Rehabs.com - The Nation's Best Rehabs.+Add.Feed Info1000FOLLOWERS
Uncover the world of behavioral and drug addiction at the Rehabs.com blog. We cover drug rehabilitation news and feature unique and engaging editorial. We have been helping people connect with addiction treatment programs, achieve sobriety, and sustain recovery for over 20 years.
Prescription opioid use, abuse, and overdose deaths continue to climb across our nation. The epidemic has medical experts scrambling to understand chronic pain and finding new forms of alternative pain management.
Believe it or not, Bonti, a biotech company, believes that Botox could be an effective option.
Botox and Pain Management
Bonti’s researchers are exploring how the body experiences pain. Their concept is when the body is injured – when muscles are pulled, stretched, or ripped – the damage creates muscle spasms. The treatment for trauma is usually some combination of opioids and muscle relaxers, with the goal of stopping the muscle spasms and allowing the area time to heal. Of course, the medication only works for a few hours, leading to the patient taking more pills. And with opiates, the more you take, the greater the risk of dependence.
Bonti’s alternative solution involves a doctor injecting a non-opioid, pain-relieving neurotoxin – a botulinum toxin serotype E, known more commonly as Botox – around the muscle. Each dose could provide two to four weeks of pain relief. By using such a targeted and lasting treatment, doctors wouldn’t have to rely so heavily on painkillers for pain control.
According to Bonti’s chief medical officer, Susan Abushakra, the neurotoxin fuses itself to the muscle cells, cutting off signals to neuronal receptors around the muscles, stopping the muscle spasms and allowing them to heal.
Cosmetic vs Medical Botox Treatment
The company is still working out the cost of the drug for pain control purposes, but they anticipate it will be less expensive than a cosmetic dose of Botox. (According to the American Society of Plastic Surgeons, the average cost for cosmetic Botox is around $385.)
While still in its testing phase, Bonti CEO, Fauad Hasan, is hopeful this Botox preparation will reach the market within four years. They’ve already met with the US Food and Drug Administration and, given the state of the current opioid epidemic, asked them to expedite the approval process.
With a reported 33,000 overdose deaths in 2015 and 2.5 million people currently struggling with opioid use disorder, new treatment options are more important than ever. An astonishing 80 percent of heroin users started with prescription pain medication. When they can no longer obtain pain medication, they switch to the more readily available and affordable heroin.
With a wide range of the population affected by these highly addictive drugs and a huge increase in the nationwide media coverage, people are finally starting to take note. Let’s hope that continues into definitive action so we can save as many lives as possible.
Each day, 44 Americans die from an opioid overdose. We’re in the midst of ever growing addiction epidemic.
Can anything be done to reverse this dangerous trend? Because the current opioid crisis affects our nation as a whole, the government could play a significant role in slowing this deadly trend.
If our legislators would ramp up intervention efforts and pass key initiatives, many agree it could make a huge impact on the opioid epidemic.
Let’s Talk About Strategies That Help
Let’s look at seven of those potential strategies and how they could positively impact the nation’s drug crisis:
#1 – Track Trends
Better information systems could provide real-time assessment of the opioid epidemic. Officials could use prescription drug monitoring programs and other data systems to identify trends, then address the driving force behind abuse and dependency rates.
#2 – Dissect Coroners’ Work
Policy makers could develop more complete and rapid testing for drugs involved in overdose deaths. Access to information from medical examiner’s and coroner’s reports could lead to better responses to changing patterns and more effective interventions.
#3 – Reduce Prescriptions
Opioids are often prescribed for pain that could be treated with other solutions. The government could promote more cautious prescribing and limit opioid prescriptions to only the most serious of medical conditions, such as cancer. Opiate dependency can occur in just a few days, so limiting the number of pills to three days of medication could reduce the chance of misuse and abuse.
#4 – Halt Marketing
Painkiller manufacturers target people with chronic conditions. Yet, their health problems often don’t benefit from opioids, or the risks far outweigh the potential benefits. The FDA could restrict or eliminate marketing efforts in these situations.
#5 – Improve Insurance
Better coverage for non-opioid pain management could cut down on medication usage and improve outcomes. Policy makers could expand insurance coverage to fully reimburse non-prescription painkillers, physical therapy, and other alternative pain management options.
#6 – Stop the Cycle
The legal system could offer substance abuse treatment more frequently as an alternative to incarceration. Correctional facilities could provide more treatment for addicted inmates and follow-up services to keep them on track after release. With these services in place, the government could break the cycle of chemical dependency, incarceration, relapse, and escalating crime.
#7 – Identify Early
Policy makers could require medical professionals to check Prescription Drug Monitoring Programs before prescribing opioids. State health officials could watch for increasing dosages, high-volumes of prescriptions, and other indicators of opioid dependency. Alert for these warning signs, officials could facilitate earlier treatment and referrals for other services, reducing the risk of overdose and other medical complications.
We Must All Play a Part
When it’s all said and done, however, it’s not solely the government’s responsibility to take action against the opioid epidemic. Turning the tide will require effort on every level, from individual all the way up to federal. But if the government takes the lead by supporting strong intervention initiatives, it could give our nation a very real chance at beating this lethal crisis.
More than two million Americans suffer from substance abuse issues related to prescription painkillers and this epidemic takes the lives of more than 90 Americans every single day.
These alarming statistics led researchers to ask: How do we make pain management safe? Specifically, how can we balance opioid prescription length and the risk of dependence?
Establishing a Balance
Some states have already taken action, limiting initial prescription lengths to less than a week. Policy makers have also created drug monitoring programs to keep a more careful watch on potential substance abuse issues, like doctor shopping. However, lawmakers and healthcare providers still have few guidelines about appropriate prescribing of opioids after surgery.
Some physicians create their own policies to balance pain management and the risk of opiate dependence. Dr. Aleksey Lazarev, orthopedic surgeon at Lenox Hill Hospital in New York City, discusses this issue with patients. Before surgery, he lays out expectations for post-op pain and recovery. He prescribes short-acting narcotics for only a few days after surgery. The prescription is usually for no more than 20 pills, and he doesn’t give refills.
Here’s the question, though: Is this the right answer for everyone?
The Answers Are Pretty Hazy
To provide the healthcare industry with better parameters for prescribing opiates, researchers investigated the issue of addiction risk. The CDC reports:
Six percent of patients prescribed opioids for pain were still on an opioid one year later. This includes patients who received as little as a single day’s supply.
Patients who took the drugs for more than a week were much more likely to experience long-term use. Among these patients, 13 percent were still on opioids a year after their initial prescription.
A recent study by the Center for Surgery and Public Health at Brigham and Women’s Hospital offers similar, but varied, results. These researchers studied opioid medication prescription patterns following common surgeries. They applied a mathematical model to determine the ideal length of painkiller prescriptions and generated this formula:
Four to nine days of opiate prescription for general surgery
Four to thirteen days for women’s health procedures
Six to fifteen days for musculoskeletal procedures
Pain is Different for Everyone
The problem is that people aren’t math equations. That’s why studies have found multiple answers, and those answers continue to change. In the end, this is a very complex issue that requires individualized solutions. No amount of research can guarantee a certain formula will work for everyone.
The truth is, one person could take Oxycodone or another prescription pain medication for two weeks and remain addiction-free, while another might take the same medication for a week and develop an opioid dependency. Everyone’s addiction switches are different.
So how long can you safely take painkillers? Turns out the answer ultimately depends on you.
When I planned my move to Portland, I was excited by the prospect of adventure and was optimistic about my future – moving to the land of opportunity.
Portland is a liberal city that’s full of creatives – my kind of people. As a person who loves the outdoors, I was drawn to the vibrant green trees that permeated every skyline. I just knew it was the place for me. And so I moved here in January.
What I hadn’t anticipated was the scent of marijuana – everywhere. I also didn’t expect that it would make me feel uncomfortable in my recovery.
In my plans to move, I’d totally overlooked that I was moving to a city where marijuana was legal. It never even occurred to me to check.
Even though marijuana wasn’t my drug of choice, it was a gateway drug for me; 12/13 years old I smoked my first joint with a bottle of vodka. I felt like someone had turned on a light in a darkened room – it awoke something inside of me. While I wasn’t a huge fan of the feeling marijuana gave me, I loved the altered state it provided. And it opened the door to the possibility of escaping myself with other drugs.
I spent the next twenty years trying other drugs in excess. Until I found myself on my knees, unable to take any more self-harm. Harm I’d been causing with substances. I found recovery in March 2012.
I had a consolidated period of recovery when I moved to the US, drugs and alcohol were so far removed from my everyday life that they just didn’t bother me. I lived in the UK – a nation known for excessive and binge drinking, with a pub on every corner. I thought if I could live there and stay sober, I could live anywhere.
It’s against those conditions that I planned my move. When I arrived, I wasn’t prepared. It felt like there was a marijuana dispensary on every corner. A brief walk down the street was punctuated by the smell of weed. The neighbors in my apartment building seemed to use marijuana in place of air freshener. Initially, it was just like being newly sober again: living among people who drink excessively, and there being a pub on every corner – except the only difference this time was the substance.
I was flummoxed.
Examining My Assumptions
What’s great about Portland is that it has a tendency – as a liberal city – to challenge your biases. Since I moved here, I’ve taken the opportunity to question all of my uncomfortable feelings and judgements – from the prevalence of body hair on women, to the plethora of marijuana dispensaries and its’ open use.
When I investigated my thoughts, feelings, and judgments, I discovered I’d been conditioned in my perception of “normal.” It’s illegal to openly use or sell marijuana in the UK – and in most states in the US. I found it was the notion that people were doing something illegal that drove my unpleasant feelings, rather than their use of cannabis. The plumes of smoke and overwhelming smell everywhere, just punctuated society’s burgeoning acceptance of medical marijuana. This freedom from judgement challenged my established belief system.
Setting a New Standard
Having challenged my preconceptions, I realized I didn’t feel threatened in my sobriety because I choose not to take drugs today and am actively engaged in maintaining my recovery. I don’t feel intimidated by the presence of so many dispensaries, or people’s open use of marijuana – I’m simply adjusting to it as a new “normal.”
While I don’t want weed in my home, in the same way I don’t want alcohol, if other people choose to do it then that’s entirely their choice. My recovery is about me living a sober life amongst all of life’s circumstances, it’s not about changing what others do to fit into my perception of a sober world.
While the nation’s opioid addiction takes up the spotlight, there’s another deadly threat lurking in the shadows: inhalant abuse.
Here’s the problem with inhalant abuse – most of these potentially lethal products are perfectly legal to possess and readily available in every household. Inhalants can be found in kitchens, bathrooms, and garages. There are thousands of ordinary items which can be used a source of abuse, including:
Compressed air or duster
Aerosol cooking spray or whipped cream
The availability and innocuous nature of these products are just two of the reasons this trend is such a problem. Inhalants are also inexpensive, so there are few impediments to experimentation. Once considered to be a “teenage” problem, inhalant abuse has actually spread into all demographics.
A Dangerous High
Often referred to as “huffing,” inhalants provide a high similar to alcohol and abuse involves sniffing the fumes from gasoline or compressed air from cans of duster. It can kill users the first time or quickly turn into a dangerous habit.
The buzz from huffing wears off quickly, lasting only seconds to a few minutes. This quick dissipation encourages repeated use and usage for extended periods of time.
Inhalants starve the human body of oxygen. And since the body needs oxygen to live, huffing is extremely dangerous. Persistently breathing in these dangerous chemicals can cause permanent damage to the brain, liver, and kidneys. It can also cause fatal heart arrhythmias. With each breath, the user is putting their life in jeopardy.
Regina Whitsett, who works with the Chesterfield, VA SAFE program, notes, “If you huff or sniff a product, it can cause you to go unconscious, and then you can go into cardiac arrest and actually die from it.”
Hooked on Fumes
Since inhalants offer a cheap high, people sometimes turn to them if they can’t get other drugs. For teens, on the other hand, it’s often a gateway into drug experimentation.
Years ago, teens were viewed as the primary users of inhalants. As recently as 2005, communities saw significant numbers of inhalant abuse among 8th graders. In the early 2000s, community youth surveys in Virginia revealed a majority of young people had tried huffing gases or glue. However, since the mid-2000s, adolescent abuse of inhalants seems to have declined. The Substance Abuse and Mental Health Services Administration reports that, by 2014, fewer than one percent of youth aged 12 to 17 were using inhalants to get high.
On the flip side of that data, it’s pretty clear that adults haven’t lost interest in huffing. The number of adults abusing inhalants has remained steady for the past ten years. In 2014, about 316,000 American adults were inhalant users.
That doesn’t mean this issue is no longer a problem among youth, however. As this viral video demonstrates, children around the world are abusing inhalants. If this boy’s words ring true for other children, many kids turn to inhalant “solutions” as a crutch to make it through the day. As with other drug addictions, the inhalant becomes more important than anything; it’s the sole focus of daily living. It steals all dreams for the future and puts the child at terrible health risk.
Why is This Addiction Hard to Treat?
All substance abuse issues pose treatment challenges, but inhalant addiction is particularly hard to treat. It’s not uncommon for people to relapse as many as ten times while they try to break this deadly habit.
According to the National Inhalant Prevention Coalition (NIPC), most substance abuse programs “are not equipped to deal with the multiplicity, intensity and complexity of problems that the inhalant abuser presents.” Approaches used in typical alcohol and drug treatment programs simply don’t cut it. Often, inhalant abuse causes psychological problems and physical damage to the brain. Chronic users may need to be treated for a dual diagnosis of mental illness and chemical dependency, thanks to the negative effects of inhalants.
For proper treatment, the NIPC recommends starting with a medical examination to assess any damage to the central nervous system, kidneys, liver, and heart. They note the chemicals inhaled during huffing can be stored in fatty tissues for extended periods of time, so detox must be longer than usual, lasting up to several weeks rather than days.
The overall treatment time should be longer, as well. Treatment providers must keep in mind that inhalant users probably have decreased reasoning and resistance than other substance abusers, due to the chemicals’ effects on the brain and thought processes. Before proceeding with treatment, providers must assess the person’s current capabilities of understanding and functioning and once again after the drugs have completely left their system.
To say these overall after-effects can make recovery from inhalant abuse “challenging” is an understatement. As the practice of huffing persists, proper treatment must be applied which meets the unique needs of inhalant abusers and works to turn the tide on this dangerous trend.
Compared to other states’ death tolls, that might not sound like much, but don’t let the numbers fool you. Since 2015, Delaware has seen a 35 percent increase in overdose fatalities. It’s also a significant portion of the population, considering the entire state is home to less than a million people.
Something has to change.
Delaware’s Official New Strategy
State representatives upset by these numbers decided it was time to take action. Gov. John Carney is utilizing Senate Bill 111 to improve the state’s addiction treatment services. His plan for Delaware includes using the most recent initiative, a Behavioral Health Consortium.
By creating a consortium group, Carney plans to bring together key Delaware stakeholders to instigate change in current protocols. The group consists of health professionals, community advocates, and state officials; its goal is to develop a plan that will effectively prevent and treat substance use disorder throughout the state.
Consortium chair Lt. Gov. Bethany Hall-Long explains, “We will directly address the gaps and set specific goals to reduce overdose deaths and improve services for those who are struggling. We have a lot of very dedicated people on this consortium who are ready to get to work, save lives and make Delaware a model for other states to follow.”
Fentanyl is a potent opioid. It’s deadly even in tiny doses. But that certainly hasn’t stopped drug dealers from mixing this lethal substance in with their heroin. In spite of the apparent danger, some users are willing to try this combination in search of a “higher” high.
Authorities have frequently discovered this deadly mix in recent heroin stashes and news accounts of officials seizing fentanyl-laced heroin have become fairly common.
Cocaine Joins the Party
The most recent drug seizures, however, reveal another new trend. Officials are finding fentanyl in samples of cocaine.
Authorities find this new combination baffling, since cocaine is in a different class of drugs than fentanyl. Cocaine is a powerful stimulant, while fentanyl is a depressant. This mixing of the two causes body systems to go haywire, constantly flipping between stimulation and depression.
Any drug abuse is dangerous, but this new combo opens up new areas of threat. People who are used to abusing cocaine may now unknowingly encounter fentanyl. Lacing cocaine with fentanyl and giving it to an unsuspecting cocaine user can prove lethal. Unaware of the added danger, they’re more likely to overdose. But let’s be honest, dealers aren’t concerned about the additional risk to their customers.
As officials investigate recent overdoses, it’s unclear whether or not the users knew about – or even wanted – fentanyl added to their cocaine. Raymond Isackila, an addiction specialist at University Hospital Cleveland Medical Center in Ohio, commented on the string of overdoses in his state, “What’s so unusual about this situation in New Haven is that it looks as if these people were not opioid users or opioid addicts.” With no tolerance for opioids, these cocaine users are particularly vulnerable to the effects of fentanyl.
Why Take the Risk?
Unfortunately, it appears this fentanyl trend is on the rise. In 2013, agents from the Tennessee Bureau of Investigation found fentanyl mixed in with 12 samples of illicit drugs. So far this year, they’ve already found 320 samples laced with the deadly opioid.
In New York City, cocaine mixed with fentanyl caused 37 percent of overdose deaths last year, prompting the New York City Health Department to issue a press release about the dangers of this lethal opioid.
Wondering why dealers are willing to make drug abuse even riskier? The answer is simple: they make more profit. By using fentanyl as a filler, they’re able to add more weight to each baggie sold on the streets and simultaneously increase the power of their product. Sadly, the fentanyl market continues to grow…and so does the death toll.
A few of the significant markers in the history of addiction stigma include:
Opiate addicts in the 1800s were almost exclusively characterized in the press as people of color, including African Americans and Chinese immigrants, even though a large segment of white middle- and upper-class women were addicted, as well.
In the early 1900s, alcoholics were described as “moral inferiors.” Their children were even labeled as “born criminals” with no ability to determine right from wrong.
In 1914, the Harrison Anti-Narcotic Act was passed and aggressively enforced. This not only criminalized addicts, as well as treating physicians, but also many existing treatment methods.
In the late 1950s and early ‘60s, many therapeutic communities established to treat substance abuse required applicants to sit quietly for hours before their intake interviews. And in those interviews, applicants were required to admit they were “stupid.”
Due to “zero-tolerance” policies, such as the War on Drugs in the 1970s, society’s focus shifted from treatment to criminalization as a “solution” to chemical dependency. As a result, incarceration rates (as well as substance abuse rates) have skyrocketed in recent decades.
Even today, in spite of the mountains of evidence proving chemical dependency is a chronic disease, the shame surrounding substance abuse remains very prevalent. This uneducated way of thinking is harmful because it feeds into the vicious cycle of addiction and discourages anyone from seeking treatment. People battling substance abuse issues constantly confront stigma-based roadblocks, whether it’s seeking employment, housing, or even health insurance.
The good news is, we can all play a part in chipping away at the negative stigma associated with substance abuse. Here’s how:
Get Help: Maintaining drug and alcohol use only perpetuates the stereotypes associated with addiction. Seeking treatment and being transparent throughout the recovery process can help others understand the true nature of chemical dependency, rather than the version they’ve created in their minds.
Share Your Story: When you’re open and honest about your struggles, you connect with people on a deeper level. Others can then see you as a human being, and not just a cliché.
Do Your Research: Learn everything you can about the disease process of drug and alcohol dependency. By fully understanding the disease of chemical dependency, you can educate others, which enables them to see someone with a substance abuse problem as a person worthy of compassion.
Our neighbor seemed to have it all: a great job, a nice house, a large circle of friends. But behind closed doors, his life wasn’t all rainbows and butterflies.
Over the years, he’d struggled with debilitating depression and alcoholism. Although he’d gone to several fancy rehabs, he never stayed sober very long. We frequently saw him stumbling home drunk late at night or looking completely disheveled and hungover most mornings.
It wasn’t until last month, however, we discovered the tight grip that alcohol had on him: one of our friends found him dead in his living room.
He’d hung himself – his life cut short from a disease he just couldn’t beat.
Three Things That Don’t Go Well Together
Unsurprisingly, depression, chemical dependency, and suicide are issues deeply intertwined in our country. In fact, the National Alliance on Mental Illness (NAMI) reports 90 percent of people who commit suicide also struggle with a mental health condition, such as depression. People with depression are also more likely to have substance abuse issues.
People with depression often turn to alcohol and drugs in an attempt to escape their feelings of pain and loneliness. These substances, in turn, only serve to worsen those symptoms, such as feelings of persistent sadness and hopelessness, and also create a host of other physical and social problems along the way. These problems can build and build until it feels like an inescapable situation for someone who’s already dealing with a lot. As a result, suicide can seem like the only feasible solution.
How to Help Someone With a Co-Occurring Disorder
If you think a friend or loved one might be struggling with substance abuse and/or a mental health disorder, there are ways you can help. Here are just a few suggestions:
#5 Keep in Touch
Check in with them regularly. This will show them you truly care, which can make a real difference in the outcome of the situation.
You Can Make a Difference
Suicide prevention requires a multifaceted approach, and ultimately hinges on whether or not someone will reach out for help. However, with your love and support, you can be the catalyst that enables your loved one to take the first step towards seeking treatment.
Walgreens stores are now stocking Narcan nasal spray – an FDA-approved form of naloxone – in all of its 8,000 pharmacies.
Narcan is used to treat an opioid overdose. It works by reversing the effects of these drugs, which include heroin and prescription painkillers. This is just one part of Walgreens comprehensive plan to combat the devastating opioid epidemic wreaking havoc and across our nation.
Stocking the Shelves
Another part of Walgreens strategy includes adopting CDC recommendations for improved drug safety education.
Anyone receiving an opioid medication with greater than 50 milligrams of morphine is taught about the dangers of accidental overdose and the proper use of Narcan by the stores’ pharmacists. They also make sure patients understand that Narcan isn’t a substitute for medical care, and they’re advised to call 911 after administering the drug since the person receiving the medication should receive immediate medical assistance.
The chain is also allowing people to purchase Narcan without a prescription at its’ stores in 45 states. Walgreens executives hope to work with legislators in the remaining states to make this life saving medication accessible to everyone.
Walgreens Group Vice President explains, “By stocking Narcan in all our pharmacies, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it is needed…As a pharmacy we are committed to making Narcan more accessible in the communities we serve.”
Seamus Mulligan, CEO at Adapt Pharma (the manufacturer of Narcan Nasal Spray) applauds Walgreens efforts to increase the drug’s availability. He explains, “This effort, combined with the opportunity for patients and caregivers to obtain Narcan nasal spray without an individual prescription in 45 states, is critical in combating this crisis.”
To show their support of Walgreens efforts pharmaceutical wholesaler, AmerisourceBergen, have distributed Narcan demo devices to pharmacists free of charge.
Making a Difference
In addition to the accessibility of naloxone, Walgreens has also collected more than 155 tons of unwanted medications through its safe medication disposal kiosks, located at 600 pharmacies nationwide. The initiative allows people to dispose of unwanted prescriptions (including controlled substances) in safe and convenient locations at no cost and year-round.
With 91 American’s dying every day from opioid overdoses, this is a step in the right direction to help stop some of these unnecessary and tragic deaths.