Are Drug Implants the Future of Drug Addiction Treatment?

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One of the most common misconceptions about drug addiction revolved around the idea that addicts somehow lack a sense of self control and moral fortitude. However, decades of research and science have led experts to a deeper understanding of how addiction actually works. Addiction is a brain disorder characterized by compulsive drug seeking and drug use despite harmful consequences. Many people with addiction (or substance abuse disorder) have an intense, unrelenting focus on obtaining and using a certain substance, such as alcohol or methamphetamine, even to the point where it will take over their lives. Many addicts suffer job loss, homelessness, loss of personal relationships, and sometimes even legal trouble. Drug implants are a new development in the field of addiction treatment.

How addiction and human brain function are interlinked

People with a substance use disorder have chemically altered the wiring of their brain and how it functions, because of this many people have distorted thinking, behavior, and bodily functions. The majority of drugs work on an area of the brain commonly known as the “reward center”. When a person uses alcohol or drugs, chemicals, mainly dopamine, are released inside the brain. These chemicals are meant to train the brain for survival, increasing the likelihood a certain action will be repeated again in the future. Over time, with repeated use of drugs or alcohol, the brain begins to rely on this substance because it has been tricked into believing that it needs it in order to survive.

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Addiction tricks your brain into thinking it needs more drugs to survive or even function properly.

Additionally, the brain begins to associate certain things like people, places, or objects with this behavior and can be triggered even years after getting sober. This helps to explain why some people relapse after they have stopped using drugs or alcohol. Thankfully though, there are many treatment options available for those seeking help with a substance abuse problem.

How to find addiction treatment options for yourself, or a loved one in Riverside, California 

Making a quick search on Google for support groups will likely bring up hundreds of results for anonymous 12-step programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). While these are offered in almost every city, for free, sometimes it just isn’t enough, especially for someone who is just getting sober for the first time. Alternatively, depending on the level of care needed, there are many drug and alcohol treatment programs available as well, such as medical detox, inpatient programs, outpatient programs, intensive outpatient programs, group counseling, and so on.

Factors to consider when trying to decide what level of treatment may be appropriate for you or a loved one will depend on many factors, such as: severity of addiction, type of drug used, quantity of drug being used, whether or not multiple drugs are being used at the same time, and how long they have been using drugs or alcohol. If you have any questions, do not hesitate to reach out to one of our addiction treatment specialists for a personalized plan today!

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Our addiction treatment specialists in Riverside, California are available to take your call 24/7.

Unfortunately, addiction treatment is not one size fits all. Otherwise, that would make solving this disease a whole lot easier, and though there may be many tried and true treatment options available for anyone who may be suffering from an active addiction, there are still ongoing studies and clinical trials with the intention of solving this problem. Their passion is to find alternative treatment methods for those individuals who are more likely to benefit from their application. One of the methods that are currently underway, and is actively being studied, is the use of implants to treat drug and/or alcohol addiction. Below is a list of several different methods currently being studied that involve the use of drug implants that work to re-wire the addicted brain.

Naltrexone Drug Implants

Perhaps the most popular of this emerging field of science would be the FDA (Food and Drug Administration) approved treatment of naltrexone implants for addiction. Naltrexone is used to help combat heroin, or other opioid addiction, as well as an addiction to alcohol. An addiction to heroin, or prescription painkillers such as Vicodin, codeine, or Oxycontin, can be extremely dangerous. The safest, sometimes only, way is to attend a medical detox program. The same can be said with an addiction to alcohol. The problem with both these substances is that the cravings for the drug early on in recovery can be extremely intense.

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The Naltrexone implant works by slowly administering an opioid antagonist that helps reduce cravings and prevent relapse.

Fortunately, the naltrexone implant works by delivering a consistent dose of naltrexone into the body for 3-6 months. It is usually implanted into the abdominal wall and has little to no recovery time after surgery. Additionally, there is no need for removal as the implant, resembling a pellet, will eventually dissolve after the allotted time frame. The important part of this medication is that it reduces the craving for drugs or alcohol by blocking the pleasurable effects substances send to the reward center of the brain, essentially re-training the brain to no longer associate drugs and alcohol with a pleasurable experience.

Deep Brain Stimulation

Another promising method for addiction treatment is deep brain stimulation. Deep brain stimulation is also gaining popularity for the treatment of things like obsessive compulsive disorders and Parkinson’s Disease. This approach to treatment hopes to combat the underlying causes for cravings, addiction itself, and relapse. Deep brain stimulation will be the tool to essentially aid in the rewiring of a person’s brain. Typically, an implant resembling that of a pacemaker is inserted under the skin, with a wire attached to the brain. In some cases, though, a person can have a chip implanted directly in the brain. The electrodes they emit target specific areas of the brain, impacting the brain’s reward system.

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Deep brain stimulation targets certain areas of the brain with electric pulses that help to train the brain to operate differently.

Buprenorphine Implants

Another implant meant to aid in the war against the opioid crisis is the buprenorphine implant. It was FDA approved in 2016 as a 6 month subdermal implant for the treatment of opioid dependence. Similar to the naltrexone implant, it releases a study supply of buprenorphine for 6 months. Although, they do not dissolve and must be surgically removed.

Keep in mind these drug implants are just a few of the alternative methods currently being researched. At its heart, addiction is a disease and needs to be treated as such. Thankfully, with decades of research behind the current science, we are becoming better at solving this problem.

Who is to Blame for the Drug Crisis?

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If there’s one thing Americans of all backgrounds, religions and political affiliations agree on, it’s that the United States is in the midst of a drug overdose epidemic, one that is fueled, largely by opioids. While virtually everyone agrees that losing over 70,000 lives a year to the drug epidemic is a travesty, many people are looking to place blame where blame is due. Complicating things further it is no one person, place or thing that created the opioid epidemic. Many historical, socioeconomic and individual factors play a role in the crisis.

One reason people look to assign blame is they believe (sometimes rightfully so), that finding the one thing to blame is the first step to solving the problem. This may be partially true, but for an honest, successful solution to the drug overdose crisis, we need to look at every possible factor that plays a role in the growing problem. Being honest with the findings is the best way to address the multitude of issues that contributed to the crisis.

Illicit drug dealers and pharmaceutical companies are who most people automatically blame for the drug crisis.

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“Big Pharma” drug manufacturers most certainly played a role in the drug crisis, by overselling the benefits of opioids and downplaying the risks. Yet there are various other factors that contributed to the opioid epidemic in the United States.

Of course the first place people look to when placing blame for the opioid epidemic is the drug dealers and manufacturers. Since President Nixon declared the “War on Drugs” in 1971, our strategy for dealing with the problems drugs cause in society was to go after the supply chain. In the nearly 50 years since this war on drugs was declared, we are nowhere close to solving the problems drugs have created in our society.

Certainly, drug dealers and big pharma have played a major role in creating the drug crisis in the United States. Many companies (including, most notably Purdue Pharma), have been found in court to have lied about the safety and efficacy of their prescription drug products. In the late 1990’s, Purdue aggressively marketed Oxycontin to doctors, claiming the extended-release of opioids would prevent misuse of the drug. This formula allowed the giant pharmaceutical company to receive FDA approval to put more opioids in each pill and we all know how that turned out.

The reality of Oxycontin was that it is much more prone to be abused or misused. People who developed a dependency to opiates found that the extended release formula could be bypassed by crushing up the pills and either snorting the powder or injecting the drug directly into their veins with intravenous needles. Because the oxycodone pills are so powerful, an addiction to opioids could develop very fast. Once the prescription ran-out, the addicted patients were forced to move on to street drugs like heroin, just to avoid the excruciatingly painful opiate withdrawal symptoms.

Even when someone successfully quit using opioids, they are highly prone to experience a relapse. A 2016 study found that people who are in recovery from opioid addiction experienced at least a 30% to 70% relapse rate within the first 6 months of their recovery. Fortunately, as a response to this contributing factor, the same pharmaceutical companies developed medications to help treat opioid addiction. Medication assisted treatment (MAT) can greatly help ease painful withdrawal symptoms from opioid addiction and they can greatly lower the rate of further relapses into substance use.

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Are doctors, physicians and other medical professionals to blame for the drug crisis? While some doctors ignored the warnings others may have been intentionally misled.

Doctors who overprescribed opioids and other painkillers are also rightfully to blame for the drug crisis in the United States.

While it is certainly easy to blame drug dealers and multi-billion dollar corporations for the opioid epidemic, the problem equally rests in the interpersonal and professional relationships of patients and doctors in their local communities. A 2016 survey found that about as many Americans blame doctors for overprescribing opioids (34%) as they do the patients who abuse prescription painkillers themselves (37%).

Illicit drug dealers market street drugs like heroin, counterfeit versions of prescription opioids and various forms of fentanyl. However, according to SAMHSA data, fewer than 10% of prescription opioids are obtained from drug dealers or other strangers. Over 50% of the misused or abused pills come from family members or close friends, while only 25% are obtained with a prescription from a doctor or physician. While the problem of patients receiving multiple prescriptions from different doctors, this only represents 3.1% of the opioids obtained for non-medical use, whereas over 22% receive prescription opioids from only one doctor.

Our overall approach to pain management drastically changed in the 1970’s when pain became the “fifth vital sign”.

Before the 1970’s, the medical profession virtually ignored the importance of pain management in a patient’s medical care. The inclusion of the question: “was your pain adequately treated” on patient surveys brought about a sort of preoccupation within the medical community on how to provide adequate pain management. Pain became the “fifth vital sign” along with body temperature, blood pressure, pulse and respiratory rate.

As a doctor, you certainly don’t want to see your patients suffer with pain symptoms. With a newfound focus on pain management, physicians and hospital administrators began aggressively treating pain symptoms, which led to a massive increase in opioid prescriptions.

We have to admit that opioids do serve as effective pain relievers and, when used appropriately, they can benefit the overall quality of health care services available in our society. Opioids do serve to benefit people who have recently undergone surgery, experienced a major bone fracture, cancer patients and other severely painful medical events. We cannot simply prohibit doctors from prescribing them appropriately.

Various forms of alternative pain management techniques are available, yet many doctors aren’t taught them in medical schools. The pharmaceutical industry provides massive funding to most of the medical schools in the US. This problem is compounded by the health insurance companies’ reimbursement policies. These policies make prescription opioids a much cheaper option for patients than other, alternative approaches to pain management, such as acupuncture, physical therapy or chiropractic techniques.

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Opioid manufactures, over-prescribing doctors, insurance policies and patients themselves have all played major roles in the drug overdose epidemic. Now that we know, it’s time to start fixing the problem.

While it is easy for people to simply blame “big pharma” as the culprits of the drug overdose crisis in America, we think that is simply just the tip of the iceberg. Of course the Sackler family from Purdue Pharma, along with other pharmaceutical giants like Johnson & Johnson seriously downplayed the risks associated with their products.

Currently, over 2,000 court cases against opioid manufactures are pending in the US. These cases rightfully assert that “big pharma” may have intentionally misled doctors into prescribing more opioids, which most certainly played a role in the creation of the opioid epidemic. Yet opioid misuse is a much more complicated issue than that.

Drug abuse typically coincides with strong feelings of hopelessness, depression and despair. The states that are the worst-hit by the opioid epidemic also suffer from the highest rates of joblessness and economic turmoil. Until we address all of the underlying causes of the current drug crisis in America, we are going to be fighting an uphill battle.

Overcoming an addiction is never easy, yet there are people who do it every day. 10 Acre Ranch offers a full medical detox and recovery program that can help you, every step of the way.

Please call us today to speak with one of our addiction specialists and we can get you, your family member or loved one the help they need right away. We are available 24/7, 365 days a year. Call now:

 

877-228-4679

 

 

The Opioid Crisis: How The Sackler Family Made Billions, While America Became Addicted to Oxycontin.

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Internal Purdue memos sought to sell higher doses of the drugs over long periods of time. This obviously made the company more money, while the higher doses also increased the likelihood of their patients to develop an addiction. Many internal emails have proven that the Sackler family cared only about their sales numbers, not the safety of the patients who were taking the drugs.
While the Sackler family was pushing blame onto people who helplessly became addicted to their drugs, they raked in billions and billions of dollars. The family fortune is said to have exceeded $13 billion dollars at the end of 2018.

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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.

Prescription Opioids: Reducing Pain Patient Use

Bottles of prescription medicine opioids

As long as doctors continue to prescribe opioids, certain patients will be in need of addiction treatment. That is a fact. Prescription opioids, or opioids of any kind for that matter, are addictive. While not everyone who takes opioids will fall into the cycle of addiction, the odds are extremely high. Millions of Americans have found that out the hard way, just by going to a doctor and complaining of pain.

Scientists and researchers continue to work hard to find opioid alternatives. Or find ways to make opioids less addictive. But, in the meantime opioids will continue to be prescribed to most people experiencing moderate to severe pain. Which is why it is so important that physicians and medical practices do everything in their power to mitigate the risks of patient addiction. Such as:

  • Only prescribing opioids when it is absolutely necessary.
  • Screening patients for a history of addiction and utilizing prescription drug monitoring programs.
  • Prescribing in low doses and mild strengths.
  • Limiting the number of refills.
  • Drug testing patients to ensure the drugs are actually being taken, and not diverted.

Everything listed above may seem like common sense. But, as a matter fact, many doctors have been resistant to being told how to prescribe. Or being instructed on how to care for their patients. This is the case, even though most physicians lack training in addiction, or spotting the signs of it. Hubris, perhaps. With so many patients succumbing to overdose, the aforementioned suggestions can’t be ignored. And fortunately, some doctors have been receptive to prescribing guidelines that could save lives. Managing to reduce the amount of opioids their patients are taking, potentially saving lives.

TOPCARE Model for Opioids

A study conducted by researchers at Boston Medical Center’s Grayken Center for Addiction Medicine showed that reducing prescription opioid use among patients significantly was possible. Using the Transforming Opioid Prescribing in Primary Care model, doctors were able to reduce patient opioid use by 40 percent, according to the research published in JAMA Internal Medicine.

The TOPCARE model involves a nurse care manager who oversees chronic pain patients’ treatment plans. Ensuring that patient monitoring occurs, assisting prescribers and coordinating opioid educational sessions for doctors.

“The TOPCARE model was so effective in lowering opioid use that two of the study sites hired nurse care managers to continue the intervention and expand services to their primary care providers. Future research should look at data from state prescription drug monitoring programs and data on other substance use to get a more comprehensive view of how patients are using opioids,” said Karen E Lasser, MD, MPH, co-principal investigator of the study.

Opioid Addiction Treatment

While TOPCARE monitoring may help to limit the number of new opioid addicts, it does little to reverse patient addiction. Primary care physicians and nurse care managers must do everything in their power to spot signs of addiction in their patients. By doing so, they can intervene and refer patients to addiction treatment services in their area.

Getting addicted to opioids is easy, breaking the cycle of addiction usually requires help. If you have become addicted to your pain medication, please contact 10 Acre Ranch. We specialize in the treatment of opioid use disorders. The longer one puts off treatment, the worse the condition will get. Along with an increased risk of overdose.

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.