December 10, 2013 by johntemple
This National Public Radio piece reports on the overprescription of painkillers to veterans, which has resulted in a death rate among Veterans Affairs patients that is twice the national average.
One retired Army psychiatrist told NPR that the complex medical needs of veterans returning from combat in Iraq or Afghanistan makes treatment difficult, “and giving a prescription… is almost a default.”
Despite painkiller prescribing regulations adopted four years ago, data
shows that the rate of VA prescriptions for opiates continues to rise.
The VA didn’t do itself any favors by ducking the reporter’s requests for an interview, as the piece focuses on statements from veterans like this one: “If a doctor is giving this to me, I’m going to take it, you know?”
November 27, 2013 by johntemple
These maps, from a newly published study in the American Journal of Preventative Medicine, provide a vivid representation of the rise in drug poisoning death rates between 1999 and 2009.
In 1999-2000, the highest death rates (13 or more per 100,000) were clustered in a core of Appalachian counties, and a few more counties in California, New Mexico and other places. By 2005, the Applachian contagion had spread, and the highest rates had reached large swaths of the West, as well as much of Florida. By 2008-2009, much of the US map is bathed in red.
AADR stands for age-adjusted death rates.
November 20, 2013 by johntemple
This week, the New York Times published a multi-day, multi-media package about Suboxone, the addiction-treatment drug that reduces cravings for prescription opioids. The series contains several interesting takeaways, including:
- “Cash-only buprenorphine clinics” have cropped up and are funneling the drug to the streets, not unlike Florida’s recent pill mill industry.
- While the effects of the drug are milder than the opioids it is designed to curb cravings for, recreational users “report a potent, durable buzz.
- Partly because it is sold in a smuggler-friendly dissolvable filmstrip form, it has become popular in prisons.
November 19, 2013 by johntemple
It’s hard to figure out how the NFL is going to deal with its concussion problem, but a new documentary series spends almost as much time probing another issue plaguing the league: painkiller addiction.
The first episode of GQ’s documentary series, Casualties of the Gridiron, tells a powerful story about former Jets quarterback Ray Lucas. After leaving the NFL a decade ago, his pre-existing conditions, including two herniated disks and severe nerve damage in his back, Lucas’s life spiraled into pain and addiction.
Says Lucas: “The pain doesn’t stop when you finish playing. But the health insurance from the NFL? It most certainly does (stop). No insurance plan was going to cover me with my pre-existing conditions from my NFL injuries. There was really nothing left I could do except take every single pain pill I could get my hands on. And when that wasn’t enough, I would get what I needed off the street.”
November 15, 2013 by johntemple
The most revealing moment in Dr. Celine Gounder’s New Yorker essay is the opening anecdote in which she was shocked by the amount of OxyContin prescribed to a patient she was treating in 2004.
Gounder was a resident at that point, and she “didn’t have much experience with narcotics for outpatients. I figured that if the previous resident — now a fully licensed doctor — was doing this, then it must be O.K.”
Multiply that moment thousands of times and you begin to see how prescribing standards changed so rapidly a decade or two ago.
Many of the facts in Dr. Celine Gounder’s New Yorker piece were originally reported in much more depth by Barry Meier in the New York Times and in his books, Pain Killer and A World of Hurt. But it’s definitely worth a read.
November 15, 2013 by johntemple
The city of Chicago has launched an investigation into whether the painkiller industry deceptively promoted their drugs as safe and effective in the treatment of chronic pain, according to a New York Times story.
If the city pursues a lawsuit, it would seek to recover millions of dollars spent on pain drugs to treat city employees and retirees.
November 10, 2013 by johntemple
The new drug Zohydro ER sounds like an addict’s dream. Massive amounts of narcotic packed into a pill that needs only to be crushed or dissolved. No liver-damaging additives like acetaminophen or ibuprofen to discourage high doses.
Sounds just like the old OxyContin, before a lawsuit forced its maker to create an abuse-deterrent version.
Acting against the recommendation of its own advisory panel, the F.D.A. has approved the extended-release version of hydrocodone with five times the amount of narcotic as the highest dose of Vicodin.
This Milwaukee Journal Sentinel and MedPage Today story documents the whole thing pretty well.
November 8, 2013 by johntemple
A single Philadelphia man employing a “small army” of accomplices bought and sold more than 380,000 oxycodone and Xanax pills, according to the DEA.
The system resembled Florida’s during its pill mill heyday from 2008-2012. The defendant, Leon Little, 33, had dozens of accomplices, mostly from the Raymond Rosen Projects, who shuttled residents to a doctor’s office, then to pharmacies and then resold the drugs on the street.
November 8, 2013 by johntemple
Years of body aches. Adrenal and testosterone deficiencies. Glucose regulation problems. And now, depression.
Long-term use of opioids can cause them all.
A new study finds that patients who remained on opioids for 180 days or longer have a 53 percent greater risk of developing depression. Notice the word “patients.” Not addicts, but patients receiving and taking the medicine according to doctor’s orders.
The study, published in the Journal of General Internal Medicine, analyzed medical record data of about 50,000 veterans who had no history of depression or opioid use.
October 27, 2013 by johntemple
Barry Meier, oft-cited in this blog, has a good piece out about the money and lobbying behind the F.D.A.’s long-overdue recommendation to tighten how doctors prescribe hydrocodone.
A few stats from the piece:
- The DAY AFTER the hydrocodone decision, the F.D.A. approved a new OxyContin-like drug named Zohydro. Like OxyContin… without its current abuse-deterrent formulation. Was this a tradeoff the F.D.A. had to make?
- Hydrocodone has long been considered less-addictive than oxycodone, but that’s based largely on the fact that it is classified as a Schedule III drug, not a Schedule II like oxy. But Meier’s piece reveals there was little science behind that designation.
- Rep. Fred Upton (R-MI), a major roadblock to new legislation on hydrocodone, also was the House’s biggest recipient of drug industry campaign contributions, hauling in nearly $300,000 in the previous election cycle.