One Upside to Opioid Overdoses: More Organ Donors

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

takyon writes:

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).

Previously:
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

takyon writes:

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

takyon writes:

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

takratomyon writes:

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

takyon writes:

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.

Original Submission

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