Drugs

Despite a $634.5 million settlement (one of the largest penalties imposed on a drug company) against Oxycontin in 2007 that found executives guilty of misleading the public about the opioid drug’s safety, pharmaceutical companies continue to race for ways to make highly dangerous pain killers more marketably “safe” against abuse. The news about a “safe” opioid is disturbing, especially at a time when addiction of prescription drugs is at epidemic proportions.

Earlier this month, the Food and Drug Administration (FDA) approved a new formula for the time-release OxyContin, which is intended to prevent the pills from being cut, broken, chewed, crushed or dissolved to release more medication. The FDA noted that such an improvement in the drug may lead to less overdose risk due to tampering. However, a pharmacist with Prescriptionaddictionradio.com has argued that the drug company has yet to present a study about the effects of heat on the drug, and that tampering could become even easier than before. And it’s known that the drug can still be abused or misused if people take more doses than recommended.

In fact, it’s after FDA approval and after the drug is released to the public that the drug company is required to conduct a study on whether the “new” formula actually reduces abuse of the drug.

Along side this news, is a report that a drug known as Acurox is looking for approval from the FDA. Acurox is a drug that contains the B vitamin niacin to oxycodone in order to combat abuse due to the fact that large doses of niacin can cause uncomfortable flushing. However, the FDA has concerns about the use of niacin as it appears to worsen the medication’s side effect profile in pain patients that weren’t abusing their dosage. The drug company also said that in addition to the niacin, other added ingredients are designed to cause burning in the nose if abuser attempts to crush and snort the drug. And the drug turns to gel if added to water or other solvents to discourage injection.

However, many are saying that it’s a lot too little and too late for drugs that has been so destructive. And that the only “safe” formula is to remove these drugs completely from the market.

For more information:

• OxyContin – Questions and Answers
• A Guide to Safe Use of Pain Medicine

 

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Are prescription drug overdoses on the rise? According to a report released by Reuters Health on April 6, the number of annual U.S. hospital admissions due to poisoning by prescription opioids, sedatives and tranquilizers rose from about 43,000 to 71,000 between 1999 and 2006, respectively. This 65 percent increase is nearly double the amount observed in admissions due to the poisoning by other drugs and medications.

According to Dr. Jeffrey Coben of West Virginia University School of Medicine, most Americans see the headlines related to stars such as Heath Ledger, Michael Jackson, and Anna Nicole Smith and think that such tragedies pertain only to Hollywood. Coben and his colleagues who performed the study, said this assumption was to the contrary. The reality is research across the country is seeing “very significant increases in serious overdoses associated with prescription drugs.”

The most predominant prescription drugs associated with these overdoses are opioids, such as morphine, methadone, Oxycontin and the active ingredient in Percocet. These powerful narcotic painkillers have been found to be habit-forming. Also, sedatives or tranquilizers such as Valium, Xanax, and Ativan are the reason for the increase in admissions.

When asked why there has been such a rise in poisoning by prescription drugs, Coben and his team noted that there wasn’t any single cause. But rather a number of variations such as the increase in availability of powerful prescription drugs, as well as the attitude toward the use, or abuse, of prescription drugs tends to be different than ones toward using other drugs. This is especially true among young people, who say that prescription drugs are easy to obtain and they see them as less addictive and less dangerous than street drugs such as cocaine and heroin.

However, the rate of accidental, or unintentional, poising by opioids, sedatives and tranquilizers nearly doubled during the seven year study period. With unintentional poisoning now the second-leading cause of unintentional injury death in the United States.

The study, which was published in the April 2010 issue of the American Journal of Preventative Medicine, also found that urban, middle-aged women seem especially vulnerable to prescription drug overdoses. And that hospitalizations for methadone poisoning increased more than any other drug during the seven-year period.

A multitude of news stories broke this week that draw further attention to the increasing threat of prescription drugs epidemic. Abuse of prescription drugs, like substance abuse in general, shows no discrimination in the target demographic.

First, on the heels of last week’s blog about teen star, Corey Haim, investigators into his death found that he was using nearly twenty different doctors for prescription drugs. In his apartment they found prescription drugs such as Valium, Vicodin, Soma, and Haloperidol. He also had prescriptions written for OxyContin. Investigators now believe him to be linked to a prescription drug ring in California.

A recent study involving senior citizens (65 years or older) found that most of them, nearly 67%, take five or more types of prescription drugs and 21% take ten or more types of prescription drugs. This puts them at risk not only for abuse of certain prescription drugs, but also increases their risk of adverse effects and fatal interactions between the various drugs. This is awareness is crucial during a time when many U.S. cities are seeing a 70-80% increase (since 2000) in accidental overdoses due to prescription drugs.

This week at a pharmaceutical warehouse in Connecticut, police witnessed the most audacious example of a growing phenomenon when thieves stole $75 million worth of prescription drugs for resale on the black market.

CNN reported this week that 1 in 5 teens in grades 9 – 12 admitted abuse of prescription medication, especially xanax.

A recent article in Gastroenterology & Endoscopy News reported that physicians who are coping with prescription painkiller abuse are often flying under the radar. “[Misuse and abuse of prescription medications] is increasing, actually rather dramatically, in the population as a whole,” said Marv Seppala, MD, himself a recovering addict who was among the first physicians in the country to be certified by the American Board of Addiction Medicine. “Abuse of prescribed medications, specifically opioids, is now second to marijuana in terms of abuse,” he said. “There is also a remarkable increase in cases involving health care professionals.”

And lastly, some of the more alarming news regarding abuse of prescription drugs was released this week by the Pentagon about the Army. As reported by USA Today, the military is trying to curb the amount of prescription drugs given to the troops when a study found that military doctors wrote almost 3.8 million prescriptions for pain relief for troops last year. This was more than four times the 866,773 doses given in 2001. Military officials and analysts see the increase in use of pain medication as a result of the continuing toll on ground troops fighting in Iraq and Afghanistan. According to the results released this year, one in four soldiers admitted abusing prescription drugs, mostly pain medication, in the 12 months prior to the Pentagon survey in 2008.

A recent study in Utah may provide a startling insight in to what may be a national trend with leftover meds. As reported by Health Day, a startling 97 percent of the study’s individuals who stated having taken opioid pain medicine not prescribed to them over the past year, had gotten the drug from a friend or relative who had a prescription. In most cases the drug was handed over willingly to the individual who reported illegally using or abusing opioid painkillers, such as Oxycontin or Vicodin.

The study, which was published in the February 19th issue of the U.S. Center for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, also alarmingly found that one in five Utah residents have at least one prescription for opioid painkillers. The majority of patients (71 percent) keep their leftover medication, stating that they paid for them and may need them again.

According to the report, 85.2 percent of the people who used an opioid without a prescription said it was given to them by someone who did, while only 9.8 percent said they took the drug without the knowledge or permission of the owner. And only 4.1 percent said they bought the drug. This study also revealed that deaths in Utah resulting from poisoning by prescription painkillers increased 600 percent from 1999 to 2007.

One warning the research team issued was that holding on to unused prescription medications could result in fatal overdoses, especially for people who aren’t prescribed the drugs. And that the excess of pills makes the possibility of misuse and abuse more likely. The team suggested throwing out leftover opioids by mixing the pills in a separate bag with something undesirable and then throwing the bottle out separately with any identifying information crossed out.

The researchers hope that the study will educate both physicians and the public about the dangers of unused prescription painkillers, and encourage doctors to be more cautious in prescribing and the public more willing to throw out unused prescription medications and to not share prescriptions with other.

Recognizing a prescription drug abuse problem can be difficult, especially since it is often a trusted doctor that’s prescribing the drugs. Currently, prescription drug abuse has hit an all time high. Millions of Americans are misusing prescription drugs. According to the Drug Enforcement Agency, there are more people abusing prescription drugs than cocaine, heroin, hallucinogens and ecstasy combined. The problem of prescription drug abuse is serious.

The tricky thing about prescription drug abuse it is that, yes, there are traditional drug dealers, online pharmacies and other black markets that sell prescription drugs like codeine, Vicodin or OxyContin. But the real suppliers are doctors, prescribing drugs for pain, anxiety, and more. At ExecuCare, we’ve seen the number of prescription drug abusers climb in Atlanta and the rest of the country. And lately, we’ve seen in the media a rise in the number of deaths surrounding prescription drug abuse: Michael Jackson, Whitney Houston, Heath Ledger. Sometimes it’s not just the amount of the prescription drug being abused but the combination of drugs that causes a lethal cocktail.

One sign that prescription drug abuse is present is “doctor shopping.” This is when an individual visits multiple doctors to try and obtain the same prescription without a problem of abuse being detected. In July 2009, CNN ran an article called “Using Dentists as Dope Dealers”. The article reported the increasing problem of “dentist-shopping”. While most primary care doctors asked patients to schedule an appointment to discuss pain, the article found that dentists often prescribed medication over the phone for toothaches and other mouth pain. Some people were even targeting veterinarians for pain medication. For doctors with patients complaining of pain, it is difficult to assess what is real or what is an attempt to get the prescription drug of abuse.

More common signs of prescription drug abuse are:

• Taking someone else’s prescribed drugs.
• Visiting multiple doctors for the same or similar prescription.
• Taking more than the prescribed dose.
• Combining medications without discussing risks with doctor.

At ExecuCare, we are well-equipped to handle prescription drug abuse. Not only does our detox program safely and quickly help someone stop the use of prescription drugs, but we have the necessary resources to help stage an intervention and guide someone through treatment. We also have an extensive after-care program that helps ensure long-term recovery.