from the lives-matter dept.
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
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."
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
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
Dr. Lowe, from In The Pipeline, writes about the development of a vaccine for heroin:
At first thought, that might seem like a weird idea. Drugs of abuse, such as heroin, cocaine, methamphetamine et al. are small molecules, and as such are too small to set off immune responses on their own. But a strategy could be to attach them to some larger protein that can raise antibodies – if those antibodies recognize the drug-labeled part of the protein conjugate, they may well retain activity against the drug molecule in its free state.
[...] It's been a long road. The first morphine immunoconjugate was described in 1970, and a morphine vaccine was tested in rabbits in 1975. But very little progress in the field occurred over the next twenty years or so, partly because methadone treatment for heroin addiction had become widely used. It's interesting to note, though, that vaccine development work against amphetamine seems to have followed a roughly similar path
[...] It would seem that we really are getting close to human clinical trials for some of these, which will be quite interesting. A drug-abuse vaccine is not going to be magic, though. Because of the specificity of the immune response, someone who's been vaccinated against heroin would almost certainly still respond to morphine, and most definitely would to compounds like fentanyl or oxycodone [...] But vaccines could, at the same time, provide the extra help needed for people to finally break free of a particular drug, and addicts who are really trying to quit need all the help that they can get.
I'd say that last part is the key. One of the big issues in drug addiction is (in the end) a philosophical argument about free will (which would explain why it never gets resolved!) Is drug addiction a disease, a choice, a behavior, a biochemical problem. . .the arguments go on forever, complicated by the way that different people attach different meanings to those terms.
"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.
U.S. Surgeon General Jerome Adams has urged more Americans to carry the opioid overdose reversal treatment naloxone, known under brand names such as Narcan and Evzio. However, the drug and its delivery systems have become more expensive in recent years:
As opioid-related deaths have continued to climb, naloxone, a drug that can reverse overdoses, has become an important part of the public health response. When people overdosing struggle to breathe, naloxone can restore normal breathing and save their lives. But the drug has to be given quickly.
On Thursday, U.S. Surgeon General Jerome Adams issued an advisory that encouraged more people to routinely carry naloxone. "The call to action is to recognize if you're at risk," he tells Morning Edition's Rachel Martin. "And if you or a loved one are at risk, keep within reach, know how to use naloxone."
[...] The medicine is now available at retail pharmacies in most states without a prescription. Between 2013 and 2015, researchers found a tenfold increase in naloxone sold by retail pharmacies in the U.S. But prices have increased along with demand. Naloxone-filled syringes that used to cost $6 apiece now cost $30 and up. A two-pack of naloxone nasal spray can cost $135 or more. And a two-pack of automatic naloxone injectors runs more than $3,700. And while it's true that naloxone can prevent many opioid-related deaths, it doesn't solve the root cause of the problem.
Related: Kroger Supermarkets to Carry Naloxone Without a Prescription
Chicago Jail Handing Out Naloxone to Inmates Upon Release
Opioid Crisis Official; Insys Therapeutics Billionaire Founder Charged; Walgreens Stocks Narcan