Deaths from heroin overdoses surged in 2014

https://www.washingtonpost.com/news/to-your-health/wp/2015/12/11/deaths-from-heroin-overdoses-surged-in-2014/

They keep including drug over dose deaths from OTC.. in the total death count …but.. don’t mention that HALF of that number is from OTC’s

Despite increased public efforts to combat opioid abuse, the number of deaths from heroin overdoses surged by 28 percent in 2014, and fatal overdoses from prescription painkillers climbed by 16.3 percent, according to federal health officials.

The 10,574 heroin deaths and the 18,893 deaths from prescription opioids were two big contributors to a sharp increase in fatal drug overdoses last year — a total of 47,055, up 7 percent from 2013, according to the National Center for Health Statistics. The heroin overdose figure was more than three times higher than the 2010 tally.

“The bottom line is the opioid overdose epidemic has not abated and appears to have soared in 2014,” said Tom Frieden, director of the Centers for Disease Control and Prevention. “It’s clear that we need to do more.”

Frieden said the data, which was published this week, may change after CDC has a chance to review them and parse out cases of  people who died with both heroin and prescription drugs in their systems. But even if some individuals were counted twice, he said, “It’s clear that the opiate epidemic from 2013 to 2014 got worse, not better.”

In the past few years, local, state and federal agencies have devoted additional resources to cracking down on illegal drug traffic, more widely distributing the drug naloxone, which reverses overdoses, and sending users to treatment instead of jail when possible.

And in recent months, the Obama administration announced new “public health-public safety partnerships” in areas plagued by drug overdoses, moved to increase access to treatment and took steps to better train doctors who prescribe prescription painkillers such as OxyContin, which have proven to be addictive. CDC is scheduled to propose new guidelines Monday for doctors who prescribe those drugs.

But the new numbers suggest that efforts to date have not stopped the tide of drugs washing through parts of the country. The Midwest, Great Lakes region and the Northeast have been particularly affected.

[One county, 69 minutes, eight overdoses]

Deaths from prescription drug overdoses had leveled off at about 16,000 annually until 2014, the data show. Heroin deaths, however, rapidly escalated starting in 2010. Authorities have said that government crackdowns on illegal pills pushed users to turn to heroin, which became cheaper and more widely available as drug cartels greatly increased their trafficking in the eastern United States.

Now, Frieden said, authorities are grappling with a rise in illegally manufactured fentanyl, which is 25 to 40 times more powerful than heroin. The drug is used legally to provide relief from severe pain caused by cancer and other diseases, but authorities say dealers are now lacing heroin with fentanyl to improve its potency, leading to more overdoses.

David J. Hickton, U.S. attorney for western Pennsylvania and co-chair of the Justice Department’s National Heroin Task Force, said Friday that fentanyl and more potent heroin appear to have contributed to the 2014 spike in fatal overdoses.

The government must do more to tighten prescription of legal opioids, provide treatment and crack down on illegal drugs, especially heroin, Frieden said. “We have to have a much greater respect for how dangerous opiates are,” he said.

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Looks like they are ramping up the fear in OHIO of filling a non-bona fide  does this mean that the Pharmacist should confiscate the prescription?..  What is going to happen if the Pharmacist’s professional discretion is largely influenced by personal phobias, biases or other issues ?  If Pharmacist starts looking for something that is doubtful, questionable, suspicious origin or poses a risk to the health of a patient.. It is not going to be hard for a Pharmacist, using personal biases, to justify saying no. If they don’t confiscate the prescription, looks like the “pharmacy crawl” is expanding from Florida to Ohio.

DATELINE: OHIO

On February 1, 2016, updates to rule 4729-5-20 of the Ohio Administrative Code will go into effect. These updates include new requirements on when a pharmacist is required to review patient information in the Ohio Automated Rx Reporting System (OARRS). To assist you in the implementation of this updated rule, the Board has put together a one-page fact sheet and pocket card that provides the circumstances in which a pharmacist will have to query OARRS.

In addition, the Board has also created a one-page sheet designed to assist pharmacists in talking with a patient in situations where they may need to refuse to fill a prescription. Entitled “Sometimes We Just Have to Say No”, the fact sheet provides an overview of when prescriptions are not considered valid, explains a pharmacist’s corresponding responsibility under the law and provides a phone number where patients and families can locate an addiction services provider.

These resources may be accessed here: www.pharmacy.ohio.gov/OARRSRules         See below

The Board would like to remind all pharmacists that a corresponding responsibility rests with the pharmacist who dispenses any prescription. An order purporting to be a prescription issued not in the usual course of bona fide treatment of a patient is not a prescription and the person knowingly dispensing such a purported prescription, as well as the person issuing it, shall be subject to the penalties of law. Pharmacists should always use their professional judgment when making a determination about the legitimacy of a prescription (OAC 4729-5-20(G), 4729-5-30(A) & 4729-5-21(A)).

Click on graphic to enlarge

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Exploring The Link Between Chronic Pain And Suicide

http://commonhealth.wbur.org/2015/11/chronic-pain-suicide

This week’s grim report about rising suicide and overall death rates among white, middle-aged Americans contains a slim silver lining. Here it is:

The new analysis by two Princeton economists, Anne Case and Angus Deaton, suggests that chronic pain — and the opioids used to treat it — may be a key driver of the rising deaths. While the “noisy” opioid epidemic has garnered near-daily headlines across the country for several years now, the equally horrible but silent epidemic of chronic pain has not yet broken through into the nation’s consciousness. Maybe things are beginning to change.

Many people still don’t realize it, but 100 million American adults live with chronic pain, many of them with pain so bad it wrecks their work, their families, their mental health and their lives.

There are no hard data on how many people with chronic pain die by suicide every year. But there are inferences. The suicide rate among people with chronic pain is known to be roughly twice that for people without chronic pain.

Since there are 41,149 suicides every year in the U.S., according to the National Center for Health Statistics,  it’s possible that roughly half of these suicides are driven by pain. Not proven fact, but plausible hypothesis. This would suggest that perhaps up to 20,000 Americans a year with chronic pain kill themselves, which would be more than the government’s tally of 16,235 deaths from prescription opioids every year.  According to a CDC spokeswoman:

In 2013, there were 8,257 deaths that involved heroin and 16,235 deaths that involved prescription opioids. These categories are not mutually exclusive: if a decedent had both a prescription opioid as well as heroin listed on their death certificate, their death is counted in both the heroin as well as the prescription opioid death categories.

The truth, of course, is devilishly difficult to figure out with any certainty. Many people in severe, chronic pain have, and should have, opioids available. But unless they leave a suicide note it’s virtually impossible to tell if they overdose on purpose or accidentally. That’s in stark contrast to a pain patient who ends his or her life using a gun. That’s clearly a suicide, with or without a note.

In the course of researching my 2014 book on chronic pain, I heard many grisly stories. One Salt Lake City truck driver I interviewed would be dead today if his wife hadn’t walked in on him with a gun in his mouth. He had been in severe headache pain and after many visits to the ER, was repeatedly dismissed as a drug seeker, even without a medical workup. (Eventually, he was diagnosed with two brain aneurysms, bulging weak spots in a blood vessel).

I also heard about a surgeon with shingles who could find no relief for his pain and took a scalpel to his back in an attempt to dig out the painful nerves; he wound up in his own ER — as a patient. I heard of another man with ophthalmic shingles who finally shot himself because of unrelieved pain. A Boston surgeon I met was on the verge of suicide due to unrelenting pain from a rare autoimmune disease.

The anecdotes go on and on. Unfortunately, from a statistical point of view, they are just anecdotes. And unlike opioid abuse deaths, the stories of these and other pain patients rarely make the headlines.

Nor do these cases routinely make it into the reports of medical examiners and coroners, according to Utah pain specialist Dr. Lynn Webster, writing in a recent issue of Pain Medicine News.

In this week’s Princeton study, the lead author, Anne Case, was particularly interested in the role poor health might play in suicide because, as she told The New York Times, she herself has suffered for 12 years from disabling and untreatable lower back pain. In her research, Case discovered that middle-aged people, unlike the young and unlike the elderly, were reporting more pain in recent years than in the past. One-third of people in this group had chronic joint pain in recent years and one in seven reported sciatica.

The dismal situation with chronic pain — and the potential link with suicide — is unlikely to improve until the federal government takes the pain epidemic seriously. While the government spends $2,562 on research for every person with HIV/AIDS, it spends only $4 for every person with pain.

Clearly, chronic pain needs more attention and more research dollars. After all, it is the main reason Americans go on disability.

And it appears to be driving growing numbers of Americans to kill themselves.

Judy Foreman is the author of “A Nation in Pain: Healing Our Biggest Health Problem.”

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Pharmacist Discusses Drug Abuse in HBO Documentary

http://www.pharmacytimes.com/careers-news/pharmacist-discusses-drug-abuse-in-hbo-documentary-?utm_source=Informz&utm_medium=Pharmacy+Times&utm_campaign=PT_eNews_Daily_12-15-15_Flumist

This Pharmacist talks to a pt about “taking too many doses” and he DIES THE NEXT DAY…  She convinces a prescriber to DISMISS A PT and then refuses to refill Rxs for a pt that is physically dependent on three different controlled meds.. .throwing the pt into cold turkey withdrawal… COMPASSIONATE MY ASS !

A Massachusetts pharmacist is speaking out about prescription drug abuse and heroin addiction in a new HBO documentary available later this month.
 
Lauren Heroux-Camirand, RPh, conducted 2 interviews with the filmmakers of Heroin: Cape Cod USA at Country Square Pharmacy in Attleboro, Massachusetts, according to The Sun Chronicle.
 
The pharmacist told the paper that she thought it was important to talk openly about illicit drug use.
 
“We are here, as pharmacists and humans, to be compassionate and help in any way we can,” she told The Sun Chronicle. “That is why I agreed to participate and speak up.”
 
In her interviews with the filmmakers, Heroux-Camirand discussed both facts about drug abuse and her experiences seeing people struggle with addiction, The Sun Chronicle reported.
 
For example, she talked about a particular patient who had often been asking for early refills of painkillers. She tried to tell him that he was taking the pills too quickly, but he died the next day.
 
In another instance, she had a patient who was prescribed a dangerous combination of 3 narcotics. The prescriber dismissed her when she called him about the issue, so she refused to fill the prescription.
 
Heroux-Camirand is also an advocate for pharmacists’ abilities to dispense naloxone.
 
She tried contacting several physicians for a standing order to provide the overdose antidote, but she never heard back. It wasn’t until one of her customers died that she was able to obtain a standing order.
 
“It took a year and for someone to die,” Heroux-Camirand told The Sun Chronicle.
 
The movie will premiere in Massachusetts before debuting on HBO on December 28, 2015.

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Lawmakers offer alternative to cold medicine sales crackdown

http://wlfi.com/2015/12/14/lawmakers-offer-alternative-to-cold-medicine-sales-crackdown/

ANOTHER UNFUNDED MANDATE … requiring Pharmacist to DIAGNOSE… which they are neither trained nor licensed to do… BUT then .. legislators seldom seem concerned about what is legal or illegal.. they just propose bills.. create laws… hoping that no one challenges the law in court as to it constitutionality.  BESIDES… they claim that 80% of the Meth in  this country is imported from south of the border.

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EFF and Human Rights Watch force DEA to destroy its mass surveillance database

https://boingboing.net/2015/12/14/eff-and-human-rights-watch-for.html

The EFF has just settled a case against the Drug Enforcement Agency on behalf of its client, Human Rights Watch, which sued the Agency over its decades-long program of illegal mass surveillance.

The DEA has promised — on penalty of perjury — that it has ceased its bulk phone records collection, and that it will destroy the only database with records of phonecalls between US numbers and international numbers in hundreds of countries.

This isn’t the only illegal, secret mass surveillance program the US government runs, and EFF is planning to sue over each and every one of them, and kill ’em all.

Despite all this additional information, we should be clear about two things:

First, the government still retains some illegally collected records, and they’ve admitted as much. The records the government retains, though, are only those that were returned in response to a query of the database—a more limited sample than the bulk collection of records of billions of Americans’ calls to hundreds of countries overseas. While ongoing retention is undesirable, according to the government, the DEA’s records are stored in “nonsearchable PDFs” and not a part of some currently-operational call record database. It also appears that, when the program was operational, agencies were instructed to destroy reports generated from querying the database after the reports were no longer needed, presumably in order to conceal the existence of the program. While that’s good for the privacy of those unwittingly swept up in the program, it’s bad news for criminal defendants. If the criminal investigation came from a “tip” generated through searching the bulk database, there’s a good chance evidence of that tip has already been destroyed.

Second, the government still collects phone records in bulk. The NSA likely continues to collect international call record information in bulk under Section 702 of the FAA and under EO 12,333. In fact, it has been reported that the DEA has similar overseas bulk collection programs as well. Nevertheless, the end of the NSA’s domestic bulk collection and now the confirmed end of the DEA’s program represents a significant step forward in curtailing some of these abuses.

The government is on notice: if they have a bulk collection program, and we find out about it, we’re going to challenge it in the courts. Challenging programs aimed at Americans in federal courts has proven easier—for legal reasons and because of the information that is publicly available—than challenging bulk collection programs aimed at those outside the U.S. But we’ll never convince judges or elected officials to respect the privacy rights of those outside the United States if we can’t convince them that Americans’ privacy is worth protecting, too. Challenging these programs is an important first step in that process, and we’re looking forward to building on these successes to ensure that the federal government respects the privacy rights of people around the world.

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A New Direction On Drugs

http://www.cbsnews.com/news/60-minutes-a-new-direction-on-drugs/

This is the 60 MINUTES piece with the new DEA Chief/ Drug Czar Michael Botticelli .. This is the fellow who stated that MJ was a JOKE.. and it was the same person whom there was a 101,000 petition delivered calling for his resignation/fired.

As this piece started.. I thought that there was hope..but. as the piece continued.. my hope was dashed.. while this may be perceived as bigoted/phobic but all of us develop our opinions and perception from what we have experienced in our life’s journey.. Mr Botticelli plainly stated that he is a GAY/RECOVERING ALCOHOLIC… and as he put it ADDICTION IS ADDICTION.. and it would seem that he perceives that the use of opiates will lead to addiction.  He does admit that addiction is a mental health issue.. but.. he also seems to believe that everyone has that mental quirk.

Not once during the interview did I hear any discussion about the valid medical need for opiates, but he did mention that opiates are HIGHLY ADDICTIVE.

You need to view all the interviews with this gentleman… IMO.. it is all about helping addicts and reducing the use of opiate pain meds… regardless of the reason they are being prescribed.  If you notice at one point, they discuss a doctor “treating” a addict.. but.. nothing about treating chronic pain pts.

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Tennessee must get with the times on medical marijuana

http://www.tennessean.com/story/opinion/contributors/2015/12/13/tennessee-must-get-times-medical-marijuana/77178916/

Saying that medical marijuana will “do more harm than good” at a recent legislative hearing, state Health Commissioner John Dreyzehner did actual harm to the hopes of thousands of hurting Tennesseans who need real help right now.

And right now is the time for state lawmakers to put Tennessee citizens first and take up the issue of legalization of medical cannabis in the upcoming session and not cause their neighbors throughout the state additional suffering.

The health commissioner said: “Currently, the weight of evidence is that when marijuana is used as medicine, it will do more harm than good to the overall population of our state.”

Dreyzehner’s opinion is a bit out of date — about 25 years out of date and out of step with medical professionals and citizens of our state.

As Dr. Sanjay Gupta of CNN fame has said: “I am here to apologize. We have been terribly and systematically misled for nearly 70 years in the United States (regarding cannabis), and I apologize for my own role in that.”

THE TENNESSEAN

Haslam: Medical marijuana unlikely to pass soon

 

Physician support for medicinal cannabis mirrors the same (75-80 percent) support as the general public holds. Safe Access Tennessee, a nonprofit group devoted solely to medicinal cannabis (not recreational legalization), would like citizens and our state legislators to examine certain significant and material facts with respect to medicinal cannabis.

The key rationale for having a Tennessee medicinal cannabis program is to protect our state’s citizens from out-of-touch and distant federal bureaucracies, particularly the Drug Enforcement Agency and its related entities, which have fought a 45-year losing battle against the cannabis plant.

This campaign of “systematically misleading” started with the proposition there is no medicinal value in cannabis.

The falsehood that there is no medicinal value in cannabis is written into U.S. federal law and has been a consistent theme to justify large governmental budgets for law enforcement.

Every medical advance related to cannabis has been opposed, slowed, delayed and harassed by DEA officials more dedicated to their bureaucratic power than patients’ suffering or the advancement of medicine. That is what Dr. Gupta means by “systematically misleading.”

The federal stranglehold on cannabis continued even after the discovery of the endocannabinoid system (ECS) in 1989. This unique system of the human body controls the immune system, appetite and pain (separately from the central nervous system), and is one of the most important scientific discoveries of the 20th century.

It seems God designed our bodies to use cannabinoids (inherent in cannabis and other plants) to maintain health — the exact opposite of the DEA propaganda.

THE TENNESSEAN

GOP medical marijuana bill delayed until next year

 

The ECS was discovered over 25 years ago and only two FDA medicines have been approved when a free market could have generated hundreds if not thousands of viable medical alternatives. State medical cannabis programs are essential to the advancement of medicine for mankind.

The large medicinal potential of the ECS is being squandered by highly paid federal bureaucrats. The DEA stopped research authorized by the 2014 legislative session of the State of Tennessee (SB 2531) by not allowing cannabis to be grown at Tennessee Tech for academic research purposes.

Our state legislature cannot let these restrictions on medical and scientific advancement stand.

Tennessee needs a medicinal cannabis program just to maintain our economic competitiveness in the area of advanced ECS health solutions. Nashville is the leading healthcare investment location in the country and our state laws need to support this critical industry.

David C Hairston, CPA, is the Chairman of the Board of Safe Access Tennessee, a nonprofit devoted solely to serving Tennessee’s medicinal cannabis patients.

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