Testing It Up

A state police drug investigator told The Boston Globe that efforts to make OxyContin harder to abuse is paying off in Vermont, but the downside is, drug addicts are switching to heroin.

Lieutenant Matt Birmingham, head of the Vermont Drug Task Force, said the move to reformulate the prescription pain medicine had been a big factor in reducing OxyContin abusers.

OxyContin’s manufacturer Purdue Pharma changed the formula of the drug two years ago by making it resistant to crushing and cutting, a common practice by drug addicts to enhance OxyContin’s effect.

However, the said changes prompted an increase in the number of heroin users in Vermont in the past two years, with use spreading into high school students. Birmingham said “the younger kids think they can start by snorting heroin” to avoid dirty needles.

“You can get addicted all the same,” Birmingham noted, adding that young people “generally end up injecting once they get a full-blown addiction.”

According to state Health Department’s statistics, deaths attributed in whole or in part to heroin overdoses averaged fewer than three a year from 2004 to 2010. Last year, nine deaths have been linked to heroin abuse and six deaths have been recorded this year.

Birmingham also expressed their concern with drug distribution networks becoming better organized, making it easier for banned substances to reach established networks in Vermont.

“Law enforcement realized very quickly that we cannot solve this problem at all by arresting our way out of it. It’s just not going to happen,” he said. ‘”As long as there is a demand here for heroin and opiate products, the supply will just keep coming. And you’re just not going to stop it unless you build a 20-foot fence around the state.”

Canada’s Health Minister Leona Aglukkaq tells her provincial and territorial counterparts in a letter that she won’t interfere in the approval process for generic OxyContin.

Aglukkaq wrote that politicians should not choose “which drugs should be approved for medical use” and said it’s “a recipe for disaster for politicians to get involved in approving drugs,” the CBC News reports.

Earlier this fall, provincial and territorial health ministers urged the Health Canada to delay approvals for generic versions of OxyContin. The patent of the original formulation is set to expire on Nov. 25 and several drug manufacturers have manifested their interest in making their own generic versions of the drug.

Critics fear that the introduction of generic OxyContin could lead to more abuse, but Aglukkaq told maintained there is no basis in the Food and Drug Act to withhold approval for a drug that is considered “safe for its recommended use.”

“We need to make the decisions on prescription drugs based on science,” she told the media. “Scientists are there to provide that advice to us and we need to work with the system that we have in place.”

Ontario Health Minister Deb Matthews is one to have expressed disappointment with Aglukkaq’s decision to disregard the potential threat of generic OxyContin’s entry to the Canadian market. Some health experts were also convinced that the generic form is a bad idea and could only end up on the street for people to misuse.

Prosecutors from Los Angeles County are set to prove that a California doctor is guilty of murder, and that she caused the deaths of three otherwise healthy men in their 20s by overprescribing painkillers.

42-year-old Dr. Hsiu-Ying “Lisa” Tseng, who has been given the nickname “Dr. Feelgood,” allegedly wrote prescriptions for such drugs as Xanax, Oxycontin, Vicodin, and Adderall at a rate of 25 per day for three years, with only brief examinations and a few questions.

Tseng was charged of being responsible for the deaths of 29-year-old Vu Nguyen of Lake Forest, who died on March 2, 2009; 25-year-old Steven Ogle of Palm Desert, who died on April 9, 2009; and 21-year-old Joseph Rovero III, a student of Arizona State University (ASU), who died on December 18, 2009.

Rovero was halfway through his senior year as a business and communications student at ASU, when he saw Dr. Tseng for the first and only time on December 9, 2009. He received prescriptions for Xanax and OxyContin on that day. Nine days later, he died of acute intoxication of the two drugs in Tempe, Arizona. Alcohol was also found in his system.

An affidavit from the Drug Enforcement Agency (DEA) revealed that Tseng wrote more than 27,000 prescriptions for a period of three years, starting in January 2007. Her license to write prescriptions was suspended by the DEA in 2010, and the Osteopathic Medical Board of California shared that she surrendered her medical license voluntarily.

In an interview with the Los Angeles Times in 2010, Tseng said that she was “really strict” with her patients, and that she followed legal guidelines. She was quoted as saying: “If my patient decides to take a month’s supply in a day, then there’s nothing I can do about that.”

It is unfortunate that breakthroughs in research and development in some areas of medicine can be a double-edged sword to the community that it aims to serve. While its primordial goal is to provide much-needed medical treatment for those in need, some medicines can be equally as deadly to those who find ways to abuse them.

Addiction experts share their concernes over one such drug: a painkiller that will reportedly be 10 times stronger than Vicodin, a drug that has become a favorite among prescription drug abusers.

This type of painkiller is said to contain a pure version of hydrocodone, which belong to the family of drugs called opiates. Opiates include such drugs as morphine, heroin, oxycodone, codeine, and methadone.

If and when the drug is approved, it will be the first pure form of hydrocodone that can be purchased legally, as drugs that are already in the market combine it with non-addictive painkillers.

Four companies are currently testing pills with this formulation. One such product is Zohydro, from Zogenix of San Diego, which plans to apply for permission to market the drug early next year. Zohydro is a timed-release drug for the management of moderate to severe pain.

April Rovero, president of the National Coalition Against Prescription Drug Abuse, expressed her concerns about the drug: “I have a big concern that this could be the next OxyContin.” Purdue Pharma’s OxyContin was developed to manage pain with timed-release doses of oxycodone.

Abusers, however, discovered that they could crush the pills to get around the timed-release feature, and get an immediate high. OxyContin is the most abused prescription drug in the United States, according to the Drug Enforcement Administration.

The other companies testing hydrocodone drugs are Purdue Pharma, Cephalon, and Egalet.

A study conducted by researchers from the Department of Veterans Affairs in Ann Arbor, Michigan, indicated that patients who are prescribed opioids in higher dosage are more at risk of suffering from unintentional overdose – and succumbing to it. The findings were published in the Journal of the American Medical Association (JAMA).

A feature on Medical News Today shared various excerpts from the study. Opioids are commonly prescribed to treat pain, and include such prescription drugs as codeine, oxycodone, morphine, and methadone. Brand names of this group of drugs include Lomotil, Percocet, Vicodin, Demerol, Darvon, Percodan, and OxyContin.

Over the last ten years, according to the VA researchers, death due to opioid overdose has become a serious public health concern, owing to the increase in incidence of these deaths. The rate of death due to unintentional overdose increased by 124 percent, according to the researchers; this figure was then attributed to an increase in overdose on prescription opioids.

The study authors wrote: “Achieving a better understanding of the factors contributing to prescription opioid overdose death is an essential step toward addressing this troubling and dramatic increase in overdose mortality.”

Researchers looked into the relationship between prescribing patterns for these drugs, and the risk of death from overdose, from 2004 to 2008. Groups of patients included in the study consisted of cancer, acute pain, substance abuse disorders, and chronic pain patients.

Information was taken from a national sample of patients from the Veterans Health Administration. This included information from unintentional death due to opioid overdose, as well as a random sample of patients who received opioids as they made use of medical services during the period of the study.

Michigan Drug Screening

Perry Moore, the executive producer of the “Chronicles of Narnia” trilogy, was found dead in his apartment in New York City last February 17, according to a report on The Hollywood Reporter. His body was apparently discovered by his partner, Hunter Hill. He was 39.

Multiple reports point to an alleged OxyContin overdose as the cause of his death, although this rumor was not confirmed by the NYPD, saying only that the cause of Moore’s death will be determined by the medical examiner. The New York Daily News and the New York Post, however, both cited sources who revealed the overdose, according to The Hollywood Reporter.

A spokesperson from the Office of the Chief Medical Examiner told The Hollywood Reporter that the autopsy results were “inconclusive,” and that more tests are needed.

The Chronicles of Narnia, which Moore helped produce, is based on the novels by C.S. Lewis, and has been ranked by BoxOfficeMojo.com as the 16th highest grossing film series of all time. The franchise has grossed more than $1.5 billion in the box office.

Moore is also known for being the author of “Hero,” a novel about a gay teenage superhero. Moore won a Lambda Literary Award for the novel, which was named best novel for young gay and lesbian adults.

Perry Moore was born William Perry Moore IV, to William and Nancy Norris Moore, on November 4, 1971, in Richmond, Virginia. He grew up in Virginia Beach, and graduated from the University of Virginia in 1994. He is survived by his parents, his two sisters, Jane Moore and Elizabeth Moore Felton, and his life partner, Hunter Hill.

New York Health Screening

Maine drugstores are being victimized by thieves, whose objective is to get their hands on prescription drugs that are widely abused, according to a report on The New York Times. The incidence of armed robberies in drugstores in Maine increased last year, according to the report, and it has caused alarm among pharmacists in the state.

Chet Hibbard, a pharmacist in Maine, has taken to hanging signs in his pharmacy that read: “We Do Not Stock OxyContin.” “I want people to know before they even get in the door that we don’t have it… Outside hiring an armed guard to be in here 24/7, I don’t know what else to do,” Mr. Hibbard shared. Last July, two robbers in ski goggles had demanded OxyContin at knifepoint, an incident that prompted Hibbard to stop dispensing the highly addictive drug.

The issue of drug-related armed robberies is hardly a problem that is unique to Mane, however. The report shared further that over the last three years, more than 1,800 pharmacy robberies occurred across the country. These robberies usually involve individuals whose objective is to acquire opioid painkillers and other abused prescription drugs, to sustain their own habits or peddle to other addicts. The most common targets of these robberies are oxycodone (the main ingredient in OxyContin), hydrocodone (the main ingredient in Vicodin), and Xanax.

In response, pharmacies have tightened security measures, which include upgrading surveillance cameras, installing bullet-proof glass, and making counters high enough to prevent robbers from jumping over them. Law enforcement, on the other hand, has been trying out new tools, such as placing tracking devices in OxyContin bottles.

New York Drug Screening

Pain relievers are an example of how medicines that are ideally developed to help people can instead bring them harm, because of abuse. A feature on WebMD shared helpful information regarding pain relievers that are usually abused, along with photos of these medicines.

Codeine and morphine. Morphine is a medicine that is usually prescribed to alleviate severe pain, while codeine is prescribed to treat milder pain. On the streets, these medicines are more commonly known through their “aliases,” which include “Captain Cody” and “Cody” for codeine, and “M” and “Miss Emma” for morphine. The medicines Oramorph and Aviniza both have morphine.

Oxycontin , Percocet and Percodan. These medicines share a common active ingredient: the opioid pain reliever oxycodone. Despite having a common ingredient, however, the medicines are not identical; they all should not, however, be taken without the supervision of a doctor. They should also not be taken along with alcohol, barbiturates, antihistamines or benzodiazepines. These combinations can be lethal and life-threatening. Many spam e-mails advertise selling these medicines online.

Oxycontin is referred to as “oxy,” “O.C.,” or “oxycotton” on the streets, while Percocet or Percodan are also called “percs”.

Vicodin, Lortab and Lorcet. Vicodin is yet another medicine that is usually the subject of advertising through spam e-mails, by shady online drug stores. They contain the opioid hydrocodone and acetaminophen; Vicodin is also known by the street names “vike” and “Watson-387.”

Opioids are known to cause drowsiness and constipation. According to NIDA, it can also depress breathing, depending on the amount taken. They are to be taken only by patients who have been prescribed the drug.

A study shared on CNN.com reveals that OxyContin and other opioids can increase the risk of suffering from fractures as well as heart conditions in older people.

Daniel H. Solomon, M.D., a rheumatologist and epidemiologist at Brigham and Women’s Hospital in Boston, Massachusetts, served as lead author for the study. Dr. Solomon shared: “Opioids are not as safe as people had hoped… We need to recognize that opioids are not without risk.”

The results of the study suggest that elderly arthritis patients who are prescribed with and take opioids – which include OxyContin – are 4.5 times more likely to break their hip, pelvis, wrist or upper arm, when compared against patients who are suffering from similar condition, but are given non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen.

In addition, it was determined that around 1 in 10 older people who are taking opiods will break a bone within a period of one year, as opposed to only 1 in 50 among those who take COX-2 inhibitors. COX-2 inhibitors are a more targeted form of NSAID, according to the feature.

The research involved studying almost 13,000 low-income Medicare patients who are suffering from osteoarthritis or rheumatoid arthritis. These patients have received prescriptions for either NSAIDs, COX-2 inhibitors, or opioids, over a period of six years.

Despite these findings, the study does not categorically discourage doctors from prescribing opioids to elderly patients. What doctors may want to do is to come up with a treatment regimen that also includes NSAIDs and other alternative methods for pain management. Dr. Solomon shared: “As an arthritis specialist, I will still use opioids, but I will do so in an informed manner and make sure the patients are aware of the risks.”