from the kicking-is-hard dept.
The Obama administration is loosening restrictions on buprenorphine/Suboxone prescriptions in order to fight the "heroin epidemic", while calling on Congress to act on a request for $1.1 billion in additional funding for opioid treatment programs across the U.S.:
The Obama administration is making it easier for people addicted to opioids to get treatment. Health and Human Services Secretary Sylvia Burwell announced new rules Wednesday to loosen restrictions on doctors who treat people addicted to heroin and opioid painkillers with the medication buprenorphine. Doctors who are licensed to prescribe the drug, which is sold mostly under the brand name Suboxone, will be allowed to treat as many as 275 patients a year. That's almost triple the current limit of 100, and HHS estimated that as many as 70,000 more people may have access to the drug as a result.
"There are a number of ways we are trying to increase access to medication-assisted treatment," said Michael Botticelli, the director of national drug control policy, on a conference call with reporters. "This rule itself expands access and gets more physicians to reach more patients."
Suboxone is itself an opioid. It eases withdrawal symptoms and cravings, but doesn't make people high. [...] Botticelli said an average 129 people a day die from opioid overdoses.
White House Announces Heroin Response Strategy for the US Northeast
Alarming Rise in Death Rates for Middle-Aged White Americans
Kroger Supermarkets to Carry Naloxone Without a Prescription
4/20: Half-Baked Headline
The White House announced a new Heroin Response Strategy on Monday to combat a "heroin/opioid epidemic" across 15 states in the northeast:
The Office of National Drug Control Policy said it would spend $2.5 million to hire public safety and public health coordinators in five areas in an attempt to focus on the treatment, rather than the punishment, of addicts. The funding — a sliver of the $25.1 billion that the government spends every year to combat drug use — will help create a new "heroin response strategy" aimed at confronting the increase in use of the drug. A recent study by the Centers for Disease Control and Prevention found that heroin-related deaths had nearly quadrupled between 2002 and 2013.
[...] Once thought of as a drug used only by hard-core addicts, heroin has infiltrated many communities, largely because of its easy availability and its low price, officials said. The problem has become especially severe in New England, where officials have called for a renewed effort to confront it. Gov. Peter Shumlin of Vermont devoted his entire State of the State Message in January to what he called "a full-blown heroin crisis" in his state. Like the new White House effort, the governor called for a new, treatment-based approach to the drug.
[More after the break...]
Gina Kolata reports at The New York Times that something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling, primarily because of the declining health and fortunes of poorly educated American whites who are dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans. "It is difficult to find modern settings with survival losses of this magnitude," say Ellen Meara and Jonathan S. Skinner.
Though not fully understood, the increased deaths are largely thought to be a result of more suicides and the misuse of drugs and alcohol, driven by easier access to powerful prescription painkillers, cheaper high quality heroin and greater financial stresses. Death rates for people with a high school education or less rose by 22 percent while they actually fell for those with a college education. The rise in death rates among middle-aged white Americans means half a million more people have died in the US since 1998 than if the previous trend had continued. The death toll is comparable to the 650,000 Americans who lost their lives during the Aids epidemic from 1981 to the middle of this year, the researchers say. Anne Case and Angus Deaton warn that middle-aged Americans who are turning to drink and drugs are set to suffer more health problems than their elders unless the downwards trend can be halted. "This is not automatic. If the epidemic is brought under control, its survivors may have a healthy old age. However, addictions are hard to treat and pain is hard to control, so those currently in midlife may be a 'lost generation' whose future is less bright than those who preceded them."
In order to help fight the heroin epidemic in the northeast United States, Kroger supermarkets and CVS pharmacies will carry the anti-overdose (opioid antagonist) drug naloxone (trade name: Narcan) over the counter:
Ohio-based grocery chain Kroger Co. said Friday it will make the overdose-reversal drug naloxone available without a prescription in its pharmacies across Ohio and northern Kentucky, a region hard-hit by deadly heroin. Kroger said more than 200 of its pharmacies will offer naloxone over the counter within days. "We want families dealing with addiction to know that they can count on having the drug available in the event that they need it," Jeff Talbot, Kroger vice president of merchandising, said in a statement.
Ohio fire crews and other first responders use naloxone thousands of times a year to revive opioid overdose victims. Ohio overdose deaths jumped 18 percent in 2014, one of the nation's sharpest increases. Those on the front lines of the battle against heroin's spread have increasingly supported allowing and educating families and friends of addicts to administer naloxone in emergencies.
State regulators in Ohio and Kentucky have allowed the drug to be sold over the counter. Ohio Attorney General Mike DeWine and U.S. Sen. Rob Portman, R-Ohio, joined Kroger officials at a Cincinnati grocery store for the retailer's announcement. Portman has been pushing a multi-pronged heroin bill in the Senate that includes expanded availability of naloxone. "This marks an important step in our fight to combat addiction and we all need to continue to work for a bottom-up, comprehensive approach to the heroin epidemic," Portman, from the Cincinnati area, said in a statement.
CVS said recently it will soon offer naloxone without a prescription at its Ohio pharmacies.
Naloxone became available over the counter in Australia on February 1.
In the U.S., there are currently a patchwork of state laws which govern access to Naloxone.
In the U.K. as of 1 October, 2015, "...[A]ny worker in a commissioned drug service can now distribute naloxone without prescription."
It's that time of the year again. Time to talk about drugs and the war on them because some stoners declared a holiday or something.
At the time, I was writing a book about the politics of drug prohibition. I started to ask Ehrlichman a series of earnest, wonky questions that he impatiently waved away. "You want to know what this was really all about?" he asked with the bluntness of a man who, after public disgrace and a stretch in federal prison, had little left to protect. "The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I'm saying? We knew we couldn't make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did."
[Oh yes, it continues...]
More organs have become available for transplant in British Columbia, Canada, due to a rise in drug overdoses:
After a brutal year where more than 900 people died of drug overdoses in British Columbia, doctors are pointing to one morbid upside. It might sound like something out of a dystopian horror comic, where drug users are wiped out and harvested for organs. New stats released by the health agency responsible for organ transplants show that's not exactly a far-off nightmare anymore. Health officials have noticed a significant uptick in organ donor deaths, and say that fentanyl is likely playing a role. According to BC Transplant, the number of organ donors in the first weeks of 2017 has doubled over this time last year, from 10 to 20. That's resulted in 59 transplants, up from 37 organs over the same period in 2016.
[...] "We started tracking the connection between fentanyl and organ donation more closely at the start of 2017, and fentanyl has been a contributing factor in about a quarter of our donors so far this year." BC Transplant's statement cautions against drawing conclusions based on a small amount of recent data. But long term trends show the proportion of organ donors dying from overdose has gone up steadily over many years. Back in 2013, 7.5 percent of organ donors tested positive for drugs. In 2016, that number rose to 22.7 percent.
Previously: Opioid Addiction is Big Business
Obama Administration Expands Access to Suboxone Treatment
DEA Welcomes Kratom to the Schedule I List Beginning September 30
Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid
The Calm Before the Kratom Ban
"The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don't start, they won't have a problem." – President Donald J. Trump
President Trump has declared the "Opioid Crisis" a nationwide public health emergency. This action will allow for "expanded access to telemedicine services" to remotely prescribe medicines for substance abuse, allow the Department of Health and Human Services to "more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation's ongoing public health emergency", allow the Department of Labor to issue dislocated worker grants for those "displaced from the workforce" due to the Opioid Crisis, and will help people with HIV/AIDS to receive substance abuse treatment. The press release lists several actions that the Trump Administration has taken to respond to the Opioid Crisis, including the July 2017 law enforcement action against AlphaBay.
The declaration has been criticized for not requesting any funds to respond to the Crisis. The "nationwide public health emergency" declaration is also distinct from a promised "national emergency declaration", which would have freed up money from the Disaster Relief Fund to be spent on the Crisis. 14 Senate Democrats have introduced a bill that would authorize $45 billion to address the Opioid Crisis. The Obama Administration called on Congress last year to pass just over $1 billion in funding for opioid treatment programs nationwide. This funding was included in the 21st Century Cures Act.
The Department of Justice has arrested and charged the founder and majority owner of Insys Therapeutics Inc., John Kapoor, along with other executives from his company. Kapoor is accused with leading a nationwide conspiracy to bribe doctors and illegally distribute the company's fentanyl spray, intended for cancer patients, so that it could be prescribed for non-cancer patients. Kapoor stepped down as CEO of Insys in January. Acting U.S. Attorney William D. Weinreb said, "Mr. Kapoor and his company stand accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit. Today's arrest and charges reflect our ongoing efforts to attack the opioid crisis from all angles. We must hold the industry and its leadership accountable - just as we would the cartels or a street-level drug dealer." Six former Insys executives and managers were charged in December.
Kratom, an herbal drug made of ground-up tree leaves, is "temporarily" joining other natural substances such as cannabis, psilocybin, and peyote on the schedule I list of the Controlled Substances Act. The active ingredients in kratom, the indole alkaloids mitragynine and 7-hydroxymitragynine, are both being added to the list for up to three years, after which they can be added permanently.
Prior to this move, the U.S. has already been seizing shipments of kratom:
In 2014, the FDA issued an import alert that allowed US Customs agents to detain kratom without a physical examination. "We have identified kratom as a botanical substance that could pose a risk to public health and have the potential for abuse," said Melinda Plaisier, the FDA's associate commissioner for regulatory affairs. According to the DEA, between February 2014 and July 2016, nearly 247,000 pounds of kratom were seized.
Advocates say that kratom is a natural treatment for opioid addiction, an application that the Drug Enforcement Agency dismisses. Meanwhile, the heroin/opioid epidemic continues with "unprecedented" events like the recent 174 heroin overdoses in just six days in Cincinnati, Ohio.
Check out the implosion of this kratom subreddit, which is attempting to get 100,000 signatures on the White House petition site:
APATHY WILL GET US NOWHERE. IF THERE WAS EVER A TIME FOR US TO BAND TOGETHER, ITS NOW. stand with me brothers and sisters. hope is not lost.
Cook County now gives at-risk inmates the overdose-reversing drug naloxone upon their release from jail and Los Angeles is poised to follow suit, putting the antidote in as many hands as possible as part of a multifaceted approach to combatting the nation's opioid epidemic.
Cook County Jail, the largest single-site jail in the country, has trained about 900 inmates how to use naloxone nasal spray devices since last summer and has distributed 400 of them to at-risk men and women as they got out. The devices can undo the effects of an opiate overdose almost immediately and are identical to those used by officers in many of the country's law enforcement agencies.
[...] It is too soon to gauge the effectiveness of Cook County's program, but Dart said anecdotal evidence suggests that the kits have saved lives, including a man who was arrested again, returned to jail, and told of how a friend he had trained to use the kit had done so when he overdosed. In New York City, more than 4,000 kits have been distributed to friends and relatives of inmates at the city's jail at Rikers Island since the program there was launched in 2014.
Related: Kroger Supermarkets to Carry Naloxone Without a Prescription
Obama Administration Expands Access to Suboxone Treatment
One Upside to Opioid Overdoses: More Organ Donors
Development of a Heroin Vaccine