Prescription Drug Abuse

The Discovering Alcoholic: Advocacy Update

November 15, 2008

The Discovering AlcoholicWe had to move the date up a bit to take advantage of a larger venue, but it is my extreme pleasure to announce that on Dec 2nd I will host a substance abuse workshop at the Calera High School auditorium. Prescription drug abuse will be the primary theme for the program, but resources and experts on all substance abuse and addiction will be available.

The presentation will include participation from the Substance Abuse Task Force, Alabama Department of Mental Health, Faces and Voices of Recovery. Community representation will also include those from law enforcement, EMS services, and health and medical officials.

I would like to offer a special TDA salute to Principal Bishop who did not hesitate to offer the school’s new 600 seat auditorium for the event; it is representative of his obvious concern and care about our kids and community. If you are local to the TDA area, check out this link for details on where (map included) and when to attend.

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Loved Ones Left with Questions and Doubt

September 29, 2008

“I’ve lamented his death every second since he died and will live with it the rest of my life.” So says Gary Neal referring to Harrison, his seventeen year-old son, who died of an overdose while abusing prescription painkillers.

With the second anniversary of Harrison Neal’s death approaching, his father still has a lot of questions and doubts. “Could I have done it better? Could I have done it different? Would the results have been different? You never know the answers to those questions because you never get a second chance. ~ CNN

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A Paradigm Shift in Drug Abuse

September 15, 2008

A Paradigm Shift in Drug Abuse- photo by snackfightIt comes as no surprise to me that Dr. Nora Volkow, director of National Institute on Drug Abuse and one of my personal idols, stated there has been a “paradigm shift” in substance abuse commenting on a study this month that shows prescription drugs have passed marijuana as the gateway drug choice of our youth.

I have seen the writing on the wall for many years now and nowhere is it more apparent than the ever increasing stream of patients into the local methadone clinic where I volunteer. Over ninety percent of those I see come are not heroin addicts, but instead they are addicted to opioid prescription pain killers Loritab, Vicoden, Oxycontin, and Dilaudid. Go ahead and throw in the benzo’s like Xanax and Valium into the mix of problems because that is what most addicts (and alcoholics) con their doctors out of by describing their depression while leaving out the fact they have a raging addiction.

Dr. Volkow mentioned this paradigm shift in abuse and treatment, but I feel there is one more important aspect of this situation she left out.

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Their Hero Rides a Pure White Horse

August 11, 2008

Prescription drug abuse is rampant with pain killing medications like Oxycontin and Vicodin (opioids) primarily being responsible for a surge in addictions. Most states have realized the problem with these medications and have implemented opioid regulations and increased scrutiny of pain management prescriptions. These actions have made a definite impact on the supply of diverted medicine on the market yet the number of addicts continues to grow. So what is an addict supposed to do?

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Medication Mistakes Blameless but Still Deadly

July 28, 2008

CHICAGO, Illinois (AP) — Deaths from medication mistakes at home, such as actor Heath Ledger’s accidental overdose, rose dramatically during the past two decades, an analysis of U.S. death certificates finds ~ CNN

drug abuse by any other nameMedication mistakes, drug errors, and even accidental overdose certainly sound less frightening than drug abuse, but as the reference to Heath Ledger suggests, they are no less deadly. Furthermore, much of the time these sanitized terms are outright misrepresentations; Heath Ledger didn’t die from an accidental overdose, he died because he was abusing prescription pain killers, psychiatric medications, and sleeping pills.

Accidently taking Oxycontin instead of aspirin could cause an accidental overdose, misreading a prescription would be a mistake, but self medicating with a hodgepodge of drugs is a premeditated willful act. While some may say it’s arguing semantics, I can’t help but wonder why there is no accountability when it comes to prescription drug abuse? Unlike the “blameless” act of “accidently” downing a methadone wafer with a tallboy, you don’t often hear of the cocaine error or heroin mistake.

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Available, Acceptable, and Addictive

June 15, 2008

Hat Tip and thanks to TDA reader AnnaZ for the heads up on this one!
photo by arcCocaine has the reputation, meth gets all the scary press, and heroin has always been the quite killer, but all of them pale in consideration to the lethality of prescription drug abuse.

A recent analysis of 2007 autopsies by the Florida Medical Examiners Commission states that deaths caused by prescription medication are triple of that caused by illicit drugs… all of them combined.

Three reasons almost ensure that this tripled death rate will continue to grow exponentially is the availability, acceptance and addictive nature of prescription drugs. Availability. I probably know better than most that illicit drug sources are always closer than you think, but you will not find black tar heroin in almost every medicine cabinet in the US. Acceptance. Like a powered-up PacMan gobbling up ghosts, we are becoming a society that will take a pill for any ill no matter how minor or even imaginary. Addictive. Almost any drug can be physically addictive, but the mental aspect of the disease is reinforced greatly by once again its availability and acceptance.

Florida examines drug related deaths more closely than other states, but similar studies by the feds back up these findings and suggest they are occurring nationwide.

The report’s findings track with similar studies by the federal Drug Enforcement Administration, which has found that roughly seven million Americans are abusing prescription drugs. If accurate, that would be an increase of 80 percent in six years and more than the total abusing cocaine, heroin, hallucinogens, Ecstasy and inhalants. ~ NY Times

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Absolutely No Link

April 9, 2008

The lawyer for Captain John Cota who rammed his ship into the San Francisco-Oakland Bay Bridge last November said in a recent interview, “There’s absolutely no link between any of the medically prescribed medications that Captain Cota used on the morning of Nov. 7 and this incident.”

But I wonder if he was able to say it with a straight face?

Cota is facing federal civil charges and declined to testify at the hearing. He was taking anti-anxiety pills, Wellbutrin for depression and medications for pain, migraines, glaucoma and to combat his sleep apnea, among other prescriptions. ~ MSNBC

Speaking of links, see if you can identify the link between Captain Cota and another infamous captain recently in the news?

That’s right, both alcoholics.

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A Really Hot Idea

February 20, 2008

Capsaicin is the active component in chili peppers that acts as a deterrent to herbivores. In mammals, especially humans, contact with capsaicin will result in an extreme burning sensation. This is the very reason it is the primary ingredient in most self defense pepper sprays. Clifford Woolf, the Richard J. Kitz Professor of Anesthesia Research at Harvard Medical School, has been working on the novel idea of using capsaicin to prevent the abuse of prescription medication.

Opioid pain medications like Oxycontin or stimulant Adderall are often crushed and snorted by those who wish to “fast forward” the designed time release action of the drug. A capsaicin coating could be developed that permitted safe swallowing and digestion, but if brought in contact with the nasal passages or ingested as a powder would cause extreme discomfort.

“Imagine snorting an extract of 50 jalapeno peppers and you get the idea,” Woolf says. “On a one to 10 scale, the pain is about a thousand. It feels like a mininuclear explosion in your mouth. It does not harm you, but you never want to experience that feeling again.”~ Harvard Gazette

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I come to bury Heath Ledger, not praise him

February 8, 2008

Heath Ledger OverdoseHis death no longer a mystery, media outlets around the world are blaring the story, “Accidental Overdose Killed Heath Ledger”. Although I enjoyed many of his movies and was looking forward (still am) to his portrayal of the Joker in the upcoming Batman movie, his death did not affect me any more than that of any other stranger who died from drug abuse. I write this post not in praise of the admittedly gifted young actor, but to make an example of his death.

Saying that Ledger’s death is “accidental” or due to “prescription drugs” is doing a disservice to what could be the actor’s last gig as the subject of a public service announcement. He died because he abused drugs. Found by his masseuse in an upscale apartment, dead from a handful of different prescription pain killers and sleeping pills should be considered the equivalent of OD’ing on heroin and being found in rigor three days later only because of the stench emanating from a public bathroom stall. In my book there is absolutely no difference between a heroin addict getting his fix and someone like Heath Ledger self medicating to live. There is a very large difference however in the way the general public and even doctors react to such occurrences.

“This is not rock star wretched excess,” said Cindy Kuhn, a pharmacology professor at Duke University. “This is a situation that could happen to plenty of people with prescriptions for these kind of drugs.”~ AP

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This Was No Mistake

July 22, 2007

Three of Purdue Pharma’s top executives were sentenced last week for their roles in misrepresenting Oxycontin, a powerful pain killing opioid, to the medical community and general public. They were convicted of a litany of charges including:

The charges included several illegal schemes to promote, market and sell OxyContin as being less likely to cause abuse, addiction, tolerance and withdrawal than other pain medications. In particular, it is reported that Purdue trained its sales representatives to make false representations to health care providers about the difficulty of extracting oxycodone, the active ingredient, from the OxyContin tablet thereby decreasing the potential for abuse, and that a lack of euphoria rendered it less addictive than immediate-release opiates and morphine. In addition, Purdue falsely labeled OxyContin as providing “fewer peaks and valleys than with immediate-release oxycodone,” and falsely represented that patients taking lower dosages of the drug can always be discontinued abruptly without suffering withdrawal symptoms or tolerance.

Purdue Pharma as a private company had already been penalized with $600 million in fines for the criminal activities. In my opinion, this should have characterized the seriousness of the crimes and been followed by draconian sentences for the three executives that orchestrated the crimes. Unfortunately it was not to be, none of the executives will set foot in prison with the worst of their sentences being probation and community service.

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Say Hello to My Little Comparison

July 21, 2007

“That’s the bad guy.” So… what that make you? Good? You’re not good. You just know how to hide, how to lie. Me, I don’t have that problem. Me, I always tell the truth. Even when I lie. So say good night to the bad guy! Come on. The last time you gonna see a bad guy like this again, let me tell you. Come on. Make way for the bad guy. There’s a bad guy comin’ through! Better get outta his way! ~ Scarface

Old school drug kingpin compared to today’s more acceptable version,
The Doctor Dealer.

Dr. Michael Brown, 53, who practiced internal medicine in Sandwich for 21 years, seemed stunned after the verdict. He was led away in cuffs to return for an afternoon sentencing. For 10 counts of Medicaid fraud, 16 counts of writing illegal prescriptions — a violation of controlled substance laws — and felony larceny, he was sentenced to 2½ to 3 years in state prison and 5 years probation. Jurors deliberated for 14 hours over three days, ultimately finding that Brown prescribed OxyContin, Roxycodone, and an oxycodone and acetaminophen mixture for no medical purpose.For a 30-month period, Brown was the state’s second largest prescriber of OxyContin, prosecutors alleged. But that argument, along with $61,000 in cash, pills and an incriminating letter improperly seized from Brown’s Jaguar, was not allowed into evidence.~ Cape Cod Online

Unfortunately, the nice demeanor and family lifestyle don’t make up for the fact that he is still just a drug dealer and now a common criminal.

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Drugs Online- The New Pusher

June 16, 2007

The National Center on Addiction and Drug Abuse at Columbia University (CASA) has a plethora of information when it comes to substance abuse. They have recently released a report entitled “You’ve Got Drugs!” that is a detailed study on so called online pharmacies that often sell drugs without a prescription. These drugs include:

Opioids: Codeine (Schedule II or III versions), Diphenoxylate (Lomotil), Fentanyl (Duragesic), Hydrocodone (Vicodin), Hydromorphone (Dilaudid), Meperidine (Demerol), Oxycodone (OxyContin, Percocet) and Propoxyphene (Darvon)

CNS Depressants: Benzodiazepines including Alprazolam (Xanax), Chlordiazepoxide hydrochloride (Librium), Diazepam (Valium), Estazolam (ProXom), Lorazepam (Ativan), and Triazolam (Halcion); and barbiturates including Mephobarbital (Mebaral), Pentobarbital sodium (Nembutal) and Secobarbital (Seconal)

Stimulants: Amphetamine-dextroamphetamine (Adderall), Dextroamphetamine (Dexedrine), Dexmethylphenidate HCl (Focalin) and Methylphenidate (Ritalin)

Addictions to such (normally) prescribed drugs often involve the added challenge of overcoming the rationalization that because the drugs are not illegal or “street”, that it’s really OK. All online pharmacies are not illegal, and can even be a boon for those too sick or who lack the physical resources to get their medications. But those that peddle highly addictive narcotics without bothering with a prescription or doctor’s orders are nothing more than drug dealers and bottom dwellers.

Click here, so that you can download the free study.

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Pain is Really Undertreated in Our Society

March 28, 2007

"How many need opioids but don’t get them? Those numbers are hard to come by, but “pain is really undertreated in our society,” opioid specialist Dr. Christopher Evans of the University of California, Los Angeles, told the NIH meeting."~ AP Story on MSNBC"

This recent AP story is supposedly about the development of abuse-resistant painkillers but the quote above found about midway through the article makes its clear that its not just the drugs that are the problem. I do not doubt that there are legitimate cases in the US where people who really need opioids are denied them because of financial, insurance, or bureaucratic reasons. But in a society where one can limp to a doc-in-a-box and proceed to walk out with a pain medication script, sometimes twice in the same day, I find it hard to believe that pain is really undertreated in our society. I know of people with chronic pain that rely upon these drugs to restore a measure of the quality to their life; this is not an attack on them. It is more of view from the other side of the fence, because clearly the sources used to develop this AP story were medical, professional, and well intentioned but just slightly out of touch with the real world.

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