The 2018 Opioid Bill

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The United States Congress reconciled both House and Senate opioid bills aimed at reducing the deadly toll of the nation’s top health care crisis: the opioid epidemic.

In the SUPPORT For Patients and Communities Act, Republican and Democrat lawmakers came to a rare agreement between both parties. The drug overdose epidemic claimed 72,000 lives in 2017 alone and roughly two thirds of those deaths were from prescription and non-prescription opioids. The bill will now head to the Senate as the House of Representatives almost unanimously passed the bill in a rare, 393-8 vote. President Trump is expected to sign this legislation into law before the midterm elections.  This is a fairly large bill, that will cost the US billions of dollars but many argue that the bill doesn’t do enough to address the nation’s greatest public health issue. Senator Elizabeth Warren has proposed a bill that would cost the US tax payer $100 billion over the next 10 years, as she argues this is what is really necessary to fully address the opioid crisis.

The SUPPORT for Patients and Communities Act takes a wide approach to the opioid epidemic from law enforcement, treatment and public health care measures.

We will talk about some of the major policy changes in the bill and the full-text of the bill is available here.

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The 2018 SUPPORT for Patients and Communities Act was passed by United States Congress and signed into law by President Trump.

One of the greatest achievements of the new bill is a provision to allow Medicaid recipients to seek care at addiction treatment centers. The restrictions on Medicaid funding for substance abuse treatment had been long outdated and congress finally addressed this problem. Allowing Medicaid to help fund up to 30 days of inpatient rehab stays, including medication-assisted treatment (MAT) is going to help a lot of people get the help they desperately need. The bill authorizes a grant program through the Substance Abuse and Mental Health Services Administration (SAMHSA) to help communities develop opioid recovery centers. While the bill does address the lack of funding for increased access to treatment programs, many addiction specialists argue the bill does not do enough in this regard. While noting that the bill is not itself bad as it does a lot to address a multitude of issues, it is severely lacking on access to treatment, which many believe is the most important technique that could help solve the opioid crisis.

Another provision in the bill lifts restrictions on medications used to treat opioid use disorder and other types of addiction. This measure simply allows more medical practitioners to prescribe medications such as buprenorphine, used to help ease withdrawal symptoms in addiction recovery. As it stands today only 5 percent of doctors are licensed to prescribe this life-saving drug. Another medication, naloxone was addressed in this bill. One provision allows first responders greater access to the life-saving opioid antagonist which can reverse the effects of an opioid overdose.

The major law enforcement provision of the SUPPORT Act is aimed at the trafficking of drugs through the postal system. Fentanyl that is illegally imported from Mexico and China has been blamed for many of the opioid-related deaths in recent years. One package seized in Philadelphia last June contained 110 pounds of fentanyl, valued at $1.7 billion dollars. This was estimated to be enough of the dangerous substance to kill the entire population of the state of Pennsylvania two times over. Fentanyl is 50 times more potent than heroin, so it is easy to smuggle large amounts of the substance through the mail system. This bill makes it harder for people to sneak illicit substances into the US from abroad. The bill will require packages coming in from foreign countries to reveal their contents and where and who they’re coming from. While the bill is broadly aimed at targeting illicit drug suppliers, it includes protection for individuals looking to import cheaper prescriptions from overseas. This was in direct opposition to pharmaceutical companies’ requests to include enforcement against importing cheaper prescriptions from other countries.

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The opioid epidemic kills nearly 200 Americans every single day.

While the SUPPORT for Patients and Communities Act does a lot to fight the opioid epidemic, there is still a lot of work to be done in the near future. The bill even authorizes research into opioid alternatives to pain management and penalizes drug manufacturers and distributors for overprescribing. A lot more could have been done to address the root causes of addiction and it should have offered greater access to outpatient treatment programs. However, while a lot of divisive partisan issues like funding were ignored in the bill, the Democrats and Republicans agreed on a lot of ‘second-tier’ issues that will definitely help save lives. Given the extreme divisiveness in American politics in the Trump era, this is a small political victory.  Thankfully, everyone finally seems to want to work together in fighting this urgent national health crisis.

Overdose Death Impacting Life Expectancy

woman suffered from drug overdose

In the 21st Century those of us living in America expect to live robust lives. Far longer than once thought possible, thanks to advances in medicine and a better understanding of healthy living. Fewer Americans smoke cigarettes across most demographics. And when people are diagnosed with certain forms of cancer the prospects for recovery are at times good. While average life expectancy has been steadily increasing over the decades, one variable has been tipping the scale—overdose death. Specifically, opioid overdose death.

It won’t come as a surprise to learn that American’s relationship with opioids has been approaching critical mass. We have steadily seen the number of premature deaths rise to greater heights with each passing year. There were more deaths in 2016 than in 2015, and overdose deaths are expected to surpass last year, in 2017. Overdose death is now the leading cause of premature death in America. And, believe it or not, these deaths are impacting figures on average life expectancy – for the worse.

A new study published in the Journal of the American Medical Association shed some light on this subject. The researchers found that our life expectancy increased overall, from nearly 77 years to 79 years, between 2000 and 2015. However, the nearly two-decade spate of overdose deaths trimmed that expectancy by 2.5 months, HeathDay reports. Dr. Deborah Dowell from the Center for Disease Control and Prevention’s (CDC) Division of Unintentional Injury Prevention points out drug overdoses have more than doubled. With opioid overdose cases, more than tripled during the same time.

Reducing Overdose Death

“[U.S.] life expectancy is now lower than in most high-income countries,” said lead researcher Dowell, noting this as the is first decrease since 1993 at the height of the AIDS epidemic.

Studies like these don’t do much to save lives, but they do give society some perspective. With over 50,000 Americans dying from overdose every year, action is desperately needed. Failure to address this epidemic with greater urgency will result in greater death tolls with each subsequent year. Perhaps what is most troubling about all of this is the fact that treatment works, and recovery is possible. Yet, the majority of the more than 2 million opioid use disorder cases are never treated in any way.

What’s worse, doctors are often unable to read the writing on the wall when it comes to their patients. It’s no secret that physicians in the U.S. are only required to have minimal education in addiction and treatment. The majority of doctors are not even licensed to prescribed certain drugs that help opioid addicts strive for recovery. It is one thing to increase access to the overdose reversal drug naloxone. But, if overdose victims are not steered towards recovery, history is bound to repeat itself.

“There is an urgency to this problem,” said Dr. Adam Bisaga, a professor of psychiatry at Columbia University Medical Center in New York City. “The tragedy is, we have medication to treat opioid addiction. But death rates keep going up.”

Opioid Addiction Treatment

It doesn’t matter which form of opioid one uses, prescription painkillers or heroin. The risk of overdose and potential death is clear and present. To make matters worse, these are not easy drugs to abstain from due to the severity of withdrawal. However, as Dr. Bisaga points out, there are a number of meds that can help with withdrawal and treatment process. Dramatically increasing one’s ability to achieve long-term addiction recovery. If you are an adult male who has become dependent on opioids of any kind, please contact 10 Acre Ranch. We can help you find recovery.

Addiction Treatment Recovery Vaccine

heroin vaccine spoon and syringe

At the beginning of the summer we discussed a topic of the utmost importance regarding addiction. A vaccine for heroin and other opioids. A drug that could influence one’s immune system to keep opioids from passing the blood-brain barrier. Effectively removing one’s ability to get high or overdose on an opioid. If you are thinking that this all sounds like science fiction, you would only be half wrong.

In fact, using animal models scientists have been able to accomplish the aforementioned task. But, given that, there are several other phases of research needed before such a drug could go to market. Specifically, human trials are needed to bear fruit before the U.S. Food and Drug Administration (FDA) will give its approval. A requirement that could be a long way from fulfillment. So, how close are way to seeing a vaccine for deadly drugs like heroin and fentanyl? The answer to that depends on who you ask.

Health and Human Services (HHS) vs Reality

With 142 Americans succumbing to opioid overdose every day, there has never been a greater need for a vaccine. While such a drug would not cure addiction, it could have a salient effect on overdose rates. Earlier this week, HHS Secretary Tom Price talked at a press briefing about the potential for an opioid vaccine, stating:

“The numbers are absolutely daunting — 52,000 overdose deaths in 2015; 33,000 of those approximately related to opioids. The numbers in 2016 are no better, and the numbers in 2017 are even worse than 2016,” Price said. “One of the exciting things that they’re [The National Institutes of Health -NIH] actually working on is a vaccine for addiction, which is an incredibly exciting prospect.”

Please take a moment to watch a short video of the press briefing:

If you are having trouble watching, please click here.

Unfortunately, Dr. Price’s optimism may be premature. There are three more phases of trials needed before an opioid vaccine could hit the market, CNN reports. A requirement that could go on for several years. If the opioid addiction epidemic has showed us anything, it’s that time is not on our side. Many more Americans with untreated opioid use disorder will perish before such a drug is available. Assuming it makes it through human trials.

“It’s a long process, and it takes years,” said Dr. Ivan Montoya, acting director of the Division of Therapeutics and Medical Consequences at the National Institute on Drug Abuse. “Sometimes, the translation from animals is not necessarily the same in humans.”

Addiction Treatment Recovery Vaccine

Addiction recovery is not a cure for this most serious illness. However, those who utilize the various programs of recovery protect themselves from relapse. It is not a guarantee, to be sure. Although, in a way, going to treatment and working a program of recovery is an antibody for preventing recidivism. Working a program can be considered a vaccine, but its effectiveness depends on the individual. Their ability to stay honest, willing and able to practice the principles of recovery in all their affairs. Day in, day out.

It is hard to say if the opioid vaccine will ever become a reality. In the meantime, those looking to save their life must turn to recovery. It is their best shot of breaking the cycle of addiction and avoiding fatal overdoses. If you are in the grips of opioid use disorder, please contact 10 Acre Ranch today.

Heroin Vaccine Shows Promise for Addiction

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Alcohol and substance use disorders have no known cure. There is not a pill you can take that will rid you of addiction. There are programs that you can work that will enable you to abstain from use for long periods of time without the need of relapse. And if such programs are worked with vigilance and honesty, people can refrain from use for the rest of their lives.

There are, however, drugs that people can take to assist in abstaining from drug and alcohol use. Such as Antabuse, Acamprosate, Naltrexone and Buprenorphine. However, they will only mitigate the risk of a relapse. Antabuse will make alcoholics sick when they drink. Regarding buprenorphine, more commonly known as Suboxone, users are still taking a partial agonist opioid receptor modulator. Which causes euphoria. The point is that these drugs are not intended to cure addiction. They are meant to help people get on the road to recovery. And stay the course.

In the field of addiction medicine, we could easily argue that at no other time in our history has a vaccine for addiction been more needed. People are dying in scores every day of the week from opioid overdoses. Those who seek treatment for opioid use disorder have especially high relapse rates. And there is no indication that the reality we all find ourselves living in today is going to change. At least not anytime soon. Nevertheless, addiction researchers continue to search in earnest for one.

Heroin Vaccine On The Horizon

As we mentioned earlier, relapse rates among opioid addicts are particularly high. Thus, and so, the need to mitigate the risk of relapse without the use of other opioids like Methadone and Suboxone is great. Fortunately, researchers have been working on a vaccine that would block the euphoric feelings caused by opioid use, Live Science reports. By blocking the high, the vaccine will reduce people’s chance of becoming addicted in the first place and prevent those already addicted from relapsing.

“The vaccine sequesters the psychoactive molecules that heroin produces and prevents distribution to the brain,” said study first-author, Paul Bremer, a graduate student at The Scripps Research Institute (TSRI).”It essentially uses your body’s own natural defense to neutralize the drug.”

Rather than cure addiction, the vaccine mimics part of the heroin molecule, according to the article. Conditioning the immune system to treat heroin molecules as foreign bodies. Disabling heroin’s ability to cross the blood-brain barrier, and thus preventing the high. Trials on monkeys have proven successful, the next step is clinical trials. If the vaccine works on humans, it could have huge implications for the future of opioid addiction in America. The researchers at TSRI are talking with biotech companies to develop a human clinical trial.

“I hope the vaccine will be useful in conjunction with other drugs,” said study leader Kim Janda, a chemistry professor at TSRI. “While there are treatments out there already, I think we need to look at other ways of fighting this problem. This could be another piece of the puzzle.”

Opioid Addiction Treatment

It will be some time before opioid users can rely on any vaccine. In the meantime, addiction treatment is the only real course of action for those whose lives have been turned upside down from opioid use. If you are an adult male who’s addicted to opioids, please contact 10 Acre Ranch today. Our center has helped a significant number of people with opioid use disorder break the cycle of addiction, and begin the life-saving journey of recovery.

Opioid Addiction Epidemic Apologia

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We have written about opioid use in the past, and for good reason. We are in the grips of a serious epidemic linked to reckless overprescribing of opioid painkillers, like OxyContin (oxycodone) and Vicodin (hydrocodone). Just two painkillers of several that have had a hand in cutting short the lives of Americans from every demographic.

Our reliance on opioid painkillers is a complex story, and like most interesting stories worth reading about, this one is filled with some unsavory characters, both individuals and entire companies, as well as deceit. With well over 2 million prescription opioid addicts and upwards of a half-a-million heroin users, there is definitely cause for concern and a demand for accountability in this narrative. But first, let’s go back to where America’s reliance on opioids began.

The Roots of Our Addiction Epidemic

If you are like most Americans, including many who work in the field of addiction medicine, then you are probably wondering how this epidemic began. You are likely aware that drugs like morphine and heroin have been around for a long time. What’s more, you know that people have been abusing drugs in the opioid family for a very long time, but you may be saying to yourself that what we are seeing today is a far cry from abuse seen in the past.

American doctors were directly responsible for prescribing opioid painkillers for all things pain. But that was not always the case. Two scores ago, American doctors were hesitant to prescribe opioids to patients, except in cases of trauma, surgery or cancer. Then one day, seemingly, caution was thrown out the window by most doctors. Leading to Americans consuming the clear majority of all prescription opioids on the planet. When tracing the path to where the change originated, look no further than the New England Journal of Medicine (NEJM). Often considered the most prestigious peer-reviewed medical journal.

In 1980, when the nation was in the grips of a cocaine epidemic, few people were thinking about opioid use disorder. So, when Dr. Hershel Jick, a drug specialist at Boston University Medical Center—at that time a graduate student—sent a letter to the NEJM about prescription opioids most people did not think much of it. The Journal chose to publish the letter, a paragraph worth of words that would result (over time) in a staggering death toll and troubling opioid addiction rates. The drug specialist said this week:

“I’m essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did,” Jick told The Associated Press. “They used this letter to spread the word that these drugs were not very addictive.”

Publishing Deadly Words Leads to Clarification

Dr. Jick wrote that out of almost 40,000 patients given prescription opioids at a hospital in Boston, only four cases of addiction were documented, CBS News reports. The letter said that it was rare for people who had no history of addiction to become dependent on opioids. Doctors, for whatever reason, took those words as absolute fact. And pharmaceutical companies with bottom lines in mind, helped disseminate the letter. Now, four decades later, here we find ourselves.

A team of researchers in Canada conducted an analysis, and found that the letter has been cited more than 600 times, according to the article. In many cases, people citing the letter failed to mention that the patients referred to in the letter were hospital patients, not outpatient or people being treated for chronic pain taking prescriptions home.

“It’s difficult to overstate the role of this letter,” said Dr. David Juurlink of the University of Toronto, who led the study. “It was the key bit of literature that helped the opiate manufacturers convince front-line doctors that addiction is not a concern.”

Finally, 40 years later, and realizing the damage that publishing Jick’s letter had on the American public and generations to come, the NEJM published an editor’s note this week, the article reports. The note states:

“For reasons of public health, readers should be aware that this letter has been ‘heavily and uncritically cited’ as evidence that addiction is rare with opioid therapy,” writes Dr. Jeffrey Drazen, the Journal’s top-editor. “People have used the letter to suggest that you’re not going to get addicted to opioids if you get them in a hospital setting. We know that not to be true.”

Treating Opioid Addiction

If you are abusing prescription opioids and/or heroin, please contact 10 Acre Ranch, today. Time is of the essence, we do not need to tell the risks of prolonging treatment any longer. Roughly a hundred people die of an overdose every day.

Dark Web Drug Sales On The Rise

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Earlier this week, we discussed the important topic of synthetic drug use, a trend that is both dangerous and indicative of the ever-changing landscape of drug addiction in America. The people making these dangerous drugs are usually one step ahead of government organizations responsible for mitigating the impact of drug use across the country, such as the Drug Enforcement Agency (DEA).

Part of the problem, or the difficulty, in policing synthetic drugs is that the chemicals that are sprayed on benign plant matter to make synthetic cannabis and salts to make “bath salts” are synthesized in China. An enormous country that lacks the kind of oversight that we find in our own country, at least when it comes to laboratories. While China has made efforts to curb the problem and commitments to the United States to do a better job at policing the manufacturing and distribution of such chemicals, the deadly chemicals are still being made and escaping the country’s borders.

In many cases, acquiring the chemical needed is as easy as opening a laptop and venturing into what is known as the “dark web.” Perhaps you have heard of the former online marketplace known as the Silk Road. If not, it was a website that operated in the darkest regions of the internet, a place where one can by heroin, passports and various chemicals to make drugs like synthetic marijuana.

The Dark Web

Once inside the Internet’s shadowy underworld, the possibilities are endless. What’s worse, people journeying into the dark web can do so anonymously, paying for goods and services with a virtually untraceable currency known as Bitcoins. The Federal Bureau of Investigation has been working tirelessly to shut down black markets residing in the dark web.

In 2015 Ross Ulbricht, the founder of the Silk Road was sentenced to life without parole after being arrested by the FBI. But as was mentioned earlier, the ever-changing landscape of drug use in America, such as buying drugs online, allows for others to do the same. Just as when a cartel head is arrested, another moves into a position of power. The Hydra Effect. Cut off one head, only to face another.

The sentence Ulbricht received was arguably harsh. While he got rich off illegal drug sales, et al., he wasn’t in fact the one selling the drugs. He just received a percentage of all sales. The stiff sentence was intended to deter others from creating similar dark marketplaces.

However, a new study published in the British Journal of Criminology, shows that in the two years since the Silk Road saw its end, Boston College sociologist Isak Ladegaard found that sales on the dark web actually increased, Wired reports. And the reasons for the rise in overall sales in the marketplaces that replaced Ulbricht’s site might be linked to a greater awareness in the public about online illegal drug sales due to the media coverage of the Silk Road.

“The timing suggests that people weren’t discouraged from buying and selling drugs,” says Ladegaard. “The data suggests that trade increased. And one likely explanation is that all the media coverage only made people more aware of the existence of the Silk Road and similar markets.”

A Dangerous Way to Buy Drugs

Setting aside the potential for arrest, buying drugs online could lead to the purchase of substance that might contain deadly ingredients. As was mentioned in other posts, fentanyl is often mixed with heroin to increase potency. The chemicals used to make synthetic drugs have unpredictable side effects, some of which can be deadly.

If you are addicted to drugs, seeking help is a lifesaving decision. Please contact 10 Acre Ranch today to end the cycle of addiction.