Take the First Step: (770) 817-0711

Drugs

Popular Prescription Drugs Pulled from Market

In November 2010,  the FDA recommended pulling propoxyphene products after new studies found they can create abnormal heart rhythms even at normal doses. As a result one of the makers of the pain medication Darvon and Darvocet said they will stop marketing the prescription drugs.

Darvon (with active ingredient propoxyphene) was first marketed in 1957. Darvocet contains propoxyphene and acetaminophen. Both drugs are popular with more than 10 million prescriptions written for them in 2009. Safety concerns have been raised about propoxyphene for decades, but studies have only linked them to episodes in which a patient exceeded the recommended dose.

The FDA issued the following statements: “Using propoxyphene causes significant changes to the electrical activity of the heart. These changes are linked to potentially deadly abnormal heart rhythms. It is not possible to monitor for, or mitigate, the risk of a fatal cardiac arrhythmia that may occur within the recommended dosing range for propoxyphene.

The drug was kept on the market 2009 with the FDA issuing its toughest warning label “taking too much of the drug could be fatal,” despite a panel having voted to have it removed from the market.

The drugs were developed by the Eli Lilly & Company, who no longer makes them. Companies that continue to produce them are generic drug companies like Xanodyne, who agreed to remove the drugs from the market. The FDA asked other companies to do the same.

Prescribing Suboxone for Ex-Prisoners

New York will give certain state prisoners Suboxone upon release as treatment/prevention from heroin use. The new plan created under the “Medication Support Recovery Project” hopes to help released inmates, who have been drug-free since arrest, stay off of heroin.

Suboxone is a treatment drug created for opioid dependence. It contains buprenorphine (an opioid) and naloxone, which blocks the opioid. When used correctly, Suboxone can minimize a person’s cravings, while prohibiting a high. However, studies have found the drug in and of itself to be addictive and often sold illegally on the street. (NYPD saw illegal Suboxone sales grow from 59 to 287 from 2007 to 2009.)

A member of the Office of Alcohol and Substance Abuse Services stated that research shows the brain to still suffer from cravings after the use of opiates has been discontinued. And that inmates who were opiate-dependent prior to incarceration have a higher risk of overdosing once released due to the combination of cravings with a lowered tolerance. (JoinTogether.org)

However, many feel that putting someone who has already detoxed and had a period of abstinence from opioids on another potentially addictive opiate drug is a bad idea. Special Narcotics Prosecutor Bridget Brennan also added, “It’s asking for trouble to put a drug that people want to buy into the hands of prisoners reentering society.” Some are concerned that it’s a situation in which the state is giving the tools without the skills, and that Suboxone without the combination of psychosocial/behavioral treatment and close monitoring is ineffective. In addition, further treatment may then be necessary to discontinue the use of Suboxone.

Are Drugs to Blame?

A tragic story the made headlines in September 2010 around the country makes you wonder if drugs are to blame:

Brian and Erin Wood were driving across Washington State, visiting relatives, when a car suddenly lost control and swerved into oncoming traffic in front of the couple’s car. What would have been a head-on collision, most likely killing both Erin, Brian, and their unborn son, was averted when Brian slammed on the breaks and swerved the car to have the impact only be on his side. In taking the brunt of it, Brian was killed; but because of his last minute decision, he saved his wife and unborn son. This story is heartbreaking in the love, bravery, and selflessness that this man showed for his wife and son, who was due to be born two months later.

The driver of the oncoming car was 21 year old Jordyn Weichert, who loss control of the car while trying to take off her sweater. There were three other people in the car with her, and the two boys in the back where both killed in the collision. As reported by MSNBC, police found in the car heroin, cocaine, marijuana, syringes, and .25 pistol.

For many in the addiction field, the question is, how does this happen? And how can this be avoided? It is a stark reminder of the effects that drugs and alcohol can have in a community. It makes one stress the need for stronger prevention and intervention tools, especially for our youth; and a call for better availability of comprehensive treatment options.

Painkillers: Common Risk Factors for Addiction?

A Geisinger study, published in Addiction in 2010, found that patients with four common risk factors have a significantly higher risk of addiction to painkillers. Chronic pain patients who are 65 years or younger, have a history of depression, and use of psychiatric medication were common risk factors for the development of a substance abuse problem. A history of drug abuse further compounds the risk. Among the patients attributed with these risk factors, statistics show that one in four (26 percent) suffer with painkiller addiction.

The significance of these findings, as reiterated by the senior investigator of the study, is that most of this information can often easily and quickly be found in a patient’s medical record. “These findings suggest that patients with pre-existing risk factors are more likely to become addicted to painkillers, providing the foundation for further clinical evaluation,” said Joseph Boscarino, PhD, an epidemiologist and senior investigator at Geisinger’s Center for Health Research, cited online at HCP Live. “By assessing patients in chronic pain for these risk factors before prescribing painkillers, doctors will be better able to treat their patients’ pain without the potential for future drug addiction.”

Additionally, even without a history of chronic pain, patients with these risk factors may still be more likely to become addicted.

The study investigators accessed an electronic database to identify patients with back pain and related orthopedic conditions, who were prescribed painkillers for more than 90 days. The sample size was 705 patients. These patients were interviewed and had their DNA collected to be studied.

The team studied a gene located on chromosome 15 that was implicated in alcohol, cocaine, and cigarette smoking dependencies.  The data suggests there is an association of DNA variants in a gene cluster on this chromosome with opioid and nicotine addiction as well.

The Dangers of Mixing Medications with Alcohol

Many of us know that mixing medications with alcohol is something that shouldn’t be done, and that goes for both prescription and over-the-counter meds. But it isn’t always clear why this is, and what dangers it poses. And often the warning is overlooked or underestimated. But lets take quick look at some numbers from the National Institute on Alcohol Abuse and Alcoholism:

  • 70 percent of adults consume alcohol at least occasionally with more than 10 percent consuming it on a daily basis
  • 14 billion prescriptions are written by doctors annually for the 2,800 prescription drugs on the market (as well as 2,000 types of over-the-counter medications)

With these figures, the chance of at some point using alcohol and medication at the same time seems nearly inevitable.

So what other risks are involved in combining alcohol and medication? For example, why shouldn’t you mix Tylenol or other forms of acetaminophen with alcohol? Because high, continuous levels of alcohol activate an enzyme that metabolizes this medication into compounds that impair liver function. The combination also increases the risk of gastric bleeding. This is especially true for older adults.

Mixing alcohol with certain antibiotics not only can weaken the effect of the antibiotic or cause adverse effects, but lead to headaches, nausea, vomiting and even convulsions. Alcohol decreases the effectiveness of common medications, such as Inderal, used to control blood pressure; it may also lead to dizziness of fainting. In addition, chronic alcohol consumption increases the risk of liver damage from surgical anesthetics such as Ethrane and Fluothane.

Combining alcohol with allergy or cold medications increases drowsiness and dizziness, especially in older adults. And products with diphenhydramine, such as Benadryl, can be increasingly more sedative. Some antipsychotic drugs, such as Thorazine, can lead to “fatal breathing difficulties” (according to the NIAAA) with mixed with alcohol. And the anti-seizure drug, Dilantin, may not control epileptic seizures as effectively if alcohol is involved.

Most people know that it is extremely risky to drink while taking prescription sedatives, opiates and other painkillers, as well as anti-anxiety medication like Xanax or Valium, but it is important to reiterate. This particular combination can be fatal, causing many to stop breathing, permanently.

With prescription drugs, alcohol can have a direct effect on a drug’s availability and its effectiveness. A night of drinking can increase a drug’s availability by competing for the same set of metabolizing enzymes. Hence, increasing the risks of harmful side effects. Long-term, heavy or chronic drinking can cause the opposite situation by decreasing a drug’s availability and effectiveness by activating metabolizing enzymes (sometimes even without the direct use of alcohol).

Efforts to Control the Problem of Pain Killers

As reported by The New York Times, Washington State is the first of hopefully many that is making a sweeping attempt to control the abuse of pain killers. The state government is developing regulations meant to stop doctors from prescribing higher doses of powerful painkillers for patients who are not benefiting from them.

Among other regulations, Washington would be the first state to require doctors to refer patients on escalating doses of pain killers for evaluation by a third party if they are not improving. This comes as a response to the national epidemic of excessive use of pain killers such as OxyContin, fentanyl and methadone that has resulted in abuse as well as fatalities due to overdose.

Pain specialists in Washington State say this move is essential in light of doctors giving high daily dosages of powerful and dangerous drugs for ailments like back pain for a long period of time without evidence that the drugs are benefiting the patient.

On a national scale, prescription drug overdoses are the second-leading cause of accidental death behind car accidents, and in some states, they are the leading cause of death, according to the Center for Disease Control and Prevention.

Washington State’s efforts reflect a growing view that current procedures of prescribing and utilizing pain medications must change. With the exception of cancer and end-of-life patients, many question just how beneficial pain medications are for most patients. In fact increasing evidence from studies, including one from Washington State, have found that many patients suffer significant side effects from pain medication including lethargy, increased sensitivity to pain, potentially fatal overdoses, and the severely increased risk of addiction.

The new regulations would require a doctor to refer patients to a pain specialist for review when their daily dosage increases to a specific level and no improvement is shown. The specialist will determine the next step for the patient, such as reducing pain medication, physical therapy, or in instances of substance abuse, helping patients find necessary treatment.

 

Page 6 of 7« First...34567

Receive Updates

Privacy Policy

All inquiries are held in the strictest confidence. Let us help you find the program that's right for you. Please call or email us TODAY!

No information on this site is intended to replace that of your physician or medical care provider.

Contact Information

ExecuCare
Advanced Recovery Center
1100 Poydras Street, Suite 2900
New Orleans, LA 70163
Main: 770.817.0711
Fax: 770.817.0640