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posted by martyb on Tuesday February 21 2017, @08:13AM   Printer-friendly
from the higher-availability dept.

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

Original Submission

Related Stories

Opioid Addiction is Big Business 24 comments

The recent uptick in heroin and opioid addiction along with new laws are making addiction treatment an attractive target for investors:

Every crisis presents an opportunity, as the saying goes. And when it comes to opioid addiction, investors and businesses are seeing a big opportunity in addiction treatment. Places like [Gosnold on Cape Cod] are being gobbled up by private equity companies and publicly-traded chains looking to do what is known in Wall Street jargon as a roll-up play. They take a fragmented industry, buy up the bits and pieces and consolidate them into big, branded companies where they hope to make a profit by streamlining and cutting costs.

One company that advises investors listed 27 transactions in which private equity firms or public companies bought or invested in addiction treatment centers and other so-called behavioral health companies in 2014 and 2015 alone. Acadia Healthcare is one national chain that has been on a shopping spree. In 2010 it had only six facilities, but today it has 587 across the country and in the United Kingdom.

What's driving the growth? The opioid addiction crisis is boosting demand for treatment and two relatively recent laws are making it easier to get insurers to pay for it. The Mental Health Parity Act of 2008 requires insurers to cover mental health care as they would cover physical health care. "Mental health parity was the beginning. We saw a big benefit. And then the Affordable Care Act was very positive for our industry," says Joey Jacobs, Acadia's CEO. He spoke at an investor conference last month.

Marketplace has an article about how data and new databases are being used to track and prevent addiction. It cites the following report from Health Affairs:

Prescription Drug Monitoring Programs Are Associated With Sustained Reductions In Opioid Prescribing By Physicians (DOI: 10.1377/hlthaff.2015.1673)

Original Submission

Obama Administration Expands Access to Suboxone Treatment 10 comments

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.

Here is some basic information about the differences between buprenorphine (Suboxone) and Naloxone (Narcan).

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

Original Submission

DEA Welcomes Kratom to the Schedule I List Beginning September 30 32 comments

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.

Original Submission

Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid 32 comments

When customers want a longer-lasting high, heroin dealers respond by augmenting their products with drugs like carfentanil:

A powerful drug that's normally used to tranquilize elephants is being blamed for a record spike in drug overdoses in the Midwest. Officials in Ohio have declared a public health emergency, and the U.S. Drug Enforcement Administration says communities everywhere should be on alert for carfentanil. The synthetic opioid is 100 times more potent than fentanyl, the prescription painkiller that led to the death earlier this year of the pop star Prince. Fentanyl itself can be up to 50 times more deadly than heroin.

In the past few years, traffickers in illegal drugs increasingly have substituted fentanyl for heroin and other opioids. Now carfentanil [alt link] is being sold on American streets, either mixed with heroin or pressed into pills that look like prescription drugs. Many users don't realize that they're buying carfentanil. And that has deadly consequences.

"Instead of having four or five overdoses in a day, you're having these 20, 30, 40, maybe even 50 overdoses in a day," says Tom Synan, who directs the Hamilton County Heroin Coalition Task Force in Southwest Ohio. He's also the police chief in Newtown, Ohio. Synan says carfentanil turned up in Cincinnati in July. At times, the number of overdoses has overwhelmed first responders. "Their efforts are truly heroic, to be going from call to call to call," he says. "One district alone had seen 14 in one shift, so they were nonstop."

First responders and emergency room workers are being told to wear protective gloves and masks. That's because carfentanil is so potent, it can be dangerous to someone who simply touches or inhales it. This was devastatingly clear back in 2002, after a hostage rescue operation in Moscow that went wrong. To overpower Chechen terrorists who'd seized control of a theater, Russian Special Forces sprayed a chemical aerosol into the building. More than 100 hostages were overcome and died. Laboratory tests by British investigators later revealed [open, DOI: 10.1093/jat/bks078] [DX] that the aerosol included carfentanil.

In the article about the DEA adding kratom to Schedule I, I mentioned an "unprecedented" amount of "heroin" overdoses in Cincinnati. The carfentanil-cut heroin boosted the overdose tally to 174 in 6 days (225 in Ohio, Indiana, Kentucky, and New Jersey):

Deaths have not spiked along with the overdose reports because police officers or emergency medical technicians are immediately administering naloxone, sometimes in more than one dose, to bring heroin users back to consciousness and start them breathing.

Original Submission

The Calm Before the Kratom Ban 27 comments

The blowback against the U.S. Drug Enforcement Administration's decision to ban kratom has caught the attention of a bipartisan group of legislators, but a DEA spokesman has said that "It's not a matter of if. It's simply a matter of when" the DEA bans kratom:

A bipartisan group of nine senators is calling on the Drug Enforcement Administration to delay its "unprecedented" decision to ban kratom, a plant that researchers say holds great potential for mitigating the effects of the opioid epidemic. [...] The Senate letter, spearheaded by Orrin G. Hatch (R-Utah) says: "Congress granted emergency scheduling authority to the DEA based on the need for law enforcement interdiction of new and previously unknown illegal synthetic street drugs that result in injuries and death. The use of this emergency authority for a natural substance is unprecedented, so it is important to determine whether the circumstances here necessitate a jump to Schedule I.

"Given the long reported history of Kratom use," the letter continues, "coupled with the public's sentiment that it is a safe alternative to prescription opioids, we believe using the regular review process would provide for a much-needed discussion among all stakeholders." [...] The DEA cites 600-plus poison-control center calls involving kratom between 2010 and 2015 in its justification for banning the plant, and notes that 15 deaths were linked to the use of the plant between 2014 and 2016. In an interview with The Washington Post, a DEA spokesman later clarified that all but one of those fatalities involved the use of other substances. Earlier this week 51 U.S. representatives similarly called on the DEA and the White House to reconsider or at least delay the ban, which was slated to go into effect as early as Friday. In an interview, DEA spokesman Russell Baer confirmed that the ban was not yet in place. "We have not yet determined a date when we will publish that final order" putting the ban into effect, he said.

There may be a public comment period before the ban takes effect, and the White House is now obligated to respond to the petition about kratom, which has reached over 140,000 signatures.

Text of the Senators' letter. Also at Ars Technica, CBS, and US News & World Report.

Previously: DEA Welcomes Kratom to the Schedule I List Beginning September 30
Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid
Alcohol Industry Bankrolls Fight Against Legal Pot in Battle of the Buzz [Updated]

Original Submission

Chicago Jail Handing Out Naloxone to Inmates Upon Release 41 comments

The Cook County Jail in Chicago, IL has trained hundreds of inmates on how to use the opioid overdose-reversing drug naloxone, and has given doses out to inmates upon release:

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

Original Submission

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  • (Score: 2) by driverless on Tuesday February 21 2017, @08:48AM

    by driverless (4770) on Tuesday February 21 2017, @08:48AM (#469626)

    I thought motorcyclists were the top organ donors, do drug overdoses outnumber them now or are they still way ahead?

    • (Score: 0) by Anonymous Coward on Tuesday February 21 2017, @09:19AM

      by Anonymous Coward on Tuesday February 21 2017, @09:19AM (#469629)

      The motorcycle stats I have heard were from the US, which has notably more days a motorcycle can be ridden, and is a far larger part of the local culture.

  • (Score: 0) by Anonymous Coward on Tuesday February 21 2017, @10:33AM

    by Anonymous Coward on Tuesday February 21 2017, @10:33AM (#469644)

    Drug addicts tend to have higher rate of potentially fatal virus infections. I don't think there is enough time in organ harvesting situation to properly test safety for organ acceptors. I guess it is situation of potentially trading one ailment for another.

    • (Score: 2, Informative) by anubi on Tuesday February 21 2017, @10:41AM

      by anubi (2828) on Tuesday February 21 2017, @10:41AM (#469648) Journal

      Treatment of the viral infection may be less problematic than complete loss of organ function.

      If one has no car at all, the gift of one with an engine malfunction is better than no car at all. Especially in a situation where no cars are available. Get the one you can get and fix it.

      My guess is the drug users generally tend to be younger, stronger, still having the resilience of youth, where organs as old as mine ( >65 yr old ) are near the end of life ( telomerically speaking ), and may not be as much use, even though they are drug-free and mostly still work.

      "Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
      • (Score: 2) by SanityCheck on Tuesday February 21 2017, @04:14PM

        by SanityCheck (5190) on Tuesday February 21 2017, @04:14PM (#469742)

        Oh thank god I got that new liver, and only with herpes, not even AIDS.

        • (Score: 2) by bob_super on Tuesday February 21 2017, @08:09PM

          by bob_super (1357) on Tuesday February 21 2017, @08:09PM (#469861)

          Bad example: Most people have Herpes.

      • (Score: 1) by Frost on Thursday February 23 2017, @10:00PM

        by Frost (3313) on Thursday February 23 2017, @10:00PM (#470919)

        It may even be possible to apply extremely aggressive (lethal) antiviral treatments to organ donors on life support, sacrificing everything except the organ(s) to be harvested for transplant.

  • (Score: 3, Touché) by cafebabe on Tuesday February 21 2017, @11:07AM

    by cafebabe (894) on Tuesday February 21 2017, @11:07AM (#469653) Journal

    In the article about Heroin, Fentanyl and Carfentanil [], I noted []:-

    Through selective breeding and/or gene editing, work is advancing to make yeast which makes opioids and/or opioid precursors. I understand that progress is about two or three steps short of dihydrocodeine and something psychoactive may be achieved within five years. When (or before) that occurs, opiates will only require one or two steps beyond brewing beer or wine. What happens from there?

    Well, the yeast will get widely propagated throughout the world and the cost of a hit of heroin (or equivalent) becomes about twice as expensive as beer. Opiate addiction and overdose will then reach record levels.

    And the powerful won't care because it dovetails with organ harvesting [].

    • (Score: 3, Interesting) by VLM on Tuesday February 21 2017, @01:07PM

      by VLM (445) on Tuesday February 21 2017, @01:07PM (#469662)

      Opiate addiction and overdose will then reach record levels.

      Yeah I wonder about that. I think I have access to heroin if I want it, which I don't.

      Kinda like I have infinite access to cheap alcohol, but I don't drink much (barely at all, really) so alcoholism is unlikely diagnosis for me.

      I suspect given the incredible addictiveness of that stuff that anyone susceptible will do anything to get it resulting in not much change if availability were free.

      The main cultural reaction I'd really enjoy seeing is a collapse in street crime, if an addict has to smash my car windows and break into my garage today, and in a decade yeast grown stuff is so cheap that panhandling for an hour will keep him high for weeks, I'm super stoked about that outcome. Its not as good as legalization and transferring all the "civil war on drugs" money into treatment, but at least its a positive step.

      I wonder if there's any BOINC or "folding at home" type distributed processing projects I could contribute to, because for my safety and the safety of my family I can't wait until opiates are cheaper than bottled water.

      • (Score: 2) by cafebabe on Tuesday February 21 2017, @02:03PM

        by cafebabe (894) on Tuesday February 21 2017, @02:03PM (#469672) Journal

        I'm going to be offline for a few days or more but I may return with a worrying dystopia. The outline is as follows:-

        1. Cost of alcohol continues to fall. I've had a tour of a brewery and it is scary to see 30 people make 0.5 million pints per week. The current limitation is distribution. If a brewery made 10 times the volume of beer then it wouldn't have 10 times the distribution area. It would just saturate one urban area. However, with robotic vehicles, 30 people could oversee the production of 10 million pints per week.
        2. Cost of opiates could be twice the cost of beer while having a much stronger effect. Contraband opiate yeast would lead to moonshine which risks immediate blindness *and* immediate opiate overdose.
        3. You'll see a decrease in petty crime. However, you'll see an increase in violent crime because opiate addicts won't feel any pain. They'll feel like 18 year olds in peak physical fitness even if they're really messed up from multiple, serious fights. I hope that point is self-evident to anyone who's been prescribed opiates and felt absolutely great.
        4. At a really coarse, economic level, your cost of living will increase. Life expectancy (of addicts) will decrease. Therefore, the taxable income which goes into immunization, education and training gets less return. Yes, we can harvest the spare organs but it is much more cost effective to keep them in their original bundles.

        Actually, from that description, it sounds like a zombie invasion. Act accordingly.

        • (Score: 2) by VLM on Tuesday February 21 2017, @02:43PM

          by VLM (445) on Tuesday February 21 2017, @02:43PM (#469683)

          moonshine which risks immediate blindness

          Yeah that's "reefer madness" stuff from prohibition, still around. I used to brew and being into or formerly into chemistry I dug in and its pretty interesting.

          First of all if you drink about 10000L of fruit juice relatively quickly or maybe 4 or 5 pallets of apple crates you'll die. Long before you'd get really sick from methanol poisoning.

          Its interesting that the problem is the fruit juice itself. Brewing just makes lazy adult humans drink more fruit juice, and obviously distillation concentrates it even more. Drinking six liters of hard cider a day won't give you any worse methanol poisoning than drinking six liters of plain old apple juice, its just more culturally acceptable or believable that someone lost their sight or died from alcohol consumption instead of drinking literal gallons per day of cider.

          Pectin in fruit (the same stuff that makes jam/jellies) can ferment or get enzymatically converted into methanol. Its a measurable problem.

          When you brew cider they want you to run a clarify step to filter the pectin and pulp crap out with diatom earth or high tech high pressure filters to clean it. I suppose a lazy as hell cider brewer could skip that and generate a murky looking brew that produces wicked hangovers. If you were to distill that into a brandy and drink a couple liters a day, assuming your liver didn't kill you, after a couple years long term methanol intake could be an issue. But most people would have died of liver cancer long before the methanol makes them blind. Yet, its statistics, and maybe 1 in 100 will live long enough to go blind first. In summary if you drink an insane amount of hard cider you'll die, and most will die of liver cancer and other extreme alcoholism effects but the extreme tail end will include people dying of methanol related problems. If you're not drinking enough to die its not going to be a problem.

          Real methanol poisoning DID happen but its because methanol smells alcohol-ish and temporarily gets people high, but its like claiming that Agatha Christie detective novels involve poison delivered by tea therefore tea is inherently poisonous. Or a heroin dealer trying to kill off someone could cut the stuff with rat poison therefore heroin is inherently poisonous. Nope. People die from methanol poisoning and its just simple first degree murder, nothing to do with brewing other than reefer madness level propaganda from the prohibition era. If someone wants to kill you or wants to frame a supplier for killing you, and you're drinking liquor, well, the drinking booze makes it easier. To some extent its like arguing gun control. Gun has never hurt anyone, ever, but murderers using guns is a problem. If a cop walked into a speakeasy during prohibition and ordered a screwdriver, it was quite possibly OJ and paint thinner, but thats because they wanted to kill the cop, not because brewing makes significant amounts of methanol. So yeah people have been killed by methanol poisoning, but its a very rare first degree murder problem not an industry wide production problem.

          Its a pity that separating methanol from water is as hard as separating ethanol as its "almost" a fuel source. If you get a fraction of a percent by volume from a million gallons of apple cider, that's probably enough to run in an engine to power at least part of the cider press plant. A small percentage of a hell of a lot of stuff is a modest amount.

      • (Score: 3, Interesting) by zeigerpuppy on Tuesday February 21 2017, @02:03PM

        by zeigerpuppy (1298) on Tuesday February 21 2017, @02:03PM (#469673)

        opiates are already very cheap, grow poppies.
        the cost is caused by keeping it illegal.
        we'll probably look back at current drug policy much as we look back at the alcohol prohibition era. A massive waste of resources and lives that does nothing but enable criminality.

    • (Score: 2) by DeathMonkey on Tuesday February 21 2017, @07:50PM

      by DeathMonkey (1380) on Tuesday February 21 2017, @07:50PM (#469848) Journal

      Well, the yeast will get widely propagated throughout the world and the cost of a hit of heroin (or equivalent) becomes about twice as expensive as beer. Opiate addiction and overdose will then reach record levels.
      Why bother with all that nonsense? According to our president they're already cheaper than a candy bar.

  • (Score: 2) by requerdanos on Tuesday February 21 2017, @04:58PM

    by requerdanos (5997) on Tuesday February 21 2017, @04:58PM (#469763) Journal

    more than 900 people died of drug overdoses in British Columbia, doctors are pointing to one morbid upside.... a significant uptick in organ donor deaths, and... fentanyl is likely playing a role.

    I have a friend in western England, near Wales, who has told me stories of NHS "accidently" opiod-overdosing (she cited morphine) likely terminal, weak, and older patients (including, she says, a beloved family member). Those using the most resources with less likely healthy outcomes.

    I know that's anecdotal, and not proof, but if it's happening... Is that euthanasia? Is it murder? Or simple shortening of the hospital stay by hastening probably impending death?

    I lean toward "murder" but see the respective points of view.

    Another thing is, like BC in Canada, my home of North Carolina has lots of opiate overdoses (mostly heroin, but also things like oxycodone, dihydromorphone, fentanyl, and friends), and lots of deaths.

    I don't understand it--for which I am very glad. There's lots of heroin and pills for sale here, but despite chronic pain I am not even slightly tempted to look for some. It seems to result in death and destruction, rather than pain management.

    I'd rather just hurt; at least the pain is an old friend by now and very very unlikely to kill me.

  • (Score: 0) by Anonymous Coward on Tuesday February 21 2017, @06:33PM

    by Anonymous Coward on Tuesday February 21 2017, @06:33PM (#469807)

    I had been hopeful that maybe, just maybe the USA would see the light as concerns substance prohibition. It figured it out once with alcohol, but it can't seem to generalize from that example. It tried with cannabis which seems to have led to similar (beneficial for society) results, but that will all be rolled back soon. This opioid epidemic is especially hilarious to me. You could legalize and regulate them, and that way people who use different kinds of opioids would at least have a chance of managing their habits with properly, accurately labeled product or even seeking help in the open. However, it just fits in too nicely with your authoritarian worldview when somebody takes what they think will be their usual dosage of heroin only to wake up dead because it had been mixed with fentanyl. You all also know goddamned well that even just legalizing cannabis greatly reduces overdoses of this entirely different class of drug.

    You are becoming a "3rd world" country, USA, just like those places mommy and daddy used to talk about that didn't even have basic plumbing and were too backwards to even participate in the Cold War. You know, like one of those nasty places where the head of state pays off the local police to assassinate suspected "drug dealers." You just haven't realized it yet because of the massive amount of wealth you still possess.

    I would bet that even a billionaire can eventually spend through his entire fortune partying and living it up in Ibiza with supermodel escorts hanging off his arm and every last sports car you could ever want to drive to wind up in the end homeless and destitute.

    You are cruel and barbaric, and the day will come soon when you wake up to consequences.

    More organ donors? You sound like a "functional alcoholic" making excuses for his habit to me.

    I don't know where we go from here, but you will wake up with a hangover, if you wake up at all from this bender.

    • (Score: 0) by Anonymous Coward on Wednesday February 22 2017, @04:34AM

      by Anonymous Coward on Wednesday February 22 2017, @04:34AM (#469996)

      Well, you're a bit misguided. That's Vancouver, Canada, not Vancouver, USA, in the article.

  • (Score: 1, Funny) by Anonymous Coward on Tuesday February 21 2017, @06:47PM

    by Anonymous Coward on Tuesday February 21 2017, @06:47PM (#469814)

    We're going to The Island.

    • (Score: 0) by Anonymous Coward on Tuesday February 21 2017, @07:07PM

      by Anonymous Coward on Tuesday February 21 2017, @07:07PM (#469822)

      Lincoln Six Echo, is that you?