Opioid Use Now Tops Tobacco Use in the U.S.

A survey released by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) shows that more people in the U.S. use opioid painkillers than tobacco, highlighting the tragic opioid crisis gripping the country. [1]

A federal review published in the spring showed that opioid prescriptions in the U.S. decreased for the 1st time in 2 decades, which suggests that doctors are finally starting to heed warnings about the drugs’ addictive properties. However, that decrease has not translated into fewer deaths. The SAMHSA report illustrates just how widespread the problem remains.

The problem is especially severe in Tennessee, where there are more opioid prescriptions written than people actually living in the state. There are 1.18 opioid prescriptions per every resident of Tennessee. More people died from overdoses in the state in 2014 than from car crashes or shootings. [2]

Source: CDC

Nationally, 37.8% of American adults are using some type of opioid painkiller, while 31.1% of U.S. adults use tobacco problems.

According to the 2015 National Survey on Drug Use and Health (NSDUH), a division of the Department of Health and Human Services (DHHS), more than 91.8 million Americans 18 and older used prescription painkillers last year. By comparison, 75.4 million U.S. adults used tobacco products. [1]

Those numbers creep even higher when children 12 and older are included; to 97.5 million and 78.3 million, respectively. And more than 12.5% of those users admitted to misusing the painkillers.

Danny Winder, director of the Vanderbilt Center for Addiction Research in Nashville, said:

“You’d like to think that is good news and reflects a reduction of tobacco use, but unfortunately that’s not the case. It’s a particularly pernicious problem because of its prevalence…Anytime you have a substance that is legally available and has addictive properties, that’s setting up the problem.” [2]

Actually, smoking rates have declined significantly in the U.S. in the last 50 years. From 2005 to 2015, smoking among adults declined from 20.9% to, or 45.1 million, to 15.1%, or 36.5 million. In the last year alone, the overall smoking rate fell 1.7 percentage points, resulting in the lowest prevalence since the CDC began collecting data in 1965.

However, you don’t generally associate tobacco use with hard drugs, yet many people who die from heroin overdoses begin with a dependence on prescription opioids. Even in those who don’t overdose or graduate to heroin, painkiller addiction can be devastating. In 2015, approximately 40% of unemployed people in the U.S. used a prescription opioid. [2]

Another disturbing finding from the survey is that in 2014, 27.0 million people aged 12 and older had reported using an illicit drug (10.2%). This percentage in 2014 was higher than those in every year from 2002 to 2013. [1]

The 2nd most common type of illicit drug use remained nonmedical painkiller use, but the percentage of people aged 12 or older in 2014 who were current nonmedical users of pain relievers (1.6%) was lower than the percentages in most years from 2002 to 2012.

The 2014 NSDUH estimated 66.9 million people aged 12 or older were tobacco users.

Dr. Richard Soper, chief at the Center for Behavioral Wellness in Nashville, said:

“We require tobacco companies to put warning labels on tobacco products; you don’t really see that in opioid products. As long as the FDA is continuing to approve opioids, there will still be access to it. There will still be doctors writing prescriptions.” [3]

In early 2016, the U.S. Food and Drug Administration (FDA) published draft guidelines outlining testing standards for generic drugs that have been produced to be harder to crush and dissolve or snort. The agency requires that generic drug makers be able to prove that their product is bioequivalent to the name brand drug. But under the new guidelines, manufacturers will also have to prove that their generic drug has the same anti-abuse properties as its name brand equivalent.

However, this is the same agency that approved OxyContin for use in children in August 2015.

Sources:

[1] Newsmax

[2] The Tennessean

[3] The Daily Caller

CDC


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The FDA Wants this Highly Addictive Opioid Taken off the Market

On June 8, 2017, the FDA requested that the drug-maker Endo Pharmaceuticals stop selling Opana ER – the extended-release version of Opana – because of “public health consequences of abuse.” It is the first time the agency has made efforts to pull an opioid from the market due to its highly addictive nature. [1]

According to the FBI, Opana ER is becoming a popular drug to crush, dissolve, and inject. An outbreak of HIV, Hepatitis C, and a serious blood disorder have been fueled by drug users sharing needles.

In March 2017, an FDA advisory committee voted that Opana ER’s benefits no longer outweighed its risks. [2]

FDA Commissioner Dr. Scott Gottlieb says:

“We are facing an opioid epidemic – a public health crisis, and we must take all necessary steps to reduce the scope of opioid misuse and abuse.

We will continue to take regulatory steps when we see situations where an opioid product’s risks outweigh its benefits, not only for its intended patient population but also in regard to its potential for misuse and abuse.” [1]

Endo said in a statement that the company is “reviewing the request and is evaluating the full range of potential options as we determine the appropriate path forward.”

But the company defended Opana ER for its ability to do what it is intended. It said:

“As a pharmaceutical company with a demonstrated commitment to the improvement of pain management, Endo feels a strong sense of responsibility to improve the care of pain for patients, while at the same time taking comprehensive steps to minimize the potential misuse of its products.”

Read: FDA Takes Major Steps to Address Growing Opioid Crisis

This is Endo’s one and only chance to cooperate, though. If the company refuses to voluntarily recall Opana ER, the FDA will revoke the painkiller’s market approval.

The FDA says:

“In the interim, the FDA is making health care professionals and others aware of the particularly serious risks associated with the abuse of this product.”

Opana ER won FDA approval in 2006. It was designed to be swallowed and to slowly release the medication into the bloodstream over several hours. But when it is snorted or inject, it gives the user a powerful high.

As the brain becomes acclimated to the euphoric feelings, more and more of the drug is required to produce the same levels of pain relief and well-being, leading to dependence, and eventually addiction. [2]

The drug is twice as powerful as OxyContin, another potent opioid that has led many drug abusers down the path to heroin addiction.

Source: U.S. Centers for Disease Control

Read: Washington City Sues OxyContin Maker Over Opioid Epidemic

Endo reformulated Opana ER in 2012 by adding a coating with the stated purpose of making the pills harder to snort or inject. Other opioid manufacturers have taken similar steps in recent years as the opioid epidemic ballooned into a full-blown crisis. [1]

The FDA said it decided to ask Endo to take Opana ER off the market after the agency reviewed all post-market data on the drug and found that when Endo reformulated the drug, people were injecting it more than they were snorting it. [2]

But the move seems to have backfired, as outbreaks of HIV, Hepatitis C, and other diseases sparked by people injecting Opana ER continued to spiral out of control.

Opana ER was the drug of choice for many addicts at the center of an HIV outbreak in Indiana in 2015.

Read: Even the “Safest” of RX Opioids Highly Addictive, Says Experts

Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, says:

“When we determined that the product had dangerous unintended consequences, we made a decision to request its withdrawal from the market.

This action will protect the public from further potential for misuse and abuse of this product.” [1]

In 2015, opioid overdose killed more than 33,000 people in the U.S., more than any year on record. Close to half of those deaths involved some type of prescription drug. [2]

Sources:

[1] NPR

[2] CNN

U.S. Centers for Disease Control


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The United Nations Says It Will Monitor the Fentanyl Market

On March 16, the United Nations (U.N.) added 2 chemicals used to make the painkiller fentanyl to an international list of controlled substances. Assistant Secretary of State William Brownfield, the chief U.S. State Department counter-narcotics official, has hailed the move, but acknowledged that it won’t immediately decrease illegal trafficking of the chemicals. [1] [2]

Source: Healthland Heart Region

Read: Even the “Safest” of RX Opioids Highly Addictive, Experts Say

Fentanyl is a man-made opioid that can be up to 100 times more powerful than morphine. It is approved to treat severe pain, particularly in patients with advanced cancer, and is considered to be America’s newest deadly drug due to misuse.

In March 2015, the DEA issued a nationwide alert after more than 700 overdose deaths were linked to fentanyl in late 2013 and 2014. In 2015, fentanyl overdoses claimed the lives of 33,000 Americans, and over 300,000 in the past 16 years. [2] [3] [4]

Fentanyl is often combined with heroin or made to resemble other painkillers that grab a higher street price, often leading to the deaths of users who are unaware that the drug has been contaminated. [2]

At its annual meeting, the Commission on Narcotic Drugs, which is also the governing body of the Vienna-based U.N. Office on Drugs and Crime (UNODC), voted in favor of “scheduling” two fentanyl precursors and a fentanyl-like substance. In other words, these chemicals were added to an international control list, which should help ensure more stringent international monitoring of suspicious orders and transactions. This could make it harder for people get their hands on them and produce fentanyl. [1]

A U.S. State Department spokeswoman said in response to the decision:

“None of us lives under the illusion that this is a silver bullet to solving our opioid crisis. But this vote will make it harder for the criminals that are illicitly producing fentanyl to access the necessary resources. It will require countries to regulate the production, sale, and export of the precursors to fentanyl, and to criminalize sale or trafficking outside of those regulations.”

Read: FDA Takes Major Steps to Address Growing Opioid Crisis

The UNODC named the two precursors as 4-anilino-N-phenethylpiperidine (ANPP) and N-phenethyl-4-piperidone (NPP). The commission also added butyrfentanyl, a fentanyl analogue that is similar to the drug.

The State Department said in a statement:

“The U.S. mission [to the United Nations in Vienna] … welcomes this decision as a concrete example of how international action can have a clear benefit for the United States, as we face a crisis taking a tremendous toll on American communities.” [1]

Sources:

[1] VOA News

[2] ABC News

[3] CDC

[4] Vice

CDC

Heartland Health Region

Huffington Post (featured image source)


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