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Saturday, November 8, 2014
Friday, November 7, 2014
RxStat Program Uses Multiple Data Sources to Reduce Opioid Overdoses
/BY CELIA VIMONT
November 5th, 2014/
Taking Narcotic Pills, a leading prescription drug that is abused.
A public health and public safety partnership program in New York City called RxStat is using data from different government agencies to pinpoint opioid overdoses and to make changes to reduce the toll of prescription drug abuse. The goal is to reduce overdose deaths and to drive home the message that opioid overdose deaths are preventable.
RxStat is housed at the New York City Department of Health and Mental Hygiene (Health Department). It involves timely analysis of drug misuse indicators from multiple data sources, according to Dr. Denise Paone, Director of Research & Surveillance Bureau of Alcohol & Drug Use Prevention, Care & Treatment at the New York City Department of Health and Mental Hygiene. “If you have timely data, you can find emerging issues and respond rapidly,” she says.
The data includes emergency room visits to city hospitals for opioid overdoses, Fire Department and Emergency Medical Services calls about overdoses, deaths due to opioids, prescription data from the state, and information from the Drug Enforcement Administration and the Manhattan District Attorney’s Office.
“If we see an increase in opioid activity in certain neighborhoods, we’ll go out to those communities and get more data,” Paone says. “Then we’ll respond with programs and initiatives.”
When the RxStat staff looked at the data, they saw rates of opioid overdoses were three times higher in Staten Island compared with the city’s other boroughs. Staten Islanders filled prescriptions for opioid painkillers at higher rates in 2012, had a longer median day supply, and were more likely to have high-dose prescriptions, compared with the city’s other boroughs.
“We took a comprehensive approach. We conducted a ‘detailing’ campaign visiting 1,000 physicians, nurse practitioners and physicians’ assistants to explain judicious prescribing, and conducted follow-up visits with most of them,” she notes. The campaign included one-on-one visits from Health Department representatives who delivered key prescribing recommendations, clinical tools and patient education materials.
Doctors were advised to avoid prescribing opioids for chronic non-cancer, non-end-of-life pain, such as for low back pain, arthritis, headache or fibromyalgia. They were told that when opioids are warranted for acute pain, a three-day supply is usually sufficient. They were also urged to avoid whenever possible prescribing opioids in patients taking benzodiazepines.
The Health Department produced public service announcements to increase awareness of the risk of opioid analgesic overdoses. One ad featured a testimonial from a mother who lost her son to an opioid painkiller overdose, and another showed a New York City resident in recovery.
The staff also held meetings with community groups and conducted two forums with doctors on Staten Island. Paone and her colleagues are now evaluating the data, and will find out soon whether changes in doctors’ knowledge about opioids has translated into a decrease in prescriptions, and high-dose prescriptions in particular.
The program has expanded to other areas of the city. Last year the RxStat staff noted an increase in opioid-related deaths in Queens. “We held town hall meetings and we’ve been doing presentations with community groups,” Paone says. The program is now starting a campaign to visit doctors in the Bronx.
RxStat can be replicated in other areas, even in cities and towns with far fewer resources than New York, according to Paone. “They may not be able to reproduce every component, but they can obtain the data and do a detailing campaign.”
The program has released a technical assistance manual to explain how it works.
Antibody Therapy May Prolong Effect of Treatment for Meth Addiction
November 5th, 2014/
An antibody therapy could prolong the effect of medication designed to treat methamphetamine addiction, a study in mice suggests.
There is currently no medication approved by the Food and Drug Administration for methamphetamine addiction. Scientists are developing promising treatments that trigger an immune system response, the Los Angeles Times reports.
If a daily anti-addiction medication is developed for meth, it will face a major challenge, according to the newspaper. The urge to use meth can easily overwhelm the desire to quit, making it likely the person will discontinue the medication and continue using meth.
The new antibody therapy is designed to prolong the effect of anti-addiction medication. The therapy would deliver genes into a person’s cells through a dismembered virus. The genes would instruct the cells to make a non-stop supply of anti-meth antibodies, the article notes.
If a person took meth weeks or even months after receiving the medication, the antibodies would bind to the meth and prevent it from reaching the brain, researchers explained at the recent annual meeting of the American Association of Pharmaceutical Scientists. As a result, the person wouldn’t get high.
The researchers from the University of Arkansas described their experiment with the new therapy in meth-addicted mice. They studied two groups of mice: one group was vaccinated with the medication, and the second group received a saline shot. Both groups of mice were given meth 50 days later. Half an hour and one hour after receiving the meth, the mice who received the antibody treatment had much more meth in their blood than the mice that received a saline shot. This suggests the meth was bound to the antibodies and did not cross the barrier into the brain, the researchers said.
Binge Drinking in Teen Years Could Lead to Lasting Changes in Brain: Rat Study
November 5th, 2014/
A new study in rats suggests heavy drinking during the teen years could lead to structural changes in the brain that last into adulthood. The changes occur in the region of the brain important in reasoning and decision-making.
The researchers found the rats given daily access to alcohol during adolescence had less myelin, the fatty coating on nerve fibers that speeds transmission of electrical signals between nerve cells. The animals that drank the most performed worse on a memory test later in adulthood, the study found. The findings suggest binge drinking during adolescence could continue to affect the brain even long after the drinking stops. Further study is needed to determine if the findings also apply to humans, the researchers noted.
The findings are published in The Journal of Neuroscience.
According to study co-author Heather Richardson of the University of Massachusetts Amherst, previous studies have shown heavy alcohol use among teenagers is linked to changes in myelin and cognitive impairment later in life. Until now, it has been unclear whether these changes are directly caused by alcohol, Medical News Today reports.
The researchers studied two groups of male adolescent rats. One group had access to sweetened alcohol each day for two weeks. The other group had access to sweetened water. At the end of the study, the researchers analyzed the rats’ myelin levels in the brain. The rats that drank alcohol had reduced myelin in the prefrontal cortex, compared with those that drank sweetened water.
Months later, when the rats reached adulthood, their levels of myelin were reassessed. The researchers found the rats that consumed the alcohol continued to show reduced myelin levels. Richardson noted in a news release, “These findings suggest that alcohol may negatively affect brain development in humans and have long-term consequences on areas of the brain that are important for controlling impulses and making decisions.”
Insomnia May Lead to Increased Relapse Risk in Early Phases of Addiction Recovery
November 6th, 2014/
Insomnia may lead to an increase in the risk of relapse for people in the early phases of recovery from addiction, suggests a new report. The researchers say the incidence of insomnia in early recovery may be five times higher than in the general population.
The problem may persist for months or even years, MedicalXpress reports. The findings appear in the Journal of Addiction Medicine.
“Treating sleep disturbance in early recovery may have considerable impact on maintenance of sobriety and quality of life,” study co-author Dr. Nicholas Rosenlicht of the University of San Francisco said in a news release.
The researchers found insomnia may be linked with a higher risk of alcohol-related problems and relapse. In addition, previous research suggests people with sleep problems are more likely to be at risk of developing addiction, the article notes. Some people with alcohol use disorders drink in the evening to help them sleep, even though alcohol causes sleep disruption.
It is unclear whether treating insomnia can reduce a person’s risk of relapse, they note. Some studies have found using insomnia medications during recovery can reduce the rate of relapse. The researchers caution doctors about prescribing insomnia medications to recovering patients, because they may be at increased risk of misuse, abuse or addiction to sleep medications. They may also be at risk of “rebound insomnia” after they stop taking the medication.
Instead of prescribing insomnia medications, doctors can have patients keep a daily sleep diary; ask them to fill out a questionnaire about their insomnia and progress during treatment; and educate patients on the best ways to promote good sleep and the effects of substances on sleep.
Behavioral approaches to sleep problems include limiting a person’s time in bed to only that time when they are sleeping, and identifying and correcting inappropriate thoughts and beliefs that may contribute to insomnia.
  
Get Ready For the Holidays...
Tonight November 6th at 7:00pm EST the Addict's Mom Live Video Online Meeting on In the Rooms www.intherooms.comwill have a special guest Al J. Mooney MD author of The Recovery Book: Answers to all your questions about addiction and alcoholism and finding health and happiness in sobriety www.therecoverybook.com
Dr. Mooney will be talking with addict's moms about not only surviving but enjoying the holiday season....
Topics to be Covered:
How to keep peace in the family during the holidays.
How to have a joyful holiday even if your addicted child is absent.
How your newly sober loved one can celebrate the holidays while staying sober.
What you can do to help your love ones that are new to sobriety.
Please sign in with Google Chrome or Firefox and check your settings. Remember you can remain anonymous or not!
Much love to all addict's moms and their families...Barbara
Get Ready For the Holidays...
Tonight November 6th at 7:00pm EST the Addict's Mom Live Video Online Meeting on In the Rooms www.intherooms.comwill have a special guest Al J. Mooney MD author of The Recovery Book: Answers to all your questions about addiction and alcoholism and finding health and happiness in sobriety www.therecoverybook.com
Dr. Mooney will be talking with addict's moms about not only surviving but enjoying the holiday season....
Topics to be Covered:
How to keep peace in the family during the holidays.
How to have a joyful holiday even if your addicted child is absent.
How your newly sober loved one can celebrate the holidays while staying sober.
What you can do to help your love ones that are new to sobriety.
Please sign in with Google Chrome or Firefox and check your settings. Remember you can remain anonymous or not!
Much love to all addict's moms and their families...Barbara
Visit The Addict's Mom at: http://addictsmom.com/?xg_source=msg_mes_network
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Wednesday, November 5, 2014
Be our guest! The Addict's Mom is looking for addiction professionals to be our guest on our Live Video Online Meetings hosted by In the Rooms every Thursday Night 7:00pm to 8:00pm EST. If you are addictions professional and would like to be our guest please email me atBarbara@theaddictsmom.com put Guest in the subject line. Be sure to include your contact information including your phone number.
A special thank you to In the Rooms for hosting the Addict's Mom meetings. They are an a.mazing community dedicated to helping those whose lives have been touched by addictionwww.intherooms.com. If you are not a member I encourage you to join they have so many wonderful resources.
Making Naloxone More Widely Available Could Prevent 20,000 U.S. Deaths: WHO
November 4th, 2014/
Increasing the availability of the opioid-overdose antidote naloxone could prevent more than 20,000 deaths in the United States annually, according to the World Health Organization (WHO).
About 69,000 people die worldwide from overdoses of heroin or other opioids each year, WHO estimates.
In most overdose cases, people using opioids misjudge the dose they are taking or their tolerance for the drug, WHO expert Nicolas Clark told Reuters. A family member is often there to witness the overdose, and that person could administer naloxone, he noted. “If opioids are easily available in people’s bathroom cabinets, it might make sense for naloxone to be equally available,” Clark said.
Naloxone, which previously was available only as an injectable drug, can now be administered as a nasal spray. It works quickly, without side effects. “We’re happy to recommend the intranasal approach as an effective approach,” Clark said. “Naloxone is cheap but it’s limited really to emergency departments and some ambulance departments.”
A growing number of states have passed laws increasing access to naloxone. As of September 2014, there were 24 states with such laws. Most of the laws allow doctors to prescribe naloxone to friends and family members of a person who abuses opioids. The laws also remove legal liability for prescribers and for those who administer naloxone.
In addition, 17 states and the District of Columbia have passed “Good Samaritan” laws, which provide limited legal immunity for people who call for help for a person who is overdosing. These laws were passed in response to concerns that people who are present during an overdose may hesitate to call 911 because they fear legal consequences.
Abuse-Deterrent Opioids Bring Up Many Thorny Issues at FDA Hearing
November 4th, 2014/
A Food and Drug Administration (FDA) hearing last week revealed there are a number of disagreements among experts about abuse-deterrent opioids, MedPageToday reports.
The FDA has granted abuse-deterrent labeling to three drugs: Targiniq (oxycodone hydrochloride plus naloxone); Embeda (morphine plus naltrexone); and a reformulated version of OxyContin (oxycodone).
Drug companies that want to produce a generic opioid that competes with an abuse-deterrent brand-name opioid lack a clear set of rules to meet FDA expectations, the article notes. It is a challenge to develop a standard battery of tests to compare two drugs’ abuse-deterrent properties, experts said. In part that is because there are a number of ways these drugs can be abused, such as crushing a pill manually with a grinder, dissolving the drug in alcohol or water, or smoking it. There are also many ways to make the drugs harder to abuse, such as causing a burning sensation in the nose if the drug is inhaled, or making it harder for the particles to be absorbed.
Several speakers at the hearing expressed concern about limiting use of opioids that lack abuse-deterrent formulations. C. Bernie Good of the Department of Veterans Affairs noted the VA spends almost $89.4 million on drugs annually, primarily on generic drugs. He said more evidence is needed that using abuse-deterrent formulas are having the intended effect. He called for more studies “to know that we are benefiting society, and it’s not just decreasing the abuse in terms of crushing or snorting, but that actually at the end of the day, we have fewer deaths, fewer unintentional overdoses, et cetera, and that there aren’t unintended consequences like people going to heroin.”
Other speakers were concerned that removing non-abuse deterrent formulations would lead to a drug shortage or increase prices so much they would become too expensive for many patients. People who are determined to abuse drugs that cannot be ground or crushed could simply take more pills, some speakers noted.
Study: 19 Percent of Americans Suffer From Chronic Pain
November 4th, 2014/
A new study concludes 19 percent of Americans suffer from chronic pain. Women and the elderly are most likely to have constant pain, HealthDay reports.
The findings come from a poll of about 35,000 American households. The researchers asked respondents if they suffer from chronic pain, defined as constant or frequent pain that lasts for at least three months.
Study author Jae Kennedy of Washington State University in Spokane said narcotic painkillers such as hydrocodone, oxycodone and morphine can be helpful in treating chronic pain, but only on a short-term basis. “We are clearly overusing opioids [narcotics],” he told HealthDay. “The U.S. consumes about 80 percent of the world’s opioid supply, and 99 percent of the hydrocodone supply. These medications are effective in the short term, [such as] for managing postoperative pain, but long-term use often leads to dependency or addiction.”
The survey found many people with arthritis or back and join pain did not say they had constant and persistent pain. Of respondents who did have chronic pain, more than two-thirds said their pain was constant, and more than half said their pain was sometimes unbearable and excruciating.
The study appears in the Journal of Pain.
“If you’re dealing with pain constantly for a long period of time, that’s going to affect your work life, your family life, your social life. It also puts you at higher risk for things like mental illness and addiction,” Kennedy said in a news release.
Bob Twillman, Director of Policy and Advocacy for the American Academy of Pain Management, noted narcotic painkillers are not helpful for many people with chronic pain. “Those medications are wonderful when they work, but on average, they only relieve about a third or less of the chronic pain people experience, and may be completely ineffective in treating some kinds of chronic pain,” he said.
Daily Quote
"In the last analysis, the individual person is responsible for living his own life and for 'finding himself.' If he persists in shifting his responsibility to somebody else, he fails to find out the meaning of his own existence." - Thomas Merton
Today's Online Meetings
Guest Speaker - 1:00 pm CST: "Progress Not Perfection"
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Tuesday, November 4, 2014
November 4 Chp 73 v 21 v 22 TWELVE STEPPING WITH STRENGTH FROM THE PSALMS
Then I realized my heart was bitter , and I was all torn up inside .I was so foolish and ignorant - I must have seemed like a senseless animal to you .
Step 1 - We admitted we were powerless over our addiction - that our lives had become unmanageable.
This was my bottom ! Bitter Broken and battered is where my life left me . This is where a lot of you are now ! Most are medicating cause they are all torn up inside . Like a senseless animal they are emotionless due to the heavy medicating they administer on the daily . Medicating the pain and running from feeling does not fix it or make it go away. Caged is where you will remain until you over medicate or your hauled off to a jail cell to add more to your life of misery. Man up and deal with it ! Expose it so it cannot keep holding on to you .Discuss it , hash it out , and cry a river but get it out before it takes you out.
1 Peter 5:9-10 Resist him, firm in your faith, knowing that the same kinds of suffering are being experienced by your brotherhood throughout the world. And after you have suffered a little while, the God of all grace,who has called you to his eternal glory in Christ, will himself restore, confirm, strengthen, and establish you.
By Joseph Dickerson
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| COMING UP IN THE FIX// Percy Menzies, Vivitrol Activist * Housing for the Sober Transgender Community * Interview with Jack Kornfield * Drug Smuggling in Prison* Hypocrisy of Smoking * Juliet Abrams Interviews Stephanie Covington about Sexism and AA * PLUS: Other incisive articles |
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