Feds Move to Stop Opioid- and Heroin-Related Overdose, Death

A targeted initiative aimed at reducing prescription opioid- and heroin-related overdose, dependence, and death has been announced by the US Health and Human Services (HHS).

“Opioid drug abuse is a devastating epidemic facing our nation,” HHS Secretary Sylvia Burwell said in a statement.

“I have seen firsthand in my home state of West Virginia, a state struggling with this very real crisis, the impact of opioid addiction,” she added.

“That’s why I’m taking a targeted approach to tackling this issue, focused on prevention, treatment, and intervention.”

HHS efforts are aimed at three priority areas. They include training and educational resources to help healthcare professionals make informed prescribing decisions to address opioid overprescribing.

These resources will include updated guidelines for prescribers and will establish new opioid prescribing guidelines for chronic pain.

Efforts will also be directed toward facilitating prescription drug monitoring programs to support data sharing for safe prescribing.

These efforts will be supported by increasing investment in state-level prevention interventions that will help track opioid prescribing and support appropriate pain management.

Secretary Burwell also plans to increase the use of naloxone and to support the development of other lifesaving drugs to reduce the number of deaths associated with prescription opioid and heroin overdose.

These efforts will include the implementation of a prescription drug overdose grant program for states to buy naloxone and train first responders on its use.

Plans are also in place to expand the use of medication-assisted treatment, or MAT.

MAT is a comprehensive effort that combines the use of medication with counseling and behavioral therapies to treat substance use disorders.

A grant program is also planned to improve access to MAT through education, training, and purchase of MAT medications for the treatment of prescription opioid and heroin addiction.

These investments are all part of the President’s FY 2016 budget to intensify efforts to reduce opioid misuse and abuse, including $133 million in new funding.

Deaths from drug overdose have risen steadily during the past 2 decades and currently outnumber deaths from motor vehicle accidents in the United States.

Among drug overdose deaths recorded in 2013, approximately 37% involved prescription opioids.

Deaths related to heroin use have also risen sharply since 2010, with a 39% increase between 2012 and 2013.

Heroin use is a public health emergency that calls for legislative solutions

MORE PEOPLE are killed now by drug overdoses than by homicides in many states, prompting alarmed state lawmakers and attorneys general to search for legislative fixes. The sense of urgency, impelled especially by a spike in lethal heroin overdoses, is justified. Some of the measures proposed to address the problem may not be.

The new focus on heroin use coincides with very sharp increases nationally in overdose deaths in middle-class and predominantly white communities. It’s a shame that that’s what it took to rally the authorities to action; still, better late than never.

About 20 states, including Maryland, and the District have enacted bills to ensure that first-responders carry naloxone, a prescription drug also known by the brand name Narcan, which can save the lives of opiate users who have overdosed. Unfortunately, the spike in demand for the antidote has driven up its cost, which is proving a burden for some states and localities. Nonetheless, more states need to step up and recognize heroin use as a public health emergency.

Virginia is a case in point. Heroin-related deaths more than doubled in the commonwealth from 2011 to 2013 and increased at an even faster rate in Northern Virginia. Yet no law requires emergency medical personnel to carry Narcan; some do and some don’t. Worse, some lawmakers apparently believe that making the antidote more accessible will encourage heroin addiction, as if the availability of treatment somehow enables disease.

There are other sensible steps that states can take. They include enacting so-called good Samaritan laws (in place in Maryland and the District but not yet in Virginia) that shield witnesses from prosecution — even if they abuse or sell drugs themselves — if they promptly report and help overdose victims.

States should also consider measures that crack down on unscrupulous doctors and pharmacists who illegally or inappropriately prescribe and dispense opiate pills like OxyContin, which can be a gateway to heroin . And it’s also worth tracking the results of legislation adopted in New York that allows addicts to remain in treatment programs while they appeal decisions by insurance companies that have denied coverage.

However, we are skeptical that some measures to further criminalize already illegal drugs such as heroin will be effective. One idea, pushed by some prosecutors, is to expose drug dealers to homicide charges if they sell what turns out to be a lethal overdose. The experience of the federal war on drugs suggests that harsher penalties fill up jails and prisons without doing much to extinguish the sale of illegal narcotics.

A wiser tack is to treat heroin addiction as a public health emergency. That means establishing more readily available long-term treatment programs, preferably in residential settings that can help shield users from dealers. Such programs cost money. That in itself will be a test for leaders like Maryland Gov.-elect Larry Hogan (R), who has rightly proclaimed that the spike in heroin overdoses is an emergency. In the face of Mr. Hogan’s promise to slash state spending, will he be able to fulfill his promise to come to grips with this epidemic

Jump in Colorado School Drug Cases May be Linked to Marijuana Legalization: Experts

Colorado middle schools reported a 24 percent increase in drug-related incidents last year, according to USA Today. School-based experts tell the newspaper they believe the jump is directly related to marijuana legalization. Recreational sales of marijuana began on January 1, 2014.

Schools do not report which kinds of drugs are involved in the incidents, the article notes. State legislators are now asking school districts to keep track of which drugs they are finding.

John Simmons, the Denver Public Schools’ Executive Director of Student Services, says schools in his city saw a 7 percent increase in drug incidents, from 452 to 482. Almost all of the incidents were related to marijuana, he said.

Middle schools across the state reported a total of 951 drug violations, the highest number in a decade. School officials say while marijuana use has long been a problem, more students are trying it now that it is more easily available and socially accepted.

“We have seen parents come in and say, ‘Oh that’s mine, they just took it out of my room,’ and that sort of thing,” said school resource officer Judy Lutkin of the Aurora Police Department. “Parents have it in their houses more often, and the kids just can take it from home.”

“Middle schoolers are most vulnerable to being confused about marijuana,” said Dr. Christian Thurstone, attending physician for the Denver Health Adolescent Substance Abuse Treatment program. “They think, ‘Well, it’s legal so it must not be a problem.’”

Meg Sanders, owner of MiNDFUL, a marijuana company that operates in Colorado, says her business is very careful not to market to children. “We feel it’s our responsibility as a responsible business to card not just once but twice for any recreational customer, and medical patients have to show several documents before they can purchase marijuana,” she said.

Marijuana Research Review Details Harmful Outcomes of Use

A review of 20 years of marijuana research concludes there are real risks to using the drug, according to researchers. These include increased risk of car crashes, dropping out of high school and cognitive impairment. Marijuana does not produce fatal overdoses, the review notes.

According to the review, published in the journal Addiction, research in the past 20 years has shown that driving while marijuana-impaired approximately doubles the risk of car crashes. About 10 percent of regular marijuana users develop dependence. Regular use of the drug during the teenage years doubles the risks of dropping out of high school and of cognitive impairment in adulthood. “Regular adolescent cannabis users have lower educational attainment than non-using peers but we don’t know whether the link is causal,” the researchers note in a press release.

The review looked at marijuana studies conducted from 1993 to 2013. It found marijuana use in teens is strongly associated with the use of other illegal drugs. It is not known whether marijuana use causes teens to start using other drugs, the review noted.

Lead researcher Wayne Hall of the University of Queensland Center for Youth Substance Abuse Research in Australia concluded marijuana use probably increases cardiovascular disease risk in middle-aged adults, “but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco.”

Hall noted that the amount of THC, the psychoactive ingredient in marijuana, has increased in the past 20 years. “The impacts of increased potency on cannabis use should be a research priority,” he wrote.

The review listed other adverse effects of regular marijuana use, including a twofold risk of experiencing psychotic symptoms and disorders, especially in someone with a personal or family history of psychotic disorders who starts using marijuana in their mid-teens.

Heroin-Linked Deaths Surge 39 Percent, CDC Finds

Overdose deaths linked to heroin jumped 39 percent in 2013 from the year before, according to data released Monday by the Centers for Disease Control and Prevention.

The CDC said 8,257 people died of heroin-related deaths in 2013, compared with 5,925 deaths in 2012. The number of overdose deaths overall increased to 43,982 from 41,340.

Many more Americans die from prescription opioids. But the rise in fatal heroin overdoses came as users of prescription painkillers switched to the cheaper, illicit street drug. The heroin deaths contributed to an overall 6 percent jump in drug overdose deaths in 2013 from 2012.

“These troubling statistics illustrate a grim reality: that drug, and particularly opioid abuse, represents a growing public health crisis,” Attorney General Eric Holder said in a statement.

As states cracked down on the illicit use of prescription painkillers in the 2000s, many users shifted to heroin, which sells for a fraction of the cost. The February 2014 death of actor Philip Seymour Hoffman from a mix of heroin, cocaine, and other drugs dramatized the shift. Deaths from heroin are often also associated with other drugs.

Despite Hoffman’s death and the broad political reaction it sparked, data on heroin abuse has been hard to find. The National Survey on Drug Use and Health found that the number of people who had used heroin in the past year rose from 2012 to 2013, but the number who had used heroin in the past month dropped.

Michael Botticelli, the acting White House drug czar, said the rising overdose deaths underscored the need for a “comprehensive solution” to the nation’s drug problem that includes prevention, education and law enforcement. Both Botticelli and Holder have increasingly emphasized the need for local police to carry naloxone, a drug that can reverse opioid overdoses.

The World Health Organization estimated earlier this month that better distribution of naloxone in the U.S. could save as many as 20,000 lives every year.

Meghan Ralston, the harm-reduction manager for the Drug Policy Alliance, a nonprofit group that aims to end the war on drugs, applauded the increased distribution of naloxone to police. She said she hopes community nonprofits are not left behind.

“Community-based naloxone distribution programs continue to struggle mightily to be able to afford to do this lifesaving work, while police departments have access to a much larger pot of money,” Ralston said.

States like New York and Maine have increased the number of law enforcement agents tasked with drug enforcement while they have expanded naloxone access. Ralston criticized the increased enforcement.

“These tactics are really just the same old, same old,” said Ralston, who had not been able to examine the CDC data in depth. “Any increase in the number of heroin-involved deaths argues loudly in favor of reforms that help save lives and reduce mortality.”

DEA Issues Alert on Fentanyl-Laced Heroin as Overdose Deaths Surge Nationwide

The Drug Enforcement Administration (DEA) has issued a nationwide alert in response to a surge in overdose deaths from heroin laced with the narcotic drug fentanyl, the most potent opioid available for medical use.

“Drug incidents and overdoses related to fentanyl are occurring at an alarming rate throughout the United States and represent a significant threat to public health and safety,” DEA Administrator Michele M. Leonhart said in a statement. “Often laced in heroin, fentanyl and fentanyl analogues produced in illicit clandestine labs are up to 100 times more powerful than morphine and 30-50 times more powerful than heroin.”

Fentanyl is potentially lethal, even at very low levels, according to the DEA.

Last year, Philadelphia officials announced at least 28 people died after using heroin laced with fentanyl in March and April. Earlier in 2014, law enforcement officials said heroin laced with fentanyl was suspected in at least 50 fatal overdoses in Pennsylvania, Maryland and Michigan.

Seizures of illegal drugs containing fentanyl more than tripled between 2013 and 2014, according to USA Today. The National Forensic Laboratory Information System, which collects data from police labs, received 3,344 fentanyl submissions last year, up from 942 the previous year.

Between 2005 and 2007, more than 1,000 U.S. deaths were attributed to fentanyl, many of them in Chicago, Detroit and Philadelphia. The source of the drug was traced to a single lab in Mexico. The surge of deaths ended when the lab was identified and dismantled, the DEA said.