Suboxone Sales Estimated to Reach $1.4 Billion in 2012—More Than Viagra or Adderall
Sales data from the first three quarters of 2012 indicate
that Suboxone retail sales in the U.S. will likely reach $1.4 billion*
this year—nearly a ten-fold increase over the $137.1 million in sales in 2006
(see figure below). Suboxone currently has the 28th highest retail
sales of all prescription drugs in the U.S., up from 198th in 2006.
Suboxone sales will likely continue to increase in light of new SAMHSA
regulations allowing Opioid Treatment Programs (OTPs) to dispense a multiple
days’ supply of take-home buprenorphine, the main ingredient in Suboxone, to
eligible patients without having to adhere to previous length of time in
treatment requirements. The steady and rapid increase in Suboxone sales
suggests that the drug is being widely adopted in the treatment of opioid
dependence, likely because of its effectiveness and because it can
be prescribed in both private physicians’ offices and OTPs. While
increased availability means that more opioid dependent persons are being
treated, it is also likely that diversion and nonmedical use will
increase. Prior issues
of the CESAR FAX have indicated that buprenorphine is being diverted for use by those who do not have a prescription and that there has been an increase in the health-related consequences of nonmedical use of buprenorphine.3 Furthermore, a recent State of Florida medical examiner report4 found that the number of buprenorphine-related deaths had increased from 6 in 2009 to 27 in 2011 (compared to 62 heroin-related deaths in 2011). These figures likely underestimate buprenorphine-related
deaths because, unlike heroin, buprenorphine is not systematically tested for by State of Florida medical examiners.
Editor’s Note: The true magnitude and scope
of buprenorphine diversion, misuse, and adverse consequences is unknown because
current epidemiologic measures do not systematically monitor buprenorphine.
Routine drug testing protocols used by workplaces and the criminal justice
system may not include buprenorphine. Similarly, buprenorphine-related deaths
are not accurately tracked because medical examiners and coroners do not
routinely test for the drug. We believe that in order to maximize the
effectiveness and legitimacy of buprenorphine as a treatment for opioid
dependence, it is essential that adequate systems for monitoring potential
diversion, misuse, and adverse consequences be put in place throughout the
country. According to the manufacturer, Suboxone “can cause serious
life-threatening respiratory depression and death, particularly when taken by
the intravenous (IV) route in combination with benzodiazepines or other central
nervous system (CNS) depressants.”5 Failure to adequately assess the
potential risks of diversion and misuse could result in serious public health
consequences and more limitations on the drug’s use.
SOURCE: Drugs.com, Suboxone Sales Data, November
2012. Online at http://www.drugs.com/stats/suboxone
Woman Accused Of
Driving Drunk After Drinking Half A Bottle Of Hand Sanitizer
FDA Panel Votes Against Recommending Zohydro for Approval
A panel of experts assembled by the U.S. Food and Drug Administration (FDA) voted against recommending approval of the painkiller Zohydro ER on Friday. The panel cited concerns over the potential for addiction, Reuters reports. FDA officials said they could still approve the painkiller by imposing safety restrictions. In the 11-2 vote against approval, the panel said that while the drug’s maker, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone. Zohydro contains the opioid hydrocodone. Unlike some hydrocodone products such as Vicodin, Zohydro does not contain acetaminophen. The FDA will decide by March 1 whether to approve Zohydro for sale in the United States for people who need an around-the-clock painkiller for an extended period. Emergency room visits related to hydrocodone have soared since 2000. Click here to read the rest of the story.Teens Who Experience Dating Violence at Increased Risk of Substance Abuse
Teenage girls who experience dating violence are more likely to binge drink compared with their peers who aren’t in abusive relationships, a new study finds. Teen boys who report dating violence are more likely to use marijuana as young adults compared with boys with healthy dating relationships. The study included more than 5,600 teens who had been in at least one relationship with someone of the opposite sex in 1996. About one-third said they had experienced dating violence, including emotional and physical abuse, WebMD reports. Five years later, those who experienced dating violence in their teen years were more likely to engage in unhealthy behaviors. For girls, those behaviors included smoking, suicidal thoughts and symptoms of depression, in addition to binge drinking. For boys, the unhealthy behaviors included suicidal thoughts and being antisocial, in addition to marijuana use. Teens who were in physically abusive relationships were two to three times more likely to be in a violent relationship between the ages of 18 and 25, the article notes. The study appears in the journal Pediatrics.Synthetic Version of “Magic Mushrooms” Tested As Treatment for Alcoholism, Smoking
Scientists are testing the synthetic version of the active compound in “magic mushrooms,” psilocybin, for a variety of purposes, including treatment of alcoholism, according to Time.com. The compound is also being studied as a smoking cessation aid. At the recent annual meeting of the American College of Neuropsychopharmacology, scientists described their research using the hallucinogen. According to the article, psilocybin is the active ingredient in more than 100 species of mushroom, and has been used for hundreds of years in ceremonies and rituals in South America. Studies on psilocybin’s effect on smoking cessation and alcoholism have just started, but early results are promising, researchers say. A study published in the Archives of General Psychiatry by UCLA researchers found psilocybin improved the mood of patients with anxiety related to a diagnosis of advanced-stage cancer for at least three months. Once ingested, magic mushrooms generally cause feelings of nausea before the desired mental effects appear. The high from using magic mushrooms is mild and may cause altered feelings and distorted perceptions of touch, sight, sound and taste. Other effects can include nervousness and paranoia. On some trips, users experience sensations that are enjoyable. Others can include terrifying thoughts, and anxiety, fears of insanity, death, or losing control. Some magic mushroom users experience “flashbacks,” which are reoccurrences of hallucinations long after ingesting the drug. The causes of these effects, which in some users occur after a single experience with the drug, are not known.Heroin deaths rise as crackdown on prescription drug abuse succeeds
Does the NFL have a drinking problem?
Since January 2000, NFL players have been arrested at least 624 times on various charges, including 42 times this year, according to data compiled by USA TODAY Sports. Of those 624 arrests, 177 (28%) were arrested because they were suspected of driving under the influence of alcohol or drugs. Despite the league's various attempts to stop the problem, it remains the single-biggest criminal issue in the NFL. Nothing else comes close. Nothing else has been more deadly. Read the rest of the story here.Prescription Painkillers Mixed With Alcohol: A Deadly Mix
On Dec. 19, 2011 a 28-year-old graduate student at the George Washington University went to sleep and never woke up. Earlier that night, Benjamin Gupta mixed a prescription painkiller with alcohol. It was a mistake that cost him his life. By all accounts, Ben Gupta was smart, motivated and much-liked -- someone with a passion for public service. The Omaha, Neb. native had worked under Secretary of State Hillary Clinton as a coordinator for the State Department's Global Partnership Initiative. He also served in 2007 as a staff assistant for then-Congressman Rahm Emanuel. Ben was dedicated to completing his graduate studies, but he never got the chance when he took oxycodone, a prescription painkiller, and then an alcoholic drink. Ben Gupta's blood alcohol level was just .04 the night of his death, far below the legal limit. Yet the mixture killed him. According to the Centers for Disease Control and Prevention (CDC), nearly three out of four prescription drug overdoses are caused by the same kind of opioid painkillers that Ben Gupta took on that fateful night. Drug overdose rates in the United States have more than tripled since 1990, paralleling an astounding 300 percent increase in sales of these prescription painkillers. Rest of the story is available hereAdministrators have launched two new alcohol-related initiatives that aim to evaluate alcohol culture at Yale and seek ways to form a safer undergraduate experience. In an email sent yesterday afternoon to the student body, Yale College Dean Mary Miller and Secretary and Vice President for Student Life Kimberly Goff-Crews announced the "Task Force on Alcohol and Other Drugs" and "University Council Committee on Alcohol in Yale College," which will each tackle alcohol use at Yale. The 15-person task force, which will be chaired by Dean of Student Affairs Marichal Gentry, will focus on three areas of alcohol culture: safety and education, programming and communications. Gentry told the News on Monday that Miller approached him earlier this semester and asked him to form the task force and develop tactics "to help Yale College make the undergraduate experience safer, and to protect that experience from the risks that alcohol and other drugs present." The committee's membership includes Yale Police Department Chief Ronnell Higgins, Associate Dean for Student Organizations and Physical Resources John Meeske and Yale College Council President John Gonzalez '14. According to Gonzalez, the task force has met five times since its first meeting on Nov. 7. Gentry said Miller may turn the task force into an "implementation committee" once the group recommends strategies and tactics regarding alcohol use to Miller. The University council committee, which University President Richard Levin will convene in January 2013, will comprise of alumni and parents and aims to provide a "broad overview and more strategic guidance to the University's senior leadership," according to the email..
To Reduce Prescription Drug Abuse, Focus Less on Patient Satisfaction
Pain management education must help prescribers focus less on patient satisfaction, and more on their functional improvement, according to Sherry Green, the CEO of the National Alliance for Model State Drug Laws (NAMSDL).Current pain management education is largely based on the concern that people in chronic pain are not receiving adequate relief, Green says. “More and more emphasis has been placed on patient satisfaction. With doctor ratings available online, some physicians are concerned that if they don’t give patients what they want, they will drive them away and receive unsatisfactory ratings. That may make them less willing not to give someone the drug they’re asking for.” The pressure to satisfy patients may also come from hospitals, whose own ratings are influenced in part by patients’ satisfaction with doctors, she adds. Improving prescriber education was one of the topics at the recent meeting convened by NAMSDL for state and local professionals from around the country to identify legislative and policy options for addressing “pill mills” and safeguarding the legitimate practice of pain management. Participants included doctors, law enforcement officials, medical board representatives and addiction treatment specialists. They crafted a preliminary set of proposals which NAMSDL will distribute in early 2013 to a wide variety of stakeholders for further review and comment. The goal of the multi-step, multi-disciplinary approach is to provide policymakers with practical solutions to preventing prescription drug abuse, addiction and diversion while safeguarding legitimate access to prescription drugs.
Participants at the meeting agreed patient satisfaction may be receiving too much emphasis. “There’s a concern we’ve gone too far down that road,” notes Green. They also discussed how pill mills have fueled the prescription drug abuse epidemic. “Pill mills do not necessarily refer to a specific location, but rather to a set of practices that is not legitimate medicine,” Green says. “Pill mills’ entire focus is on prescribing drugs, without taking medical histories, performing physical exams or providing followup. There is no individualized care, and the same kinds of pills are given across multiple types of patients.” Legitimate pain management involves practices diametrically opposed to pill mills, according to Green. “Pain management is more holistic – it looks at other ways of treating pain in addition to pills,” she notes. Prescription drug monitoring databases as a tool for combating prescription drug abuse will be a big focus on the state level in 2013, she adds. There are many details that states must consider, including whether to require doctors and other prescribers to use the databases. “Our goal is to see what are the best kinds of policy and regulatory changes that are needed to reduce prescription drug abuse. Once we agree, our stakeholder groups can move forward and make these changes,” she says.
Children and Teens Who Overeat More Likely to Start Using Marijuana
A new study finds children and teens who overeat are more likely to start using marijuana and other drugs, compared with their peers who don’t eat too much. The study is based on surveys of almost 17,000 youth, Reuters reports.“Physicians and parents should be aware that both overeating and binge eating are quite common in adolescents, and these problems put them at risk for other problems, such as drug use,” lead researcher Kendrin Sonneville of Boston Children’s Hospital told Reuters. “The earlier we can screen for who is at risk, the more able we are to prevent the onset of drug use.”
Dr. Sonneville said pediatricians should talk to their patients about eating patterns. Parents who notice their child is eating much more than usual in one sitting should consult the child’s doctor, she advised. The children in the study, who were between the ages of 9 and 15 when it began, filled out health questionnaires every year or two between 1996 and 2005. During that period, 41 percent started using marijuana, and 32 percent used other illicit drugs.Those who reported overeating were 2.7 times more likely to start using marijuana or other drugs. Binge eaters—those who lost control during overeating—were 1.9 times more likely to start using drugs. The findings appear in the Archives of Pediatrics & Adolescent Medicine.
Military cracks
down on alcohol abuse amid age-old binging habit
Officials within the U.S. military are actively targeting
over-boozing troops at home and abroad, but addiction specialists and service
members say binge drinking remains as rampant as ever inside the armed
services.
Among the new initiatives to stem the problem: The Marines, starting next year, will give random breathalyzer tests to Corps members; the Air Force and Army curbed some overnight liquor sales for U.S. military personnel in Germany; and American service members in Japan were barred from leaving their residences after consuming more than one adult beverage. The restrictions seem to have been independently created by brass within each branch - for example, the new rules for service members in Japan follow the October sexual assault of an Okinawa woman allegedly carried out by two U.S. sailors. Still, the fresh regulations arise three months after a study commissioned by the Department of Defense found that binge drinking by active-duty troops now constitutes "a public health crisis," noting as well that drunken soldiers were cited as a problem as far back as the Revolutionary War. Rest of the story is available here.
Among the new initiatives to stem the problem: The Marines, starting next year, will give random breathalyzer tests to Corps members; the Air Force and Army curbed some overnight liquor sales for U.S. military personnel in Germany; and American service members in Japan were barred from leaving their residences after consuming more than one adult beverage. The restrictions seem to have been independently created by brass within each branch - for example, the new rules for service members in Japan follow the October sexual assault of an Okinawa woman allegedly carried out by two U.S. sailors. Still, the fresh regulations arise three months after a study commissioned by the Department of Defense found that binge drinking by active-duty troops now constitutes "a public health crisis," noting as well that drunken soldiers were cited as a problem as far back as the Revolutionary War. Rest of the story is available here.
“Data show meaningful reductions in underage
drinking, particularly among younger age groups. From 2004 to 2012, young
people ages 12 to 20 showed statistically significant declines in both
past-month alcohol use and binge alcohol use,” according to the 2012 Report to Congress on the Prevention
and Reduction of Underage Drinking, from the Secretary of Health and Human Services,
released on November 30, 2012. However the new summary of the latest
scientific research confirms that “alcohol continues to be the most widely used
substance of abuse among America’s youth, a greater proportion of whom use alcohol
than use tobacco or other drugs.” The annual report was prepared by the Substance Abuse
and Mental Health Services Administration (SAMHSA) on behalf of the federal Interagency Coordinating Committee on the
Prevention of Underage Drinking (ICCPUD). SAMHSA administrator Pamela S. Hyde,
J.D. serves as the ICCPUD Chair. In her Foreword to this fourth report in the
series, Hyde notes that it includes a new section on prevention of binge drinking
on college and university campuses, and an expanded section about underage
drinking prevention and enforcement activities in the 50 states and the
District of Columbia.
Surgery Destroys Parts of Brain’s “Pleasure Centers” in Attempt to Cure Addiction
A controversial surgical procedure being studied in China attempts to cure addiction by destroying parts of the brain’s “pleasure centers,” Time.com reports. The research is being conducted on alcoholics and people addicted to heroin. The procedure risks permanently damaging a person’s ability to have longings and feel joy, the article notes.The Chinese Ministry of Health banned the procedure in 2004. Some doctors were allowed to continue to perform the operation for research purposes. In a recent study published in the journal Stereotactic and Functional Neurosurgery, researchers called the surgery “a feasible method for alleviating psychological dependence on opiate drugs.” They note more than half of the 60 patients in the study had lasting side effects. These included memory problems and loss of motivation. After five years, 47 percent of participants were still drug free. That compares with a 30-40 percent rate of significant recovery with conventional addiction treatment, the news outlet states. Experts feel the small increase in success rates with the surgery is not worth the large risk.
Patients are awake during the procedure, to minimize the risk of destroying parts of the brain involved in movement, consciousness or sensation. A surgeon uses heat to destroy cells in small sections of the part of the brain containing large amounts of brain chemicals called dopamine and endogenous opioids, which are involved in desire and pleasure. Experts say they are opposed to using the procedure to treat addiction. “To lesion this region that is thought to be involved in all types of motivation and pleasure risks crippling a human being,” Dr. Charles O’Brien, head of the Center for Studies of Addiction at the University of Pennsylvania, told Time.com.
Sharp rise in admissions for certain drug combinations over 10 years
Substance abuse treatment admissions for addiction involving
combined use of benzodiazepine and narcotic pain relievers rose a total of
569.7 percent, to 33,701, from 2000 to 2010, according to a report by the
Substance Abuse and Mental Health Services Administration (SAMHSA). Overall
substance abuse treatment admissions of people ages 12 and older in the same
period rose 4 percent, to 1.82 million, the agency said. Read the rest of the press release
here.
An insidious
threat to AA, NA
It is projected that nearly three-quarters of a million
members of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) will die from
tobacco-related causes, according to a 2012 study from the Wisconsin Nicotine
Dependence Integration Project (WINTIP), with nearly half a million of those
individuals residing in the United States and Canada. Attempts at encouraging
AA and NA, highly successful addiction recovery societies, to address tobacco as
a central issue have been unsuccessful so far. Both societies have traditions
that discourage them from dealing with what they have described as “outside
issues.” Click
here to read the rest of the story.
Treatment Rate Jumps for Addiction to Benzodiazepines and Narcotic Pain Relievers
Treatment admissions for people addicted to both benzodiazepines and narcotic pain relievers jumped 569.7 percent between 2000 and 2010, according to a new government report. Overall, substance abuse treatment admissions increased 4 percent over the same period. The report, by the Substance Abuse and Mental Health Services Administration (SAMHSA), found 33,701 people received treatment for addiction to both medications in 2010, Science Daily reports.“Clearly, the rise in this form of substance abuse is a public health problem that all parts of the treatment community need to be aware of,” SAMHSA Administrator Pamela S. Hyde said in a news release. “When patients are battling severe withdrawal effects from two addictive drugs, new treatment strategies may be needed to meet this challenge. These findings will help us better understand the nature and scope of this problem and to develop better approaches to address it.”
According to the report, 38.7 percent of those with this combined addiction began using both drugs in the same year, while 34.1 percent first became addicted to narcotic pain relievers, and 27.1 percent started with benzodiazepines. Almost half of patients treated for the combined addiction also had a psychiatric disorder. Non-Hispanic whites accounted for 91.4 percent of combination treatment admissions. Women accounted for 49.2 percent of such admissions, and people ages 18 to 34 represented 66.9 percent of those treated.
Children in Kentucky Pay Price for Parents’ Prescription Drug Abuse
More than 86,000 children in Kentucky are being raised by someone other than a biological parent, and prescription drug abuse is largely to blame, community leaders say. CNN reports that while it is difficult to assess how many children are orphaned after a parent overdoses from prescription drugs, state data shows Kentucky is the fourth most medicated state in the country, and has the sixth highest rate of overdose deaths.“Someone has to take care of these kids, and we simply do not have the facilities to do that,” said U.S. Representative Hal Rogers, whose district in Kentucky is hard hit by prescription drug abuse. “So it’s neighbors, it’s churches, other civic groups that are trying to be parents to these kids who are orphaned by drug-abusing parents. That’s a huge undertaking, because there’s literally tens of thousands of these young children.” He started the Operation UNITE drug task force in 2003 to fight the prescription drug abuse epidemic in Kentucky. The task force has set up programs at schools across the state to help children who have lost their parents to these drugs.
The state has taken steps to combat prescription drug abuse. Earlier this year, Kentucky Governor Steve Beshear signed into law a bill requiring that all pain clinics be licensed, specifies requirements for ownership and employment, and obliges Kentucky’s licensure board to develop regulations for pain clinics. It gives law enforcement easier access to the state’s prescription drug monitoring database. Doctors must examine patients, take full medical histories, and check electronic prescription records before writing prescriptions for opioids. Last month, Dan Smoot, Law Enforcement Director of Operation UNITE, noted that as Kentucky begins to see results from its crackdown on prescription drug abuse, officials are reporting a rise in heroin use.
Don’t Eat Daddy’s Cookies: How to Talk to Your Kids About Pot
Washington
state’s legalization of marijuana last week was a professional triumph for
Alison Holcomb, a Seattle attorney who wrote the law. But the legal victory
created a personal dilemma: how to discuss the no-longer illicit drug with her
4-year-old son. “He’s a sponge right now, and I don’t know if he’s yet at the
age when I can have a meaningful conversation with him about it,” says Holcomb,
the drug policy director for the American Civil Liberties Union (ACLU) of
Washington. “He has never seen me smoke anything. I probably won’t do it in
front of him.” Read
more here.
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