. Rink, M. (2017, Oct. 17). County hires law firms to sue drug companies over opioid epidemic. GoErie.com. Retrieved Oct. 18, 2017, from http://www.goerie.com/news/20171017/county-hires-law-firms-to-sue-drug-companies-over-opioid-epidemic

Tom Marino, Trump’s Pick As Drug Czar, Withdraws After Damaging Opioid Report

Posted on: October 17th, 2017 by sobrietyresources No Comments

October 17, 2017 8:54 AM ET
Written by Bill Chappell

damaging opioid report

Rep. Tom Marino, R-Pa., has withdrawn his name from consideration as America’s drug czar, President Trump said Tuesday. Marino is stepping back days after reports that legislation he sponsored hindered the Drug Enforcement Administration in its fight against the U.S. opioid crisis.

A joint report by The Washington Post and 60 Minutes found that Marino’s measure “helped pump more painkillers into parts of the country that were already in the middle of the opioid crisis,” as NPR’s Kelly McEvers said earlier this week. The bill had been opposed by the DEA and embraced by companies in the drug industry.
As NPR’s White House Correspondent Tamara Keith notes, Marino’s withdrawal leaves the Trump administration without nominees for several important domestic roles, including drug czar, the director of the DEA, and secretary of Health and Human Services.

Marino was a main backer of the Ensuring Patient Access and Effective Drug Enforcement Act; among other things, the measure changed the standard for identifying dangers to local communities, from “imminent” threats to “immediate” threats. That change cramped the DEA’s authority to go after drug companies that didn’t report suspicious — and often very large — orders for narcotics.
After the Post and 60 Minutes report, several members of Congress called for the White House to pull Marino’s nomination as drug czar.
Sen. Joe Manchin, D-W.Va., said he was “horrified” by the story, adding that he “cannot believe the last administration did not sound the alarm on how harmful that bill would be for our efforts to effectively fight the opioid epidemic.”

In a letter to the president, Manchin wrote about the ability of wholesale drug distributors to send millions of pills into small communities:

“As the report notes, one such company shipped 20 million doses of oxycodone and hydrocodone to pharmacies in West Virginia between 2007 and 2012. This included 11 million doses in one small county with only 25,000 people in the southern part of the state: Mingo County. As the number of pills in my state increased, so did the death toll in our communities, including Mingo County.”

After Marino’s name was withdrawn, Manchin tweeted to Trump, “thanks for recognizing we need a drug czar who has seen the devastating effects of the problem.”

Manchin has co-sponsored legislation that would repeal the changes made by the 2016 law, along with Sen. Claire McCaskill, D-Mo., and Sen. Margaret Wood Hassan, D-N.H.
In the Senate, the drug enforcement bill was sponsored by Sen. Orrin Hatch, R-Utah — who also saw it through the markup process. In Congress and on Twitter, Hatch has defended his role this week, calling the Post story “flawed” and “one-sided.”
Hatch also said the bill was supported by patient groups who “were concerned about DEA’s unfettered enforcement authority.”

“I spent months negotiating with DEA and with DOJ until they were at a point where they were comfortable allowing the bill to proceed,” Hatch said Monday on Capitol Hill. “If they had asked me to hold the bill or to continue negotiations, I would have done so.”

Hatch noted via Twitter that “President Obama signed this bill into law. DEA and DOJ, who work for the President, could have urged him to veto it. They did not.”
Tens of thousands of Americans are dying from drug overdoses each year. In its preliminary report about the opioid crisis, President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis said in August that “with approximately 142 Americans dying every day, America is enduring a death toll equal to Sept. 11 every three weeks.”

In an interview with NPR, here’s how Post reporter Scott Higham described the way in which Marino’s bill became law:
“We’ve obtained internal memos, emails, other documents from the DEA and from the Justice Department that show that the DEA and the Department of Justice for many years was opposed to this. They had written memos. They had written emails saying this is going to upend our ability to go after these companies. Why are you doing this? And Marino had introduced this legislation in 2014, and the DEA got it killed; and in 2015, and the DEA got it killed.

“And then there was a change in leadership. Eric Holder stepped down. Loretta Lynch took over the AG’s office. And then there was a new DEA administrator who came in who said that, I think that we need to work with these people. And there was also enormous amounts of pressure being placed on the DEA by Capitol Hill to pass this bill. And it was at the behest of the pharmaceutical industry. In fact, the bill was written by a pharmaceutical industry attorney [D. Linden Barber] who used to be a DEA attorney … a senior DEA attorney. So it’s, you know, the classic kind of revolving door in Washington.”

The president had nominated Marino to lead the White House Office of National Drug Control Policy. In his tweet announcing Marino’s decision to withdraw Tuesday morning, Trump added, “Tom is a fine man and a great Congressman!”

The opioid story was revealed by whistleblower Joe Rannazzisi, a former high-ranking DEA official, who told 60 Minutes, “This is an industry that allowed millions and millions of drugs to go into bad pharmacies and doctors’ offices, that distributed them out to people who had no legitimate need for those drugs.”
Rannazzisi said he was in “total disbelief” when the White House announced that Trump had chosen to nominate Marino, adding, “The bill was bad. Him being the drug czar is a lot worse.”

http://www.npr.org/sections/thetwo-way/2017/10/17/558276546/tom-marino-trumps-pick-as-drug-czar-withdraws-after-damaging-opioid-report

The Top 5 Most Overdosed Drugs

Posted on: October 17th, 2017 by sobrietyresources No Comments

By David Heitz

By now, we all know that hundreds of people in America are dying of drug overdose every single day.

We also know that most of it is from opioids, which come in a range of formulations from painkillers like hydrocodone to heroin.

But which opioids and other drugs, specifically, are people overdosing on?

The U.S. Centers for Disease Control and Prevention (CDC) published the most recent overdose surveillance data available in December 2016. That report looked at death data from 2010 to 2014. (1)

Death by painkillers and heroin both are up, but heroin has seen the biggest spike by far.

Why? Most likely, it’s the result of painkillers becoming less available to those addicted to opioids. State monitoring programs, intense law enforcement and doctors whose feet are being held to the fire has led to fewer prescriptions being written.

So, opioid addicts are just turning to heroin they can buy on the street instead.

And that’s why it has landed in the top position of the Top 5 Most Overdosed Drugs.

 

  1. Heroin.  In 2014, the CDC tallied 10,863 deaths, up 23.1 percent from 2010. We know the problem is far worse than that now, even though specific U.S. numbers are not yet available.

 

Availability, above all else, likely describes why heroin leads the pack of killer opioids.

Heroin comes from the poppy plant. You may recall that poppies are what puts Dorothy and her friends to sleep in the “Wizard of Oz,” one of the most legendary movies of all time.

Dorothy, the Tin Man, Scarecrow and Dorothy’s dog, Toto, are en route to Oz via the Yellow Brick Road. But the wicked witch stops them by putting poppies in their path. They fall into a deep sleep.

Glenda the good witch saves the day by causing snow to fall upon the poppies and die. Dorothy and her friends awaken, and they make it to Oz on time.

The analogy to “The Wizard of Oz” poppy scene is actually kind of profound and prophetic. “The Wizard of Oz” was made way back in 1939. Today, it is one of the most classic films of all time.

“The Wizard of Oz” was considered a breakthrough film in terms of special effects and technology at the time of its release. Indeed, it changed the face of the motion pictures in America.

Meanwhile, we now know that those pretty poppies can be deadly. Just as Glenda the Good Witch saved Dorothy and her friends, Naloxone is bringing back those who overdose on heroin and other opioids from the brink of death.

Naloxone reverses an opioid’s effects to bring the OD’d back from the brink.

Those who are saved by Naloxone also can find long-term relief and support at residential drug treatment centers.  Treatment is more affordable than most people think.

Two types of heroin: Pure, and black tar

“Pure heroin is a white powder with a bitter taste that predominantly originates in South America and, to a lesser extent, from Southeast Asia, and dominates U.S. markets east of the Mississippi River,” according to the National Institute on Drug Abuse.

Many first-time users will try pure heroin because they can snort it. It takes a great deal of apathy to get to the point of injecting since it is so highly stigmatized. Far too many opioid addicts reach that point, however, and snorting pure heroin is a sure way to get there quick.

Once an opioid user no longer can afford pure heroin (and everyone knows the financial havoc addiction wreaks), they turn to black tar heroin. Black tar heroin, which is injected, is usually the cheapest way for an opioid addict to get high.

“Black tar” heroin is sticky like roofing tar or hard like coal and is predominantly produced in Mexico and sold in U.S. areas west of the Mississippi River,” NIDA explains. “The dark color associated with black tar heroin results from crude processing methods that leave behind impurities.

 

  1. Fentanyl.  Although the 2014 CDC trend report puts this drug at No. 5 on the overdose list, 2016 numbers provided by CDC Wonder already have it at more than 20,000 deaths for that year alone. (2) For that reason, we are placing it in the No. 2 position. Reliable recent statistics for heroin are not yet available, and for that reason heroin is remaining in the No. 1 spot on this list, for now.

 

Fentanyl, a powerful painkiller given to dying cancer patients and others in severe pain, is unbelievably dangerous. Overdose deaths are up over 500 percent in the past three years alone.

What’s worse, some people are injecting heroin laced with fentanyl.

There are so many ways to die with fentanyl that those who survive it have lots of reasons to celebrate – and for getting sober.

Now, people are even overdosing on carfentanil, an elephant tranquilizer. It is 10,000 times more potent than morphine.

Law enforcement officers and even police dogs are OD’ing just by touching or smelling it.

 

  1. Cocaine.  According to the CDC, 5,856 deaths occurred in 2014, up 12.4 percent from 2010.

 

For those who have been addicted to cocaine, this isn’t surprising. Cocaine can make a user’s heart pound very fast. Also, people who use cocaine tend to use a variety of other drugs, and alcohol, too.

Mixing drugs is a sure way to end up in the grave. In particular, opioids mixed with benzodiazepines, such as Ativan and Xanax, is particularly dangerous.

And yet, the fact remains that cocaine still came in at No. 2 in overdose deaths in 2014.

And the fact remains that many people who recreationally use cocaine think it’s relatively harmless. It’s not surprising given the focus of news media coverage has radically shifted away from cocaine in recent years to opioids.

Even the topic of marijuana, which never has had a recorded overdose, is stealing media attention away from deadly drugs like cocaine and Xanax (which comes in at No. 5 on the list).

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  1. Oxycodone (OxyContin). In 2014, 5,417 people OD’d on this opioid per CDC data. That’s up 11.5 percent from 2010. More recent numbers from the CDC have 2015 overdoses from all opioids having tripled since 2010, to a staggering 64,000. (3)

 

OxyContin often catches people by surprise. They may take too much and become sleepy. The next thing they know they are unconscious. Their heart and breathing slow down. They can die if nobody is around.

Of course, OxyContin until recently was a fairly commonly prescribed painkiller. A person with a prescription who finds themselves repeatedly refilling it – and having the sorts of experiences I just described above – would be wise to have their use evaluated by a professional.

It’s nobody’s fault if they have begun to take too much in an effort to stay well. The problem is, it doesn’t work long term. Nobody deserves to die for something that isn’t their fault.

 

  1. Alprazolam (Xanax). In 2014, 4,217 people overdosed on Xanax.

 

Xanax is in a class of drugs known as benzodiazepines. It is commonly prescribed for anxiety.

Benzodiazepines affect the brain the same way as alcohol, and should be avoided by alcoholics in recovery.

These numbers are grossly underestimated

The truth is, the problem of drug overdose is even worse than what is described here. Surveillance methods (monitoring of deaths by the CDC) are clunky. Even classifying how someone died is much harder than you might think.

And the most recent and reliable U.S. numbers we have already are three years old. Consider just how bad the opioid epidemic has worsened since 2014, both in terms of anecdotal reports and also with recent overdose statistics available in some states or in partial form.

Finally, a big part of not having a true handle on overdose numbers is this: Often it’s impossible to trace the overdose to a single drug. So, sometimes it is not even classified as an overdose.

Nobody needs lectured about the dangers of overdose. However, if you or someone you care about is hooked on a drug on this list, consider reaching out for help.

Addiction is nobody’s fault.

 

Bibliography

 

  1. Warner, M. et al. (2016, Dec. 20). Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2010-2014. Retrieved Sept. 21, 2017, from

https://www.cdc.govon /nchs/data/nvsr/nvsr65/nvsr65_10.pdf

 

  1. Katz, J. et al. (2017, Sept. 2). The first count of Fentanyl deaths in 2016. The New York Times. Retrieved Sept. 21, 2017, from https://www.nytimes.com/interactive/2017/09/02/upshot/fentanyl-drug-overdose-deaths.html

 

  1. Overdose death rates. (2017, September). National institute on Drug Abuse. Retrieved Sept. 21, 2017, from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

 

 

FDA approves first doctor-prescribed app to keep you sober

Posted on: October 13th, 2017 by sobrietyresources No Comments

 

By David Heitz

 

We use technology and Smartphone apps, specifically, to dial up our health in all kinds of ways these days.

“The health apps, for example, help those with diabetes track and record every blood sugar reading and insulin injection,” reports Stat. “One invites users to photograph their moles, and offers analysis on whether they are changing in a way that signals skin cancer.” (1)

So, it only makes sense that now we have an app to help people addicted to drugs and alcohol disconnect from urges to use.

This latest app goes beyond other innovative sobriety apps to emerge in recent years, including Sober Grid and WeConnect. More on those a bit later.

The new app is the first actually approved by the U.S. Food and Drug Administration to be marketed for the treatment of substance use disorder.

Substance use disorder is the official DSM IV code that behavioral health professionals use to officially record addiction. Its definition, simply, is that a person’s drug or alcohol use has gotten to the point that it is interfering with the activities of daily living, such as going to work.

DSM IV stands for Diagnostic and Statistical Manual of Mental Health Disorders, fifth edition.

In short, this app has received a federal seal of approval in the addiction space that has never before been seen.

 

Clinical study proves reSET’s mettle

 

The reSET is made by Pear Therapeutics. It actually is prescribed to patients by doctors.

reSET works as a supplement to cognitive behavioral therapy for addiction (talk therapy).

In a study of more than 500 patients at about a dozen rehabilitation centers across the country, reSET proved highly effective at keeping people sober.

The only down side? It’s not approved for treatment of substance use disorder from opioids, which is a public health crisis in America.

“In patients who were dependent on stimulants, marijuana, cocaine, or alcohol (395), 58.1 percent of patients receiving reSET were abstinent in study weeks 9-12, while 29.8 percent of patients receiving face-to-face therapy alone were abstinent during the same time frame,” Pear reports on its website. (2)

Pear has plenty more products in the works, including a reSET for opioid use disorder.

“Pear’s product development pipeline includes reSET®-OTM for opioid use disorder (OUD) and additional prescription digital therapeutics in schizophrenia (ThriveTM), combat posttraumatic stress disorder (reCALLTM), general anxiety disorder (reVIVETM), pain, major depressive disorder, and insomnia, for which Pear intends to obtain FDA clearance,” the company reported in a news release last month.

The release described how Pear “has been selected as one of nine companies to participate in the FDA’s Digital Health Software Pre-Cert Pilot Program. The goal of the pilot program is to leverage the best processes and principles from all nine participants to inform the development of a new digital health regulatory framework.” (3)

 

How reSET works

ReSET is a remarkable way for a patient and a clinician to interact much more frequently even though they are not face to face.

For a person exiting inpatient treatment, being on their own can be scary. An app like this allows a clinician to “tag along” and keep tabs on the person in recovery.

The app asks the patient how they are feeling each day. Are they hungry? Angry? It also helps them manage any illnesses they may have that complicate the addiction or go along with it, such as HIV or Hepatitis C. The app helps keep the patient linked to physical health care as well as mental health care and sobriety.

The clinician who prescribes the app keeps tabs on a desktop dashboard. They are able to identify successes and challenges, and address challenges before they become problems. The clinician actually is able to dispense cognitive behavioral therapy through the app.

 

Hook-up app inspires Sober Grid

There are many other non-FDA approved sobriety apps that offer social support, which can be just as important as help from a clinician.

Sober Grid was founded by Beau Mann. Beau tumbled from sobriety after breaking up with a mate and ending up at Sundance Film Festival alone.

“I wanted to connect with other sober guys or girls, maybe see a screening, have a cup of coffee,” Mann told the website HIV Equal. “But all the parties, they involved drinking. That’s not what I wanted. I wanted to be with the sober population.”

Because he was familiar with various meeting apps, he wondered why a similar app could not be made for sober people looking for support. An app that used GPS to find other nearby sober people and 12-step meetings in a pinch.

Thus, Sober Grid was born.

“Not all users are focused on a 12-step program, though the majority are,” Mann said. “It ranges from people in recovery, to people who just want to be in a sober atmosphere with like-minded people.” (4)

 

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WeConnect has features similar to reSET

Another popular app is WeConnect, Last year, the app won TechCrunch’s Disrupt SF and Seattle Meet Up events in 2016.

“There’s three components to recovery,” WeConnect co-founder Daniel Tudor told TechCrunch as she demonstrated the device. “One is communication. So, adding your connections; the second is clarity — so that’s whatever activity you consider part of your recovery, that keeps you centered and a good connection in relation with yourself.

“The third part of the recovery, which is probably the most crucial, initially especially, is what your in-person support routine is — so that’d include any of these 12-step or CBT cognitive behavioral therapy sessions,” Tudor said. (5)

 

Sobriety Counter, I Am Sober, Coach.me

Sobriety Counter for Android, NOMO, I Am Sober and Coach.me all are sobriety apps both popular and free.

Medical News Today describes Sobriety Counter this way:

“Sobriety Counter is a fun app full of vibrant colors and bold icons that gamify your stop drinking journey. The bright dashboard shows you how much money you have saved by not drinking. You can also set up a treat as a goal with a personal image, and the app will show you the duration until you reach your target.

Scientific statistics show aspects of your health improvement, such as blood circulation, cell regeneration, gray matter, and mental health, as well as your risk of heart disease and cancer decrease.”

NOMO, meanwhile, which is available for iPhone as well as Android, “accurately breaks down the time you are sober to the minute, which means that it can show you your sobriety time in terms of years, months, weeks, days, hours, and minutes,” Medical News Today explains.

“Your sobriety clock can also be shared with your accountability partner, so they can check in on you and see how long you have been clean.”

As for reSET, top FDA official Carlos Pena says, “This is an example of how innovative digital technologies can help provide patients access to additional tools during their treatment.

Pena is director of the Division of Neurological and Physical Medicine Devices in FDA’s Center for Devices and Radiological Health.

“More therapy tools mean a greater potential to help improve outcomes, including abstinence, for patients with substance use disorder.” (6)

 

Bibliography

  1. Associated Press. (2016, Dec. 5). Many smartphone health apps don’t flag danger, says review. Stat. Retrieved Oct. 11, 2017, from https://www.statnews.com/2016/12/05/smartphone-health-apps/

 

  1. Pear Therapeutics. ReSET for Substance Use Disorder. Retrieved Oct. 11, 2017, from

https://peartherapeutics.com/reset/

  1. Heitz, D. (2015, July 15). Gay, Sober and Looking to Connect? There’s an App for That. HIV Equal. Retrieved Oct. 11, 2015, from http://www.hivequal.org/hiv-equal-online/gay-sober-and-looking-to-connect-there-s-an-app-for-that
  2. Nichols, H. (2017, Aug. 10). Best apps to stop drinking alcohol. Medical News Today. Retrieved Oct. 11, 2017, from https://www.medicalnewstoday.com/articles/318913.php
  3. Lomas, N. (2016, Sept. 13.). WeConnect is an app to support addiction recovery. TechCrunch. retrieved Oct. 11, 2017, from https://techcrunch.com/2016/09/13/weconnect-is-an-app-to-v support-addiction-recovery/

 

  1. FDA News Release. (2017, Sept. 14). FDA permits marketing of mobile medical application for substance use disorder. Retrieved Oct. 11, 2017, from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm576087.htm

 

 

 

 

Is everything from staying sober to soothing anxiety really as easy as being mindful?

Posted on: October 13th, 2017 by sobrietyresources No Comments

 

By David Heitz

 

The research is churning out at a rapid clip: Being “mindful” can solve lots of problems that even medications cannot.

 

In the past month alone, studies appearing in peer-reviewed journals have claimed it can help addicts recovering from stimulants stay sober and even do a better job than antidepressants at lifting some people out of depression.

 

But what is mindfulness, how does it work, and where do you go to learn it? Do things like meditation and yoga really help?

 

It sure does. Just look at the latest research:

 

UCLA showed in a recent study that mindfulness – being aware of one’s self and one’s surroundings – helps those with depression and anxiety disorders move past addiction to stimulants.

 

Those snagged in the grip of cocaine or crystal meth have a better chance of recovery with mindfulness.

 

“In light of the known associations between stress, negative affect, and relapse, mindfulness strategies hold promise as a means of reducing relapse susceptibility,” reported the authors. (1)

 

The paper was published in February of this year in the journal Mindfulness.

 

Anxiety of stimulant withdrawals managed with mindfulness

 

Although small, the clinical trial of 63 stimulant addicts in recovery showed extremely promising results.

 

Nearly everyone who received three months of meditation training remained off drugs.

 

“When stimulant users attempt to quit, some of the most frequent complaints have to do with intolerable feelings of depression, sadness and anxiety, conditions that often lead people to drop out of treatment early,’’ Suzette Glasner, lead author of the study and associate professor at UCLA’s Semel Institute for Neuroscience and Human Behavior, said in a UCLA news release.

 

“Mindfulness practice not only helps them to manage cravings and urges, but also enables them to better cope with the psychological discomfort that can precipitate a relapse.” (2)

 

Scientifically speaking, the authors referred to mindfulness as “Learning to tolerate discomfort without reacting to it.”

 

Here’s what mindfulness is in plain language

 

Mindfulness, simply, is knowing yourself, and being aware of your surroundings. If you can do both, you can achieve true inner peace. With that, urges to drink or use greatly dissipate.

 

For example, maybe you have PTSD. Maybe when you go to the supermarket you see someone who has hurt you.

 

Your heart begins to race and you know what may happen next. You don’t want to lose your temper or have a heart attack in the supermarket.

 

Hopefully you have learned a coping mechanism, also known as a “mantra.” A mantra can be, “Protect me Jesus and keep me safe.”

 

Or, it can be, “I am stronger than the miserable narcissist who hurt me.”

 

Whatever works to calm your mind will also reduce your heart rate.

 

Next, being aware of your surroundings and your feelings, thoughts and emotions, leaving your cart behind and heading for the door is a no-brainer.

 

Perhaps you are bipolar. Something sends you into a manic spin.

 

This is tricky. Everyone is different. But often, with the help of a therapist or even on your own after many years of living with the disorder, you will figure out a way to turn things down a notch.

 

You might feel the electrical impulses begin to shoot up and down your spine. Maybe chamomile tea stops it. Maybe a lavender candle.

 

Mindfulness won’t work without honesty

 

If you’re not honest with yourself, it won’t work

 

The trick is to know you’re cycling up, acknowledge the feeling, and know you must squash it. Then you take whatever your coping mechanism is and indulge in it.

 

Acknowledging who you are and acknowledging your feelings is a must to maintaining sobriety. Many people cannot do this wearing their heart on their sleeve. Others cannot admit it to themselves without affirmation.

 

This is why Alcoholics Anonymous is wildly popular and has helped millions and millions of people.

 

But for many others, it doesn’t work. These people must be able to achieve knowing one’s self via mindfulness.

 

 

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Options beyond the 12 steps gravely needed

 

Psychologists long have been saying mindfulness works in combatting addiction, but it’s an idea that’s gaining traction. Venerable programs such as those in the 12-step tradition have helped millions but are failing many, particularly those addicted to opioids.

 

There must be alternatives so even more people can be saved.

 

“If I have a patient who is using drugs or even food to manipulate their moods I first refer them to a nutritionist; a psychiatrist or psychopharmacologist; or a holistic doctor, such as an integrative medical doctor, to break this habit,” wrote psychologist Ronald Alexander in Psychology Today in 2010.

 

“In addition to this I recommend mindfulness meditation, yoga practice, and regular exercise as they are all excellent to help mood regulation.

 

“These types of activities lower the levels of the stress hormone cortisol in your bloodstream, increase your interleukin levels (enhancing your immune system and providing you with greater energy), and streamline your body’s ability to cleanse itself of chemical toxins, such as lactic acid in your muscles and bloodstream, which can affect neurotransmitter receptors and alter your mood (Chopra 1994; Rossi 1993).” (3)

 

It’s important to note, however, that for those who feel a fight or flight anxiety response – such as people with PTSD – research also shows intense cardiovascular exercise actually can increase cortisol response. A relaxing walk is more appropriate.

 

Study: Mindfulness better than AA at preventing relapse

 

In November 2015, a study showed that mindfulness-based relapse prevention actually is more effective than Alcoholics Anonymous.

 

“The present randomized trial offers evidence that RP and MBRP are beneficial aftercare interventions compared with typical 12-step aftercare treatment,” concluded the authors of the research, published in JAMA.

 

“In addition, MBRP resulted in significantly less drug use and a lower probability of any heavy drinking than RP at a 12-month follow-up. These findings suggest that MBRP may support longer term sustainability of treatment gains for individuals with substance-use disorders.” (4)

 

Researchers from the University of Washington Addictive Behaviors Research Center monitored clients from two non-profit recovery centers to arrive at their findings.

 

“Similar to Mindfulness-Based Cognitive Therapy for depression, Mindfulness-Based Relapse Prevention is designed as an aftercare program integrating mindfulness practices and principles with cognitive-behavioral relapse prevention,” the center explains on its website.

 

“Mindfulness-based Relapse Prevention is best suited to individuals who have undergone initial treatment and wish to maintain their treatment gains and develop a lifestyle that supports their well-being and recovery.” (5)

 

Bibliography

 

 

  1. Glasner, S. et al. (2016, Aug. 4). Mindfulness-based Relapse Prevention for Stimulant-Dependent Adults: A Pilot, Randomized Clinical Trial. Journal Mindfulness. Retrieved Oct. 8, 2017, from https://link.springer.com/article/10.1007/s12671-016-0586-9

 

  1. Gordon, D. (2016, Aug. 4). Mindfulness Training Helpful in the Recovery of Adults Addicted to Stimulants. UCLA Newsroom. Retrieved Oct. 8, 2017, from http://newsroom.ucla.edu/releases/mindfulness-training-helpful-in-the-recovery-of-adults-addicted-to-stimulants

 

  1. Alexander, R. et al. (2010, April 16). Mindfulness Meditation & Addiction. Psychology Today. Retrieved Oct. 8, 2017, from https://www.psychologytoday.com/blog/the-wise-open-mind/201004/mindfulness-meditation-addiction

 

  1. Bowen, et al. (2014, Jan. 21). Relative Efficacy of Mindfulness-Based Relapse Prevention, Standard Relapse Prevention, and Treatment as Usual for Substance Abuse Disorders. JAMA Psychiatry. Retrieved Oct. 8, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489711/

 

  1. Mindfulness Based Relapse Prevention. (Bowen, et al. 2010). Retrieved Oct. 8, 2017, from http://www.mindfulrp.com

 

 

Addiction and National Health: The Effect of the Crisis

Posted on: October 10th, 2017 by sobrietyresources No Comments

By Kayly Lange

There are many encouraging aspects of American health: cancer and heart disease deaths are going down, technology and medication are improving at a substantial rate, water consumption is out-pacing soda consumption, and Americans are eating more vegetables than ever. Yet last year, for the first time in decades, the U.S. life expectancy is on the decline.

Why the unexpected downturn in the average American’s lifespan? Many experts point to the addiction crisis that is sweeping across the nation. In the age of unprecedented opportunities and knowledge of health and wellness, many find themselves feeling trapped in poor health because of their addictions.
According to Dr. Tom Frieden, the former director of the CDC, it is the only aspect of American health that is getting worse.

However, the spotlight that the addiction crisis has received has motivated more politicians, clinicians, and programs to find help and prevent needless deaths. By targeting and seeking to prevent addiction, many are seeking to restore and improve American health.

Addiction: A Look at The Numbers

Addiction in America has skyrocketed over the past two decades to unprecedented levels. While other areas of health have been slowly improving, the number of Americans who are finding themselves trapped in addiction has been silently taking the lives of so many.

In fact, overdose deaths surpassed car and gun accidents combined to be the number one cause of death in Americans under 50. Each year has only seen an increase in deaths with 2016 being the highest annual jump yet.

It is estimated that there were 59,000 overdose deaths in 2016 and the numbers show no signs of slowing down. Although it takes the CDC 2 years to come out with the official number of overdose deaths for a year, the general opinion amongst many experts has been that deaths were higher than ever in 2016.

Part of the reason for this jump is the increased access to opioids. As the gateway to addiction, the startling number of Americans who take prescription pain relievers in any given year only fuels the crisis. More people used a prescription painkiller in the past year than tobacco.

The dangers of tobacco are well communicated to the public, and the social stigma surrounding it has turned away many who would potentially become addicted to it. However, not only are the dangers of opioid addiction not well known amongst the general population but since they are prescribed by doctors at such an alarming rate, many feel that it is safe to take.

As a result, more than 2 million Americans find themselves addicted to opioids. This addiction is not only dangerous in and of itself, but it also leads to addiction to even more harmful drugs. With the resurgence of fentanyl and heroin, the effect on American health has been disastrous.

Over the span of 6 years, from 2010 to 2016, addiction has skyrocketed 493%. What is equally concerning, however, is that treatment has only increased 65%. Because the crisis has been so new and unexpected, the country has found itself unprepared to handle it. Especially as attitudes and the shame towards addiction have been changing across the nation, there has been a recent push to expand treatments to those who need it.

However, the need to expand treatment to those who need it has never been direr. According to the Surgeon General, only 1 in 10 receive treatment for their addiction. Not only do so few receive treatment, but up to 40% of those who suffer from addiction never even seek treatment in the first place. Not only are so many Americans aware of the dangers of addiction when they are prescribed opioids, but they feel trapped once they are addicted and do not seek the help that they need.

Aspects of General Health Affected by Addiction

While the risk of overdosing is a serious, severe and common side effect of addiction, it is not the only aspect that will affect the health of the one addicted. There are other serious health complications that can arise because of addiction.

One of the first negative consequences of addiction is mental illness. There is a very strong link between addiction and mental illness, and many drugs have been known to fuel and even cause mental illness in otherwise healthy individuals before addiction.

The most common mental illnesses to be fueled by addiction are depression, anxiety, and paranoia. Although many might have these illnesses before their addiction, the drugs further propel and amplify the issues that they had before.

Another serious side effect of long-term drug misuse is heart disease. Drugs are extremely stressful on the heart and will often lead to a heart attack after too many uses.

Diseases of the lungs are also a common side effect of certain drugs. Not only are those who inhale drugs (such as cocaine) at risk for pulmonary issues, but there is also an increase in injection drug users as well. Complications include pneumonia, bronchitis, hemorrhaging, emphysema and pulmonary edema. Long-term use of drugs can create lung problems in otherwise healthy individuals.

Those who are addicted to drugs also find themselves more susceptible to certain cancers as well. There are a wide variety of cancers that can result from any drug addiction from lung cancer, liver cancer, digestive system cancers and has even been known to be a factor in leukemia. Any addictive substance over a long period will break down the immune system and leave those addicted vulnerable to certain cancers.

Kidney failure is also a common side-effect of long-term addiction. Any substance must pass through the kidneys before leaving the body, so abuse will eventually leave the kidneys damaged. Drug and alcohol abuse, even when not taken to overdose levels, will still leave serious physical consequences for those who do not address their addiction in time.

Lastly, a serious effect of addiction is negative birth outcomes. Common side effects for children born to addicted mothers include stunted growth, facial abnormalities, behavioral and learning problems, and poor language development. Addiction has far-reaching consequences for American health and affects far more than the one addicted.

Although it is hard for researchers to estimate exactly how many children are suffering because of drug use, the skyrocketing rates of addiction in America will lead to more children affected.

The Addiction Crisis: The Downfall of American Health

Although Americans seem to be getting healthier in many aspects, the rise of the addiction crisis has left many in poorer health than ever before. Not only has the addiction crisis lowered the average American’s lifespan, but it has also created more heart disease, kidney failure, liver diseases, mental illnesses, and extremely affected children.

To improve health in the U.S., then, addiction treatment is vital. Although there has been a slow rise in addiction treatment, many government agencies are seeking to step up their treatment resources. It is impossible to neglect those who have a drug and alcohol abuse problem and expect health to continue to rise in the country.

It is only by addressing addiction issues as medical issues and taking the addiction crisis seriously that we can hope to improve health in the United States.

Study shows Medicare and Medicaid still too loose about paying for opioid painkillers

Posted on: October 10th, 2017 by sobrietyresources No Comments

By David Heitz

Our most vulnerable populations continue to receive opioids at high doses under the Medicare Part D program, even though private insurers already have taken steps to curb such practices.

Powerful opioid painkillers may be appropriate in rare cases, for the short-term, or for people with terminal illness. But the U.S. Centers for Disease Control and Prevention (CDC) has emphasized they should only be used as a last resort.

“Despite increased formulary restrictiveness, unrestrictive coverage persisted for many opioids, especially at high doses, including for drugs commonly associated with overdose,” concluded the authors of the study published Monday in Annals of Internal Medicine. (1)

The paper marked the first time such an analysis was conducted among Medicare patients.

Led by researchers at Yale School of Public Health, the team analyzed data from the Centers for Medicare and Medicaid Services, or CMS. CMS is the largest third-party payer in the U.S.

Medicare serves the elderly; Medicaid serves the poor. Both are government programs.

“The researchers compared coverage for all available doses of commonly used short- and long-acting opioid medications except for methadone,” Annals reported in a news release. “They found that more than two thirds of drug-dosage combinations had no opioid prescribing restrictions in 2006 and 2011 and approximately one third had no restrictions in 2015.

“While quantity limits and prior authorization to restrict daily allowable prescribed dosing increased over the years, unrestrictive coverage persisted for many opioids.” (2)

How did this happen?

One reason stands out like a sore thumb – and a staggering example of bureaucrats not seeing the forest for the trees.

CMS limits number of opioid pills dispensed, but not doses

“Medicare Part D formularies increasingly used quantity limits and, to a lesser extent, prior authorization to restrict daily allowable prescribed dosing of prescription opioids between 2006 and 2015,” the authors reported.

It goes without saying that a 90-day supply of a medication at 250 mg is not the same as a 90-day supply of a medication at 500 mg.

Apparently, the bureaucrats did not think of this when they wrote Medicare Part D guidelines.

“Despite increased formulary restrictiveness, unrestrictive coverage persisted for many opioids, especially at high doses, including for drugs commonly associated with overdose,” the authors concluded.

The Medicare Part D program also applies to people on Medicaid.

So, for the most part, the people being prescribed these high levels of opioids – the same opioids causing dangerous overdoses in just about every town in America – are elderly and poor.

What’s more, as Medicaid or Medicare recipients, there are alternative pain treatments available under their coverage.
The Social Security Act Section 1905 specifically included a provision for covering alternative therapies, leaving it open ended enough to stand the test of time.

It reads, “Other diagnostic, screening, preventive, and rehabilitative services, including… any medical or remedial services (provided in a facility, a home, or other setting) recommended by a physician or other licensed practitioner of the healing arts within the scope of their practice under State law, for the maximum reduction of physical or mental disability and restoration of an individual to the best possible functional level.” (3)

However, most states don’t actively point participants in this direction, according to one watchdog organization.

A few facts about pain and Medicaid: Where are we headed?

According to the National Academy for State Health Policy:
• People on Medicaid are prescribed opioids at a disproportionately higher rate than also other Americans. They are also  more likely to overdose
• Less than half of state Medicaid agencies have taken steps to encourage or require non-opioid pain relief methods.
• “Medicaid agencies are faced with important policy considerations, including budget constraints that make covering additional services difficult and provider and beneficiary educational needs to raise awareness on when these services may be appropriate,” according to NASHP.
• “The evidence base for or against non-pharmacological alternatives will become more robust as more Medicaid agencies implement programs encouraging the use of these services,” NASHP predicted. (4)
Private insurers find success limiting opioid prescriptions

“A private insurer showed that implementing prior authorization, quantity limits, and provider–patient agreements was associated with a 15 percent decrease in opioid prescribing,” the research letter published Monday noted.

NASHP urges third-party payers, as well as CMS, to make it easier to access alternative therapies.

In their report, “Chronic Pain Management Therapies in Medicaid: Policy Considerations for Non-Pharmacological Alternatives to Opioids,” the authors cite medical research showing non-opioid pain medications are at least somewhat effective.

“For example, a systematic review found that Cognitive Behavioral Therapy (talk therapy) had small to moderate effects on pain, disability and mood immediately post-treatment when compared to usual treatment,” they wrote.
“Similarly, a systematic review found that acupuncture may benefit people with osteoarthritis,” they continued. “The systematic reviews also suggest lower costs for patients experiencing spine pain who received chiropractic care, although the included studies had many methodological limitations.
For the most part, Big Pharma funds medical research in this country. It’s not in their best business interests to fund research into non-pharmacological alternatives to pain.

“The cost effectiveness of alternative pain management services compared against conventional treatments has not been adequately studied,” the authors of the NASHP report explained. “As more evidence becomes available, state Medicaid agencies can better evaluate which services should be included as a coverage benefit.

“These coverage decisions may ultimately vary based on the type and location of the pain.”
One more reason why it’s not your fault

“Addiction is not your fault” might be all the catchphrase these days, but for people addicted to opioids, it absolutely is true and they need to know that it’s true.

Addiction often is perpetuated by a cycle of shame, regardless of how a person became addicted in the first place. People who end up dependent on opioids after being prescribed them by a doctor simply don’t relate to “addict.” In fact, they resent it.

“As shown by formulary coverage of hydrocodone–acetaminophen, formularies tended to be
less restrictive at higher doses, largely because they maintained identical quantity limits
regardless of dose,” the researchers of the study published in Annals emphasized.

“This factor allowed for higher prescribed MMEs (morphine milligram equivalents) per day. Given that higher doses are associated with higher overdose rates, limiting prescribed MME per day or requiring prior authorization or step therapy for high-dose opioids may facilitate better adherence to Centers for Disease Control and Prevention prescribing recommendations.

“Because formulary coverage directly affects prescribing, our study suggests that formularies
present an underused opportunity to restrict opioid prescribing.”

The research, presented in the form of a letter, was signed by Dr. Elizabeth A. Samuels of Yale University, Yale New Haven Hospital, and Veterans Affairs Connecticut.

If you or someone you know just can’t get off painkillers, or maybe have turned to heroin, do not stop fighting for your life. You didn’t get yourself into this mess to begin with.

Professional help getting off painkillers is more affordable than you might think, and often covered by insurance. Reach out to someone or someplace you trust today.

Bibliography

1. Samuels, E. et al. (2017, Oct. 10). Medicare Formulary Coverage Restrictions for Prescription Opioids, 2006-2015. Annals of Internal Medicine. Retrieved Oct. 10, 2017, from http://annals.org/errors/404.aspx?aspxerrorpath=/aim/article/doi/10.7326/M17-1823
2. Annals of Internal Medicine. (2017, Oct. 3). A substantial number of opioid-dosage combinations have no prescribing restrictions under Medicare formulary. Annals news release.
3. Social Security Act. Section 1905. Retrieved Oct. 5, 2017, from https://www.ssa.gov/OP_Home/ssact/title19/1905.htm
4. Dorr, H. et al. (2016, August). Chronic Pain Management Therapies in Medicaid: Policy considerations for non-pharmacological solutions to opioids. National Academy for State Health Policy (NASHP). Retrieved Oct. 6, 2017, from
http://www.nashp.org/wp-content/uploads/2016/09/Pain-Brief.pdf

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Research shows why memories are delayed in people with PTSD

Posted on: October 5th, 2017 by sobrietyresources No Comments

 

By David Heitz

 

Most people who live with PTSD have encountered something so awful it can be difficult for others to even imagine.

 

That leads to resentment by the person living with PTSD. Far too many people with PTSD reach a point of anger and fear and, with nobody supporting them, turn to drugs and alcohol in an attempt to medicate the pain.

 

To “just shut everything off in my head” is what people with PTSD often say they long for.

 

Do you feel like nobody understands the trauma you have been through?

 

Scientists do, and they are working every day to improve the lives of people living with PTSD.

 

In fact, a new scientific discovery may shed light on why people with PTSD react the way they do, months, years, decades later, to the terrifying event or events that they experienced.

 

The study, by scientists in Canada and India, was performed on rats. It showed the hippocampus area of the brain, important to regulating emotions and memory, shrinks after a single traumatic event. The amygdala, meanwhile, also important to memory and emotions, becomes hyperactive.

 

The result? An explosively angry person. However, sometimes these symptoms do not surface until about 10 days after the traumatic event.

 

The reason? Memories of the trauma initially were squashed, perhaps due to the shrinking hippocampus.

 

A hyperactive amygdala and a shrinking hippocampus

 

What does it all mean?

 

“The work pinpoints key molecular and physiological processes that could be driving changes in brain architecture,” the National Centre for Biological Sciences reported in a news release. (1)

 

The center’s Sumantra Chattarji, who also performs research at the institute for Stem Cell Biology, led a team that discovered how the amygdala explodes with electrical activity even 10 days after a traumatic event.

 

“This activity sets in late, occurring ten days after a single stressful episode, and is dependent on a molecule known as the N-Methyl-D-Aspartate Receptor (NMDA-R), an ion channel protein on nerve cells known to be crucial for memory functions,” according to the news release. “Changes in the amygdala are linked to the development of Post-Traumatic Stress Disorder (PTSD), a mental condition that develops in a delayed fashion after a harrowing experience.”

 

The amygdala is a group of nerve cells in the shape of an almond. It is located deep inside the brain’s temporal lobe.

 

Because of the delayed effects associated with PTSD, victims of crimes and other traumas often are doubted when reporting the experience — to friends, family…even police.

 

When a victim of any kind of harrowing event feels nobody is listening, the odds of turning to drugs and/or alcohol skyrocket.

 

Drinking and PTSD – like a beer and a cigarette

 

On its website, the Veterans Administration explains why alcohol and PTSD seem to go hand in hand.

 

“People with PTSD are more likely than others with the same sort of background to have drinking problems. By the same token, people with drinking problems often have PTSD,” the VA explains. (2)

 

“Those with PTSD have more problems with alcohol both before and after getting PTSD. Having PTSD increases the risk that you will develop a drinking problem.”

 

This is why the very last thing anyone who cares about a person with PTSD should ever do is doubt the magnitude of their trauma.

 

But people inevitably do, unaware of the damage they are causing. People with PTSD don’t “make up” what happened to them. The kind of chronic anger, fear and paranoia that people with PTSD often exhibit cannot be faked.

 

It’s why research like Chattarji’s is so important. What if we could “shut the brain off,” like people with PTSD often long for, without booze or drugs like benzodiazepines (Xanax, Ativan), which work on the brain the same way as booze?

 

First, we need to understand what happens in the brains of people with PTSD.

 

“We showed that our study system is applicable to PTSD. This delayed effect after a single episode of stress was reminiscent of what happens in PTSD patients,” says Chattarji. “We know that the amygdala is hyperactive in PTSD patients. But no one knows as of now, what is going on in there,” Chattarji said in the news release.

 

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Amygdala becomes lightning rod as hippocampus shrinks

 

Chattarji and colleagues showed that after the single traumatic event, the amygdala in the rats grew new connections, known as synapses. It’s these connections that conduct the electricity.

 

“Most studies on stress are done on a chronic stress paradigm with repeated stress, or with a single stress episode where changes are looked at immediately afterwards – like a day after the stress,” said Farhana Yasmin, one of the Chattarji’s students, in the news release. “So, our work is unique in that we show a reaction to a single instance of stress, but at a delayed time point.”

 

The researchers have pinpointed some promising new therapies for blocking the delayed effects of PTSD after an event. Medications would work with receptors in the brain to accomplish this, but much more research is needed before such a medication would ever become reality. Still, it’s a groundbreaking discovery.

 

Previous work by Chattarji had concluded that a single traumatic event had no immediate impact on rats. Thus, the observations of the hippocampus and amygdala 10 days later is significant.

 

PTSD just doesn’t go away that easily.

 

In an interview with the Canadian Broadcasting Company, or CBC, Chattarji said timing is key to effective treatments. Researchers believe the receptor can be turned off from a day up to a week after the traumatic event.

 

“Since NMDA receptors are needed for forming memories — a generic blocking will indeed be a problem,” Chattarji said. “That is why we cannot simply block this receptor in anticipation of a traumatic experience, because that may impair the formation of other memories as well.

“However, at the time of the trauma, having the blocker on board would help prevent that experience from becoming of the source of subsequent emotional symptoms in the amygdala.

“So, it is a fine balance.” (3)

 

The takeaway: Don’t let the trauma you survived kill you later

 

If you survived something traumatic – the death of a parent, domestic abuse, rape, incest, military combat, attempted murder or some other assault – seek professional help.

 

This research offers early scientific indicators of what we already know anecdotally – memories of traumatic experiences can be delayed, sometimes for a year or even longer.

 

If you encountered a recent life event that perhaps only registered “disturbing” on your internal trauma scale, the incident may have been far worse than you originally remember. You may even remember more later.

 

Cautions the VA, “Women who go through trauma have more risk for drinking problems. They are at risk for drinking problems even if they do not have PTSD.

 

“Women with drinking problems are more likely than other women to have been sexually abused at some time in their lives. Both men and women who have been sexually abused have higher rates of alcohol and drug use problems than others.”

 

This is why it is critical to stop drinking. Drinking is like throwing gasoline on a fire for people with PTSD. Oddly enough, the benzodiazepines used to treat PTSD affect the brain exactly the same way. These drugs can be incredibly dangerous over time.

 

The best way to find lasting recovery is to replace bad habits and ineffective ways of coping with triggers with effective ones. Good treatment centers will offer the assistance of counselors who will help you do that.

 

Bibliography

 

  1. Krishnan, A. (2016, Dec. 28). The Late Effects of Stress: New Insights into how the Brain Responds to Trauma. National Centre for Biological Sciences. Retrieved Oct 4, 2017, from

http://news.ncbs.res.in/research/late-effects-stress-new-insights-how-brain-responds-trauma

 

  1. S. Department of Veterans Affairs. (2015, Aug. 15). National Center for PTSD: PTSD and Problems with Alcohol Use. Retrieved Oct. 4, 2017, from https://www.ptsd.va.gov/public/problems/ptsd-alcohol-use.asp
  2. Mortillaro, N. (2016, Dec. 30). New research may offer hope for post-traumatic stress treatment. Canadian Broadcasting Company (CBC). Retrieved Oct. 4, 2017, from http://www.cbc.ca/news/technology/ptsd-brain-research-1.3915357

 

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