opioids | Addiction Treatment Strategies

Academics PROFIT By Making the Case for Opioid Painkillers
As an epidemic of narcotic painkiller abuse raged across America in 2006, researchers at the U.S. Centers for Disease Control and Prevention issued a medical journal report connecting deaths from those drugs to up to a 500% increase prescriptions.
In that same journal, a couple of officials with a little-known group at the University of Wisconsin School of Medicine and Public Health took issue with the paper, issuing their own warning against any attempt to increase regulation of the drugs.
But the article from the UW group did not disclose that over the last decade or so, as this…

Fatal overdoses involving prescribed opioids tripled in the United States between 1999 and 2006, climbing to almost 14,000 deaths annually — more than cocaine and heroin overdoses combined. Hospitalizations and emergency room visits related to prescription opioid pain medicines such as oxycodone (brand name Oxycontin) and hydrocodone (Vicodin) also increased dramatically in the same period.
 
Now a report in the August issue of Health Affairs describes a major initiative at Group Health to make opioid prescribing safer while improving care for patients with chronic pain. Health Affairs is the nation’s premier health policy…

Among the many signs of a turnaround is a new substance abuse center in Portsmouth, Ohio. The newspaper describes other successes, including the closing of eight of nine pain clinics that prescribed millions of doses of opioids in one Ohio county. A new state law gives the state’s Medical Board more power to regulate “pill mills.” And a new spirit of cooperation is allowing federal, state and local agencies to work together on prescription drug abuse.
But, there are still ample signs that prescription drug abuse remains a major problem in the state. In Scioto County, in the south central part of the state, 10 percent of babies born so…

The FDA has approved a short-acting opioid painkiller with abuse-deterrent properties, the drugmaker Pfizer announced Monday.Oxecta, a new formulation of oxycodone, had previously been under development as Acurox, which included niacin to deter oral abuse. That version received a thumbs downfrom an FDA advisory panel in 2009.The new drug uses “Aversion” technology, licensed from Acura Pharmaceuticals — which is described as a “unique composition of commonly used pharmaceutical ingredients” — to stop potential abusers from crushing, chewing, snorting, or injecting the opioid. It does not deter oral…

Methadone appears to be involved in a large proportion of opioid-related deaths in the U.S., researchers found.
A third of the deaths related to this painkiller class implicated methadone, although the addiction-recovery drug represents less than 5% of opioid prescriptions, according to Lynn Webster, MD, of Lifetree Pain Clinic in Salt Lake City, and colleagues.
They reported the findings in a special issue of Pain Medicine devoted to assessing the causes of recent increases in opioid-related deaths — the prevention of which “should be a central focus for everyone working in the field of pain medicine,” Webster said in a…

Deaths related to prescription opioid therapy are under intense scrutiny, prompting those in pain medicine — clinicians, patient advocates, and regulators — to understand the causes behind avoidable mortality in legitimately treated patients. Studies reporting on statistics, causes, and adverse events involving opioid treatment are now available in a special supplement of Pain Medicine, a journal published by Wiley-Blackwell on behalf of the American Academy of Pain Medicine (AAPM).
Opioids are prescribed to treat moderate to severe pain and include extended-release opioid analgesic drugs such as methadone, morphine, and…

Sales of opioid analgesics, such as oxycodone and hydrocodone, have increased more than 600% since 1997, according to data from the Drug Enforcement Administration (DEA). Opioid analgesic sales increased from 96 milligrams per person in 1997 to 698 milligrams per person in 2007. During the same time period, the number of unintentional deaths involving opioid analgesics quadrupled, from 2,901 in
1999 to 11,499 in 2007 (the most recent year for which data are available). The increase in deaths and sales are highly correlated (r=0.99), supporting previous research1 showing a strong, statistically significant correlation between states with…

Deaths from opioid use in Ontario, Canada, have doubled since 1991 and the addition of long-acting oxycodone to the drug formulary was associated with a 5-fold increase in oxycodone-related deaths, found a new study in CMAJ (Canadian Medical Association Journal). Most of these additional deaths were accidental.
Opioids are among the most commonly prescribed medications in Canada and are often used for patients with chronic non-malignant pain. Other studies have argued that prescribing is not a major contributor to the adverse health effects of opioid abuse, yet this study suggests that increased rates of opioid prescriptions are a…

A group representing pain management physicians is calling for mandatory education for doctors who prescribe opioids. The American Society of Interventional Pain Physicians (ASIPP) is advocating for legislation that would require health care professionals who prescribe drugs to receive specialized training. Several such bills are currently circulating in the House and Senate.
Between 80 and 90 percent of doctors in the United States have no formal training in prescribing opioid medications, says David Kloth, MD, a Connecticut-based pain management specialist and spokesperson and former president of ASIPP. “I would never prescribe…